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Han Q, Xiang M, An N, Tan Q, Shao J, Wang Q. Effects of vitamin D3 supplementation on strength of lower and upper extremities in athletes: an updated systematic review and meta-analysis of randomized controlled trials. Front Nutr 2024; 11:1381301. [PMID: 38860160 PMCID: PMC11163122 DOI: 10.3389/fnut.2024.1381301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Background Coaches and athletes are increasingly interested in understanding athletes' serum vitamin D levels, their impact on strength, physical performance, and athletic outcomes. Previous meta-analyses were reported with limited sample size and no significant overall effect was found. Hence, it is crucial to conduct a thorough and up-to-date systematic examination and meta-analysis to elucidate the potential advantages of supplementing with vitamin D3 in enhancing muscle strength for athletes. Methods We performed a thorough investigation, spanning three databases (PubMed, EBSCO, and Cochrane Library), seeking randomized controlled trials (RCTs) in all languages. These trials delved into the influence of vitamin D3 supplementation on the changes of pre- and post-intervention muscle strength in healthy athletes. Our systematic examination and meta-analysis took into account serum 25(OH)D levels exceeding 30 ng/mL as a marker of adequacy. Results Ten RCTs, comprising 354 athletes (185 in the vitamin D3 group and 169 in the placebo group), fulfilled the inclusion criteria. During the study, 36 athletes were lost to follow-up, leaving 318 athletes (166 in the vitamin D3 group and 152 in the placebo group) with documented complete results. In comparison with the placebo group, there is a significant increase between the changes of pre- and post-intervention serum 25(OH)D levels among athletes following a period of vitamin D3 supplementation (MD 14.76, 95% CI: 8.74 to 20.77, p < 0.0001). Overall effect of four strength measurements including handgrip, one repetition maximum Bench Press (1-RM BP), vertical jump, and quadriceps contraction was not significantly improved (SMD 0.18, 95% CI: -0.02 to 0.37, p = 0.08), but there was a significant increase in quadriceps contraction (SMD 0.57, 95% CI: 0.04 to 1.11, p = 0.04). Conclusion This updated meta-analysis indicates the potential benefits of vitamin D supplementation for enhancing muscle strength in athletes when analyzing its quantitatively synthesized effects. With limited available studies for the quantitative synthesis, it cannot warrant significant overall enhancements in muscle strength when athletes attain adequate serum 25(OH)D levels through supplementation.
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Affiliation(s)
- Qi Han
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- Sport Science College, Beijing Sport University, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Mai Xiang
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- Sport Science College, Beijing Sport University, Beijing, China
| | - Nan An
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Qiushi Tan
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Jing Shao
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
| | - Qirong Wang
- Sports Nutrition Center, National Institute of Sports Medicine, Beijing, China
- Key Lab of Sports Nutrition, State General Administration of Sport of China, Beijing, China
- National Testing & Research Center for Sports Nutrition, Ministry of Science and Technology of the People’s Republic of China, Beijing, China
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Olagunju MT, Abodunrin OR, Omotoso IO, Adewole IE, Ola OM, Abel C, Akinsolu FT. Egg consumption and bone mass density among the elderly: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002519. [PMID: 38696440 PMCID: PMC11065246 DOI: 10.1371/journal.pgph.0002519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 04/08/2024] [Indexed: 05/04/2024]
Abstract
Eggs offer a range of essential nutrients that could support skeletal health as individuals age. Maintaining bone density is crucial for reducing the risk of fractures and improving overall mobility and quality of life in later years. Understanding the potential benefits of habitual egg consumption on bone mass density among older people is essential, given that the natural decline in bone mass density occurs with age. This area of research has not garnered sufficient attention basically because of the mixed reactions and conflicting reports about the safety of egg consumption especially among the older adults. This scoping review aims to systematically examine the existing literature to map the evidence regarding the association between habitual egg consumption and bone mass density in older adults' individuals. The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines to ensure methodological rigor and transparency. Five electronic databases were searched for published pieces of literature. While high egg intake has been linked to increased mortality and dyslipidemia, eggs contain compounds like Ovo transferrin and carotenoids that may benefit bone health. As aging increases vulnerability to bone fragility and fractures, it's crucial to provide comprehensive dietary recommendations. The complex relationship between egg consumption, cholesterol, and health highlights the need for nuanced assessment. Overall, eggs present a potentially valuable dietary component for promoting bone health in aging populations. Limited research on the link between egg consumption and bone mass density in older adults highlights the need for further investigation. Concerns about cholesterol have overshadowed potential benefits. Given aging populations and bone health challenges, exploring eggs' role in preventing falls and fractures is essential for a proactive approach to older adults' well-being.
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Affiliation(s)
| | | | | | | | | | | | - Folahanmi T. Akinsolu
- Lead City University, Ibadan, Nigeria
- Nigerian Institute of Medical Research, Lagos, Nigeria
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Xiong T, Wu Y, Li Y, Chen W, Zhang Z, Lu W, He M, Chen L, Tang Y, Yao P, Xiong J, Li Y. Association of serum 25-hydroxyvitamin D with bone health measured by calcaneal quantitative ultrasound: a large cross-sectional analysis in children and adolescents. Food Funct 2024; 15:1379-1389. [PMID: 38214533 DOI: 10.1039/d3fo04811j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Background: Vitamin D plays a crucial role in bone health; however, findings in children and adolescents remain inconsistent, and few studies have examined its impact on bone health measured by quantitative ultrasound (QUS). This study aims at assessing the relationship between serum vitamin D levels and bone health, as evaluated by QUS, across varying pubertal stages and genders. Methods: A baseline cross-sectional survey of an ongoing cohort study included 4682 children and adolescents aged 6 to 18 years from Shenzhen, China. Serum levels of 25-hydroxyvitamin D (25(OH)D), which is the sum of 25(OH)D2 and 25(OH)D3, were quantified using liquid chromatography-mass spectrometry. Bone health was measured through calcaneal QUS, utilizing the speed of sound (SOS) in the heel as a principal measure-a higher SOS indicating a denser bone structure. Generalized linear models were used to evaluate the association of serum 25(OH)D, 25(OH)D2, and 25(OH)D3 levels with the SOS. Results: Forty-one point-one percent of this population was vitamin D deficient (serum 25(OH)D < 20 ng ml-1), with only 11.1% being sufficient. In the fully adjusted model, we observed a significant positive association between increased serum 25(OH)D quartiles and SOS. Compared with the participants in the lowest quartiles of serum 25(OH)D, those in successive quartiles of 25(OH)D were 3.54 (95% CI: 0.81, 6.28) m s-1, 5.74 (95% CI: 2.87, 8.61) m s-1, and 8.83 (95% CI: 5.83, 11.84) m s-1, respectively (P for trend < 0.0001). The correlations observed for serum 25(OH)D2 and 25(OH)D3 with SOS were similar to those of serum 25(OH)D. Importantly, this association was primarily observed in post-pubertal children and adolescents but was absent in pre- and mid-pubertal participants (P for interaction = 0.0004). Conclusion: Elevated serum 25(OH)D levels were associated with better bone health, as measured through calcaneal QUS, in children and adolescents, particularly among those who had reached the post-pubertal stage. These findings highlight the crucial importance of maintaining sufficient vitamin D levels to support optimal bone health in this demographic.
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Affiliation(s)
- Ting Xiong
- Department of Nutrition and Food Hygiene, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yuanjue Wu
- Department of Nutrition and Food Hygiene, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Yan Li
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
| | - Wenjing Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Ziyang Zhang
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
| | - Wenlong Lu
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
| | - Min He
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Yuhan Tang
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Ping Yao
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety and the Ministry of Education (MOE) Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Jingfan Xiong
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
| | - Yanyan Li
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020, China.
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Qi H, Hu C, Zhang J, Lin L, Wang S, Lin H, Jia X, Zhu Y, Zhang Y, Wu X, Li M, Xu M, Xu Y, Wang T, Zhao Z, Wang W, Bi Y, Dai M, Chen Y, Lu J. Early-life famine exposure, adulthood obesity patterns, and risk of low-energy fracture. Front Med 2024; 18:192-203. [PMID: 37938429 DOI: 10.1007/s11684-023-1023-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/20/2023] [Indexed: 11/09/2023]
Abstract
Malnutrition in early life increases the risk of osteoporosis, but the association of early-life undernutrition combined with adulthood obesity patterns with low-energy fracture remains unknown. This study included 5323 community-dwelling subjects aged ⩾40 years from China. Early-life famine exposure was identified based on the participants' birth dates. General obesity was assessed using the body mass index (BMI), and abdominal obesity was evaluated with the waist-to-hip ratio (WHR). Low-energy fracture was defined as fracture occurring after the age of ⩾40 typically caused by falls from standing height or lower. Compared to the nonexposed group, the group with fetal, childhood, and adolescence famine exposure was associated with an increased risk of fracture in women with odds ratios (ORs) and 95% confidence intervals (CIs) of 3.55 (1.57-8.05), 3.90 (1.57-9.71), and 3.53 (1.05-11.88), respectively, but not in men. Significant interactions were observed between fetal famine exposure and general obesity with fracture among women (P for interaction = 0.0008). Furthermore, compared with the groups with normal BMI and WHR, the group of women who underwent fetal famine exposure and had both general and abdominal obesity had the highest risk of fracture (OR, 95% CI: 3.32, 1.17-9.40). These results indicate that early-life famine exposure interacts with adulthood general obesity and significantly increases the risk of low-energy fracture later in life in women.
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Affiliation(s)
- Hongyan Qi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Chunyan Hu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jie Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lin Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Shuangyuan Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Hong Lin
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xiaojing Jia
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yuanyue Zhu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yi Zhang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xueyan Wu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Meng Dai
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Yuhong Chen
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
| | - Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the People's Republic of China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
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Chokor FAZ, Hwalla N, Naja F, Nasreddine L. Food sources of fiber and micronutrients of concern among infants and young children in Lebanon: a national cross-sectional study. BMC Pediatr 2024; 24:57. [PMID: 38243229 PMCID: PMC10797939 DOI: 10.1186/s12887-024-04535-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/03/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND Intakes of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate were shown to be low in a substantial proportion of infants and children in Lebanon. The study aims to identify the top food sources of fiber, iron, zinc, calcium, vitamin D, vitamin A, and folate amongst infants and young children in Lebanon and to evaluate the evolution of food sources of these nutrients from the beginning of the complementary feeding journey up until the age of 47.9 months. METHODS A national cross-sectional survey was conducted in 2012 as part of the "Early Life Nutrition and Health in Lebanon" project using stratified cluster sampling. Dietary intakes for infants and young children aged 6-47.9 months (n = 763) were assessed using 24- Hour Dietary Recall. Food items were categorized into food groups and the percent contribution of each food group to nutrient intakes was determined to identify the top food sources of fiber and selected micronutrients for three age groups: 6-11.9 m (infants), 12-23.9 m (toddlers), and 24-47.9 m (preschoolers). RESULTS The top food source of fiber was vegetables among children aged 6-47.9 months. Among infants and toddlers, infant/young child formula was the main contributor to iron, zinc, calcium, vitamin D, vitamin A, and folate intakes. Baby cereals also contributed to around 14% of iron intakes among infants. Among preschoolers, meat and fish contributed to 13% of iron intakes and 29% of zinc intakes, while cow's milk was the major contributor of calcium (41%), vitamin D (81%) and vitamin A (25%) intakes. Sweetened beverages and sweet bakery were also ranked among the major food sources contributing to substantial intakes of key nutrients, including fiber, iron, zinc, calcium, vitamin A, and folate among infants, toddlers, and preschoolers. CONCLUSIONS In addition to milk sources, vegetables, beans and legumes, breads, meats, and rice and pasta, sweet bakery and sweetened beverages have contributed to intakes of key nutrients from early ages. This calls for implementing initiatives and designing approaches to support nutrition education and improve nutrient intakes in infancy and early childhood.
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Affiliation(s)
- Fatima Al Zahraa Chokor
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut, Lebanon
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6
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Wu F, Fuleihan GEH, Cai G, Lamberg-Allardt C, Viljakainen HT, Rahme M, Grønborg IM, Andersen R, Khadilkar A, Zulf MM, Mølgaard C, Larnkjær A, Zhu K, Riley RD, Winzenberg T. Vitamin D supplementation for improving bone density in vitamin D-deficient children and adolescents: systematic review and individual participant data meta-analysis of randomized controlled trials. Am J Clin Nutr 2023; 118:498-506. [PMID: 37661104 DOI: 10.1016/j.ajcnut.2023.05.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 04/25/2023] [Accepted: 05/23/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND Vitamin D supplements are widely used for improving bone health in children and adolescents, but their effects in vitamin D-deficient children are unclear. OBJECTIVES This study aimed to examine whether the effect of vitamin D supplementation on bone mineral density (BMD) in children and adolescents differs by baseline vitamin D status and estimate the effect in vitamin D-deficient individuals. METHODS This is a systematic review and individual participant data (IPD) meta-analysis. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, MBASE, CINAHL, AMED, and ISI Web of Science (until May 27, 2020) for randomized controlled trials (RCTs) of vitamin D supplementation reporting bone density outcomes after ≥6 mo in healthy individuals aged 1-19 y. We used two-stage IPD meta-analysis to determine treatment effects on total body bone mineral content and BMD at the hip, femoral neck, lumbar spine, and proximal and distal forearm after 1 y; examine whether effects varied by baseline serum 25-hydroxyvitamin D [25(OH)D] concentration, and estimate treatment effects for each 25(OH)D subgroup. RESULTS Eleven RCTs were included. Nine comprising 1439 participants provided IPD (86% females, mean baseline 25(OH)D = 36.3 nmol/L). Vitamin D supplementation had a small overall effect on total hip areal BMD (weighted mean difference = 6.8; 95% confidence interval: 0.7, 12.9 mg/cm2; I2 = 7.2%), but no effects on other outcomes. There was no clear evidence of linear or nonlinear interactions between baseline 25(OH)D and treatment; effects were similar in baseline 25(OH)D subgroups (cutoff of 35 or 50 nmol/L). The evidence was of high certainty. CONCLUSIONS Clinically important benefits for bone density from 1-y vitamin D supplementation in healthy children and adolescents, regardless of baseline vitamin D status, are unlikely. However, our findings are mostly generalizable to White postpubertal girls and do not apply to those with baseline 25(OH)D outside the studied range or with symptomatic vitamin D deficiency (e.g., rickets). This study was preregistered at PROSPERO as CRD42017068772. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42017068772.
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Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia; Baker Department of Cardiometabolic Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia.
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism & Osteoporosis Program, WHO CC in Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Guoqi Cai
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | | | - Maya Rahme
- Calcium Metabolism & Osteoporosis Program, WHO CC in Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ida M Grønborg
- Research Group for Risk-Benefit, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Rikke Andersen
- Research Group for Risk-Benefit, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Anuradha Khadilkar
- Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Mughal M Zulf
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, United Kingdom
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Anni Larnkjær
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Richard D Riley
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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Calcaterra V, Magenes VC, Tagi VM, Grazi R, Bianchi A, Cena H, Zuccotti G, Fabiano V. Association between Vitamin D Levels, Puberty Timing, and Age at Menarche. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1243. [PMID: 37508740 PMCID: PMC10378582 DOI: 10.3390/children10071243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 07/15/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Pubertal development represents the process of physical maturation where an adolescent reaches sexual maturity and attains reproductive function. The effects of vitamin D are mainly mediated by the vitamin D receptor (VDR), which is expressed in almost all body cells, including the ovary and human pituitary gland and animal hypothalamus. Thus, vitamin D has gained great interest as pathogenic factor of pubertal disorders and fertility. This narrative review aimed to provide a broad overview of the available literature regarding the association between vitamin D levels, puberty timing, and age at menarche. A review of the data on the involvement of micronutrient deficiency, as a modifiable cause of pubertal disorders, is important for the prediction and prevention of deficiencies as well as for fertility protection and should be considered a public health priority. Reported data support that vitamin D is a regulator of neuroendocrine and ovarian physiology and, more in detail, a deficiency of vitamin D is involved in altered pubertal timing. Considering the long-term consequences of early pubertal development and early menarche, the detection of modifiable causes is crucial in preventive strategies. Future studies in humans and with an increased scale are needed to elucidate the vitamin D role in sexual maturation and puberty development.
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Affiliation(s)
- Valeria Calcaterra
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | | | | | - Roberta Grazi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Alice Bianchi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
| | - Hellas Cena
- Laboratory of Dietetics and Clinical Nutrition, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
- Clinical Nutrition and Dietetics Service, Unit of Internal Medicine and Endocrinology, Clinical Scientific Institutes Maugeri IRCCS, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
| | - Valentina Fabiano
- Pediatric Department, Buzzi Children's Hospital, 20154 Milano, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milano, Italy
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8
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Karkenny AJ, Avarello J, Hanstein R, Lo Y, Burlage A, Crabb R, McNally K, Merwin S, Schulz JF, Poon S. Pediatric Fractures: Does Vitamin D Play a Role? J Pediatr Orthop 2023:01241398-990000000-00315. [PMID: 37390504 DOI: 10.1097/bpo.0000000000002462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND Vitamin D (25-OHD) deficiency and insufficiency are reported in about half of all children. The literature on low 25-OHD and pediatric fracture risk presents inconsistent results. This study evaluates the association between pediatric fractures and 25-OHD, parathyroid hormone (PTH), and calcium. METHODS This is a prospective case-control study in 2 urban pediatric emergency departments (2014-2017). Patients aged 1 to 17 requiring intravenous access were enrolled. Demographics, nutrition, and activity information were recorded and levels of 25-OHD, calcium, and PTH were measured. RESULTS Two hundred forty-five subjects were enrolled: 123 fractures and 122 controls. Overall, the mean 25-OHD level was 23 ng/mL±8.5: 52 (21%) of patients were 25-OHD sufficient; 193 (79%) were not. Ninety-six percent of patients with lower extremity fractures had low 25-OHD versus 77% of patients with upper extremity fractures (P=0.024). The fracture cohort was younger (P=0.002), included more males (P=0.020), and spent more time playing outdoor sports (P=0.011) than the control cohort. The 25-OHD level (fracture 22.8 ng/mL±7.6 vs. nonfracture 23.5 ng/mL±9.3, P=0.494) and median calcium level (fracture 9.8 mg/dL vs. nonfracture 10.0 mg/dL, P=0.054) were similar between cohorts. The median PTH level was higher in the fracture than the control cohort (33 vs. 24.5 pg/mL; P<0.0005); PTH was elevated to hyperparathyroidism (>65 pg/mL) in 13% of fractures and 2% of controls (P=0.006). Matched subgroup analysis of 81 fracture patients and 81 controls by age, gender, and race showed that PTH was the only variable independently associated with increased odds of fracture (odds ratio=1.10, 95% CI, 1.01-1.19, P=0.021) in a model adjusted for vitamin D sufficiency and time spent playing outdoor sports. CONCLUSIONS Low 25-OHD is common in children with fractures but we found no difference in 25-OHD levels between fracture and nonfracture cohorts. This research can impact evidence-based guidelines on vitamin D level screening and/or supplementation after fracture. LEVEL OF EVIDENCE Diagnostic level IV-case-control study.
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Affiliation(s)
| | | | | | - Yungtai Lo
- Albert Einstein College of Medicine, Bronx
| | - Ashley Burlage
- Northwell Health Orthopaedic Institute at Huntington, Huntington
| | - Rocio Crabb
- Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | | | | | | | - Selina Poon
- Shriners Hospital for Children, Pasadena, CA
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9
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Segal D, Ziv A, Meisman A, Fry J, Altaye M, Gordon CM. Relationship Between Hypovitaminosis D and Fractures Among Adolescents With Overweight or Obesity. Clin Pediatr (Phila) 2023; 62:107-114. [PMID: 35883262 DOI: 10.1177/00099228221112461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Adolescents with overweight/obesity are at risk for vitamin D insufficiency and deficiency. Both overweight/obesity and vitamin D insufficiency/deficiency may predispose to fractures. We enrolled 103 participants (53.3% females, 15.9 ± 2.2 years) in a retrospective case-control study to determine whether an association exists between fractures and a low 25-hydroxyvitamin D (25[OH]D) among adolescents whose body mass index (BMI) ≥ 85 percentile. Cases (n = 28) sustaining a low/medium impact fracture were matched to controls (n = 75) without a fracture history. A conditional-logistic regression analysis addressing the common vitamin D insufficiency/deficiency cutoffs was used. Overweight, obesity, and significant obesity rates were 10.7%, 53.4%, and 35.9%, respectively. Mean (±SD) 25(OH)D was 16.5 ± 6.4 ng/mL. In all, 25(OH)D insufficiency rates (level <20 ng/mL) were 70.5%. Matched cases and controls had similar 25(OH)D insufficiency/deficiency rates (P > .05). Controlling for race and seasonality showed no association between fractures and 25(OH)D insufficiency/deficiency (P > .05). These data suggest that fractures are not associated with low 25(OH)D levels among adolescents whose BMI ≥ 85th percentile.
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Affiliation(s)
- David Segal
- Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Orthopaedic Surgery, Meir Medical Center and Tel Aviv University, Kfar Saba, Israel
| | - Adi Ziv
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Adolescent Medicine Unit, Department of Day Care Hospitalization, Schneider Children's Medical Center of Israel and Sackler Faculty of Medicine, Tel Aviv University, Petach Tikva, Israel
| | - Andrea Meisman
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jordan Fry
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Mekibib Altaye
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Catherine M Gordon
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
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Mesquita EDDL, Exupério IN, Agostinete RR, Luiz-de-Marco R, da Silva JCM, Maillane-Vanegas S, Kemper HCG, Fernandes RA. The Combined Relationship of Vitamin D and Weight-Bearing Sports Participation on Areal Bone Density and Geometry Among Adolescents: ABCD - Growth Study. J Clin Densitom 2022; 25:674-681. [PMID: 36184388 DOI: 10.1016/j.jocd.2022.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/18/2022] [Accepted: 09/02/2022] [Indexed: 11/24/2022]
Abstract
Osteoporosis is a public health problem, which negatively impacts society and national health services worldwide. Altered mineralization of the skeleton can be caused by persistent vitamin D deficiency. However, the combined impact of both on bone health is still under investigation. In fact, although there is compelling evidence in the literature about the positive effect of weight-bearing sports participation on bone mineral density, its impact on bone geometry gains more attention in pediatric population. The sports modalities that we evaluated were artistic gymnastics and track and field. Nonsports group was composed of 43 adolescents. Bone density was assessed using dual-energy X-ray absorptiometry. Vitamin D concentration was assessed by blood analysis. In the crude comparison of bone outcomes, the sport group presented higher aBMD only in the trochanter (p-value = 0.040). Considering the combination of the engagement in sports and vitamin D, adolescents in the sports group presented significantly higher values of aBMD in lower limbs, whole body, trochanter, shaft, and femur whole body (p-value = 0.024, 0.035, 0.001, 0.019 and 0.003 respectly). In contrast, only the sport group with high vitamin D presented a higher CSA (p-value = 0.015) and femur neck aBMD compared to the non-sport/low vitamin D group. Only adolescents with a combination of sports participation and higher serum concentrations of vitamin D presented better bone geometry, denoting the relevance of the combination of both factors to bone health.
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Affiliation(s)
- Eduardo Duarte de Lima Mesquita
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil.
| | - Isabella Neto Exupério
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Ricardo Ribeiro Agostinete
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Rafael Luiz-de-Marco
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Jéssica Casarotti Miguel da Silva
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Santiago Maillane-Vanegas
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
| | - Han C G Kemper
- Amsterdam Public Health Research Institute, Amsterdam UMC, The Netherlands
| | - Rômulo Araújo Fernandes
- Laboratory of Investigation in Exercise (LIVE), Department of Physical Education, São Paulo State University (UNESP), São Paulo, Brazil
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Mărginean CO, Meliț LE, Borka Balas R, Văsieșiu AM, Fleșeriu T. The Crosstalk between Vitamin D and Pediatric Digestive Disorders. Diagnostics (Basel) 2022; 12:diagnostics12102328. [PMID: 36292016 PMCID: PMC9600444 DOI: 10.3390/diagnostics12102328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/18/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamin D is a cyclopentane polyhydrophenanthrene compound involved mainly in bone health and calcium metabolism but also autophagy, modulation of the gut microbiota, cell proliferation, immune functions and intestinal barrier integrity. The sources of vitamin D include sunlight, diet and vitamin D supplements. Vitamin D3, the most effective vitamin D isoform is produced in the human epidermis as a result of sunlight exposure. Vitamin D undergoes two hydroxylation reactions in the liver and kidney to reach its active form, 1,25-dihydroxyvitamin D. Recent studies highlighted a complex spectrum of roles regarding the wellbeing of the gastrointestinal tract. Based on its antimicrobial effect, it was recently indicated that vitamin D supplementation in addition to standard eradication therapy might enhance H. pylori eradication rates. Moreover, it was suggested that low levels of vitamin D might also be involved in the acquisition of H. pylori infection. In terms of celiac disease, the negative effects of vitamin D deficiency might begin even during intrauterine life in the setting of maternal deficiency. Moreover, vitamin D is strongly related to the integrity of the gut barrier, which represents the core of the pathophysiology of celiac disease onset, in addition to being correlated with the histological findings of disease severity. The relationship between vitamin D and cystic fibrosis is supported by the involvement of this micronutrient in preserving lung function by clearing airway inflammation and preventing pathogen airway colonization. Moreover, this micronutrient might exert anticatabolic effects in CF patients. Inflammatory bowel disease patients also experience major benefits if they have a sufficient level of circulating vitamin D, proving its involvement in both induction and remission in these patients. The findings regarding the relationship between vitamin D, food allergies, diarrhea and constipation remain controversial, but vitamin D levels should be monitored in these patients in order to avoid hypo- and hypervitaminosis. Further studies are required to fill the remaining gaps in term of the complex impact of vitamin D on gastrointestinal homeostasis.
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Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Lorena Elena Meliț
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
- Correspondence:
| | - Reka Borka Balas
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Anca Meda Văsieșiu
- Department of Infectious Disease, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Tudor Fleșeriu
- Department of Infectious Disease, County Clinical Hospital Târgu Mureș, Gheorghe Doja Street No 89, 540394 Târgu Mureș, Romania
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Youness RA, Dawoud A, ElTahtawy O, Farag MA. Fat-soluble vitamins: updated review of their role and orchestration in human nutrition throughout life cycle with sex differences. Nutr Metab (Lond) 2022; 19:60. [PMID: 36064551 PMCID: PMC9446875 DOI: 10.1186/s12986-022-00696-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
Age and Gender are vital determinants for the micronutrient demands of normal indviduals. Among these micronutrients are vitamins that are required in small amounts for optimum metabolism, homeostasis, and a healthy lifestyle, acting as coenzymes in several biochemical reactions. The majority of previous studies have examined such issues that relates to a specific vitamin or life stage, with the majority merely reporting the effect of either excess or deficiency. Vitamins are classified into water-soluble and fat-soluble components. The fat-soluble vitamins include vitamins (A, D, E, and K). Fat-soluble vitamins were found to have an indisputable role in an array of physiological processes such as immune regulation, vision, bone and mental health. Nonetheless, the fat-soluble vitamins are now considered a prophylactic measurement for a multitude of diseases such as autism, rickets disease, gestational diabetes, and asthma. Herein, in this review, a deep insight into the orchestration of the four different fat-soluble vitamins requirements is presented for the first time across the human life cycle beginning from fertility, pregnancy, adulthood, and senility with an extensive assessment ofthe interactions among them and their underlying mechanistic actions. The influence of sex for each vitamin is also presented at each life stage to highlight the different daily requirements and effects.
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Affiliation(s)
- Rana A Youness
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt. .,Biology and Biochemistry Department, School of Life and Medical Sciences, University of Hertfordshire Hosted By Global Academic Foundation, Cairo, Egypt.
| | - Alyaa Dawoud
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt.,Biochemistry Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt
| | - Omar ElTahtawy
- Molecular Genetics Research Team (MGRT), Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, German University in Cairo, Cairo, Egypt
| | - Mohamed A Farag
- Pharmacognosy Department, College of Pharmacy, Cairo University, Kasr El Aini St, Cairo, 11562, Egypt.
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Basil M, Chmagh AA, Hassan MS. The Predictive Role of Vitamin D Deficiency in Urinary Tract Infection at Reproductive Age in Women. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Urinary tract infections (UTIs) are common health infections in pregnant women with high complications. Many of the worldwide population suffer from vitamin D deficiency (VDD) due to insufficient exposure to sunlight. The relationship between VDD and UTI and giving vitamin D supplementation contributes to preventing UTI.
AIM: The present study aims to find the effect of VDD and UTIs in women of reproductive age as risk factors during pregnancy.
METHODS: The samples were collected from May 2020 to February 2021 from gynecology clinic outpatients and private clinics in Basrah city. A 104 sample was collected from females of reproductive age between 15 and 45 years divided into three age groups suffering recurrent UTI and VDD.
RESULTS: Of 104 women who followed up with UTIs during the study period, the deficiency of vitamin D levels in women was 62.5%. The levels of deficiency were significantly higher in the age group 25-34y is 71.1%, followed by 15-24y is 63.2%, and 35-45 y is 50% with mean 24 ± 6.8 years. In addition, the results showed the vitamin D levels at an insufficient level (30.8%) higher in the age group 35-45 y is 42.9% with a mean of 10 ± 1.2. Furthermore, the results showed that the vitamin D levels at an insufficient level (30.8%) higher in the age group 35–45 years are 42.9% with a mean of 10 ± 1.2.
CONCLUSION: Our current study revealed that there is a clear correlation between women who suffer from VDD and UTIs, whether severe or frequent infection at reproductive age and this affects their fertility and pregnancy. In addition, the study concluded that adolescent girls and young women are the most vulnerable to VDD and UTIs.
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Zheng C, Li H, Rong S, Liu L, Zhen K, Li K. Vitamin D level and fractures in children and adolescents: a systematic review and meta-analysis. J Bone Miner Metab 2021; 39:851-857. [PMID: 34115219 DOI: 10.1007/s00774-021-01238-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The aim of the study was to determine the relationship between vitamin D levels and the risk of bone fractures in children and adolescents. MATERIALS AND METHODS PubMed, Embase, and Cochrane library databases were searched using subject and free words. The Newcastle-Ottawa scale form was used to assess literature quality. ReVman 5.2 and Stata 13.0 were used for statistical analyses. The results were expressed as the mean difference (MD)/odds ratio (OR) and 95% confidence interval (95% CI). The heterogeneity test was conducted according to I2 and Q tests. Egger's test was used to evaluate publication bias. RESULTS Thirteen studies (3943 participants ≤ 18 years old) were included, and the quality of the literature was acceptable. Regarding the 25-hydroxyvitamin D (25OHD) level in the random effects model, the MD = - 0.12 ng/mL (95% CI: -1.93, 1.69), I2 = 83%, and P < 0.00001, indicating large heterogeneity. Subgroup analyses were conducted according to vitamin D supplementation and 25OHD level, the sources of heterogeneity were not found. Regarding the proportion of subjects with vitamin D deficiency in the random effects model, OR = 1.09 (95% CI: 0.67, 1.79), I2 = 79%, and P < 0.0001. By sensitivity analysis, after removing Al-Daghri's study, OR = 1.22 (95% CI: 0.96, 1.56), I2 = 0%, and P = 0.64. CONCLUSION There is no relationship between vitamin D level and the risk of bone fractures in children and adolescents.
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Affiliation(s)
- Chong Zheng
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Hao Li
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Shuai Rong
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Liantao Liu
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Kepei Zhen
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China
| | - Kewei Li
- Pediatric Orthopaedics, The Third Hospital of Shijiazhuang, 15, Sports South Street, Shijiazhuang, 050011, Hebei, China.
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Maev IV, Kucheryavyy YA, Andreev DN. Exocrine pancreas insufficiency: clinical significance and approaches to correction from evidence medicine. TERAPEVT ARKH 2021; 93:509-515. [DOI: 10.26442/00403660.2021.04.200800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/12/2022]
Abstract
Exocrine pancreatic insufficiency (EPI) is a common complication of both benign and malignant diseases of the pancreas, as well as a consequence of radical surgical operations on the pancreas and a whole range of other variable extra-pancreatic causes. In clinical practice in the adult population, most cases of EPI are associated with chronic pancreatitis, while in the pediatric population with cystic fibrosis. The regression of the production of digestive enzymes in EPI mediates the development of the syndrome of maldigestion and malabsorption, leading to the progressive development of malnutrition, the importance of which is often underestimated by practitioners. At the same time, the development of nutritional deficiency is not just a complication of EPI, but also has an important effect on the course of the underlying causative disease, worsening the prognosis and quality of life of the patient, and is also a proven risk factor for osteoporosis and sarcopenia. To date, compensation for the absolute deficiency of pancreatic enzymes using enzyme replacement therapy is the only possible way to correct the EPI and prevent nutritional deficiency.
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Miyagaki S, Yamaguchi M, Ota T, Kawabe Y, Morimoto H, Oka Y, Mori J. Alfacalcidol improves the growth velocity in children with vitamin D deficiency/insufficiency: A single center retrospective cohort study. PLoS One 2021; 16:e0247886. [PMID: 33684119 PMCID: PMC7939371 DOI: 10.1371/journal.pone.0247886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 02/15/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the growth velocity-improving effects of vitamin D replacement therapy in pediatric patients diagnosed with vitamin D deficiency and insufficiency. STUDY DESIGN A retrospective cohort study was conducted in 34 pediatric patients diagnosed with vitamin D deficiency/insufficiency. Based on the clinical findings, the subjects were divided into two groups: a bowed leg (BL) group and a non-bowed leg (non-BL) group. After the initiation of alfacalcidol, the standard deviation score (SDS) of their heights, weights and growth velocities in each group were monitored. RESULTS The median age at the first visit was significantly lesser in the BL group (1.58 years old [interquartile range (IQR): 1.33, 2.17]) than that in the non-BL group (3.00 years old [IQR: 2.33, 3.67]). On the contrary, the SDS for height was significantly lower in the non-BL group (-2.27 [IQR: -2.63, -1.94]) than that in the BL group (-1.37 [IQR: -1.91, -1.07]). One-year treatment with alfacalcidol showed significant improvements in both height SDSs and growth velocity SDSs not only in the BL group but also in the non-BL group. CONCLUSIONS The current study revealed that vitamin D replacement therapy improved the growth rate in children with vitamin D deficiency/insufficiency, regardless of the presence of BL. This study emphasizes the importance of assessing the vitamin D status in children with poor growth rates and suggests that alfacalcidol could be a valid option for the treatment of short stature.
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Affiliation(s)
- Satoshi Miyagaki
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Mihoko Yamaguchi
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Takeshi Ota
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yasuhiro Kawabe
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hidechika Morimoto
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Yoshinobu Oka
- Department of Pediatric Orthopaedics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Jun Mori
- Department of Pediatrics, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
- * E-mail:
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Song K, Kwon A, Chae HW, Suh J, Choi HS, Choi Y, Oh JS, Kim HS. Vitamin D status is associated with bone mineral density in adolescents: Findings from the Korea National Health and Nutrition Examination Survey. Nutr Res 2021; 87:13-21. [DOI: 10.1016/j.nutres.2020.12.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 11/10/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022]
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Abstract
FGF23 is a phosphotropic hormone produced by the bone. FGF23 works by binding to the FGF receptor-Klotho complex. Klotho is expressed in several limited tissues including the kidney and parathyroid glands. This tissue-restricted expression of Klotho is believed to determine the target organs of FGF23. FGF23 reduces serum phosphate by suppressing the expression of type 2a and 2c sodium-phosphate cotransporters in renal proximal tubules. FGF23 also decreases 1,25-dihydroxyvitamin D levels by regulating the expression of vitamin D-metabolizing enzymes, which results in reduced intestinal phosphate absorption. Excessive actions of FGF23 cause several types of hypophosphatemic rickets/osteomalacia characterized by impaired mineralization of bone matrix. In contrast, deficient actions of FGF23 result in hyperphosphatemic tumoral calcinosis with high 1,25-dihydroxyvitamin D levels. These results indicate that FGF23 is a physiological regulator of phosphate and vitamin D metabolism and indispensable for the maintenance of serum phosphate levels.
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Tan ML, Abrams SA, Osborn DA. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. Cochrane Database Syst Rev 2020; 12:CD013046. [PMID: 33305822 PMCID: PMC8812278 DOI: 10.1002/14651858.cd013046.pub2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Vitamin D deficiency is common worldwide, contributing to nutritional rickets and osteomalacia which have a major impact on health, growth, and development of infants, children and adolescents. Vitamin D levels are low in breast milk and exclusively breastfed infants are at risk of vitamin D insufficiency or deficiency. OBJECTIVES To determine the effect of vitamin D supplementation given to infants, or lactating mothers, on vitamin D deficiency, bone density and growth in healthy term breastfed infants. SEARCH METHODS We used the standard search strategy of Cochrane Neonatal to 29 May 2020 supplemented by searches of clinical trials databases, conference proceedings, and citations. SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs in breastfeeding mother-infant pairs comparing vitamin D supplementation given to infants or lactating mothers compared to placebo or no intervention, or sunlight, or that compare vitamin D supplementation of infants to supplementation of mothers. DATA COLLECTION AND ANALYSIS Two review authors assessed trial eligibility and risk of bias and independently extracted data. We used the GRADE approach to assess the certainty of evidence. MAIN RESULTS We included 19 studies with 2837 mother-infant pairs assessing vitamin D given to infants (nine studies), to lactating mothers (eight studies), and to infants versus lactating mothers (six studies). No studies compared vitamin D given to infants versus periods of infant sun exposure. Vitamin D supplementation given to infants: vitamin D at 400 IU/day may increase 25-OH vitamin D levels (MD 22.63 nmol/L, 95% CI 17.05 to 28.21; participants = 334; studies = 6; low-certainty) and may reduce the incidence of vitamin D insufficiency (25-OH vitamin D < 50 nmol/L) (RR 0.57, 95% CI 0.41 to 0.80; participants = 274; studies = 4; low-certainty). However, there was insufficient evidence to determine if vitamin D given to the infant reduces the risk of vitamin D deficiency (25-OH vitamin D < 30 nmol/L) up till six months of age (RR 0.41, 95% CI 0.16 to 1.05; participants = 122; studies = 2), affects bone mineral content (BMC), or the incidence of biochemical or radiological rickets (all very-low certainty). We are uncertain about adverse effects including hypercalcaemia. There were no studies of higher doses of infant vitamin D (> 400 IU/day) compared to placebo. Vitamin D supplementation given to lactating mothers: vitamin D supplementation given to lactating mothers may increase infant 25-OH vitamin D levels (MD 24.60 nmol/L, 95% CI 21.59 to 27.60; participants = 597; studies = 7; low-certainty), may reduce the incidences of vitamin D insufficiency (RR 0.47, 95% CI 0.39 to 0.57; participants = 512; studies = 5; low-certainty), vitamin D deficiency (RR 0.15, 95% CI 0.09 to 0.24; participants = 512; studies = 5; low-certainty) and biochemical rickets (RR 0.06, 95% CI 0.01 to 0.44; participants = 229; studies = 2; low-certainty). The two studies that reported biochemical rickets used maternal dosages of oral D3 60,000 IU/day for 10 days and oral D3 60,000 IU postpartum and at 6, 10, and 14 weeks. However, infant BMC was not reported and there was insufficient evidence to determine if maternal supplementation has an effect on radiological rickets (RR 0.76, 95% CI 0.18 to 3.31; participants = 536; studies = 3; very low-certainty). All studies of maternal supplementation enrolled populations at high risk of vitamin D deficiency. We are uncertain of the effects of maternal supplementation on infant growth and adverse effects including hypercalcaemia. Vitamin D supplementation given to infants compared with supplementation given to lactating mothers: infant vitamin D supplementation compared to lactating mother supplementation may increase infant 25-OH vitamin D levels (MD 14.35 nmol/L, 95% CI 9.64 to 19.06; participants = 269; studies = 4; low-certainty). Infant vitamin D supplementation may reduce the incidence of vitamin D insufficiency (RR 0.61, 95% CI 0.40 to 0.94; participants = 334; studies = 4) and may reduce vitamin D deficiency (RR 0.35, 95% CI 0.17 to 0.72; participants = 334; studies = 4) but the evidence is very uncertain. Infant BMC and radiological rickets were not reported and there was insufficient evidence to determine if maternal supplementation has an effect on infant biochemical rickets. All studies enrolled patient populations at high risk of vitamin D deficiency. Studies compared an infant dose of vitamin D 400 IU/day with varying maternal vitamin D doses from 400 IU/day to > 4000 IU/day. We are uncertain about adverse effects including hypercalcaemia. AUTHORS' CONCLUSIONS For breastfed infants, vitamin D supplementation 400 IU/day for up to six months increases 25-OH vitamin D levels and reduces vitamin D insufficiency, but there was insufficient evidence to assess its effect on vitamin D deficiency and bone health. For higher-risk infants who are breastfeeding, maternal vitamin D supplementation reduces vitamin D insufficiency and vitamin D deficiency, but there was insufficient evidence to determine an effect on bone health. In populations at higher risk of vitamin D deficiency, vitamin D supplementation of infants led to greater increases in infant 25-OH vitamin D levels, reductions in vitamin D insufficiency and vitamin D deficiency compared to supplementation of lactating mothers. However, the evidence is very uncertain for markers of bone health. Maternal higher dose supplementation (≥ 4000 IU/day) produced similar infant 25-OH vitamin D levels as infant supplementation of 400 IU/day. The certainty of evidence was graded as low to very low for all outcomes.
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Affiliation(s)
- May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Malaysia
| | - Steven A Abrams
- Department of Pediatrics, Dell Medical School, The University of Texas at Austin, Austin, Texas, USA
| | - David A Osborn
- Central Clinical School, School of Medicine, The University of Sydney, Sydney, Australia
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Ali SB, Perdawood D, Abdulrahman R, Al Farraj DA, Alkubaisi NA. Vitamin D deficiency as a risk factor for urinary tract infection in women at reproductive age. Saudi J Biol Sci 2020; 27:2942-2947. [PMID: 33100850 PMCID: PMC7569126 DOI: 10.1016/j.sjbs.2020.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022] Open
Abstract
Vitamin D deficiency is a pandemic problem and an ever-increasing issue in human nutrition and health. Vitamin D (serum 25-hydroxyvitamin D) deficiency causes many health problems such as autoimmune diseases, Crohn's disease, diabetes, inflammation, asthma, hypertension, and cancer. Vitamin D3 (cholecalciferol) deficiency has been documented as a persistent problem among adults, children, and elderly persons in most of the countries. Our main objective of this study was to determine the hypothesis that the vitamin D deficiency among women can lead to them developing frequent urinary tract infections. Vitamin D has a potential role in immune regulation and it prevents infections especially urinary tract infections (UTI). Therefore it has positive regulatory role in both acute and recurrent infections especially in women of reproductive ages. As women at this age group have specific differences in their urinary tract and the reproductive organ anatomy, make them more prone for micro-organisms' invasion, The present study was carried out to ascertain certain relation between serum 25-hydroxyvitamin D levels and UTI in women while contemplating the significance of knowing the risk factors associated with UTI and also finding ways to avoid serious complications. 75 women with (case group) UTI were differentiated with 35 healthy with no UTI (control group) and 40 women with UTI and their serum 25-hydroxyvitamin D levels were checked in a case control study. The women were between at 17-52 years of age. Using ELISA, Serum 25-hydroxyvitamin D levels were measured. Analysis and comparison of the results were done among the two groups. Vitamin D mean levels in the case group was considerably lower when in comparison with the control group (11.09 ± 7.571 ng/mL vs. 24.08 ± 11.95 ng/mL, P < 0.001).
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Affiliation(s)
- Shahnaz Burhan Ali
- Biology Department, College of Science, Salahaddin University, Kirkuk Road, Erbil, Kurdistan Region 44002, Iraq
| | - Dedan Perdawood
- Senior Obstetrician and Gynaecologist, Rizgary Teaching Hospital, PeshawaQazi, Erbil, Iraq
| | - RabarMohsin Abdulrahman
- Department of Medical Microbiology, Faculty of Science and Health, Koya University, Koya KOY45, Kurdistan Region, Iraq
| | - Dunia A. Al Farraj
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
| | - Noorah A. Alkubaisi
- Department of Botany and Microbiology, College of Science, King Saud University, Riyadh 11451, Saudi Arabia
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Bukhari AF, Felemban MJ, Alem H. The Association Between Serum 25-Hydroxyvitamin D Levels and Patients With Allergic Rhinitis. Cureus 2020; 12:e9762. [PMID: 32821632 PMCID: PMC7430690 DOI: 10.7759/cureus.9762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Many studies have suggested a link between vitamin D deficiency and the development of other atopic diseases like allergic rhinitis (AR). AR can lead to sleep disturbance, fatigue, depressed mood, and compromised cognitive function, which can impair the quality of life and productivity in many people. Objective We aimed to determine the association between vitamin D levels and AR and the effect of vitamin D on atopy markers. Methods All patients with AR who were diagnosed, treated, and followed up at the King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2012 to January 2020 were included in the study. Our exclusion criteria were as follows: pediatric patients, patients with insufficient follow-up data, patients with no atopy markers, patients with comorbid conditions affecting their serum vitamin D levels, and patients with a history of taking medications that affect serum vitamin D levels. Results Fifty-five adult patients with AR were included in the study. Patients with vitamin D deficiency were more likely to have uncontrolled AR. Regarding the effect of vitamin D deficiency on atopy markers, there was no statistically significant relationship between vitamin D deficiency and serum immunoglobulin E (IgE) levels. However, serum eosinophil levels were significantly higher in patients with vitamin D deficiency. Conclusion Our results showed that vitamin D deficiency is strongly associated with uncontrolled AR; there was a statistically significant relationship between vitamin D deficiency and eosinophil levels, but no significant relationship between vitamin D deficiency and serum IgE was found.
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Affiliation(s)
- Afnan F Bukhari
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University Hospital, Jeddah, SAU
| | - Mohammed J Felemban
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University, Jeddah, SAU
| | - Hesham Alem
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University, Jeddah, SAU
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Al Khalifah R, Alsheikh R, Alnasser Y, Alsheikh R, Alhelali N, Naji A, Al Backer N. The impact of vitamin D food fortification and health outcomes in children: a systematic review and meta-regression. Syst Rev 2020; 9:144. [PMID: 32546259 PMCID: PMC7298752 DOI: 10.1186/s13643-020-01360-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 04/14/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Vitamin D (vitD) deficiency is a global childhood health problem. Food fortification is a promising strategy to curb vitD deficiency. We aimed to assess the effectiveness of utilizing vitD fortification in staple foods to improve 25hydroxyvitamin D (25(OH)D) concentration and to reduce the prevalence of vitD deficiency among healthy children. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of vitD fortified food products compared to no fortification among healthy children aged 1-18 years old. We searched Medline, Embase, Global Health, and Cochrane (CENTRAL) databases from database inception until May 2019. Independently, six reviewers in pairs screened titles and abstracts, assessed the full text for eligibility, and performed data extraction and quality assessment. The primary outcome is the impact of fortification on 25(OH)D concentration. The secondary outcomes included the impact of fortification on the prevalence of vitD deficiency, school performance, cognitive function, school absences, infection rate, hospital admission length, and compliance with fortified food product consumption. RESULTS We identified 2229 articles. After assessing eligibility, 20 RCTs met the inclusion criteria. The eligible RCTs assessed the fortification of milk, cereal, juice, bread, yogurt, and cheese compared with no fortification. All RCTs, except for three, had a low risk of bias. Food fortification improved 25(OH)D concentration by a mean difference (MD) of 15.51 nmol/L (95% confidence interval (CI) 6.28, 24.74; I2 = 99%), which resulted in a mean increase of 3 nmol/l for every 100 IU of vitD, when adjusted for baseline 25(OH)D concentration and country latitude. Additionally, the prevalence of vitD deficiency decreased by a risk ratio of 0.53 (95% CI 0.41, 0.69; I2 = 95%), and cognitive function improved by a MD of 1.22 intelligence quotient (IQ) points (95% CI 0.65, 1.79; I2 = 0%). The overall evidence quality was high. CONCLUSION VitD food fortification is an effective way to improve 25(OH)D concentration, prevent vitD deficiency, and improve IQ levels. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017057631.
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Affiliation(s)
- Reem Al Khalifah
- Division of Pediatric Endocrinology, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia. .,College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Rawan Alsheikh
- Pediatric Department, King Saud University, Riyadh, Saudi Arabia
| | - Yossef Alnasser
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Pediatric Department, King Saud University, Riyadh, Saudi Arabia.,Pediatric Department, BC Children's Hospital, Vancouver, BC, Canada
| | - Rana Alsheikh
- Pediatric Department, King Saud University, Riyadh, Saudi Arabia
| | - Nora Alhelali
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ammar Naji
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Nouf Al Backer
- College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Division of Developmental-Behavioral Pediatric, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Patseadou M, Haller DM. Vitamin D in Adolescents: A Systematic Review and Narrative Synthesis of Available Recommendations. J Adolesc Health 2020; 66:388-407. [PMID: 31685374 DOI: 10.1016/j.jadohealth.2019.08.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Practical guidelines help clinicians make their preventive and therapeutic choices and improve care management. Our purpose was to collect and synthesize available recommendations concerning vitamin D in adolescents (aged 10-19 years). METHODS We searched PubMed, EMBASE, and Cochrane databases from inception to February 5, 2019, for guidance published by different professional associations and governments. We also searched the reference lists of identified recommendations and explored the gray literature using Web search engines. We organized documents by theme: dietary requirements, thresholds, prophylactic supplementation, and treatment of deficiency. RESULTS A total of 32 documents were identified. Most of them targeted the general population and not specifically the age group of adolescents. There is a general agreement that adolescents should not have serum 25-hydroxyvitamin D concentrations below 25-30 nmol/L to avoid poor bone health. However, there is lack of consensus on the optimal concentration to aim for, levels varying between 25 nmol/L and 150 nmol/L. Adequate nutritional requirements of vitamin D are also subject to debate with values ranging between 200 IU/d and 1,000 IU/d. The upper tolerable intake is estimated at 4,000 IU/d by all study groups. Certain associations recommend routine vitamin D supplementation in adolescents. The recommended daily preventive doses vary between 400 IU and 4,000 IU, depending on season, skin pigmentation, sun exposure, consumption of vitamin D-fortified foods, body mass index, and coexistence of certain medical conditions. In case of deficiency, different therapeutic regimens of oral vitamin D are proposed depending on the presence of illness and/or the baseline serum 25-hydroxyvitamin D concentrations. Duration of the treatment varies between 4 weeks and 3 months. A maintenance dose is generally recommended after treatment. CONCLUSIONS At present, there is no consensus among the different societies about vitamin D needs during adolescence. Stronger, evidence-based guidance is needed to inform clinical practice.
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Affiliation(s)
- Magdalini Patseadou
- Adolescent and Young Adult Health Clinic, Department of Woman, Child and Adolescent Health, Geneva University Hospitals, Geneva, Switzerland; Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Dagmar M Haller
- Adolescent and Young Adult Health Clinic, Department of Woman, Child and Adolescent Health, Geneva University Hospitals, Geneva, Switzerland; Primary Care Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Serum 25-hydroxyvitamin D concentrations in 16-year-old Icelandic adolescent and its association with bone mineral density. Public Health Nutr 2020; 23:1329-1333. [PMID: 32188523 PMCID: PMC7196732 DOI: 10.1017/s1368980019004142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The aim of the study was to assess the potential association between serum 25-hydroxyvitamin D (25(OH)D) and whole-body bone mineral density (BMD) among 16-year-old adolescents and to study the prevalence of 25(OH)D insufficiency, defined as concentration under 50 nmol/l. DESIGN A cross-sectional study. SETTING Reykjavik, Iceland, latitude 64°08'N. Measurements took place in the Icelandic Heart Association's research lab during April-June 2015. PARTICIPANTS In total, 411 students in Reykjavik, Iceland, were invited to participate, 315 accepted the invitation (76·6 %) and 289 had valid data (mainly Caucasian). RESULTS 25(OH)D < 50 nmol/l was observed in 70 % of girls and 66·7 % of boys. 25(OH)D ≥ 50 nmol/l was significantly associated with higher whole-body BMD after adjusting for the influence of sex, height, fat mass and lean mass. A linear relationship between 25(OH)D and whole-body BMD was significant for 25(OH)D < 50 nmol/l (n 199, P < 0·05) but NS for 25(OH)D ≥ 50 nmol/l (n 86, P = 0·48). CONCLUSIONS Our results are in line with some but not all previous studies on the relationship between BMD and 25(OH)D in adolescents. The observed difference in BMD between those with above v. below a 25(OH)D concentration of 50 nmol/l was of about a fifth of one SD, which may have a clinical relevance as one SD decrease in volumetric BMD has been associated with a 89 % increase in 2 years risk of fracture. Icelandic adolescents should be encouraged to increase their vitamin D intake as it is possible that their current intake is insufficient to achieve optimal peak bone mass.
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Krzysztoszek J, Kleka P, Laudańska-Krzemińska I. Assessment of selected nutrient intake by Polish preschool children compared to dietary recommendations: a meta-analysis. Arch Med Sci 2020; 16:635-647. [PMID: 32399113 PMCID: PMC7212230 DOI: 10.5114/aoms.2020.93046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/23/2018] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION In recent years a steady increase in the number of obese people has been observed worldwide. This problem is also increasingly applicable to children and adolescents. In this study, we conducted a meta-analysis of studies carried out in Poland over ten years (2005-2015) which analysed the diet of preschool children and assessed how significantly it affects the prevention of diet-dependent disease. MATERIAL AND METHODS Two of the researchers independently performed a systematic search of Medline, Embase, Google Scholar, and the Polish Medical Bibliography to find studies published between 2005 and 2015. The variance of the means of differences between selected factors in relation to dietary guidelines and standards for preschool children was estimated by summing the individual variances of means. The means of differences between selected factors across the studies were pooled using random-effects model meta-analysis. RESULTS The analysis included a total of 2095 children. Mean protein content in the diet of children studied is 111% higher than indicated in dietary recommendations for this age group; mean consumption of carbohydrates in the study group is 24% higher than recommended. In moderately high calorie diets, analysis showed that the recommended norm is exceeded by 47%, CE 0.77, p < 0.001. CONCLUSIONS Nutrient intake is not compliant with recommendations for this age group and could not only inhibit physical development, but also increase the risk of diet-dependent diseases.
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Affiliation(s)
- Jana Krzysztoszek
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Poznan, Poland
| | - Paweł Kleka
- Institute of Psychology, Adam Mickiewicz University, Poznan, Poland
| | - Ida Laudańska-Krzemińska
- Department of Physical Activity Study and Health Promotion, Poznan University of Physical Education, Poznan, Poland
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Han Q, Li X, Tan Q, Shao J, Yi M. Effects of vitamin D3 supplementation on serum 25(OH)D concentration and strength in athletes: a systematic review and meta-analysis of randomized controlled trials. J Int Soc Sports Nutr 2019; 16:55. [PMID: 31771586 PMCID: PMC6878631 DOI: 10.1186/s12970-019-0323-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 11/06/2019] [Indexed: 12/19/2022] Open
Abstract
Background The purpose of this systematic review and meta-analysis is to investigate the effects of vitamin D3 supplementation on skeletal muscle strength in athletes. Vitamin D3 supplements or vitamin D3 fortified foods always have claims for bringing people health benefits including bone and muscle health. An up-to-date rigorous systematic review and meta-analysis is important to better understand the effect of vitamin D3 supplementation on muscle strength. Methods English written randomized controlled trials (RCTs) that looked at effects of vitamin D3 supplementation on muscle strength in healthy athletes were searched using three databases (PubMed, Embase and Cochrane Library). Serum 25(OH)D above 30 ng/mL is considered to be sufficient in this systematic review and meta-analysis. Results Five RCTs with 163 athletes (vitamin D3 n = 86, placebo n = 77) met inclusion criteria. Fourteen athletes were lost to follow-up and 149 athletes (vitamin D3 n = 80, placebo n = 69) were documented with complete result. Among athletes with baseline serum 25(OH)D values suggesting insufficiency, vitamin D3 daily dosage at 5000 IU for over 4 weeks led to a serum 25(OH)D concentration of 31.7 ng/mL. Athletes with sufficient serum 25(OH)D level at baseline were recruited in only one study, and the participants of which were assigned to either vitamin D3 at a daily dosage of 3570 IU or placebo for 12 weeks, their serum 25(OH)D sufficiency (VD: 37.2 ± 7.6 vs. 45.6 ± 7.6; PL: 38 ± 6.8 vs. 32 ± 8.4) was well maintained above the cut-off boundary. One repetition maximum Bench Press (1-RM BP) was not improved significantly (SMD 0.07, 95% CI: − 0.32 to 0.47, P = 0.72) and there was no significant increase in maximal quadriceps contraction (SMD -2.14, 95% CI: − 4.87 to 0.59, P = 0.12). Furthermore, there was no significant overall effect of vitamin D3 intervention on muscle strength in this meta-analysis (SMD -0.75, 95% CI: − 1.82 to 0.32, P = 0.17). Conclusion Although, serum 25(OH)D concentrations after supplementation reached sufficiency was observed, muscle strength did not significantly improve at this point of current meta-analysis. Additional well-designed RCTs with large number of participants examined for the effect of vitamin D3 supplementation on serum 25(OH)D concentrations, muscle strength in a variety of sports, latitudes and diverse multicultural populations are needed.
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Affiliation(s)
- Qi Han
- National Research Institute of Sports Medicine, Beijing, China. .,Beijing Sport University, Beijing, China.
| | - Xueyang Li
- Institute of Scientific and Technical Information of China, Beijing, China
| | - Qiushi Tan
- National Research Institute of Sports Medicine, Beijing, China
| | - Jing Shao
- National Research Institute of Sports Medicine, Beijing, China
| | - Muqing Yi
- National Research Institute of Sports Medicine, Beijing, China.,Beijing Sport University, Beijing, China
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Chakrabarti A, Eiden M, Morin-Rivron D, Christinat N, Monteiro JP, Kaput J, Masoodi M. Impact of multi-micronutrient supplementation on lipidemia of children and adolescents. Clin Nutr 2019; 39:2211-2219. [PMID: 31677804 DOI: 10.1016/j.clnu.2019.09.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 09/24/2019] [Accepted: 09/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Micronutrient supplementation has been extensively explored as a strategy to improve health and reduce risk of chronic diseases. Fat-soluble vitamins like A and E with their antioxidant properties and mechanistic interactions with lipoproteins, have potentially a key impact on lipid metabolism and lipidemia. OBJECTIVE The impact of micronutrients on lipid metabolism requires further investigation including characterization of plasma lipidome following supplementation and any cause-effect on circulating lipids. DESIGN In this study, we elucidate the effect and associations of a multi-micronutrient intervention in Brazilian children and teens with lipoprotein alterations and lipid metabolism. RESULTS Our analysis suggests a combination of short and long-term impact of supplementation on lipid metabolism, potentially mediated primarily by α-tocopherol (vitamin E) and retinol (vitamin A). Among the lipid classes, levels of phospholipids, lysophospholipids, and cholesterol esters were impacted the most along with differential incorporation of stearic, palmitic, oleic and arachidonic acids. Integrated analysis with proteomic data suggested potential links to supplementation-mediated alterations in protein levels of phospholipases and pyruvate dehydrogenase kinase 1 (PDK1). CONCLUSIONS Associations between the observed differences in lipidemia, total triglyceride, and VLDL-cholesterol levels suggest that micronutrients may play a role in reducing these risk factors for cardiovascular disease in children. This would require further investigation.
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Affiliation(s)
| | - Michael Eiden
- Lipid Metabolism, Nestlé Research, EPFL Innovation Park, 1015, Switzerland; Eidea Bioscience Ltd., Cambridge, United Kingdom
| | | | - Nicolas Christinat
- Lipid Metabolism, Nestlé Research, EPFL Innovation Park, 1015, Switzerland
| | - Jacqueline P Monteiro
- Department of Pediatrics and Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto, 14049-900, Brazil
| | - Jim Kaput
- Nestlé Research, EPFL Innovation Park, 1015, Lausanne, Switzerland
| | - Mojgan Masoodi
- Lipid Metabolism, Nestlé Research, EPFL Innovation Park, 1015, Switzerland; Institute of Clinical Chemistry, Inselspital, Bern University Hospital, Bern, Switzerland.
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Shor E, Roelfs D. Climate shock: Moving to colder climates and immigrant mortality. Soc Sci Med 2019; 235:112397. [DOI: 10.1016/j.socscimed.2019.112397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 05/17/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022]
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Karacin O, Mutlu I, Kose M, Celik F, Kanat-Pektas M, Yilmazer M. Serum vitamin D concentrations in young Turkish women with primary dysmenorrhea: A randomized controlled study. Taiwan J Obstet Gynecol 2018; 57:58-63. [PMID: 29458904 DOI: 10.1016/j.tjog.2017.12.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aims to investigate the possible role of vitamin D deficiency in primary dysmenorrhea by assessing serum 25-hydroxyvitamin D3 levels in a cohort which includes young Turkish women with primary dysmenorrhea and healthy controls. MATERIALS AND METHODS A total of 683 women who were aged between 18 and 25 years and who were consecutively admitted to the study center were eligible. After the exclusion of 55 women, 184 women with primary dysmenorrhea were randomly assigned into the dysmenorrhea group and 184 women without dysmenorrhea were randomly allocated into the control group. RESULTS The dysmenorrhea group had significantly less consumption of dairy products (p = 0.001), lower serum calcium (p = 0.001), lower serum vitamin D (p = 0.001) and higher serum parathyroid hormone (p = 0.001) than those of the control group. Hyperparathyroidism was significantly less frequent whereas vitamin D deficiency was significantly more frequent in the dysmenorrhea group (p = 0.001 for each). The dysmenorrhea patients with vitamin D deficiency had significantly higher visual analogue scale (VAS) scores (p = 0.001). Depression, irritability, mood swings, fatigue, headache and breast tenderness were significantly more frequent in the vitamin D deficiency group (p < 0.05 for all). The VAS scores of the dysmenorrhea patients correlated positively and significantly with serum parathyroid hormone levels (r = 0.666, p = 0.001) whereas these VAS scores correlated negatively and significantly with serum vitamin D levels (r = -0.713, p = 0.001). DISCUSSION The significant and positive correlation between vitamin D levels and VAS scores and the significant reduction in serum vitamin D levels of the dysmenorrhea patients designate the possible role of vitamin D deficiency in the primary dysmenorrhea.
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Affiliation(s)
- Osman Karacin
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Ilknur Mutlu
- Department of Obstetrics and Gynecology, Novaart In Vitro Fertilization Center, Ankara, Turkey
| | - Mesut Kose
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Fatih Celik
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Mine Kanat-Pektas
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey.
| | - Mehmet Yilmazer
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
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Teerapornpuntakit J, Chanprapaph P, Charoenphandhu N. Previous Adolescent Pregnancy and Breastfeeding Does Not Negatively Affect Bone Mineral Density at the Age of Peak Bone Mass. Breastfeed Med 2018; 13:500-505. [PMID: 30156423 DOI: 10.1089/bfm.2018.0080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine bone mineral density (BMD) at the age of peak bone mass in women who previously experienced pregnancy and breastfeeding during adolescence. MATERIALS AND METHODS In this retrospective study, female volunteers aged 24-30 years who were pregnant during the age of 15-19 years and have had one to two babies were recruited. All of them experienced breastfeeding without history of bone- or calcium-related problems, such as fracture or low calcium intake. BMD was determined at the femur and L1-L4 spine by dual-energy X-ray absorptiometry. RESULTS We found that both volunteers who previously experienced breastfeeding and age-matched control volunteers had similar BMD at the L1-L4 spines and femora. Further analysis for site-specific changes of lumbar and femoral BMDs showed that the values of the breastfeeding group were not different from those of the control group except at L1 and L2, where BMD values were greater in breastfeeding group compared with the control group. At both femoral and vertebral sites, T- and Z-scores were apparently similar between the two groups. In addition, the BMD at peak bone mass had no significant correlation with breastfeeding duration. CONCLUSIONS Teenage pregnancy and breastfeeding did not negatively affect BMD later at the age of peak bone mass. Therefore, breastfeeding can be encouraged in teenage mothers.
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Affiliation(s)
- Jarinthorn Teerapornpuntakit
- 1 Center of Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University , Bangkok, Thailand .,2 Department of Physiology, Faculty of Medical Science, Naresuan University , Phitsanulok, Thailand
| | - Pharuhas Chanprapaph
- 3 Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
| | - Narattaphol Charoenphandhu
- 1 Center of Calcium and Bone Research (COCAB), Faculty of Science, Mahidol University , Bangkok, Thailand .,4 Department of Physiology, Faculty of Science, Mahidol University , Bangkok, Thailand .,5 Institute of Molecular Biosciences, Mahidol University , Nakhon Pathom, Thailand .,6 The Academy of Science , The Royal Society of Thailand, Dusit, Bangkok, Thailand
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Tan ML, Abrams SA, Osborn DA. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2018. [DOI: 10.1002/14651858.cd013046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- May Loong Tan
- RCSI & UCD Malaysia Campus (formerly Penang Medical College); Department of Paediatrics; 4 Jalan Sepoy Lines Georgetown Penang Malaysia 10450
| | - Steven A Abrams
- Dell Medical School, The University of Texas at Austin; Department of Pediatrics; Austin Texas USA
| | - David A Osborn
- Central Clinical School, School of Medicine, The University of Sydney; Sydney Australia 2006
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Bone Health Considerations for the Adolescent Female Athlete. CURRENT PEDIATRICS REPORTS 2018. [DOI: 10.1007/s40124-018-0160-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, de’ Angelis GL, Massari M, Miraglia Del Giudice E, Miraglia Del Giudice M, Peroni D, Terracciano L, Agostiniani R, Careddu D, Ghiglioni DG, Bona G, Di Mauro G, Corsello G. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr 2018; 44:51. [PMID: 29739471 PMCID: PMC5941617 DOI: 10.1186/s13052-018-0488-7] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.
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Affiliation(s)
- Giuseppe Saggese
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Flavia Prodam
- Division of Pediatrics, Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Fabio Cardinale
- Pediatric Unit, Division of Pulmonology, Allergy, and Immunology, AOU Policlinico-Giovanni XXIII, Bari, Italy
| | - Irene Cetin
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Elena Chiappini
- Pediatric Infectious Disease Unit, Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Gian Luigi de’ Angelis
- Gastroenterology and Digestive Endoscopy Unit and Clinical Paediatrics Unit, Department of Paediatrics and Maternal Medicine, University of Parma Hospital Trust, Parma, Italy
| | - Maddalena Massari
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
| | | | - Domenico Careddu
- Pediatric Primary Care, National Pediatric Health Care System, Novara, Italy
| | - Daniele Giovanni Ghiglioni
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianni Bona
- Division of Pediatrics, University of Piemonte Orientale, Novara, Italy
| | - Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Caserta, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, Neonatal Intensive Care Unit, AOUP, University of Palermo, Palermo, Italy
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Birth size, body composition, and adrenal androgens as determinants of bone mineral density in mid-childhood. Pediatr Res 2018; 83:993-998. [PMID: 29360806 DOI: 10.1038/pr.2018.12] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/18/2017] [Indexed: 01/24/2023]
Abstract
BackgroundBirth weight has an impact on adult bone mass. Higher birth weight is associated with greater bone mineral content (BMC) and children born small for gestational age (SGA) are at an increased risk for impaired accrual of bone mass. Our aim was to study whether the impact of birth size or early childhood growth on bone mass is visible already in mid-childhood.MethodsWe studied 49 children born large for gestational age (LGA), 56 children born appropriate for gestational age (AGA), and 23 children born SGA at 5.0-8.7 years of age. Body composition was assessed by whole-body dual-energy X-ray absorptiometry. Fasting blood samples and anthropometric data were collected.ResultsThe children born SGA had lower bone mineral density (BMD) Z-score (P<0.001) and age- and sex-adjusted BMD (P<0.005) than the LGA and AGA children. Adjusted BMC, muscle mass, and body fat percentage (%BF) did not differ between the study groups. Muscle mass, BMI SD score (SDS), %BF, and serum dehydroepiandrosterone sulfate (DHEAS) concentration were the strongest predictors of high BMD in mid-childhood.ConclusionSGA-born children had lower BMD in mid-childhood compared with AGA- and LGA-born ones. Muscle mass or BMI SDS, %BF, and DHEAS were significant predictors of childhood BMD.
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van der Tas JT, Elfrink MEC, Heijboer AC, Rivadeneira F, Jaddoe VWV, Tiemeier H, Schoufour JD, Moll HA, Ongkosuwito EM, Wolvius EB, Voortman T. Foetal, neonatal and child vitamin D status and enamel hypomineralization. Community Dent Oral Epidemiol 2018; 46:343-351. [PMID: 29493792 PMCID: PMC6446811 DOI: 10.1111/cdoe.12372] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 01/21/2018] [Indexed: 02/05/2023]
Abstract
Objectives Recent literature suggested that higher vitamin D concentrations in childhood are associated with a lower prevalence of molar incisor hypomineralization (MIH). As tooth development already starts in utero, we aimed to study whether vitamin D status during foetal, postnatal and childhood periods is associated with the presence of hypomineralized second primary molars (HSPMs) and/or MIH at the age of six. Methods Our study was embedded in the Generation R Study, a population‐based, prospective cohort from foetal life onwards in Rotterdam, the Netherlands. HSPMs and MIH were scored from intraoral photographs of the children at their age of six. Serum 25(OH)D concentrations were measured at three points in time, which resulted in three different samples; mid‐gestational in mothers’ blood (n = 4750), in umbilical cord blood (n = 3406) and in children's blood at the age of 6 years (n = 3983). Results The children had a mean (±SD) age of 6.2 (±0.5) years at the moment of taking the intraoral photographs. After adjustment for confounders, no association was found between foetal 25(OH)D concentrations and the presence of HSPMs (OR 1.02 per 10 nmol/L higher 25(OH)D, 95% CI: 0.98‐1.07) or MIH (OR 1.05 per 10 nmol/L increase, 95% CI: 0.98‐1.12) in 6‐year‐olds. A higher 25(OH)D concentration in umbilical cord blood resulted in neither lower odds of having HSPM (OR 1.05, 95% CI: 0.98‐1.13) nor lower odds of having MIH (OR 0.95, 95% CI: 0.84‐1.07) by the age of six. Finally, we did not find higher 25(OH)D concentrations at the age of six to be associated with a significant change in the odds of having HSPM (OR 0.97, 95% CI: 0.92‐1.02) or MIH (OR 1.07, 95% CI: 0.98‐1.16). Conclusions 25(OH)D concentrations in prenatal, early postnatal and later postnatal life are not associated with the presence of HPSMs or with MIH at the age of six. Future observational research is required to replicate our findings. Furthermore, it is encouraged to focus on identifying other modifiable risk factors, because prevention of hypomineralization is possible only if the causes are known.
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Affiliation(s)
- Justin T van der Tas
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marlies E C Elfrink
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, VU University Medical Center, Amsterdam, The Netherlands
| | - Fernando Rivadeneira
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/psychology, Erasmus University Medical Center/Sophia, Rotterdam, The Netherlands.,Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Josje D Schoufour
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Henriëtte A Moll
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Pediatrics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Edwin M Ongkosuwito
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
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Wu F, Xiao C, Aitken D, Jones G, Winzenberg T. The optimal dosage regimen of vitamin D supplementation for correcting deficiency in adolescents: a pilot randomized controlled trial. Eur J Clin Nutr 2018; 72:534-540. [PMID: 29374249 DOI: 10.1038/s41430-018-0098-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/28/2017] [Accepted: 01/09/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Vitamin D deficiency is common in adolescents but the optimal dosage regimen for correcting deficiency is unknown. To test the safety and efficacy of two different vitamin D dosage regimens to correct vitamin D deficiency in adolescents. SUBJECTS/METHODS In this 12-month, double-blind, randomized placebo-controlled trial, 28 adolescents (serum 25 hydroxyvitamin D (25(OH)D) of 21 to 50 nmol/L) were randomly assigned to one of three groups: monthly (n = 9; vitamin D3 50,000 IU orally monthly plus three placebo tablets 3-monthly), 3-monthly (n = 9; 150,000 IU (3 × 50,000 IU tablets) 3-monthly and placebo orally monthly), or placebo (n = 10; placebo monthly and three placebo tablets 3-monthly). Serum 25(OH)D was measured at baseline, 3, 6 and 12 months. RESULTS Two participants withdrew after their baseline measurement from the 3-monthly group. At 12 months, one participant was deficient (≤50 nmol/L) in both the monthly and 3-monthly groups, whereas six out of ten in the placebo remained deficient (P = 0.055). At 12 months, the average serum 25(OH)D levels for the monthly, 3-monthly and placebo groups were 76.4, 64.7 and 49.7 nmol/L, respectively (P < 0.001 and P = 0.04 for differences between monthly and placebo groups and 3-monthly and placebo groups respectively, after adjustment for age, sex and seasonal variation). Adherence was 100% and adverse events were minor. CONCLUSIONS Both 50,000 IU monthly and 150,000 IU 3-monthly of vitamin D3 safely and effectively corrects vitamin D deficiency in adolescents. These data provide treatment options which can be used by health practitioners to tailor vitamin D dosage regiments according to patient preference and context.
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Affiliation(s)
- Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Cecilia Xiao
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia. .,Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
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Winzenberg T, Lamberg-Allardt C, El-Hajj Fuleihan G, Mølgaard C, Zhu K, Wu F, Riley RD. Does vitamin D supplementation improve bone density in vitamin D-deficient children? Protocol for an individual patient data meta-analysis. BMJ Open 2018; 8:e019584. [PMID: 29362271 PMCID: PMC5786083 DOI: 10.1136/bmjopen-2017-019584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Our previous study-level (aggregate data) meta-analysis suggested that vitamin D supplements may be beneficial for bone density specifically in children with vitamin D deficiency. However, the misclassification of vitamin D status inherent in study-level data means that the results are not definitive and cannot provide an accurate assessment of the size of any effect. Therefore, we propose to undertake an individual patient data (IPD) meta-analysis to determine whether the effect of vitamin D supplementation on bone density in children differs according to baseline vitamin D status, and to specifically estimate the effect of vitamin D in children who are vitamin D deficient. METHODS AND ANALYSIS This study has been designed to adhere to the Preferred Reporting Items for Systematic Review and Meta-Analyses of IPD statement. We will include randomised placebo-controlled trials of vitamin D supplementation reporting bone density outcomes at least 6 months after the study commenced in children and adolescents (aged <20 years) without coexistent medical conditions or treatments causing osteoporosis. We will update the search of the original review to cover the period 2009-2017, using the same methods as the original review. Fully anonymised data on all randomised patients will be requested. Outcomes will be femoral neck, total hip, lumbar spine and proximal and distal forearm bone mineral density, and total body bone mineral content. A two-stage IPD meta-analysis will be used to examine the effect of baseline serum 25-hydroxyvitamin D (25(OH)D) on treatment effect for each bone density outcome. Restricted maximum likelihood will be used to estimate the random-effects meta-analysis models, with 95% CI for summary effects. Heterogeneity will be assessed by I2 and potential publication bias (small-study effects) and availability bias by funnel plots, Egger's test and Peter's test. ETHICS AND DISSEMINATION Ethics approval will not be required as the data are to be used for the primary purpose for which they were collected and all original individual studies had ethics approval. Results of the IPD meta-analysis will be submitted for publication in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42017068772.
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Affiliation(s)
- Tania Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Feitong Wu
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Richard D Riley
- Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire, UK
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Associations of Low Vitamin D and Elevated Parathyroid Hormone Concentrations With Bone Mineral Density in Perinatally HIV-Infected Children. J Acquir Immune Defic Syndr 2017; 76:33-42. [PMID: 28797019 DOI: 10.1097/qai.0000000000001467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Perinatally HIV-infected (PHIV) children have, on average, lower bone mineral density (BMD) than perinatally HIV-exposed uninfected (PHEU) and healthy children. Low 25-hydroxy vitamin D [25(OH)D] and elevated parathyroid hormone (PTH) concentrations may lead to suboptimal bone accrual. METHODS PHIV and PHEU children in the Pediatric HIV/AIDS Cohort Study had total body (TB) and lumbar spine (LS) BMD and bone mineral content (BMC) measured by dual-energy x-ray absorptiometry; BMD z-scores (BMDz) were calculated for age and sex. Low 25(OH)D was defined as ≤20 ng/mL and high PTH as >65 pg/mL. We fit linear regression models to estimate the average adjusted differences in BMD/BMC by 25(OH)D and PTH status and log binomial models to determine adjusted prevalence ratios of low 25(OH)D and high PTH in PHIV relative to PHEU children. RESULTS PHIV children (n = 412) were older (13.0 vs. 10.8 years) and more often black (76% vs. 64%) than PHEU (n = 207). Among PHIV, children with low 25(OH)D had lower TB-BMDz [SD, -0.38; 95% confidence interval (CI), -0.60 to -0.16] and TB-BMC (SD, -59.1 g; 95% CI, -108.3 to -9.8); high PTH accompanied by low 25(OH)D was associated with lower TB-BMDz. Among PHEU, children with low 25(OH)D had lower TB-BMDz (SD, -0.34; 95% CI, -0.64 to -0.03). Prevalence of low 25(OH)D was similar by HIV status (adjusted prevalence ratio, 1.00; 95% CI, 0.81 to 1.24). High PTH was 3.17 (95% CI, 1.25 to 8.06) times more likely in PHIV children. CONCLUSIONS PHIV and PHEU children with low 25(OH)D may have lower BMD. Vitamin D supplementation trials during critical periods of bone accrual are needed.
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Vitamin D Modulation of TRAIL Expression in Human Milk and Mammary Epithelial Cells. Sci Rep 2017; 7:4362. [PMID: 28659589 PMCID: PMC5489519 DOI: 10.1038/s41598-017-04521-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/26/2017] [Indexed: 12/19/2022] Open
Abstract
The vitamin D levels in mothers affect the health status of both the mother and breastfeeding infant. Vitamin D deficient mothers’ infants are prone to rickets. While tumor necrosis factor-related apoptosis inducing ligand (TRAIL) has been implicated in cellular growth/apoptosis, immune cell function and bone-resorbing osteoclast formation, the expression of TRAIL in human milk as a function of vitamin D status in mothers remains unknown. We hypothesized that vitamin D deficiency alters TRAIL protein levels in human breast milk and mammary epithelial cells. Milk from vitamin D deficient mothers showed high levels of TRAIL (α and β) proteins compared to milk from vitamin D replete women. Western blot analysis of total cell lysate obtained from normal human mammary epithelial (HME-1) cells treated with variable doses (0–20 nM) of vitamin D for 24 h demonstrated that low levels (0.5 to 5 nM) significantly increased the TRAIL α but no change in β expression. In contrast, vitamin D at 20 nM concentration suppressed the expression of both TRAIL α and β proteins. Consistently, vitamin D regulated TRAIL mRNA expression in HME-1 cells. Our results indicate that vitamin D status in mothers modulates TRAIL expression in breast milk, which may have implications for both mother and infant health.
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Anderson LN, Heong SW, Chen Y, Thorpe KE, Adeli K, Howard A, Sochett E, Birken CS, Parkin PC, Maguire JL, Abdullah K, Anderson LN, Birken CS, Borkhoff CM, Carsley S, Chen Y, Katz-Lavigne M, Kavikondala K, Kowal C, Maguire JL, Mason D, Omand J, Parkin PC, Persaud N, Heuvel MVD, Baker J, Barozzino T, Bonifacio J, Campbell D, Cheema S, Chisamore B, Danayan K, Das P, Derocher MB, Do A, Dorey M, Freeman S, Fung K, Guiang C, Handford C, Hatch H, Jacobson S, Kiran T, Knowles H, Kwok B, Lakhoo S, Lam-Antoniades M, Lau E, Leung FH, Loo J, Mahmoud S, Moodie R, Morinis J, Naymark S, Neelands P, Owen J, Peer M, Perlmutar M, Persaud N, Pinto A, Porepa M, Ramji N, Ramji N, Rosenthal A, Saunderson J, Saxena R, Sgro M, Shepherd S, Smiltnieks B, Taylor C, Weisdors T, Wijayasinghe S, Wong P, Ying E, Young E. Vitamin D and Fracture Risk in Early Childhood: A Case-Control Study. Am J Epidemiol 2017; 185:1255-1262. [PMID: 28459987 DOI: 10.1093/aje/kww204] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/22/2016] [Indexed: 12/17/2022] Open
Abstract
The objective of this study was to evaluate the association of vitamin D intake and serum levels with fracture risk in children under 6 years of age. A case-control study was conducted in Toronto, Ontario, Canada. Cases were recruited from the fracture clinic at the Hospital for Sick Children, and matched controls were obtained from the TARGet Kids! primary-care research network. Controls were matched to cases on age, sex, height, and season. Fracture risk was estimated from conditional logistic regression, with adjustment for skin type, fracture history, waist circumference, outdoor free play, neighborhood income, soda consumption, and child's birth weight. A total of 206 cases were recruited during May 2009-April 2013 and matched to 343 controls. Serum 25-hydroxyvitamin D concentration (per 10-nmol/L increment: adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.88, 1.03) and intake of cow's milk (<2 cups/day vs. 2 cups/day: aOR = 0.95 (95% CI: 0.60, 1.52); >2 cups/day vs. 2 cups/day: aOR = 1.39 (95% CI: 0.85, 2.23)) were not significantly associated with reduced odds of fracture. A statistically significant association was observed between child use of vitamin D supplements and decreased odds of fracture (yes vs. no: aOR = 0.42, 95% CI: 0.25, 0.69). Vitamin D supplementation, but not serum 25-hydroxyvitamin D level or milk intake, was associated with reduced fracture risk among these healthy young children.
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Affiliation(s)
- Laura N. Anderson
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sze Wing Heong
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yang Chen
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kevin E. Thorpe
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Khosrow Adeli
- Clinical Biochemistry Division, Department of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrew Howard
- Division of Orthopaedics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Etienne Sochett
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Pediatric Outcomes Research Team, Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Patricia C. Parkin
- Child Health Evaluative Sciences Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Pediatric Outcomes Research Team, Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Pediatric Outcomes Research Team, Division of Pediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Gorter EA, Oostdijk W, Felius A, Krijnen P, Schipper IB. Vitamin D Deficiency in Pediatric Fracture Patients: Prevalence, Risk Factors, and Vitamin D Supplementation. J Clin Res Pediatr Endocrinol 2016; 8:445-451. [PMID: 27550850 PMCID: PMC5198004 DOI: 10.4274/jcrpe.3474] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Although vitamin D levels are not routinely monitored in pediatric fracture patients, identification of children with a vitamin D deficiency may be clinically relevant because of the potential role of vitamin D in fracture healing. This study aimed to determine the prevalence of vitamin D deficiency in a pediatric fracture population and to identify risk factors for deficiency. METHODS All pediatric patients (<18 years) who were treated for a fracture of the upper or lower extremity from September 2012 to October 2013 in the outpatient setting of a level one trauma center were included in this cross-sectional study. Vitamin D deficiency was defined as a serum calcidiol <50 nmol/L. Potential risk factors for vitamin D deficiency were analysed using multivariable logistic regression analysis. RESULTS A total of 108 boys (58%) and 79 girls, of a mean age 11.1 years (standard deviation 3.9), who had undergone 189 fractures were included in the study. Sixty-four children (34%) were vitamin D deficient. Of those with follow-up measurements, 74% were no longer deficient after supplementation. Vitamin D status did not influence the occurrence of complications during fracture treatment. Independent risk factors for vitamin D deficiency were older age, season (spring), and a non-Caucasian skin type. CONCLUSION Clinicians who treat children with a fracture should inform patients and parents on vitamin D supplementation. Vitamin D measurement and supplementation may be needed for children with a non-Caucasian skin type or for those who present with a fracture during spring months.
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Affiliation(s)
- Erwin A. Gorter
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
,* Address for Correspondence: Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands GSM: +31 71 526 1065 E-mail:
| | - Wilma Oostdijk
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | - Abraham Felius
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | - Pieta Krijnen
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
| | - Inger B. Schipper
- Leiden University Medical Center, Department of Surgery and Traumatology, Leiden, The Netherlands
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Trummer C, Pandis M, Verheyen N, Grübler MR, Gaksch M, Obermayer-Pietsch B, Tomaschitz A, Pieber TR, Pilz S, Schwetz V. Beneficial Effects of UV-Radiation: Vitamin D and beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1028. [PMID: 27775585 PMCID: PMC5086767 DOI: 10.3390/ijerph13101028] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 12/11/2022]
Abstract
Aside from its well-known effects on bone and mineral metabolism, vitamin D may also play an important role in extra-skeletal processes like immunologic diseases, cancer, or cardiovascular diseases. Even though meta-analyses showed that vitamin D supplementation reduces fractures, falls, and overall mortality, its potential benefits did not find universal acclaim. Several health care authorities published Recommended Dietary Allowances (RDAs) for vitamin D, most of them ranging from 600 to 800 international units (IU) per day, corresponding to a serum level of 25-hydroxyvitamin D of at least 20 ng/mL (50 nmol/L). However, studies conducted in the general population revealed a much lower overall intake of vitamin D than the proposed RDAs. Thus, strategies to increase the vitamin D intake in the general population, e.g., food fortification or vitamin D supplementation, are needed to match the existing evidence and recommendations. Therefore, several currently ongoing projects aim to investigate the effect of vitamin D supplementation in the general population and try to establish food-based solutions to improve vitamin D status.
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Affiliation(s)
- Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Marlene Pandis
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Nicolas Verheyen
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Martin R Grübler
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Freiburgstrasse 8, Bern 3010, Switzerland.
| | - Martin Gaksch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Andreas Tomaschitz
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
- Bad Gleichenberg Clinic, Schweizereiweg 4, Bad Gleichenberg 8344, Austria.
| | - Thomas R Pieber
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
| | - Verena Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, Graz 8036, Austria.
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Fong CY, Kong AN, Poh BK, Mohamed AR, Khoo TB, Ng RL, Noordin M, Nadarajaw T, Ong LC. Vitamin D deficiency and its risk factors in Malaysian children with epilepsy. Epilepsia 2016; 57:1271-9. [DOI: 10.1111/epi.13443] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2016] [Indexed: 02/01/2023]
Affiliation(s)
- Choong Yi Fong
- Division of Pediatric Neurology; Department of Pediatrics; Faculty of Medicine; University Malaya; Kuala Lumpur Malaysia
| | - Ann Nie Kong
- Division of Pediatric Neurology; Department of Pediatrics; Faculty of Medicine; University Malaya; Kuala Lumpur Malaysia
| | - Bee Koon Poh
- Nutritional Sciences Program; Faculty of Health Sciences; University Kebangsaan Malaysia; Kuala Lumpur Malaysia
| | | | - Teik Beng Khoo
- Pediatric Neurology Unit; Pediatric Institute; Hospital Kuala Lumpur; Malaysia Malaysia
| | - Rui Lun Ng
- Division of Pediatric Neurology; Department of Pediatrics; Faculty of Medicine; University Malaya; Kuala Lumpur Malaysia
- Pediatric Department; Hospital Sultanah Bahiyah; Alor Setar Kedah Malaysia
| | - Mazidah Noordin
- Division of Pediatric Neurology; Department of Pediatrics; Faculty of Medicine; University Malaya; Kuala Lumpur Malaysia
| | - Thiyagar Nadarajaw
- Pediatric Department; Hospital Sultanah Bahiyah; Alor Setar Kedah Malaysia
| | - Lai Choo Ong
- Division of Pediatric Neurology; Department of Pediatrics; Faculty of Medicine; University Malaya; Kuala Lumpur Malaysia
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Abstract
Until recently, much of the research exploring the role of nutrition on bone mass accrual has focused on single nutrients. Although randomised controlled trials have provided key information about the effects of calcium and vitamin D on bone, they also have limitations, e.g. generalisation, implementation of the results and long-term consequences. Human subjects do not eat single nutrients, but foods, and describing healthy food patterns for optimising bone mineral accrual is warranted. Recent advances in research suggest that the effects of whole diet are larger than those of single nutrients on bone health. Research should focus on younger age groups to identify the life-course determinants of osteoporosis during prenatal, infancy, childhood and adolescence that would help to maximise peak bone mass. Food patterns that describe the variability, quality and choices of individuals give broader insight and may provide new strategies for preventing osteoporosis.
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45
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Winzenberg T, Jones G. In time: vitamin D deficiency: who needs supplementation? REVISTA PAULISTA DE PEDIATRIA (ENGLISH EDITION) 2016. [PMID: 26830601 PMCID: PMC4795714 DOI: 10.1016/j.rppede.2015.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Winzenberg T, Jones G. [In time: vitamin D deficiency: who needs supplementation?]. REVISTA PAULISTA DE PEDIATRIA 2015; 34:3-4. [PMID: 26830601 DOI: 10.1016/j.rpped.2015.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 08/13/2015] [Accepted: 08/16/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Tania Winzenberg
- Instituto Menzies de Pesquisa Médica, Universidade da Tasmânia, Hobart, Tasmânia, Austrália; Faculdade de Saúde, Universidade da Tasmânia, Hobart, Tasmânia, Austrália.
| | - Graeme Jones
- Instituto Menzies de Pesquisa Médica, Universidade da Tasmânia, Hobart, Tasmânia, Austrália
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Zambrano MB, Brizola E, Pinheiro B, Vanz AP, Mello ED, Félix TM. Study of the Determinants of Vitamin D Status in Pediatric Patients With Osteogenesis Imperfecta. J Am Coll Nutr 2015; 35:339-45. [PMID: 26709914 DOI: 10.1080/07315724.2015.1057776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Vitamin D is essential to the development and maintenance of the skeleton, especially for children with bone disorders such as osteogenesis imperfecta (OI). We evaluated serum 25-hydroxyvitamin D (25-OHD) levels to assess the relationship between determinants of vitamin D status in pediatric patients with OI. METHODS This cross-sectional study evaluated sex, age, weight, height, body mass index, OI type, sunscreen use, season of assessment, sun exposure, vitamin D and calcium supplementation, bisphosphonate treatment, bone mineral density (BMD), milk and soda consumption, mobility, and time of sedentary activity. Levels of serum 25-OHD, calcium, parathyroid hormone (PTH), phosphorus, and alkaline phosphatase (ALP) were analyzed. Serum levels of 25-OHD were classified according to sufficient (>30 ng/ml or 75 nmol/L), insufficient (20-30 ng/ml or 50-75 nmol/L), moderately deficient (20-10 ng/ml or 50-25 nmol/L), and severely deficient (<10 ng/ml or 25 nmol/L). RESULTS Fifty-two patients were included and 46 (88.4%) were classified as having insufficient or deficient 25-OHD. An inverse correlation between serum 25-OHD and time of sedentary activity (r = -0.597, p < 0.001) and a positive correlation with height (r = 0.521, p = 0.046) and whole body BMD (r = 0.586, p = 0.022) were observed. A significant difference between the number of glasses of milk consumed (p = 0.010) was observed. CONCLUSION To optimize bone health, patients with OI need to be educated regarding habits that can improve serum 25-OHD levels, such as a reduction in periods of inactivity, the importance of sun exposure, and increasing consumption of milk and fortified dairy products.
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Affiliation(s)
- Marina B Zambrano
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL
| | - Evelise Brizola
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL
| | - Bruna Pinheiro
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL
| | - Ana Paula Vanz
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL
| | - Elza D Mello
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL.,b Pediatric Service (E.D.M.), Medical Genetics Service (T.M.F.), Hospital de Clinicas of Porto Alegre , Porto Alegre , BRAZIL
| | - Têmis Maria Félix
- a PostGraduate Program in Child and Adolescent Health, University of Rio Grande do Sul , Porto Alegre , BRAZIL.,b Pediatric Service (E.D.M.), Medical Genetics Service (T.M.F.), Hospital de Clinicas of Porto Alegre , Porto Alegre , BRAZIL
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Fuleihan GEH, Bouillon R, Clarke B, Chakhtoura M, Cooper C, McClung M, Singh RJ. Serum 25-Hydroxyvitamin D Levels: Variability, Knowledge Gaps, and the Concept of a Desirable Range. J Bone Miner Res 2015; 30:1119-33. [PMID: 25952470 DOI: 10.1002/jbmr.2536] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/09/2015] [Accepted: 04/16/2015] [Indexed: 12/21/2022]
Abstract
Hypovitaminosis D is prevalent worldwide but proportions vary widely between regions, depending on genetic and lifestyle factors, the threshold to define deficiency, and accuracy of 25-hydroxyvitamin D (25OHD) assays used. Latitude, pollution, concealing clothing, sun exposure, gender, dietary habits, and lack of government regulation account for up to 50% in variations in serum 25OHD levels, whereas genetic polymorphisms in the vitamin D pathway account for less than 5%. Organizations/societies have developed guidelines for recommended desirable 25OHD levels and vitamin D doses to reach them, but their applicability across age groups and populations are still debated. This article and the accompanying online Supporting Information highlight sources of variations in circulating 25OHD levels, uncertainties and knowledge gaps, and analytical problems facing 25OHD assays, while keeping efficacy and safety data as the dominant factors when defining a desirable range for 25OHD levels. We propose a desirable range of 20 to 40 ng/mL (50 to 100 nmol/L), provided precise and accurate assays are used. Although slightly lower levels, 15 to 20 ng/mL, may be sufficient for some infants and adults, higher levels, 40 to 60 ng/mL, may still be safe. This desirable range allows physicians to tailor treatment while taking season, lifestyle, vitamin D intake, and other sources of variation into account. We reserve 25OHD measurements for at-risk patients, defined by disease or lifestyle, and the use of 25OHD assays calibrated against the recommended international standards. Most target groups reach desirable target levels by a daily intake of 400 to 600 IU for children and 800 IU for adults. A total daily allowance of vitamin D of up to 1000 IU in the pediatric age groups, and up to 2000 IU in adults, tailored to an individual patient risk profile, is probably safe over long durations. Additional data are needed to validate the proposed range and vitamin D doses, especially in children, pregnant women, and non-white populations.
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Affiliation(s)
- Ghada El-Hajj Fuleihan
- Department of Internal Medicine, Calcium Metabolism and Osteoporosis Program, American University of Beirut, Beirut, Lebanon
| | - Roger Bouillon
- Department of Endocrinology and Laboratory Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Bart Clarke
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Foundation, Rochester, MN, USA
| | - Marlene Chakhtoura
- Department of Internal Medicine, Calcium Metabolism and Osteoporosis Program, American University of Beirut, Beirut, Lebanon
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | | | - Ravinder J Singh
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Foundation, Rochester, MN, USA
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Merkiel S, Chalcarz W. Dietary intake in 6-year-old children from southern Poland: part 2--vitamin and mineral intakes. BMC Pediatr 2014; 14:310. [PMID: 25539749 PMCID: PMC4297393 DOI: 10.1186/s12887-014-0310-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Studies on vitamin and mineral intakes in children are very important: firstly because of the high prevalence of diet-related diseases and secondly because of the widespread consumption of highly processed foods which are characterised by high energy content and low density of essential nutrients. Therefore, the purpose of this study was to analyse vitamin and mineral intakes in 6-year-old children from southern Poland. METHODS Vitamin and mineral intakes were estimated from a three-day food record in 120 children, 64 girls and 56 boys, aged 6 years. Nutrient densities were estimated as amounts per 1000 kcal (4185 kJ) of energy intake. Statistical analysis was carried out by means of the IBM SPSS Statistics computer programme, version 19. The studied population was divided according to gender. RESULTS Intakes of folic acid (μg/1000 kcal) and vitamin C (mg, mg/1000 kcal) were significantly higher in girls. Nutrient densities for all vitamins were higher in girls, however, these results did not reach statistical significance. Intake of vitamin D was lower than EAR in all of the studied children. Intakes of sodium (mg) and zinc (mg) were significantly higher in boys. Intakes of the remaining minerals were higher in boys, however, these findings did not reach statistical significance. Nutrient densities for all minerals, except for sodium, zinc and manganese, were higher in girls. All of the studied children had sodium intakes above UL. CONCLUSIONS Inadequate intakes of vitamin D, calcium and potassium in the studied 6-year-olds along with excessive sodium intake are the risk factors for developing osteoporosis and hypertension. To prevent these diseases in the studied children, educational programmes for both preschool staff and parents should be worked out and implemented.
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Affiliation(s)
- Sylwia Merkiel
- Food and Nutrition Department of the Eugeniusz Piasecki University School of Physical Education in Poznan, Poland Królowej Jadwigi 27/39 Street, 61-871, Poznan, Poland.
| | - Wojciech Chalcarz
- Food and Nutrition Department of the Eugeniusz Piasecki University School of Physical Education in Poznan, Poland Królowej Jadwigi 27/39 Street, 61-871, Poznan, Poland.
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50
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Sato Y, Miyauchi Y, Yoshida S, Morita M, Kobayashi T, Kanagawa H, Katsuyama E, Fujie A, Hao W, Tando T, Watanabe R, Miyamoto K, Morioka H, Matsumoto M, Toyama Y, Miyamoto T. The vitamin D analogue ED71 but Not 1,25(OH)2D3 targets HIF1α protein in osteoclasts. PLoS One 2014; 9:e111845. [PMID: 25375896 PMCID: PMC4222951 DOI: 10.1371/journal.pone.0111845] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/08/2014] [Indexed: 11/19/2022] Open
Abstract
Although both an active form of the vitamin D metabolite, 1,25(OH)2D3, and the vitamin D analogue, ED71 have been used to treat osteoporosis, anti-bone resorbing activity is reportedly seen only in ED71- but not in 1,25(OH)2D3 -treated patients. In addition, how ED71 inhibits osteoclast activity in patients has not been fully characterized. Recently, HIF1α expression in osteoclasts was demonstrated to be required for development of post-menopausal osteoporosis. Here we show that ED71 but not 1,25(OH)2D3, suppress HIF1α protein expression in osteoclasts in vitro. We found that 1,25(OH)2D3 or ED71 function in osteoclasts requires the vitamin D receptor (VDR). ED71 was significantly less effective in inhibiting M-CSF and RANKL-stimulated osteoclastogenesis than was 1,25(OH)2D3in vitro. Downregulation of c-Fos protein and induction of Ifnβ mRNA in osteoclasts, both of which reportedly block osteoclastogenesis induced by 1,25(OH)2D3in vitro, were both significantly higher following treatment with 1,25(OH)2D3 than with ED71. Thus, suppression of HIF1α protein activity in osteoclasts in vitro, which is more efficiently achieved by ED71 rather than by 1,25(OH)2D3, could be a reliable read-out in either developing or screening reagents targeting osteoporosis.
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Affiliation(s)
- Yuiko Sato
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Musculoskeletal Reconstruction and Regeneration Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshiteru Miyauchi
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Shigeyuki Yoshida
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Mayu Morita
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Tami Kobayashi
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Integrated Bone Metabolism and Immunology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hiroya Kanagawa
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Eri Katsuyama
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Atsuhiro Fujie
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Wu Hao
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Toshimi Tando
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Ryuichi Watanabe
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Kana Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Hideo Morioka
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yoshiaki Toyama
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Takeshi Miyamoto
- Department of Orthopedic Surgery, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department of Integrated Bone Metabolism and Immunology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- * E-mail:
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