<i  >Introduction</i>. There are reported associations between vitamin D deficiency and breast, prostate, and colon cancer, but the relationship in thyroid cancer has not been evaluated. <i  >Methods</i>. We evaluated serum calcium, creatinine, albumin, and 25-hydroxy vitamin D (25-OH-D) in 42 thyroid nodule, 45 thyroid cancer in remission, and 24 active thyroid cancer patients. <i  >Results</i>. 25-OH-D was not different between groups. The percent with 25-OH-D levels <svg     style="vertical-align:-0.04095pt;width:10.1px;" id="M1" height="8.9125004" version="1.1" viewBox="0 0 10.1 8.9125004" width="10.1"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,8.8)"><path id="x3C" d="M512 -3l-437 233v51l437 233v-58l-378 -200v-2l378 -199v-58z" /></g>

		
	
</svg>75&#x2009;nmol/L was not significantly different between groups and was not affected by season of measurement, age, or cancer stage. Multivariate regression showed a BMI of <svg     style="vertical-align:-0.546pt;width:14.825px;" id="M2" height="10.15" version="1.1" viewBox="0 0 14.825 10.15" width="14.825"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,9.413)"><path id="x2265" d="M531 285l-474 -214v56l416 183l-416 184v56l474 -215v-50zM531 -40h-474v50h474v-50z" /></g>

		
	
</svg>30&#x2009;kg/<svg     style="vertical-align:-0.0pt;width:20.375px;" id="M3" height="15.8375" version="1.1" viewBox="0 0 20.375 15.8375" width="20.375"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,15.775)"><path id="x6D" d="M797 0h-214v26q46 5 58 17.5t12 63.5v167q0 116 -88 116q-48 0 -112 -52q3 -18 3 -42v-195q0 -46 11 -58t53 -17v-26h-214v26q48 5 59.5 17t11.5 60v172q0 115 -88 115q-47 0 -109 -52v-235q0 -47 10 -59.5t48 -17.5v-26h-211v26q50 5 62.5 17t12.5 60v207q0 48 -9 59.5&#xA;t-52 18.5v23q79 14 139 41v-81q3 2 29 20.5t44 29.5q45 28 81 28t66 -22t46 -61q25 20 83 57q39 26 76 26q59 0 93 -40t34 -113v-193q0 -49 10.5 -60.5t54.5 -16.5v-26z" /></g>

			<g transform="matrix(.012,-0,0,-.012,13.987,7.613)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g>

		
	
</svg> to be the only significant predictor of vitamin D deficiency. <i  >Conclusions</i>. Rates of vitamin D deficiency are similar in thyroid nodules and thyroid cancer, although higher than the general population. This is different than previous studies for other cancers, which show higher rates of vitamin D deficiency. BMI was the only predictor of vitamin D deficiency.

Nathan Laney

Jane Meza

Elizabeth Lyden

Judi Erickson

Kelly Treude

Whitney Goldner

The Prevalence of Vitamin D Deficiency Is Similar between Thyroid Nodule and Thyroid Cancer Patients

We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT) initiatives to improve in-hospital care of fracture (Fx) patients. Effectiveness was evaluated for 181
medical records of 4 cohorts in four successive years of consecutive patients who were admitted
with a fragility hip Fx. The Discharge Initiative (DI) (computer-based) includes 1200 mg calcium and
1000 IU vitamin <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:msub><mml:mtext>D</mml:mtext><mml:mn>3</mml:mn></mml:msub></mml:math> daily. The Admission Initiative (AI) was introduced one year later with
reminders for serum 25OHD measurement, initiation of daily calcium (1200 mg) and vitamin D (800 IU), and an order for Endocrinology consultation, with an amendment for a computer-assisted
reminder and a dose of <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:msub><mml:mtext>D</mml:mtext><mml:mn>2</mml:mn></mml:msub></mml:math> (50 000 IU). Initially, the computer-based DI was more effective (67%)
than the surgeon-driven AI (33%, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>.001</mml:mn></mml:math>). After introduction of a computer-assisted reminder, AI
effectiveness increased to 68%. The marked prevalence of vitamin D insufficiency reaffirms the
importance of incorporating vitamin D recommendations in Fx care pathways.

Julie Glowacki

Mitchel B. Harris

Josef Simon

John Wright

Nikheel S. Kolatkar

Thomas S. Thornhill

Meryl S. LeBoff

Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures:  A Paradigm Shift

Adequate vitamin D levels are necessary for good vascular health. 1,25-dihydroxycholecalciferol activates CYP3A4, an enzyme of the cytochrome P450 system, which metabolizes atorvastatin to its main metabolites. The objective of this study was to evaluate the response of cholesterol and triglycerides to
atorvastatin according to vitamin D levels. Sixty-three patients with acute myocardial infarction treated with low and high doses of atorvastatin were
included. Levels of total cholesterol, triglycerides, HDL cholesterol, and LDL cholesterol
were measured at baseline and at 12 months of follow-up. Baseline
levels of 25-hydroxyvitamin D (25-OHD) were classified as deficient (<svg style="vertical-align:-0.30096pt;width:10.825px;" id="M1" height="8.8500004" version="1.1" viewBox="0 0 10.825 8.8500004" width="10.825"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,8.85)">
		<g transform="translate(72,-64.92)">
			<text transform="matrix(1,0,0,-1,-71.95,65.27)">
				<tspan style="font-size: 12.50px; " x="0" y="0">&lt;</tspan>
			</text>

		</g>
	</g>
</svg>30&#x2009;nmol/L), insufficient (30&#x2013;50&#x2009;nmol/L), and normal (<svg style="vertical-align:-0.30096pt;width:10.825px;" id="M2" height="8.8500004" version="1.1" viewBox="0 0 10.825 8.8500004" width="10.825"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,8.85)">
		<g transform="translate(72,-64.92)">
			<text transform="matrix(1,0,0,-1,-71.95,65.27)">
				<tspan style="font-size: 12.50px; " x="0" y="0">&gt;</tspan>
			</text>

		</g>
	</g>
</svg>50&#x2009;nmol/L). In patients with
25-OHD <svg style="vertical-align:-0.30096pt;width:30.799999px;" id="M3" height="11.0625" version="1.1" viewBox="0 0 30.799999 11.0625" width="30.799999"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,11.0625)">
		<g transform="translate(72,-63.15)">
			<text transform="matrix(1,0,0,-1,-71.95,63.5)">
				<tspan style="font-size: 12.50px; " x="0" y="0">&lt;</tspan>
				<tspan style="font-size: 12.50px; " x="12.027886" y="0">3</tspan>
				<tspan style="font-size: 12.50px; " x="18.279387" y="0">0</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;nmol/L, there were no significant changes in levels of total
cholesterol (<svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M4" height="12.05" version="1.1" viewBox="0 0 56.849998 12.05" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
		<g transform="translate(72,-62.36)">
			<text transform="matrix(1,0,0,-1,-71.95,63.5)">
				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">7</tspan>
				<tspan style="font-size: 12.50px; " x="12.503" y="0">3</tspan>
				<tspan style="font-size: 12.50px; " x="21.530167" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="32.870388" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="39.121887" y="0">7</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL versus <svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M5" height="12.2375" version="1.1" viewBox="0 0 56.849998 12.2375" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.2375)">
		<g transform="translate(72,-62.21)">
			<text transform="matrix(1,0,0,-1,-71.95,63.35)">
				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">6</tspan>
				<tspan style="font-size: 12.50px; " x="12.503" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="21.530167" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="32.870388" y="0">5</tspan>
				<tspan style="font-size: 12.50px; " x="39.121887" y="0">1</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL), triglycerides (<svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M6" height="12.2375" version="1.1" viewBox="0 0 56.849998 12.2375" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.2375)">
		<g transform="translate(72,-62.21)">
			<text transform="matrix(1,0,0,-1,-71.95,63.35)">
				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">5</tspan>
				<tspan style="font-size: 12.50px; " x="12.503" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="21.530167" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="32.870388" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="39.121887" y="0">9</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL
versus <svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M7" height="12.05" version="1.1" viewBox="0 0 56.849998 12.05" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
		<g transform="translate(72,-62.36)">
			<text transform="matrix(1,0,0,-1,-71.95,63.5)">
				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">7</tspan>
				<tspan style="font-size: 12.50px; " x="12.503" y="0">7</tspan>
				<tspan style="font-size: 12.50px; " x="21.530167" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="32.870388" y="0">9</tspan>
				<tspan style="font-size: 12.50px; " x="39.121887" y="0">4</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL), and LDL cholesterol (<svg style="vertical-align:-1.09097pt;width:56.849998px;" id="M8" height="12.05" version="1.1" viewBox="0 0 56.849998 12.05" width="56.849998"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.05)">
		<g transform="translate(72,-62.36)">
			<text transform="matrix(1,0,0,-1,-71.95,63.5)">
				<tspan style="font-size: 12.50px; " x="0" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="12.503" y="0">1</tspan>
				<tspan style="font-size: 12.50px; " x="21.530167" y="0">±</tspan>
				<tspan style="font-size: 12.50px; " x="32.870388" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="39.121887" y="0">8</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL versus 92 <svg style="vertical-align:-1.09097pt;width:33.400002px;" id="M9" height="12.2375" version="1.1" viewBox="0 0 33.400002 12.2375" width="33.400002"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,12.2375)">
		<g transform="translate(72,-62.21)">
			<text transform="matrix(1,0,0,-1,-71.95,63.35)">
				<tspan style="font-size: 12.50px; " x="0" y="0">4</tspan>
				<tspan style="font-size: 12.50px; " x="6.2515001" y="0">5</tspan>
				<tspan style="font-size: 12.50px; " x="15.278666" y="0">±</tspan>
			</text>

		</g>
	</g>
</svg>&#x2009;mg/dL); whereas patients with insufficient (30&#x2013;50&#x2009;nmol/L) and normal vitamin D (<svg style="vertical-align:-0.30096pt;width:10.825px;" id="M10" height="8.8500004" version="1.1" viewBox="0 0 10.825 8.8500004" width="10.825"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,8.85)">
		<g transform="translate(72,-64.92)">
			<text transform="matrix(1,0,0,-1,-71.95,65.27)">
				<tspan style="font-size: 12.50px; " x="0" y="0">&gt;</tspan>
			</text>

		</g>
	</g>
</svg>50&#x2009;nmol/L) had a good response to atorvastatin. We suggest that vitamin D
concentrations <svg style="vertical-align:-0.30096pt;width:10.825px;" id="M11" height="8.8500004" version="1.1" viewBox="0 0 10.825 8.8500004" width="10.825"  xmlns="http://www.w3.org/2000/svg">
	<g transform="matrix(1.25,0,0,-1.25,0,8.85)">
		<g transform="translate(72,-64.92)">
			<text transform="matrix(1,0,0,-1,-71.95,65.27)">
				<tspan style="font-size: 12.50px; " x="0" y="0">&gt;</tspan>
			</text>

		</g>
	</g>
</svg>30&#x2009;nmol/L may be required for atorvastatin to reduce lipid
levels in patients with acute myocardial infarction.

Jos&#x00E9; Luis P&#x00E9;rez-Castrill&#x00F3;n

Laura Abad Manteca

Gemma Vega

Javier del Pino Montes 

Daniel de Luis

Antonio Due&#x0148;as Laita

Vitamin D Levels and Lipid Response to Atorvastatin

Vitamin D functions are not limited to skeletal health benefits and may extend to preservation of insulin secretion and insulin sensitivity. This review summarizes the literature related to potential vitamin D influences on glucose homeostasis and insulin sensitivity. Cross-sectional data provide some evidence that circulating 25-hydroxyvitamin D (25(OH)D) is inversely associated with insulin resistance, although direct measurements of insulin sensitivity are required for confirmation. Reported associations with insulin secretion, however, are contradictory. Available prospective studies support a protective influence of high 25(OH)D concentrations on type 2 diabetes mellitus risk. There is a general lack of consistency in vitamin D intervention outcomes on insulin secretion and sensitivity, likely due to differences in subject populations, length of interventions, and forms of vitamin D supplementation. Vitamin D receptor gene polymorphisms and vitamin D interactions with the insulin like growth factor system may further influence glucose homeostasis. The ambiguity of optimal vitamin D dosing regimens and optimal therapeutic concentrations of serum 25(OH)D limit available intervention studies. Future studies, including cross-sectional and prospective, should be performed in populations at high risk for both vitamin D deficiency and type 2 diabetes mellitus. Well-designed, placebo-controlled, randomized intervention studies are required to establish a true protective influence of vitamin D on glucose homeostasis.

Jessica A. Alvarez

Ambika Ashraf

Role of Vitamin D in Insulin Secretion and Insulin Sensitivity for Glucose Homeostasis

Vitamin D deficiency is common in the developing countries and exists in both childhood and adult life. The great importance of Vitamin D is the moderation of calcium (Ca) and phosphorus (P) homeostasis as well as the absorption of Ca. While insufficiency of vitamin D is a significant contributing factor to risk of rickets in childhood, it is possible that a more marginal deficiency of vitamin D during life span contribute to osteoporosis as well as potentially to the development and various other chronic diseases such as cardiovascular disease, cancer and diabetes. This paper reviews the metabolism, epidemiology, and treatment of vitamin D and calcium insufficiency as well as its relation to various diseases during childhood and adolescence.

Dimitrios Papandreou

Pavlos Malindretos

Zacharoula Karabouta

Israel Rousso

Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review

<i>Objectives</i>. Statin drugs act as inhibitors of the 3-hydroxy-3methylglutaryl coenzyme A (HMG-CoA) reductase enzyme early in the mevalonate pathway, thereby reducing the endogenous cholesterol synthesis. In recent studies, it has been suggested from epidemiological data that statins also may improve vitamin D status, as measured by increased plasma 25-hydroxyvitamin D (25OHD) levels. We now report the results from a randomised controlled trial on effects of simvastatin on plasma 25OHD levels. <i>Design and Methods</i>. We randomised 82 healthy postmenopausal women to one year of treatment with either simvastatin 40 mg/d or placebo and performed measurement at baseline and after 26 and 52 weeks of treatment. The study was completed by 77 subjects. <i>Results</i>. Compared with placebo, plasma levels of cholesterol and low-density lipoproteins decreased in response to treatment with simvastatin, but our study showed no effect of simvastatin on vitamin D status. However, plasma levels of triglycerides were inversely associated with tertiles of plasma 25OHD levels and changes in plasma triglycerides levels correlated inversely with seasonal changes in vitamin D status. <i>Conclusion</i>. Our data do not support a pharmacological effect of statins on vitamin D status, but do suggest that vitamin D may influence plasma lipid profile and thus be of importance to cardiovascular health.

Lars Rejnmark

Peter Vestergaard

Lene Heickendorff

Leif Mosekilde

Simvastatin Does Not Affect Vitamin D Status, but Low Vitamin D Levels Are Associated with Dyslipidemia: Results from a Randomised, Controlled Trial

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<p><em>International Journal of Endocrinology</em> publishes original research articles and&nbsp;review articles that provide insights into the endocrine system and its associated diseases at a genomic, molecular, biochemical and cellular level.</p>


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<p>Chief Editor, Dr. Zhongjian Xie, is based at the Second Xiangya Hospital of Central South University, China. He is mainly engaged in research on the skeletal and extraskeletal function of vitamin D and calcium.</p>


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