{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T16:40:32Z","timestamp":1791996032012,"version":"4.4.0"},"reference-count":82,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T00:00:00Z","timestamp":1678060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Research and Innovation","award":["33PFE\/30.12.2021"],"award-info":[{"award-number":["33PFE\/30.12.2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Vitamin D deficiency is one of the most common medical conditions, with approximately one billion people having low vitamin D levels. Vitamin D is associated with a pleiotropic effect (immunomodulatory, anti-inflammatory and antiviral), which can be essential for a better immune response. The aim of this research was to evaluate the prevalence of vitamin D deficiency\/insufficiency in hospitalized patients focusing on demographic parameters as well as assessing the possibility of its associations with different comorbidities. Of 11,182 Romanian patients evaluated in the study over 2 years, 28.83% had vitamin D deficiency, 32.11% insufficiency and 39.05% had optimal vitamin D levels. The vitamin D deficiency was associated with cardiovascular disorders, malignancies, dysmetabolic disorders and SARS-CoV2 infection, older age and the male sex. Vitamin D deficiency was prevalent and showed pathology association, while insufficiency of vitamin D (20\u201330 ng\/mL) had lower statistical relevance and represents a grey zone in vitamin D status. Guidelines and recommendations are necessary for homogeneity of the monitoring and management of inadequately vitamin D status in the risk categories.<\/jats:p>","DOI":"10.3390\/diagnostics13050998","type":"journal-article","created":{"date-parts":[[2023,3,6]],"date-time":"2023-03-06T06:29:06Z","timestamp":1678084146000},"page":"998","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Association of Vitamin D Deficiency and Insufficiency with Pathology in Hospitalized Patients"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-3829","authenticated-orcid":false,"given":"Sandica","family":"Bucurica","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University Central Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Prodan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Pavalean","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Taubner","sequence":"additional","affiliation":[{"name":"Medical Analysis Laboratory, \u201cCarol Davila\u201d University Central Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Bucurica","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calin","family":"Socol","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Calin","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Pucioasa City Hospital, 135400 Pucioasa, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina","family":"Ionita-Radu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University Central Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Jinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University of Medicine and Pharmacy Bucharest, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u201cCarol Davila\u201d University Central Emergency Military Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1911","DOI":"10.1210\/jc.2011-0385","article-title":"Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline","volume":"96","author":"Holick","year":"2011","journal-title":"Med. J. Clin. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1152\/physrev.00014.2015","article-title":"Vitamin D: Metabolism, Molecular Mechanism of Action, and Pleiotropic Effects","volume":"96","author":"Christakos","year":"2016","journal-title":"Physiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.chembiol.2013.12.016","article-title":"Vitamin D Metabolism, Mechanism of Action, and Clinical Applications","volume":"21","author":"Bikle","year":"2014","journal-title":"Chem. Biol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e00242","DOI":"10.1016\/j.plabm.2021.e00242","article-title":"Comparative study of two immunoassays used for the determination of serum vitamin D","volume":"26","author":"Lahoz","year":"2021","journal-title":"Pract. Lab. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1080\/10408363.2022.2070595","article-title":"Vitamin D: Sources, physiological role, biokinetics, deficiency, therapeutic use, toxicity, and overview of analytical methods for detection of vitamin D and its metabolites","volume":"59","author":"Nomura","year":"2022","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"102661","DOI":"10.1016\/j.amsu.2021.102661","article-title":"Vitamin D deficiency and COVID-19: A case-control study at a tertiary care hospital in India","volume":"68","author":"Nimavat","year":"2021","journal-title":"Ann. Med. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.abb.2006.11.028","article-title":"Nuclear receptor 4A2 and C\/EBP\u03b2 regulate the parathyroid hormone-mediated transcriptional regulation of the 25-hydroxyvitamin D3-1\u03b1-hydroxylase","volume":"460","author":"Zierold","year":"2007","journal-title":"Arch. Biochem. Biophys."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1354","DOI":"10.1016\/j.cca.2010.05.037","article-title":"Independent association between 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D and the renin\u2013angiotensin system: The Ludwigshafen Risk and Cardiovascular Health (LURIC) study","volume":"411","author":"Tomaschitz","year":"2010","journal-title":"Clin. Chim. Acta"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Kovalenko, P.L., Zhang, Z., Cui, M., Clinton, S.K., and Fleet, J.C. (2010). 1,25 dihydroxyvitamin D-mediated orchestration of anticancer, transcript-level effects in the immortalized, non-transformed prostate epithelial cell line, RWPE1. BMC Genom., 11.","DOI":"10.1186\/1471-2164-11-26"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Gaksch, M., Jorde, R., Grimnes, G., Joakimsen, R., Schirmer, H., Wilsgaard, T., Mathiesen, E.B., Nj\u00f8lstad, I., L\u00f8chen, M.-L., and M\u00e4rz, W. (2017). Vitamin D and mortality: Individual participant data meta-analysis of standardized 25-hydroxyvitamin D in 26916 individuals from a European consortium. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0170791"},{"key":"ref_11","first-page":"56","article-title":"Coronary artery disease and its association with Vitamin D deficiency","volume":"7","author":"Aggarwal","year":"2016","journal-title":"J. Midlife Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jsbmb.2016.11.021","article-title":"Vitamin D and type 2 diabetes","volume":"173","author":"Lips","year":"2017","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/j.biopha.2018.10.140","article-title":"Vitamin D and liver fibrosis: Molecular mechanisms and clinical studies","volume":"109","author":"Udomsinprasert","year":"2019","journal-title":"Biomed. Pharmacother."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pludowski, P., Takacs, I., Boyanov, M., Belaya, Z., Diaconu, C.C., Mokhort, T., Zherdova, N., Rasa, I., Payer, J., and Pilz, S. (2022). Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients, 14.","DOI":"10.3390\/nu14071483"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"P23","DOI":"10.1530\/EJE-18-0736","article-title":"Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: A position statement of the European Calcified Tissue Society","volume":"180","author":"Lips","year":"2019","journal-title":"Eur. J. Endocrinol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e10417","DOI":"10.1002\/jbm4.10417","article-title":"Controversies in Vitamin D: A Statement From the Third International Conference","volume":"4","author":"Giustina","year":"2020","journal-title":"JBMR Plus"},{"key":"ref_17","unstructured":"(2023, February 19). Anexa2-Ghid-Pentru-Evaluarea-Statusului-Vitaminei-D-La-Adulti-1-1.pdf. Available online: https:\/\/www.ms.ro\/wp-content\/uploads\/2019\/07\/Anexa2-Ghid-pentru-evaluarea-statusului-vitaminei-D-la-adulti-1-1.pdf."},{"key":"ref_18","unstructured":"(2023, February 19). ANEXA1vit-D-La-Nou-Nascut-Copil-Gravida.pdf. Available online: https:\/\/www.ms.ro\/wp-content\/uploads\/2019\/07\/ANEXA1vit-D-la-nou-nascut-copil-gravida.pdf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s12931-014-0131-0","article-title":"Severe vitamin D deficiency is associated with frequent exacerbations and hospitalization in COPD patients","volume":"15","author":"Malinovschi","year":"2014","journal-title":"Respir. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"6313","DOI":"10.3402\/jchimp.v1i3.6313","article-title":"Correlation of admitted nursing home residents\u2019 hospital length of stay and vitamin D levels","volume":"1","author":"Golestany","year":"2011","journal-title":"J. Community Hosp. Intern. Med. Perspect."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1080\/07315724.2018.1446194","article-title":"Vitamin D Status in Hospitalized Chronically Ill Patients","volume":"37","author":"Botros","year":"2018","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"R292","DOI":"10.1186\/cc10585","article-title":"Vitamin D deficiency is associated with mortality in the medical intensive care unit","volume":"15","author":"Venkatram","year":"2011","journal-title":"Crit. Care"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2418","DOI":"10.1093\/gerona\/glaa010","article-title":"Vitamin D Status of Adults in the Community, in Outpatient Clinics, in Hospital, and in Nursing Homes in the West of Ireland","volume":"75","author":"Griffin","year":"2020","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/j.1745-7599.2007.00277.x","article-title":"Suboptimal vitamin D status is a highly prevalent but treatable condition in both hospitalized patients and the general population","volume":"19","author":"Moore","year":"2007","journal-title":"J. Am. Acad. Nurse Pract."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Petrelli, F., Oldani, S., Borgonovo, K., Cabiddu, M., Dognini, G., Ghilardi, M., Parati, M.C., Petro\u2019, D., Dottorini, L., and Rea, C. (2023). Vitamin D3 and COVID-19 Outcomes: An Umbrella Review of Systematic Reviews and Meta-Analyses. Antioxidants, 12.","DOI":"10.3390\/antiox12020247"},{"key":"ref_26","first-page":"78","article-title":"Relation of Vitamin D Status with Season, Living Place, Age Gender and Chronic Disease","volume":"42","author":"Okan","year":"2020","journal-title":"Erciyes Med. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.3945\/jn.115.227728","article-title":"National Estimates of Serum Total 25-Hydroxyvitamin D and Metabolite Concentrations Measured by Liquid Chromatography\u2013Tandem Mass Spectrometry in the US Population during 2007\u20132010","volume":"146","author":"Schleicher","year":"2016","journal-title":"J. Nutr."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.3945\/ajcn.115.120873","article-title":"Vitamin D deficiency in Europe: Pandemic?","volume":"103","author":"Cashman","year":"2016","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s00223-019-00559-4","article-title":"Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing","volume":"106","author":"Cashman","year":"2020","journal-title":"Calcif. Tissue Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1038\/s41430-020-0558-y","article-title":"Vitamin D deficiency 2.0: An update on the current status worldwide","volume":"74","author":"Amrein","year":"2020","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chirita-Emandi, A., Socolov, D., Haivas, C., Calapi\u0219, A., Gheorghiu, C., and Puiu, M. (2015). Vitamin D Status: A Different Story in the Very Young versus the Very Old Romanian Patients. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0128010"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s11657-017-0407-3","article-title":"Seasonal variation of serum vitamin D levels in Romania","volume":"12","author":"Niculescu","year":"2017","journal-title":"Arch. Osteoporos."},{"key":"ref_33","unstructured":"Ene, M.C., Ter\u00feiu, O., Vr\u00e2ncianu, O., and Chifiriuc, M.C. (2023, February 19). Vitamin D Status in Adult and Pediatric Romanian Population. Available online: https:\/\/roami.ro\/wp-content\/uploads\/2019\/08\/198-212-Art-Marin-Cristian-Ene-Archives-32018-1.pdf."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e18113","DOI":"10.1097\/MD.0000000000018113","article-title":"Vitamin D deficiency is highly prevalent in malnourished inpatients and associated with higher mortality","volume":"98","author":"Merker","year":"2019","journal-title":"Medicine"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s12020-016-0960-3","article-title":"Prevalence and determinants of vitamin D deficiency in healthy French adults: The VARIETE study","volume":"53","author":"Souberbielle","year":"2016","journal-title":"Endocrine"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"16790","DOI":"10.1038\/s41598-022-21279-0","article-title":"Vitamin D status and determinants in Indian children and adolescents: A multicentre study","volume":"12","author":"Khadilkar","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"da Silveira, E.A., Moura, L.d.A.N.e., Castro, M.C.R., Kac, G., Hadler, M.C.C.M., Noll, P.R.E.S., Noll, M., Rezende, A.T.d.O., Delpino, F.M., and de Oliveira, C. (2022). Prevalence of Vitamin D and Calcium Deficiency and Insufficiency in Women of Childbearing Age and Associated Risk Factors: A Systematic Review and Meta-Analysis. Nutrients, 14.","DOI":"10.3390\/nu14204351"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/ajm.AJM_20_18","article-title":"Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status","volume":"8","author":"Kweder","year":"2018","journal-title":"Avicenna J. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"19713","DOI":"10.1038\/s41598-019-56297-y","article-title":"A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States","volume":"9","author":"Wei","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"353","DOI":"10.4065\/81.3.353","article-title":"High Prevalence of Vitamin D Inadequacy and Implications for Health","volume":"81","author":"Holick","year":"2006","journal-title":"Mayo Clin. Proc."},{"key":"ref_41","first-page":"121","article-title":"Serum 25-Hydroxyvitamin D Levels as an Aging Marker: Strong Associations With Age and All-Cause Mortality Independent From Telomere Length, Epigenetic Age Acceleration, and 8-Isoprostane Levels","volume":"74","author":"Hagen","year":"2018","journal-title":"J. Gerontol. Ser. A"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.nutos.2021.11.002","article-title":"Vitamin D Status and Seasonal Variation: A Retrospective Single Institution Database Study of Patients Pursuing Metabolic\/Bariatric Surgery","volume":"41","author":"Hays","year":"2021","journal-title":"Clin. Nutr. Open Sci."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1590\/1806-9282.66.10.1431","article-title":"Seasonal variation of vitamin D among healthy adult men in a subtropical region","volume":"66","author":"Fontanive","year":"2020","journal-title":"Rev. Assoc. Med. Bras."},{"key":"ref_44","first-page":"1","article-title":"Seasonal Variation in Vitamin D in Association with Age, Inflammatory Cytokines, Anthropometric Parameters, and Lifestyle Factors in Older Adults","volume":"2017","author":"Castillo","year":"2017","journal-title":"Mediat. Inflamm."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"267","DOI":"10.2174\/1871530314666141027102627","article-title":"Vitamin D and Infectious Diseases","volume":"14","author":"Miragliotta","year":"2014","journal-title":"Endocr. Metab. Immune Disord.\u2014Drug Targets"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1080\/14787210.2022.2035217","article-title":"COVID-19 and vitamin D (Co-VIVID study): A systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Varikasuvu","year":"2022","journal-title":"Expert Rev. Anti Infect. Ther."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Pinzariu, A.C., Sova, I.A., Maranduca, M.A., Filip, N., Drochioi, I.C., Vamesu, C.G., Clim, A., Hurjui, L.L., Moscalu, M., and Soroceanu, R.P. (2022). Vitamin D Deficiency in Both Oral and Systemic Manifestations in SARS-CoV-2 Infection: Updated Review. Medicina, 59.","DOI":"10.3390\/medicina59010068"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Gois, P.H.F., Ferreira, D., Olenski, S., and Seguro, A.C. (2017). Vitamin D and Infectious Diseases: Simple Bystander or Contributing Factor?. Nutrients, 9.","DOI":"10.3390\/nu9070651"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"AlSafar, H., Grant, W.B., Hijazi, R., Uddin, M., Alkaabi, N., Tay, G., Mahboub, B., and Al Anouti, F. (2021). COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents. Nutrients, 13.","DOI":"10.3390\/nu13051714"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e2119","DOI":"10.1002\/rmv.2119","article-title":"A brief review of interplay between vitamin D and angiotensin-converting enzyme 2: Implications for a potential treatment for COVID-19","volume":"30","author":"Mahdavi","year":"2020","journal-title":"Rev. Med. Virol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"105522","DOI":"10.1016\/j.jsbmb.2019.105522","article-title":"Principal results of the VITamin D and OmegA-3 TriaL (VITAL) and updated meta-analyses of relevant vitamin D trials","volume":"198","author":"Manson","year":"2019","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Zittermann, A., Trummer, C., Theiler-Schwetz, V., Lerchbaum, E., M\u00e4rz, W., and Pilz, S. (2021). Vitamin D and Cardiovascular Disease: An Updated Narrative Review. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22062896"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1161\/CIRCRESAHA.116.309115","article-title":"Decline in Cardiovascular Mortality: Possible Causes and Implications","volume":"120","author":"Mensah","year":"2017","journal-title":"Circ. Res."},{"key":"ref_54","first-page":"1179","article-title":"Vitamin D Status, Supplementation and Cardiovascular Disease","volume":"38","author":"Zittermann","year":"2018","journal-title":"Anticancer Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Cosentino, N., Campodonico, J., Milazzo, V., De Metrio, M., Brambilla, M., Camera, M., and Marenzi, G. (2021). Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives. Nutrients, 13.","DOI":"10.3390\/nu13103603"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"346","DOI":"10.14336\/AD.2016.1021","article-title":"Vitamin D and Chronic Diseases","volume":"8","author":"Wang","year":"2017","journal-title":"Aging Dis."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.pbiomolbio.2006.02.016","article-title":"Vitamin D physiology","volume":"92","author":"Lips","year":"2006","journal-title":"Prog. Biophys. Mol. Biol."},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Vrani\u0107, L., Mikola\u0161evi\u0107, I., and Mili\u0107, S. (2019). Vitamin D Deficiency: Consequence or Cause of Obesity?. Medicina, 55.","DOI":"10.3390\/medicina55090541"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1089\/met.2017.0003","article-title":"High Prevalence of Vitamin D Deficiency and Correlation of Serum Vitamin D with Cardiovascular Risk in Patients with Metabolic Syndrome","volume":"15","author":"Alkhatatbeh","year":"2017","journal-title":"Metab. Syndr. Relat. Disord."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"181","DOI":"10.3892\/etm.2011.205","article-title":"Prevalence of serum vitamin D deficiency and insufficiency in cancer: Review of the epidemiological literature","volume":"2","author":"Gupta","year":"2011","journal-title":"Exp. Ther. Med."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nrc3691","article-title":"The role of vitamin D in reducing cancer risk and progression","volume":"14","author":"Feldman","year":"2014","journal-title":"Nat. Rev. Cancer"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1809944","article-title":"Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease","volume":"380","author":"Manson","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1007\/s40519-016-0312-6","article-title":"Vitamin D: Not just the bone. Evidence for beneficial pleiotropic extraskeletal effects","volume":"22","author":"Caprio","year":"2017","journal-title":"Eat. Weight. Disord.-Stud. Anorex. Bulim. Obes."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"v95","DOI":"10.1093\/annonc\/mdz240.106","article-title":"Prevalence of vitamin D3 deficiency among women with early breast cancer receiving chemotherapy in an oncology dayward","volume":"30","author":"Finstad","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"3167","DOI":"10.2147\/JIR.S363840","article-title":"The Role of Vitamin D in Immune System and Inflammatory Bowel Disease","volume":"15","author":"Wu","year":"2022","journal-title":"J. Inflamm. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1186\/s12967-019-2070-5","article-title":"Vitamin D deficiency associated with Crohn\u2019s disease and ulcerative colitis: A meta-analysis of 55 observational studies","volume":"17","author":"Li","year":"2019","journal-title":"J. Transl. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2021\/5556354","article-title":"NAFLD and Infection, a Nuanced Relationship","volume":"2021","author":"Adenote","year":"2021","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e000052","DOI":"10.1136\/bmjgast-2015-000052","article-title":"Vitamin D associates with improved quality of life in participants with irritable bowel syndrome: Outcomes from a pilot trial","volume":"2","author":"Tazzyman","year":"2015","journal-title":"BMJ Open Gastroenterol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s12937-022-00777-x","article-title":"The efficacy of vitamin D supplementation for irritable bowel syndrome: A systematic review with meta-analysis","volume":"21","author":"Huang","year":"2022","journal-title":"Nutr. J."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1158\/1940-6207.CAPR-11-0105","article-title":"Effects of Supplemental Vitamin D and Calcium on Biomarkers of Inflammation in Colorectal Adenoma Patients: A Randomized, Controlled Clinical Trial","volume":"4","author":"Hopkins","year":"2011","journal-title":"Cancer Prev. Res."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2147\/JIR.S63898","article-title":"Vitamin D and inflammatory diseases","volume":"7","author":"Agrawal","year":"2014","journal-title":"J. Inflamm. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"167","DOI":"10.3389\/fpsyt.2019.00167","article-title":"Prevalence and Correlates of Vitamin D Deficiency in a Sample of 290 Inpatients With Mental Illness","volume":"10","author":"Cuomo","year":"2019","journal-title":"Front. Psychiatry"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Wintermeyer, E., Ihle, C., Ehnert, S., St\u00f6ckle, U., Ochs, G., de Zwart, P., Flesch, I., Bahrs, C., and Nussler, A.K. (2016). Crucial Role of Vitamin D in the Musculoskeletal System. Nutrients, 8.","DOI":"10.3390\/nu8060319"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"358","DOI":"10.2215\/CJN.04040411","article-title":"Vitamin D Therapy in Chronic Kidney Disease and End Stage Renal Disease","volume":"7","author":"Melamed","year":"2012","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1159\/000498838","article-title":"Effects of Vitamin D Supplementation on Renal Function, Inflammation and Glycemic Control in Patients with Diabetic Nephropathy: A Systematic Review and Meta-Analysis","volume":"44","author":"Wang","year":"2019","journal-title":"Kidney Blood Press. Res."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"868961","DOI":"10.1155\/2015\/868961","article-title":"Prevalence and Prognostic Implications of Vitamin D Deficiency in Chronic Kidney Disease","volume":"2015","author":"Obi","year":"2015","journal-title":"Dis. Markers"},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"Kantas, T., Capriles, C.A.A., Babor, S., Tamdin, T., Al-Rihani, H., Thalla, A., Abdelmawla, A.A., Muthanna, F.M.S., and Tousif, S. (2022). Relationship between Chronic Kidney Disease Staging and Vitamin D Deficiency: A Retrospective Study. Cureus.","DOI":"10.7759\/cureus.r55"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"e3533","DOI":"10.1097\/MD.0000000000003533","article-title":"Vitamin D Deficiency Strongly Predicts Adverse Medical Outcome Across Different Medical Inpatient Populations: Results from a Prospective Study","volume":"95","author":"Graedel","year":"2016","journal-title":"Medicine"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e250553","DOI":"10.1136\/bcr-2022-250553","article-title":"Vitamin D intoxication and severe hypercalcaemia complicating nutritional supplements misuse","volume":"15","author":"Alkundi","year":"2022","journal-title":"BMJ Case Rep."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1016\/j.mayocp.2015.02.012","article-title":"Changing Incidence of Serum 25-Hydroxyvitamin D Values above 50 ng\/mL: A 10-Year Population-Based Study","volume":"90","author":"Dudenkov","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.mayocp.2015.03.015","article-title":"Vitamin D Is Not as Toxic as Was Once Thought: A Historical and an Up-to-Date Perspective","volume":"90","author":"Holick","year":"2015","journal-title":"Mayo Clin. Proc."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1210\/er.2016-1070","article-title":"Vitamin D-Mediated Hypercalcemia: Mechanisms, Diagnosis, and Treatment","volume":"37","author":"Tebben","year":"2016","journal-title":"Endocr. Rev."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/5\/998\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:48:57Z","timestamp":1760122137000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/5\/998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,6]]},"references-count":82,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["diagnostics13050998"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13050998","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,6]]}}}