{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T11:12:55Z","timestamp":1773745975376,"version":"3.50.1"},"reference-count":46,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:00:00Z","timestamp":1773705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Vitamin deficiencies remain prevalent worldwide and contribute to chronic disease burden. This study evaluated serum concentrations of vitamins D, A, and E in Italian general practice populations and examined their associations with prevalent chronic diseases. Methods: This multicenter cross-sectional study enrolled 500 adult patients (median age: 60.7 years; 40.4% male) attending 21 general practice offices across Italy between January 2021 and December 2024. Serum concentrations of 25-hydroxyvitamin D [25(OH)D], vitamin A, and vitamin E were measured alongside demographic, clinical, and biochemical parameters. Statistical analyses included chi-square tests, correlation analyses, and stepwise logistic regression. Results: The median 25(OH)D concentration was 20.4 ng\/mL, below optimal levels. Vitamin D deficiency was significantly associated with osteoporosis (p = 0.015), arterial hypertension (p = 0.047), and coronary artery disease (p = 0.002). The median vitamin A (654 \u03bcg\/L) and vitamin E (11.3 mg\/L) concentrations were within normal ranges. Notably, elevated vitamin A levels were significantly associated with arterial hypertension (p = 0.005), diabetes mellitus (p = 0.036), and cancer (p = 0.010). In the multivariate analysis, elevated vitamin A levels emerged as an independent predictor of multiple comorbidities (p &lt; 0.001) and cancer presence (p = 0.014), alongside age, male gender, and body mass index. Conclusions: Vitamin D insufficiency is highly prevalent in Italian primary care populations. Vitamin A concentrations show independent associations with multimorbidity and cancer, suggesting a potential negative influence of an animal-based diet, warranting prospective investigation. These findings highlight the importance of comprehensive vitamin assessment in general practice settings.<\/jats:p>","DOI":"10.3390\/nu18060943","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T10:21:41Z","timestamp":1773742901000},"page":"943","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Serum Vitamin D, A, and E Concentrations and Their Associations with Chronic Diseases in Adult Patients Referred to Italian General Practitioners\u2019 Offices"],"prefix":"10.3390","volume":"18","author":[{"given":"Paolo","family":"Baron","sequence":"first","affiliation":[{"name":"Health District of Udine, Azienda Sanitaria Universitaria Integrata Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Bigotto","sequence":"additional","affiliation":[{"name":"Health District of Udine, Azienda Sanitaria Universitaria Integrata Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Brignolo","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella Maria","family":"Camusso","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Cannavino","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) Roma Lazio, 00193 Roma, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norberto","family":"Carli","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria dell\u2019Alto Adige, 39100 Bolzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Castronuovo","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmine","family":"Colleluori","sequence":"additional","affiliation":[{"name":"Health District of Udine, Azienda Sanitaria Universitaria Integrata Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Provvidenza","family":"Fazio","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto Ferroni","family":"Nichelino","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giorgio Fiorello","family":"Chieri","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Fontana","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lino","family":"Gambardelli","sequence":"additional","affiliation":[{"name":"Azienda USL di Reggio Emilia, 42122 Reggio Emilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrizia","family":"Mascarello","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriella","family":"Musica","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Nardo","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Immacolata","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale Caserta, 81100 Caserta, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herbert","family":"Rainer","sequence":"additional","affiliation":[{"name":"Azienda Socio-Sanitaria Territoriale dei Sette Laghi, 21049 Tradate, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Rolfo","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Locale (ASL) TO5, 10023 Torino, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Vignando","sequence":"additional","affiliation":[{"name":"Health District of Udine, Azienda Sanitaria Universitaria Integrata Friuli Centrale, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Cmet","sequence":"additional","affiliation":[{"name":"Clinical Pathology, Azienda Sanitaria Universitaria Integrata, University of Udine, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9934-2528","authenticated-orcid":false,"given":"Annarosa","family":"Cussigh","sequence":"additional","affiliation":[{"name":"Azienda Sanitaria Universitaria Giuliano Isontina, 34148 Trieste, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmondo","family":"Falleti","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Azienda Sanitaria Universitaria Integrata, Department of Medicine, University of Udine, P.zale S.M. della Misericordia 1, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2566-3041","authenticated-orcid":false,"given":"Pierluigi","family":"Toniutto","sequence":"additional","affiliation":[{"name":"Hepatology and Liver Transplantation Unit, Azienda Sanitaria Universitaria Integrata, Department of Medicine, University of Udine, P.zale S.M. della Misericordia 1, 33100 Udine, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ciarcia, G., Bianchi, S., Tomasello, B., Acquaviva, R., Malfa, G.A., Naletova, I., La Mantia, A., and Di Giacomo, C. 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