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Chen X, Tang J, Hu D, Jiang W, Feng J, Yang Y. C3-epi-25(OH)D3 percentage, not level, may be a potential biomarker to reflect its pathological increase in multiple diseases: a cross-sectional case-control study. Sci Rep 2023; 13:23004. [PMID: 38155294 PMCID: PMC10754939 DOI: 10.1038/s41598-023-50524-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023] Open
Abstract
National surveys in developed countries have examined the presence of C3-epimer of 25-hydroxyvitamin D3 [C3-epi-25(OH)D3]. However, controversy remains regarding its association with disease occurrence due to its high correlation with 25-hydroxyvitamin D3 [25(OH)D3]. This study aims to investigate whether %C3-epi-25(OH)D3 can serve as an indicator for this relationship with various diseases. A total of 3086 healthy participants and 4120 patients were included in this study. We investigated the association between C3-epi-25(OH)D3 and %C3-epi-25(OH)D3 levels with gender, age, and season; compared the performance of C3-epi-25(OH)D3 and %C3-epi-25(OH)D3 across different disease conditions; and explored the correlation between %C3-epi-25(OH)D3 and various diseases. Results indicated that C3-epi-25(OH)D3 varied significantly by gender, age, and season (z/χ2 = 3.765, 10.163, and 150.975, all P < 0.01), while only season for %C3-epi-25(OH)D3 (χ2 = 233.098, P < 0.001). In contrast to the significant decrease in C3-epi-25(OH)D3, %C3-epi-25(OH)D3 showed a significant increase in 8 out of 11 disease categories (z = 3.464 ~ 11.543, all Padj < 0.05). Similar opposite changes were also observed in most of the investigated 32 specific diseases. Moreover, an elevation in %C3-epi-25(OH)D3 was found to be significantly associated with 29 specific diseases both in univariate analysis (OR = 1.16 ~ 2.10, all P < 0.05) and after adjusting for gender, age, and season (OR = 1.15 ~ 1.50, all P < 0.05). However, after further adjustment for 25(OH)D3 levels, the association remained significant only for 15 specific diseases (OR = 1.11 ~ 1.50, all P < 0.05). Seasonal stratification analysis further supports the consistent association of %C3-epi-25(OH)D3 with disease across all or nearly all four seasons. In conclusion, %C3-epi-25(OH)D3 may better reflect the production of C3-epi-25(OH)D3 in disease conditions, thereby offering a more applicable approach to investigate its association with diseases. However, the interpretation of this relationship may be confounded by 25(OH)D3 as a potential covariate.
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Affiliation(s)
- Xiaohong Chen
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China
| | - Jie Tang
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China
| | - Dong Hu
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China
| | - Wenqiang Jiang
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China
| | - Jiafu Feng
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China.
| | - Yuwei Yang
- Department of Laboratory Medicine, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of China, Mianyang, 621000, People's Republic of China.
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Caliskan M, Dabak M, Tumer KC. The relationship between serum cytokine profile and vitamin D in calves with neonatal diarrhea. Cytokine 2023; 165:156173. [PMID: 36933398 DOI: 10.1016/j.cyto.2023.156173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/02/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
It is important to know the characteristics of the immunological response in newborn calf diarrhea, which is often caused by bacterial, viral and protozoal pathogens. Cytokinesare proteins that serve as chemical messengers to regulate theinnate and adaptive arms of theimmune response. Changes in circulatory cytokine levels provide valuable information for understanding the pathophysiological process and monitoring disease progression and inflammation. Vitamin D has important immunomodulatory effects, which include enhancing the innate immune system and inhibiting adaptative immune responses. The objective of this study was to evaluate the relationship between serum cytokine profile and vitamin D level in neonatal calves with diarrhea. The study population was comprised of 40 neonatal calves, 32 of which had diarrhea and 8 of which were healthy calves. The calves with diarrhea were allocated to four groups according to bacterial (Escherichia coli), viral (Rotavirus, Coronavirus) and protozoal (Cryptosporidium parvum) etiologies. Circulatory vitamin D metabolites (25-hydroxyvitamin D, 1,25-dihydroxyvitamin D) and cytokines (TNF-α, IFN-γ, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13 and IL-17) in the calves were determined. There was no statistically significant difference among the groups in 25-hydroxyvitamin D levels. 1,25-dihydroxyvitamin D levels were higher in Coronavirus and E. coli groups compared to the controls. Serum levels of all cytokines except for IL-13, were higher in E. coli group than those of the control group. As a result, differences in serum cytokines and vitamin D levels according to etiological factors in calf diarrhea indicate that vitamin D may play a role in the immune response in the disease.
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Affiliation(s)
- Mehmet Caliskan
- Department of Internal Medicine, Veterinary Teaching Hospital, Firat University, 23119 Elazig, Turkey.
| | - Murat Dabak
- Department of Internal Medicine, Veterinary Teaching Hospital, Firat University, 23119 Elazig, Turkey.
| | - Kenan Cagri Tumer
- Department of Internal Medicine, Faculty of Veterinary Medicine, Kastamonu University, 37150 Kastamonu, Turkey.
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Towards harmonization of directly measured free 25-hydroxyvitamin D using an enzyme-linked immunosorbent assay. Anal Bioanal Chem 2022; 414:7793-7803. [PMID: 36109397 PMCID: PMC9568476 DOI: 10.1007/s00216-022-04313-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/19/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022]
Abstract
The majority of circulating 25-hydroxyvitamin D (25(OH)D) is protein bound and perhaps less available than the free fraction of 25(OH)D; therefore, researchers have proposed that the measurement of free 25(OH)D in human serum may be a better indicator of vitamin D health status than total 25(OH)D. The availability of a new enzyme-linked immunosorbent assay (ELISA) for the determination of free 25(OH)D provides a method for direct measurement of the low levels of non-protein bound 25(OH)D. As an initial step towards harmonization of measurements of free 25(OH)D, the ELISA was used to measure free 25(OH)D in three existing Standard Reference Materials (SRMs): SRM 972a Vitamin D Metabolites in Frozen Human Serum, SRM 2973 Vitamin D Metabolites in Frozen Human Serum (High Level), and SRM 1949 Frozen Prenatal Human Serum. Target values for free 25(OH)D in the nine SRM serum pools, obtained by combining the results from two laboratories, ranged from 3.76 ± 0.36 to 10.0 ± 0.58 pg/mL. Of particular significance is the assignment of free 25(OH)D target values to SRM 1949, which consists of four serum pools from non-pregnant female donors of reproductive age and pregnant women in each of the three trimesters and which also has values assigned for vitamin D binding protein, which increases during pregnancy. The availability of target values for free 25(OH)D in these SRMs will allow researchers to validate new analytical methods and to compare their results with other researchers as an initial step towards harmonization of measurements among different studies and laboratories.
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Martins TS, Bott-Neto JL, Machado SAS, Oliveira ON. Label-Free Electrochemical Immunosensor Made with Tree-like Gold Dendrites for Monitoring 25-Hydroxyvitamin D3 Metabolite. ACS APPLIED MATERIALS & INTERFACES 2022; 14:31455-31462. [PMID: 35776164 DOI: 10.1021/acsami.2c08381] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Flexible, fully printed immunosensors can meet the requirements of precision nutrition, but this demands optimized molecular architectures to reach the necessary sensitivity. Herein, we report on flexible and label-free immunosensor chips made with tree-like gold dendrites (AuDdrites) electrochemically formed by selective desorption of l-cysteine (L-cys) on (111) gold planes. Electrodeposition was used because it is scalable and cost-effective for a rapid, direct growth of Au hyperbranched dendritic structures. The 25-hydroxyvitamin D3 (25(OH)D3) metabolite was detected within 15 min with a limit of detection (LOD) of 0.03 ng mL-1. This high performance was possible due to the careful optimization of the electroactive layer and working conditions for square wave voltammetry (SWV). Electrocrystallization was manipulated by controlling the deposition potential and the molar ratio between HAuCl4 and L-cys. Metabolite detection was performed on human serum and saliva samples with adequate recovery between 97% and 100%. The immunosensors were stable and reproducible, unresponsive to interference from other molecules in human serum and saliva. They can be extended for use as wearable sensors with their mechanical flexibility and possible customization.
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Affiliation(s)
- Thiago S Martins
- São Carlos Institute of Chemistry, University of São Paulo, 13560-970 São Carlos, SP, Brazil
| | - José L Bott-Neto
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos, SP, Brazil
| | - Sergio A S Machado
- São Carlos Institute of Chemistry, University of São Paulo, 13560-970 São Carlos, SP, Brazil
| | - Osvaldo N Oliveira
- São Carlos Institute of Physics, University of São Paulo, 13560-970 São Carlos, SP, Brazil
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¿Es una quimera corregir la deficiencia de vitamina D en la población sana española? Rev Clin Esp 2022; 222:370-371. [PMID: 35571365 PMCID: PMC9079867 DOI: 10.1016/j.rce.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Azriel S. Is it an illusion to correct vitamin D deficiency in the healthy Spanish population? Rev Clin Esp 2022; 222:370-371. [PMID: 35660254 PMCID: PMC9765387 DOI: 10.1016/j.rceng.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 03/14/2022] [Indexed: 12/24/2022]
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Trimboli F, Rotundo S, Armili S, Mimmi S, Lucia F, Montenegro N, Antico GC, Cerra A, Gaetano M, Galato F, Giaquinto Carinci L, Iania D, Mancuso S, Martucci M, Teti C, Greco M, Cuda G, Angotti E. Serum 25-hydroxyvitamin D measurement: Comparative evaluation of three automated immunoassays. Pract Lab Med 2021; 26:e00251. [PMID: 34386568 PMCID: PMC8342948 DOI: 10.1016/j.plabm.2021.e00251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: the different analytical methods for measurement of serum 25-hydroxyvitamin D (25(OH)D) are not yet fully harmonized and no consensus exists on a threshold of 25(OH)D defining a deficiency status. In this study, we compared the results from the assays of serum 25(OH)D performed with three different methods to evaluate the presence of potential biases and how much these biases can influence the assignment of patients to specific 25(OH)D deficiency/sufficiency categories. Design and Methods: Liaison 25(OH) Vitamin D Total (DiaSorin Liaison XL), Elecsys Vitamin D Total II (Roche Elecsys) and Lumipulse G25(OH) Vitamin D (Fujirebio Lumipulse G1200) were used. Methods comparability was established performing Passing-Bablok regression and Bland-Altman analysis to prove whether the differences found were lower than the preliminarily pre-established maximum acceptable bias. Results: all Passing-Bablok regressions exhibited the presence of a proportional and constant systematic error. Bland-Altman analysis revealed biases well above the maximum acceptable bias, so the 25(OH)D concentrations measured were not comparable. To evaluate whether the three methods had the same ability to classify patients into different categories of vitamin D levels, we categorized results obtained by each method in reference classes. Lumipulse categorized most patients into the class with the lowest 25(OH)D concentrations (<20 ng/mL) whereas Elecsys ranked the lowest number. Conclusions: Liaison XL and Elecsys have shown good accuracy compared to Lumipulse in measuring 25(OH)D levels. Nevertheless, the assays were not interchangeable due to the lack of comparability of results as well as to the disagreement in classification of hormone deficiency or sufficiency. Three immunometric assays for the measuring of serum 25(OH)Vitamin D were compared. Two of three assay show good accuracy whereas the third only fair. Due to the lack of comparability of the results, the assays were not exchangeable. Assays are at odds in the classification of hormone deficiency or sufficiency. Efforts will be required in the future to improve the immunoassays harmonization.
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Affiliation(s)
- Francesca Trimboli
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
- Corresponding author.
| | - Salvatore Rotundo
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
| | - Simone Armili
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
| | - Selena Mimmi
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
| | - Fortunata Lucia
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Nicola Montenegro
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Giulio Cesare Antico
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Alessandro Cerra
- Clinical Pathology Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Maria Gaetano
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Francesco Galato
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Lorenza Giaquinto Carinci
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Danilo Iania
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Serafina Mancuso
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Maria Martucci
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Consuelo Teti
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Marta Greco
- Department of Health Science, Magna Græcia University, Catanzaro, Italy
- Clinical Pathology Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
| | - Giovanni Cuda
- Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy
- Corresponding author.
| | - Elvira Angotti
- Clinical Biochemistry Unit, Azienda Ospedaliera Universitaria Mater Domini Hospital, Catanzaro, Italy
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Makris K, Bhattoa HP, Cavalier E, Phinney K, Sempos CT, Ulmer CZ, Vasikaran SD, Vesper H, Heijboer AC. Recommendations on the measurement and the clinical use of vitamin D metabolites and vitamin D binding protein - A position paper from the IFCC Committee on bone metabolism. Clin Chim Acta 2021; 517:171-197. [PMID: 33713690 DOI: 10.1016/j.cca.2021.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 01/10/2021] [Accepted: 03/04/2021] [Indexed: 02/08/2023]
Abstract
Vitamin D, an important hormone with a central role in calcium and phosphate homeostasis, is required for bone and muscle development as well as preservation of musculoskeletal function. The most abundant vitamin D metabolite is 25-hydroxyvitamin D [25(OH)D], which is currently considered the best marker to evaluate overall vitamin D status. 25(OH)D is therefore the most commonly measured metabolite in clinical practice. However, several other metabolites, although not broadly measured, are useful in certain clinical situations. Vitamin D and all its metabolites are circulating in blood bound to vitamin D binding protein, (VDBP). This highly polymorphic protein is not only the major transport protein which, along with albumin, binds over 99% of the circulating vitamin D metabolites, but also participates in the transport of the 25(OH)D into the cell via a megalin/cubilin complex. The accurate measurement of 25(OH)D has proved a difficult task. Although a reference method and standardization program are available for 25(OH)D, the other vitamin D metabolites still lack this. Interpretation of results, creation of clinical supplementation, and generation of therapeutic guidelines require not only accurate measurements of vitamin D metabolites, but also the accurate measurements of several other "molecules" related with bone metabolism. IFCC understood this priority and a committee has been established with the task to support and continue the standardization processes of vitamin D metabolites along with other bone-related biomarkers. In this review, we present the position of this IFCC Committee on Bone Metabolism on the latest developments concerning the measurement and standardization of vitamin D metabolites and its binding protein, as well as clinical indications for their measurement and interpretation of the results.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 14561 Athens, Greece; Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", Medical School, University of Athens, Athens, Greece.
| | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Domaine du Sart-Tilman, B-4000 Liège, Belgium
| | - Karen Phinney
- Biomolecular Measurement Division, National Institute of Standards and Technology, Gaithersburg, MD, USA
| | - Christopher T Sempos
- Coordinator, Vitamin D Standardization Program (VDSP), Havre de Grace, MD 21078, USA
| | - Candice Z Ulmer
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Samuel D Vasikaran
- PathWest Laboratory Medicine, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - Hubert Vesper
- Clinical Chemistry Branch, Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology Endocrinology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites part II-the measurement of the various vitamin D metabolites. Hormones (Athens) 2020; 19:97-107. [PMID: 32221839 DOI: 10.1007/s42000-020-00188-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 03/10/2020] [Indexed: 12/18/2022]
Abstract
Today, the possibility exists to measure a number of different vitamin D metabolites with accurate and precise methods. The most abundant vitamin D metabolite, 25(OH)D, is considered the best marker for estimating vitamin D status and is therefore the most commonly measured in clinical practice. There is no consensus on the added value of measuring other metabolites beyond 25-hydroxyvitamin D, although, in some special clinical scenarios and complicated cases, these metabolites may provide just the information needed for an accurate diagnosis. The problem this review addresses is which metabolite to measure and when and how to measure it.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, 2 Nikis Str., 14561, Kifissia, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Belgium
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Makris K, Sempos C, Cavalier E. The measurement of vitamin D metabolites: part I-metabolism of vitamin D and the measurement of 25-hydroxyvitamin D. Hormones (Athens) 2020; 19:81-96. [PMID: 31919677 DOI: 10.1007/s42000-019-00169-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
It has been more than 80 years since the discovery of vitamin D and its ability to cure rickets in children. Vitamin D is a secosteroid and comes in two distinct forms, vitamin D2 and vitamin D3. During the last 40 years, the synthesis and metabolism of vitamin D were elucidated and more than 50 metabolites of vitamin D have been discovered, though commercial measurement procedures have been developed for only a few of them. The clinical significance of vitamin D in calcium and phosphorus homeostasis is well appreciated. However, recent epidemiological data have indicated that it has several extra-skeletal physiologic actions which are still a matter of scientific debate. Both research findings and the debate around the interpretation of the research results have created increased interest in more measurements of vitamin D. With the ever growing family of measurable vitamin D metabolites and the measuring techniques comes a question: What metabolic product will provide the right answers and which is the best way to measure it. The right choice of analytical technique is connected with the question of which metabolite we aim to measure, what is its serum concentration, and the purpose of the measurement. The aim of the first part of this review is to provide a brief overview of vitamin D metabolism and a more detailed analysis of the existing methods and the status of standardization for the measurement of 25-hydroxyvitamin D.
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Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece.
| | - Christopher Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, 21078, USA
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
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Free vitamin D levels in steroid-sensitive nephrotic syndrome and healthy controls. Pediatr Nephrol 2020; 35:447-454. [PMID: 31845055 DOI: 10.1007/s00467-019-04433-1] [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: 09/21/2019] [Revised: 11/15/2019] [Accepted: 11/20/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Body stores of vitamin D are measured as "total" serum 25-hydroxy vitamin D (25(OH)D). Its largest component is protein bound and lost in urine in nephrotic syndrome (NS). Our study investigates whether "free" 25(OH)D levels are a better guide to bone health and need for vitamin D supplementation in patients with steroid-sensitive NS (SSNS). METHODS A cross-sectional study was performed in children with SSNS and healthy controls. Blood was tested for albumin, creatinine, calcium, phosphate, ALP, total and free (by direct ELISA) 25(OH)D, iPTH, and urine for protein-creatinine ratio. RESULTS Seventy-nine NS patients (48 in relapse, 31 in remission) and 60 healthy controls were included. The levels of total 25(OH)D were significantly different (lowest in NS relapse and highest in controls) (p < 0.001). Corrected calcium and phosphate levels were normal, and there were no differences in free 25(OH)D, ALP, or iPTH levels between groups. Only total and not free 25(OH)D correlated significantly and negatively with urinary protein creatinine ratios (rs = - 0.42 vs. 0.04). Free 25(OH)D values of 3.75 and 2.85 pg/ml corresponded to total 25(OH)D levels of 20 and 12 ng/ml, respectively, in healthy controls. CONCLUSION These results confirm that total 25(OH)D levels are low in NS and related to degree of proteinuria. However levels of free 25(OH)D, ALP, and iPTH did not change in relapse or remission in comparison with healthy controls. Our results suggest that in proteinuric renal diseases, free 25(OH)D rather than total 25(OH)D levels should be used to diagnose vitamin D deficiency and guide therapy.
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de la Puente Yagüe M, Collado Yurrita L, Ciudad Cabañas MJ, Cuadrado Cenzual MA. Role of Vitamin D in Athletes and Their Performance: Current Concepts and New Trends. Nutrients 2020; 12:E579. [PMID: 32102188 PMCID: PMC7071499 DOI: 10.3390/nu12020579] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/18/2020] [Indexed: 01/13/2023] Open
Abstract
We are currently experiencing a vitamin D (VITD) deficiency pandemic across the world. Athletes have the same predisposition to low levels of vitamin D, the majority of its concentrations being below 20 ng/mL in a wide range of sports, especially in the winter months. Vitamin D is important in bone health, but recent research also points out its essential role in extraskeletal functions, including skeletal muscle growth, immune and cardiopulmonary functions and inflammatory modulation, which influence athletic performance. Vitamin D can also interact with extraskeletal tissues to modulate injury recovery and also influence the risk of infection. The data presented in this paper has triggered investigations in relation to the importance of maintaining adequate levels of vitamin D and to the possible positive influence supplementation has on immune and musculoskeletal functions in athletes, benefiting their performance and preventing future injuries. The objective of this review is to describe the latest research conducted on the epidemiology of vitamin D deficiency and its effects on sports performance and musculoskeletal health.
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Affiliation(s)
- Mirian de la Puente Yagüe
- Department of Public and Maternal Child Health University, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Luis Collado Yurrita
- Department of Medicine, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (M.J.C.C.); (M.A.C.C.)
| | - Maria J. Ciudad Cabañas
- Department of Medicine, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (M.J.C.C.); (M.A.C.C.)
| | - Marioa A. Cuadrado Cenzual
- Department of Medicine, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain; (M.J.C.C.); (M.A.C.C.)
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Heravi AS, Michos ED. Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk? Methodist Debakey Cardiovasc J 2020; 15:207-213. [PMID: 31687100 DOI: 10.14797/mdcj-15-3-207] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.
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Affiliation(s)
- Amir S Heravi
- JOHNS HOPKINS SCHOOL OF MEDICINE, BALTIMORE, MARYLAND
| | - Erin D Michos
- JOHNS HOPKINS SCHOOL OF MEDICINE, BALTIMORE, MARYLAND
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Zajic P, Heschl S, Schörghuber M, Srekl-Filzmaier P, Stojakovic T, Weixler V, Zelzer S, Amrein K. Vitamin D assessment in perioperative medicine and critical care : A prospective observational pilot study. Wien Klin Wochenschr 2019; 133:79-85. [PMID: 31802221 PMCID: PMC7875852 DOI: 10.1007/s00508-019-01584-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 11/15/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. METHODS In this prospective observational pilot study in adult patients undergoing cardiovascular surgery on cardiopulmonary bypass (CPB), blood samples drawn at preoperative baseline (t1), after weaning from CPB (t2), on intensive care unit (ICU) admission (t3) and on the first (t4) and second (t5) postoperative days were analyzed. RESULTS A total of 26 patients (130 samples) were included in this study. Fluid loading by CPB led to a median reduction of 25(OH)D by -22.6% (range -54.5% to -19.5%) between t1 and t2. Cohen's kappa (κ) for method agreement for vitamin D deficiency (tested cut-off values 20 ng/ml and 12 ng/ml), was κ = 0.291 (p < 0.001) and κ = 0.469 (p < 0.001), respectively. The mean difference between measurements by ECLIA and LC-MS/MS was 4.8 ng/ml (±5.7), Pearson's r for correlation was 0.73 (p < 0.001). The biologically inactive C3-epimer did not contribute to 25(OH)D levels assessed by LC-MS/MS. CONCLUSION The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate. TRIAL REGISTRATION DRKS00009216, German Clinical Trials Registry ( www.drks.de ).
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Affiliation(s)
- Paul Zajic
- Div. of General Anaesthesiology, Emergency- and Intensive Care Medicine, Dept. of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.
| | - Stefan Heschl
- Div. of Anaesthesiology for Cardiovascular and Thoracic Surgery and Intensive Care Medicine, Dept. of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Michael Schörghuber
- Div. of Anaesthesiology for Cardiovascular and Thoracic Surgery and Intensive Care Medicine, Dept. of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Petra Srekl-Filzmaier
- Div. of Cardiac Surgery, Dept. of Surgery, Medical University of Graz, Graz, Austria
| | - Tatjana Stojakovic
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, University Medical Centre Graz, Graz, Austria
| | - Viktoria Weixler
- Div. of Cardiac Surgery, Dept. of Surgery, Medical University of Graz, Graz, Austria
| | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, University Medical Centre Graz, Graz, Austria
| | - Karin Amrein
- Div. of Endocrinology and Diabetology, Dept. of Internal Medicine, Medical University of Graz, Graz, Austria
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Lippi G, Targher G. Are we overrating the extra-skeletal benefits of oral vitamin D supplementation? ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:499. [PMID: 31700935 DOI: 10.21037/atm.2019.08.93] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy
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Tuckey RC, Cheng CYS, Slominski AT. The serum vitamin D metabolome: What we know and what is still to discover. J Steroid Biochem Mol Biol 2019; 186:4-21. [PMID: 30205156 PMCID: PMC6342654 DOI: 10.1016/j.jsbmb.2018.09.003] [Citation(s) in RCA: 125] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 09/04/2018] [Accepted: 09/04/2018] [Indexed: 01/08/2023]
Abstract
Vitamin D, referring to the two forms, D2 from the diet and D3 primarily derived from phototransformation in the skin, is a prohormone important in human health. The most hormonally active form, 1α,25-dihydroxyvitamin D (1α,25(OH)2D), formed from vitamin D via 25-hydroxyvitamin D (25(OH)D), is not only important for regulating calcium metabolism, but has many pleiotropic effects including regulation of the immune system and has anti-cancer properties. The major circulating form of vitamin D is 25(OH)D and both D2 and D3 forms are routinely measured by LC/MS/MS to assess vitamin D status, due to their relatively long half-lives and much higher concentrations compared to 1α,25(OH)2D. Inactivation of both 25(OH)D and 1α,25(OH)2D is catalyzed by CYP24A1 and 25-hydroxyvitamin D3 3-epimerase. Initial products from these enzymes acting on 25(OH)D3 are 24R,25(OH)2D3 and 3-epi-25(OH)D3, respectively, and both of these can also be measured routinely in some clinical laboratories to further document vitamin D status. With advances in LC/MS/MS and its increased availability, and with the help of studies with recombinant vitamin D-metabolizing enzymes, many other vitamin D metabolites have now been detected and in some cases quantitated, in human serum. CYP11A1 which catalyzes the first step in steroidogenesis, has been found to also act on vitamins D3 and D2 hydroxylating both at C20, but with some secondary metabolites produced by subsequent hydroxylations at other positions on the side chain. The major vitamin D3 metabolite, 20S-hydroxyvitamin D3 (20S(OH)D3), shows biological activity, often similar to 1α,25(OH)2D3 but without calcemic effects. Using standards produced enzymatically by purified CYP11A1 and characterized by NMR, many of these new metabolites have been detected in human serum, with semi-quantitative measurement of 20S(OH)D3 indicating it is present at comparable concentrations to 24R,25(OH)2D3 and 3-epi-25(OH)D3. Recently, vitamin D-related hydroxylumisterols derived from lumisterol3, a previtamin D3 photoproduct, have also been measured in human serum and displayed biological activity in initial in vitro studies. With the current extensive knowledge on the reactions and pathways of metabolism of vitamin D, especially those catalyzed by CYP24A1, CYP27A1, CYP27B1, CYP3A4 and CYP11A1, it is likely that many other of the resulting hydroxyvitamin D metabolites will be measured in human serum in the future, some contributing to a more detailed understanding of vitamin D status in health and disease.
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Affiliation(s)
- Robert C Tuckey
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia.
| | - Chloe Y S Cheng
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Andrzej T Slominski
- Department of Dermatology, University of Alabama at Birmingham, AL, 35294, USA; Comprehensive Cancer Center Cancer Chemoprevention Program, University of Alabama at Birmingham, AL, 35294, USA; VA Medical Center, Birmingham, AL, 35294, USA
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Wei Y, Chen P, Chen Q, Zhu H. Serum vitamin D levels and erectile dysfunction: A systematic review and meta-analysis. Andrologia 2018; 51:e13211. [PMID: 30523636 DOI: 10.1111/and.13211] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/13/2018] [Accepted: 10/22/2018] [Indexed: 01/11/2023] Open
Abstract
Suboptimal levels of serum vitamin D levels have been implied to be associated with cardiovascular diseases and endothelial dysfunction, conditions closely associated with erectile dysfunction (ED). The present systematic review and meta-analysis was performed to evaluate the vitamin D levels in subjects with ED compared to controls and the 5-item version of the international index of erectile function (IIEF-5) score in subjects with vitamin D deficiency compared to those without vitamin D deficiency in order to elucidate the role of vitamin D in the pathogenesis of ED. Studies evaluating the possible association between vitamin D levels and ED were initially screened and thus included following electronic literature search of database Cochrane Library, PUBMED, EMBASE and MEDLINE. Essential article information including outcome measures was extracted from the qualified studies by two independent authors, and STATA 12.0 software was used conducted the meta-analysis. Subgroup analyses were conducted by vitamin D detection methods and sample size. The standard mean difference (SMD) as well as the 95% confidence intervals (95% CIs) was applied to estimate the outcome measures. A total of seven articles were included in our meta-analysis with a total of 4,132 subjects. Pooled estimate was in favour of increased vitamin D levels in subjects without ED with a SMD of 3.027 ng/ml, 95%CI 2.290-3.314, p = 0.000. However, subgroup analysis showed an opposite trend, after one study with a sample size over 1,000 that could possibly influence the weight balance was excluded, with a SMD of 0.267, 95%CI -0.052 to 0.585, p = 0.101. We also identified about 0.320 higher in IIEF-5 score (95%CI = 0.146-0.494, p = 0.000) in subjects without vitamin D deficiency versus with vitamin D deficiency. Nevertheless, subgroup analysis based on vitamin D detection methods obtained differential results (radioimmunoassay subgroup, SMD(95%CI) = 0.573 (0.275-0.870), p = 0.000; immunoassay subgroup, SMD(95%CI) = 0.189 (-0.025 to 0.404), p = 0.084). In conclusion, results from the present meta-analysis did not provide a strong relationship between vitamin D and the risk of ED. However, the results should be interpreted with caution and more high quality studies are warranted.
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Affiliation(s)
- Yong Wei
- Department of Urology, Nanjing Gaochun People's Hospital, Nanjing, China
| | - Peng Chen
- Department of Urology, Nanjing Gaochun People's Hospital, Nanjing, China
| | - Quanbing Chen
- Department of Urology, Nanjing Gaochun People's Hospital, Nanjing, China
| | - Hongru Zhu
- Department of Urology, Nanjing Gaochun People's Hospital, Nanjing, China
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Lima JJ, Castro M, King TS, Lang JE, Ortega VE, Peters SP, Denlinger LC, Israel E, Sorkness CA, Wechsler ME, Wenzel SE, Smith LJ. Association of free vitamin D 3 concentrations and asthma treatment failures in the VIDA Trial. Ann Allergy Asthma Immunol 2018; 121:444-450.e1. [PMID: 29908319 DOI: 10.1016/j.anai.2018.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 05/11/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Use of vitamin D3 serum concentrations as a biomarker of vitamin D status is questionable because of variation in vitamin D binding protein. OBJECTIVE To determine associations between free vitamin D3 concentrations and rates of treatment failure and exacerbations in patients with asthma participating in the Vitamin D Add-on Therapy Enhances Corticosteroid Responsiveness in Asthma (VIDA) trial. METHODS Free concentrations were directly measured by enzyme-linked immunosorbent assay and stratified into low, medium, and high groups: less than 5pg/mL (n = 65), 5 to 9pg/mL (n = 84), and greater than 9pg/mL (n = 48) after 12 weeks of supplementation with oral vitamin D3 and associated with outcomes. RESULTS Outcomes did not associate with free concentrations: overall treatment failure rates were 0.60 (95% confidence interval [CI] 0.46-0.78), 0.53 (95%CI 0.40- 0.70), and 0.69 (95%CI 0.54-0.90)/person-year (P = .51), respectively; overall exacerbation rates were 0.28 (95%CI 0.17-0.48), 0.15 (95%CI 0.08-0.30) and 0.42 (95%CI 0.27-0.66)/person-year (P = .22). Mean (standard deviation) baseline free concentrations were lower in non-Hispanic blacks and Hispanics compared with non-Hispanic whites: 4.10 (1.33) and 4.38 (1.11) pg/mL vs 5.16 (1.65) pg/ml, (P < .001 and P = 0.038), respectively. Mean (standard deviation) baseline free concentrations differed between females and males: 4.57 (1.58) and 5.08 (1.41) (P = .026); and between non-overweight (body mass index [BMI] < 25) and overweight (BMI > 25): 5.45 (1.86) vs 4.54 (1.39) (P < .001). The free fraction differed by race and sex but not by BMI. CONCLUSION The use of free concentrations was inferior to total concentrations as a biomarker of efficacy of vitamin D3 supplementation in VIDA trial participants. Future studies of vitamin D status in patients with asthma should measure both free and total concentrations to better understand which marker of vitamin D function is most informative.
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Affiliation(s)
- John J Lima
- Nemours Children's Health System, Jacksonville, Florida.
| | - Mario Castro
- Washington University School of Medicine, St Louis, Missouri
| | | | - Jason E Lang
- Duke University School of Medicine, Durham, North Carolina
| | - Victor E Ortega
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Loren C Denlinger
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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von Websky K, Hasan AA, Reichetzeder C, Tsuprykov O, Hocher B. Impact of vitamin D on pregnancy-related disorders and on offspring outcome. J Steroid Biochem Mol Biol 2018; 180:51-64. [PMID: 29169993 DOI: 10.1016/j.jsbmb.2017.11.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 12/16/2022]
Abstract
Observational studies from all over the world continue to find high prevalence rates of vitamin D insufficiency and deficiency in many populations, including pregnant women. Beyond its classical function as a regulator of calcium and phosphate metabolism, vitamin D elicits numerous effects in the human body. Current evidence highlights a vital role of vitamin D in mammalian gestation. During pregnancy, adaptations in maternal vitamin D metabolism lead to a physiologic increase of vitamin D levels, mainly because of an increased renal production, although other potential sources like the placenta are being discussed. A sufficient supply of mother and child with calcium and vitamin D during pregnancy ensures a healthy bone development of the fetus, whereas lack of either of these nutrients can lead to the development of rickets in the child. Moreover, vitamin D insufficiency during pregnancy has consistently been associated with adverse maternal and neonatal pregnancy outcomes. In multitudinous studies, low maternal vitamin D status was associated with a higher risk for preeclampsia, gestational diabetes mellitus and other gestational diseases. Likewise, several negative consequences for the fetus have been reported, including fetal growth restriction, increased risk of preterm birth and a changed susceptibility for later-life diseases. However, study results are diverging and causality has not been proven so far. Meta-analyses on the relationship between maternal vitamin D status and pregnancy outcomes revealed a wide heterogeneity of studied populations and the applied methodology in vitamin D assessment. Until today, clinical guidelines for supplementation cannot be based on high-quality evidence and it is not clear if the required intake for pregnant women differs from non-pregnant women. Long-term safety data of vitamin D supplementation in pregnant women has not been established and overdosing of vitamin D might have unfavorable effects, especially in mothers and newborns with mutations of genes involved in vitamin D metabolism. Reliable data from large observational and interventional randomized control trials are urgently needed as a basis for any detailed and safe recommendations for supplementation in the general population and, most importantly, in pregnant women. This is of utmost importance, as ensuring a sufficient vitamin D-supply of mother and child implies a great potential for the prevention of birth complications and development of diseases.
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Affiliation(s)
- Karoline von Websky
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; Center for Cardiovascular Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ahmed Abdallah Hasan
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Egypt
| | - Christoph Reichetzeder
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; Center for Cardiovascular Research, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Oleg Tsuprykov
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; Institute for Laboratory Medicine, IFLB, Berlin, Germany
| | - Berthold Hocher
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany; Institute for Laboratory Medicine, IFLB, Berlin, Germany; Department of Basic Medicine, Medical College of Hunan Normal University, Changsha, China.
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21
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The relationship between Vitamin D status and exacerbation in COPD patients– a literature review. Respir Med 2018; 139:34-38. [DOI: 10.1016/j.rmed.2018.04.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 02/20/2018] [Accepted: 04/18/2018] [Indexed: 01/09/2023]
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Abstract
Despite it is now undeniable that indoor tanning exposure is associated with a number of skin cancers, its favorable effects on vitamin D status may bear some underestimated and currently unexplored health benefits. Vitamin D is a fat-soluble vitamin naturally present in a limited number of foods, the concentration of which largely depends on ultraviolet (UV) B sources exposure in humans. A strong, graded, and inverse association has been documented between serum vitamin D and the risk of developing certain types of malignancy, especially colorectal, breast, lung, bladder, and kidney cancers. The overall mortality from any type of cancer is also apparently lower in subjects with increased values of serum vitamin D. Both genomic and nongenomic mechanisms have been identified to support the anticancer effects of vitamin D. Notably, UVB radiation emitted from indoor tanning devices is effective to linearly increase the serum vitamin D concentration, up to twofold. Therefore, some favorable effects against the risk of developing many human diseases, including nonskin cancers, cannot be excluded at first glance, although they may not be only linked to vitamin D status. Further large, prospective or randomized studies should be hence planned to definitely establish whether the unfavorable effects of indoor tanning exposure on skin cancers may be outweighed by the still unexplored benefits attributable to amelioration of vitamin D status.
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