title: Clinical correlates of vitamin D deficiency in established psychosis.
abstract: BACKGROUND
  Suboptimal vitamin D levels have been identified in populations with psychotic disorders. We sought to explore the relationship between vitamin D deficiency, clinical characteristics and cardiovascular disease risk factors among people with established psychosis.
  
  
  METHODS
  Vitamin D levels were measured in 324 community dwelling individuals in England with established psychotic disorders, along with measures of mental health, cardiovascular risk and lifestyle choices. Vitamin D deficiency was defined as serum 25-hydroxyvitamin D (25-OHD) levels below 10 ng/ml (equivalent to <25 nmol/L) and "sufficient" Vitamin D as above 30 ng/ml (>50 nmol/L).
  
  
  RESULTS
  The mean 25-OHD serum level was 12.4 (SD 7.3) ng/ml, (range 4.0-51.7 ng/ml). Forty nine percent (n = 158) were vitamin D deficient, with only 14 % (n = 45) meeting criteria for sufficiency. Accounting for age, gender, ethnicity and season of sampling, serum 25-OHD levels were negatively correlated with waist circumference (r = -0.220, p < 0.002), triglycerides (r = -0.160, p = 0.024), total cholesterol (r = -0.144, p = 0.043), fasting glucose (r = -0.191, p = 0.007), HbA1c (r = -0.183, p = 0.01), and serum CRP levels (r = -0.211, p = 0.003) and were linked to the presence of metabolic syndrome.
  
  
  CONCLUSIONS
  This is the largest cross sectional study of serum 25-OHD levels in community dwelling individuals with established psychosis, indicating a high level of vitamin D deficiency. Lower vitamin D levels are associated with increased cardiovascular disease risk factors and in particular metabolic syndrome. Further research is needed to define appropriate protocols for vitamin D testing and supplementation in practice to see if this can improve cardiovascular disease risk.
  
  
  BACKGROUND
  ISRCTN number is ISRCTN58667926 Date of registration: 23/04/2010.
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AF, UK.|National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Lally
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AF, UK.
authors.forename: P
authors.initials: P
authors.lastname: Gardner-Sood
authors.affiliation: South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Firdosi
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AF, UK.
authors.forename: C
authors.initials: C
authors.lastname: Iyegbe
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Honorary Senior Research Fellow, School of Psychology, University of Sussex, Brighton and Early Intervention in Psychosis Service, Sussex Partnership NHS Foundation Trust, West Sussex, UK.
authors.forename: K
authors.initials: K
authors.lastname: Greenwood
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London and Honorary Consultant, National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Murray
authors.affiliation: Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London and Honorary Consultant, National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AF, UK.|Department of Psychosis Studies, MRC Clinical Sciences Centre, Imperial College- Hammersmith Hospital Campus, London, W12 0NN, UK, London, UK.
authors.forename: O
authors.initials: O
authors.lastname: Howes
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, SE5 8AF, UK. Fiona.p.gaughran@kcl.ac.uk.|National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK. Fiona.p.gaughran@kcl.ac.uk.
authors.forename: F
authors.initials: F
authors.lastname: Gaughran
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology; D015995:Prevalence; D011618:Psychotic Disorders / Q000097:blood* / Q000453:epidemiology*; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology*
chemical_list: D014280:Triglycerides; D014807:Vitamin D; D002784:Cholesterol; C104450:25-hydroxyvitamin D
keywords: Cardiovascular; Metabolic syndrome; Psychosis; Schizophrenia; Vitamin D