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Fang A, Zhao Y, Yang P, Zhang X, Giovannucci EL. Vitamin D and human health: evidence from Mendelian randomization studies. Eur J Epidemiol 2024:10.1007/s10654-023-01075-4. [PMID: 38214845 DOI: 10.1007/s10654-023-01075-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/30/2023] [Indexed: 01/13/2024]
Abstract
We summarized the current evidence on vitamin D and major health outcomes from Mendelian randomization (MR) studies. PubMed and Embase were searched for original MR studies on vitamin D in relation to any health outcome from inception to September 1, 2022. Nonlinear MR findings were excluded due to concerns about the validity of the statistical methods used. A meta-analysis was preformed to synthesize study-specific estimates after excluding overlapping samples, where applicable. The methodological quality of the included studies was evaluated according to the STROBE-MR checklist. A total of 133 MR publications were eligible for inclusion in the analyses. The causal association between vitamin D status and 275 individual outcomes was examined. Linear MR analyses showed genetically high 25-hydroxyvitamin D (25(OH)D) concentrations were associated with reduced risk of multiple sclerosis incidence and relapse, non-infectious uveitis and scleritis, psoriasis, femur fracture, leg fracture, amyotrophic lateral sclerosis, anorexia nervosa, delirium, heart failure, ovarian cancer, non-alcoholic fatty liver disease, dyslipidemia, and bacterial pneumonia, but increased risk of Behçet's disease, Graves' disease, kidney stone disease, fracture of radium/ulna, basal cell carcinoma, and overall cataracts. Stratified analyses showed that the inverse association between genetically predisposed 25(OH)D concentrations and multiple sclerosis risk was significant and consistent regardless of the genetic instruments GIs selected. However, the associations with most of the other outcomes were only pronounced when using genetic variants not limited to those in the vitamin D pathway as GIs. The methodological quality of the included MR studies was substantially heterogeneous. Current evidence from linear MR studies strongly supports a causal role of vitamin D in the development of multiple sclerosis. Suggestive support for a number of other health conditions could help prioritize conditions where vitamin D may be beneficial or harmful.
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Affiliation(s)
- Aiping Fang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Yue Zhao
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Ping Yang
- School of Nursing, Peking University, Beijing, China
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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2
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Turkmen BO, Can B, Buker S, Beser B, Büyükgök D, Dernek B, Bovatekin S, Kucukdagli P, Ilhan B, Kalem ŞA, Erten N, Karan MA, Bahat G. The effect of vitamin D on neurocognitive functions in older vitamin D deficient adults: a pilot longitudinal interventional study. Psychogeriatrics 2023; 23:781-788. [PMID: 37391231 DOI: 10.1111/psyg.12997] [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: 05/13/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND The relationship between vitamin D and cognitive status remains controversial. We aimed to evaluate the effect of vitamin D replacement on cognitive functions in healthy and cognitively intact vitamin D deficient older females. METHODS This study was designed as a prospective interventional study. A total of 30 female adults aged ≥60 with a serum 25 (OH) vitamin D level of <10 ng/ml were included. Participants were administered 50 000 IU vitamin D3 weekly for 8 weeks followed by a maintenance therapy of 1000 U/day. Detailed neuropsychological assessment was performed prior to vitamin D replacement and repeated at 6 months by the same psychologist. RESULTS Mean age was 63 ± 6.7 years and baseline vitamin D level was 7.8 ± 2.0 (range: 3.5-10.3) ng/ml. At 6 months, vitamin D level was 32.5 ± 3.4 (32.2-55) ng/ml. The Judgement of Line Orientation Test (P = 0.04), inaccurate word memorizing of the Verbal Memory Processes Test (P = 0.02), perseveration scores of the Verbal Memory Processes Test (P = 0.005), topographical accuracy of the Warrington Recognition Memory Test (P = 0.002), and the spontaneous self-correction of an error in the Boston Naming Test (P = 0.003) scores increased significantly, while the delayed recall score in the Verbal Memory Processes Test (P = 0.03), incorrect naming of words in the Boston Naming Test (P = 0.04), interference time of the Stroop Test (P = 0.05), and spontaneous corrections of the Stroop Test (P = 0.02) scores decreased significantly from baseline. CONCLUSION Vitamin D replacement has a positive effect on cognitive domains related to visuospatial, executive, and memory processing functions.
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Affiliation(s)
- Banu Ozulu Turkmen
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Busra Can
- Department of Internal Medicine, Division of Geriatrics, Marmara University Medical School, Istanbul, Turkey
| | - Seda Buker
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Birsu Beser
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Deniz Büyükgök
- Department of Neuroscience, Istanbul University, Istanbul, Turkey
| | - Bahar Dernek
- Physical Medicine and Rehabilitation Clinic, Istanbul Kanuni Sultan Suleyman Research and Training Hospital, Istanbul, Turkey
| | - Sevilay Bovatekin
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Pınar Kucukdagli
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Birkan Ilhan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | | | - Nilgun Erten
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Mehmet Akif Karan
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
| | - Gulistan Bahat
- Istanbul Medical School, Department of Internal Medicine, Division of Geriatrics, Istanbul University, Istanbul, Turkey
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3
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Chen WY, Cheng YC, Chiu CC, Liu HC, Huang MC, Tu YK, Kuo PH. Effects of Vitamin D Supplementation on Cognitive Outcomes: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2023:10.1007/s11065-023-09598-z. [PMID: 37418225 DOI: 10.1007/s11065-023-09598-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/11/2023] [Indexed: 07/08/2023]
Abstract
Clinical studies examining the effects of vitamin D on cognition have reported inconsistent results. To date, no comprehensive study has examined this effect on the basis of sample characteristics or intervention model-related factors. This systematic review and meta-analysis of randomized controlled trials investigated the effects of vitamin D supplementation on global cognitive function and specific cognitive domains. This review was preregistered in the PROSPERO database (CRD42021249908) and comprised 24 trials enrolling 7557 participants (mean age: 65.21 years; 78.54% women). The meta-analysis revealed that vitamin D significantly influenced global cognition (Hedges' g = 0.128, p = .008) but not specific cognitive domains. A subgroup analysis indicated that the effect size of vitamin D was stronger for vulnerable populations (Hedges' g = 0.414) and those with baseline vitamin D deficiency (Hedges' g = 0.480). On the basis of subgroup analyses in studies without biological flaws (Hedges' g = 0.549), we suggest that an intervention model should correct baseline vitamin D deficiency. Our results indicate that vitamin D supplementation has a small but significant positive effect on cognition in adults.
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Affiliation(s)
- Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsing-Cheng Liu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
- College of Public Health, Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan.
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4
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Harse JD, Zhu K, Bucks RS, Hunter M, Lim EM, Cooke BR, Walsh JP, Murray K. Investigating Potential Dose-Response Relationships between Vitamin D Status and Cognitive Performance: A Cross-Sectional Analysis in Middle- to Older-Aged Adults in the Busselton Healthy Ageing Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010450. [PMID: 35010710 PMCID: PMC8744852 DOI: 10.3390/ijerph19010450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/20/2021] [Accepted: 12/27/2021] [Indexed: 01/20/2023]
Abstract
Low vitamin D status has been linked to adverse cognitive outcomes in older adults. However, relationships at higher levels remain uncertain. We aimed to clarify patterns of association between vitamin D status and cognitive performance, using flexible regression methods, in 4872 middle- to older-aged adults (2678 females) from the Busselton Healthy Ageing Study. Cross-sectional associations of serum levels of 25-hydroxyvitamin D (25OHD) and performance in cognitive domains were modelled using linear regression and restricted cubic splines, controlling for demographic, lifestyle, and health factors. Mean ± SD serum 25OHD levels were 78 ± 24 nM/L for women and 85 ± 25 nM/L for men. Increasing levels in women were associated with better global cognition (linear trend, p = 0.023) and attention accuracy (continuity of attention), with improvement in the latter plateauing around levels of 80 nM/L (nonlinear trend, p = 0.035). In men, increasing levels of serum 25OHD were associated with better attention accuracy (linear trend, p = 0.022), but poorer semantic verbal fluency (linear trend, p = 0.025) and global cognition (nonlinear trend, p = 0.015). We identified patterns of association between serum 25OHD levels and cognitive performance that may reflect early dose–response relationships, particularly in women. Longitudinal analyses extending through to older ages may help to clarify the nature, strength, and temporality of these relationships.
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Affiliation(s)
- Janis D. Harse
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia; (M.H.); (K.M.)
- Correspondence:
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth 6009, Australia; (K.Z.); (E.M.L.); (J.P.W.)
- Discipline of Internal Medicine, Medical School, University of Western Australia, Perth 6009, Australia
| | - Romola S. Bucks
- School of Psychological Science, University of Western Australia, Perth 6009, Australia;
| | - Michael Hunter
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia; (M.H.); (K.M.)
- Busselton Population and Medical Research Institute, Busselton 6280, Australia
| | - Ee Mun Lim
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth 6009, Australia; (K.Z.); (E.M.L.); (J.P.W.)
- PathWest Laboratory Medicine, Department of Clinical Biochemistry, Queen Elizabeth II Medical Centre, Perth 6009, Australia
| | - Brian R. Cooke
- PathWest Laboratory Medicine, Department of Clinical Biochemistry, Fiona Stanley Hospital, Perth 6150, Australia;
| | - John P. Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth 6009, Australia; (K.Z.); (E.M.L.); (J.P.W.)
- Discipline of Internal Medicine, Medical School, University of Western Australia, Perth 6009, Australia
| | - Kevin Murray
- School of Population and Global Health, University of Western Australia, Perth 6009, Australia; (M.H.); (K.M.)
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Frank J, Kisters K, Stirban OA, Obeid R, Lorkowski S, Wallert M, Egert S, Podszun MC, Eckert GP, Pettersen JA, Venturelli S, Classen HG, Golombek J. The role of biofactors in the prevention and treatment of age-related diseases. Biofactors 2021; 47:522-550. [PMID: 33772908 DOI: 10.1002/biof.1728] [Citation(s) in RCA: 6] [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: 09/21/2020] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 02/07/2023]
Abstract
The present demographic changes toward an aging society caused a rise in the number of senior citizens and the incidence and burden of age-related diseases (such as cardiovascular diseases [CVD], cancer, nonalcoholic fatty liver disease [NAFLD], diabetes mellitus, and dementia), of which nearly half is attributable to the population ≥60 years of age. Deficiencies in individual nutrients have been associated with increased risks for age-related diseases and high intakes and/or blood concentrations with risk reduction. Nutrition in general and the dietary intake of essential and nonessential biofactors is a major determinant of human health, the risk to develop age-related diseases, and ultimately of mortality in the older population. These biofactors can be a cost-effective strategy to prevent or, in some cases, even treat age-related diseases. Examples reviewed herein include omega-3 fatty acids and dietary fiber for the prevention of CVD, α-tocopherol (vitamin E) for the treatment of biopsy-proven nonalcoholic steatohepatitis, vitamin D for the prevention of neurodegenerative diseases, thiamine and α-lipoic acid for the treatment of diabetic neuropathy, and the role of folate in cancer epigenetics. This list of potentially helpful biofactors in the prevention and treatment of age-related diseases, however, is not exhaustive and many more examples exist. Furthermore, since there is currently no generally accepted definition of the term biofactors, we here propose a definition that, when adopted by scientists, will enable a harmonization and consistent use of the term in the scientific literature.
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Affiliation(s)
- Jan Frank
- University of Hohenheim, Institute of Nutritional Sciences, Stuttgart, Germany
| | - Klaus Kisters
- Medical Clinic I, St. Anna-Hospital & ESH Excellence Centre, Herne, Germany
| | | | - Rima Obeid
- Department of Clinical Chemistry and Laboratory Medicine, Saarland University Hospital, Homburg/Saar, Germany
| | - Stefan Lorkowski
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany
| | - Maria Wallert
- Institute of Nutritional Sciences, Friedrich Schiller University Jena, Jena, Germany
- Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany
| | - Sarah Egert
- University of Hohenheim, Institute of Nutritional Medicine, Stuttgart, Germany
| | - Maren C Podszun
- University of Hohenheim, Institute of Nutritional Sciences, Stuttgart, Germany
| | - Gunter P Eckert
- Department of Nutritional Sciences, Laboratory for Nutrition in Prevention and Therapy, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Jacqueline A Pettersen
- Northern Medical Program, University of Northern British Columbia, Prince George, Canada
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Sascha Venturelli
- University of Hohenheim, Institute of Nutritional Sciences, Stuttgart, Germany
| | - Hans-Georg Classen
- University of Hohenheim, Institute of Nutritional Sciences, Stuttgart, Germany
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6
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Siachpazidou DI, Kotsiou OS, Stavrou V, Pastaka C, Gogou E, Kechagia M, Varsamas C, Economou NT, Zouridis S, Patrikioy E, Seitanidis G, Pinaka M, Sistou A, Hatzoglou C, Gourgoulianis KI. Serum vitamin D levels in patients with obstructive sleep apnea syndrome and level changes after continuous positive airway pressure therapy. Sleep Breath 2020; 25:657-668. [PMID: 32740855 DOI: 10.1007/s11325-020-02146-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Patients with obstructive sleep apnea syndrome (OSAS) have been found to exhibit lower serum vitamin D levels, even when the control groups are matched for confounding conditions. However, contradictory studies are also present. This study aimed to compare serum 25-hydroxyvitamin D (25(OH)D) levels between adult patients with OSAS and non-apneic controls and to evaluate the changes in 25(OH)D levels after 3 and 12 months of continuous positive airway pressure (CPAP) therapy. METHODS The study was comprised of 30 patients with OSAS and 30 controls. Serum 25(OH)D levels were determined at baseline and after 3 and 12 months of CPAP therapy in all patients with OSAS. For analysis, patients with OSAS were divided into subgroups by adherence, with adherence defined as CPAP usage for > 4 h per night on at least 70% of nights. RESULTS The 25(OH)D levels were not significantly different between OSAS and control groups at baseline. 25(OH)D levels did not change after 3 and 12 months of CPAP therapy. Patients who were CPAP-adherent showed less reduction in 25(OH)D levels compared with non-adherent ones (21.18 ± 9.3 vs. 12.13 ± 3.8 ng/mL, p = 0.022) after 1 year. The 25(OH)D levels were significantly correlated with higher daily CPAP usage at 3 and 12 months. Mean daily CPAP usage was a significant predictor of serum 25(OH)D levels at 12 months. CONCLUSIONS Patients with OSAS who demonstrated good CPAP adherence showed significantly higher 25(OH)D levels after 1 year compared with those not adequately using CPAP. Long-term good CPAP adherence and highly daily CPAP usage positively affected 25(OH)D levels in patients with OSAS.
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Affiliation(s)
- Dimitra I Siachpazidou
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Ourania S Kotsiou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece.
| | - Vasileios Stavrou
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Chaido Pastaka
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Eudoxia Gogou
- Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria Kechagia
- Department of Clinical Biochemistry, Aghia Sophia Children's Hospital, Athens, Greece
| | - Charalampos Varsamas
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Nicholas-Tiberio Economou
- Division of Pulmonology, Department of Clinical Therapeutics, School of Medicine, Alexandra Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Zouridis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Eleni Patrikioy
- Laboratory of Rheumatology Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - George Seitanidis
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Maria Pinaka
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Alexandra Sistou
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Chrissi Hatzoglou
- Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece.,Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
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7
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Siachpazidou DI, Stavrou V, Zouridis S, Gogou E, Economou NT, Pastaka C, Hatzoglou C, Gourgoulianis KI. 25-hydroxyvitamin D levels in patients with obstructive sleep apnea and continuous positive airway pressure treatment: a brief review. SLEEP SCIENCE (SAO PAULO, BRAZIL) 2020; 13:78-83. [PMID: 32670496 PMCID: PMC7347362 DOI: 10.5935/1984-0063.20190126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the present study is to summarize the information available, to time, regarding the relationship between obstructive sleep apnea (OSA) and vitamin-D (vD) levels. Moreover, the association between vD deficiency and OSA severity will also be examined. At the end of the present study the possible advantageous effect of CPAP on vD-levels will be summarized. Extensive literature search was conducted in PubMed, Scopus, The Cochrane Library and Embase database. 13 articles were found concerning OSA and vD, of which 2 articles included treatment with a CPAP. Patients with OSA exhibit low levels of vD in the blood serum, and women present an even lower mean value than men. Lack of VD in blood serum seems to be related to the severity of the OSA syndrome, and to the short duration of sleep. OSA patients with concurrent metabolic syndrome exhibit lower serum vD-levels, as compared with those without metabolic syndrome. Long-term continuous positive airway pressure treatment (CPAP) treatment can increase vD-levels in male OSA patients while no change is observed in women. OSA patients demonstrate lower levels of vD in multiple studies. The severity of the OSA may be associated with vD-levels and deficiency, however more studies are needed to assess that relationship due to contradictions in current bibliography. CPAP can increase vD-levels in male patients. The relation between vD and OSA and/or CPAP is important but recent; therefore further research is needed about the exact relationship to be clarified. Also, the effect of gender hormones on vD regulation in OSA patients should be further investigated.
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Affiliation(s)
- Dimitra I Siachpazidou
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Larissa, Greece
| | - Vasileios Stavrou
- Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Spyridon Zouridis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Eudoxia Gogou
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Chaido Pastaka
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Chrissi Hatzoglou
- Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Laboratory of Respiratory Sleep Disorders, Department of Respiratory Medicine, Faculty of Medicine University of Thessaly, Larissa, Greece.,Laboratory of Cardio-Pulmonary Testing, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Larissa, Greece.,Sleep Study Unit, Eginition Hospital, University of Athens Medical School, Athens, Greece.,Department of Physiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
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8
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Hatchell KE, Lu Q, Mares JA, Michos ED, Wood AC, Engelman CD. Multi-ethnic analysis shows genetic risk and environmental predictors interact to influence 25(OH)D concentration and optimal vitamin D intake. Genet Epidemiol 2019; 44:208-217. [PMID: 31830327 DOI: 10.1002/gepi.22272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/27/2019] [Accepted: 11/27/2019] [Indexed: 12/30/2022]
Abstract
25-Hydroxyvitamin D (25(OH)D) concentration is a complex trait with genetic and environmental predictors that may determine how much vitamin D exposure is required to reach optimal concentration. Interactions between continuous measures of a polygenic score (PGS) and vitamin D intake (PGS*intake) or available ultraviolet (UV) radiation (PGS*UV) were evaluated in individuals of African (n = 1,099) or European (n = 8,569) ancestries. Interaction terms and joint effects (main and interaction terms) were tested using one-degree of freedom (1-DF) and 2-DF models, respectively. Models controlled for age, sex, body mass index, cohort, and dietary intake/available UV. In addition, in participants achieving Institute of Medicine (IOM) vitamin D intake recommendations, 25(OH)D was evaluated by level PGS. The 2-DF PGS*intake, 1-DF PGS*UV, and 2-DF PGS*UV results were statistically significant in participants of European ancestry (p = 3.3 × 10-18 , p = 2.1 × 10-2 , and p = 2.4 × 10-19 , respectively), but not in those of African ancestry. In European-ancestry participants reaching IOM vitamin D intake guidelines, the percent of participants achieving adequate 25(OH)D ( >20 ng/ml) increased as genetic risk decreased (72% vs. 89% in highest vs. lowest risk; p = .018). Available UV radiation and vitamin D intake interact with genetics to influence 25(OH)D. Individuals with higher genetic risk may require more vitamin D exposure to maintain optimal 25(OH)D concentrations.
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Affiliation(s)
- Kathryn E Hatchell
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Erin D Michos
- Department of Cardiology, Ciccarone Center for the Prevention of Cardiovascular Disease, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Alexis C Wood
- Children's Nutrition Research Center, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Texas
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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9
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Müller T, Lohse L, Blodau A, Frommholz K. Vitamin D rise enhances blood perfusion in patients with multiple sclerosis. J Neural Transm (Vienna) 2019; 126:1631-1636. [PMID: 31620863 DOI: 10.1007/s00702-019-02093-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/04/2019] [Indexed: 12/19/2022]
Abstract
The chemical structure of vitamin D resembles steroids and anabolics. Following activation by enzymatic hydroxylation, vitamin D enhances numerous body functions. We determined 25-hydroxy-vitamin D, number of erythrocytes, haematocrit, mean corpuscular haemoglobin and mean corpuscular volume in 97 patients with multiple sclerosis initially and 6 months later. Patients with deficient levels of 25-hydroxyvitamin D (< 30 ng/mL) were advised to perform vitamin D supplementation and received a prescription of a vitamin D formulation. Six months later we observed a rise of 25-OH-vitamin D, as to be expected, and a modified constellation of blood parameters such as elevation of mean corpuscular haemoglobin concentration and fall of mean corpuscular volume. Mean corpuscular haemoglobin and number of erythrocytes remained stable. The haematocrit went down. We suggest that vitamin D elevation may be beneficial in disorders characterised by chronic neuroinflammation and neurodegeneration, since changes of blood perfusion parameters may enhance cellular tissue oxygenation.
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Affiliation(s)
- Thomas Müller
- Department of Neurology, St. Joseph Hospital Berlin-Weißensee, Gartenstr. 1, 13088, Berlin, Germany.
| | - Lutz Lohse
- MFSZ GmbH, Sternstr 28, 01139, Dresden, Germany
| | | | - Katja Frommholz
- Department of Radiology, Klinikum Frankfurt (Oder) GmbH, Müllroser Chaussee 7, 15236, Frankfurt, Germany
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10
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Hatchell KE, Lu Q, Hebbring SJ, Michos ED, Wood AC, Engelman CD. Ancestry-specific polygenic scores and SNP heritability of 25(OH)D in African- and European-ancestry populations. Hum Genet 2019; 138:1155-1169. [PMID: 31342140 PMCID: PMC7041489 DOI: 10.1007/s00439-019-02049-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/21/2019] [Indexed: 02/07/2023]
Abstract
Vitamin D inadequacy, assessed by 25-hydroxyvitamin D [25(OH)D], affects around 50% of adults in the United States and is associated with numerous adverse health outcomes. Blood 25(OH)D concentrations are influenced by genetic factors that may determine how much vitamin D intake is required to reach optimal 25(OH)D. Despite large genome-wide association studies (GWASs), only a small portion of the genetic factors contributing to differences in 25(OH)D has been discovered. Therefore, knowledge of a fuller set of genetic factors could be useful for risk prediction of 25(OH)D inadequacy, personalized vitamin D supplementation, and prevention of downstream morbidity and mortality. Using PRSice and weights from published African- and European-ancestry GWAS summary statistics, ancestry-specific polygenic scores (PGSs) were created to capture a more complete set of genetic factors in those of European (n = 9569) or African ancestry (n = 2761) from three cohort studies. The PGS for African ancestry was derived using all input SNPs (a p value cutoff of 1.0) and had an R2 of 0.3%; for European ancestry, the optimal PGS used a p value cutoff of 3.5 × 10-4 in the target/tuning dataset and had an R2 of 1.0% in the validation cohort. Those with highest genetic risk had 25(OH)D that was 2.8-3.0 ng/mL lower than those with lowest genetic risk (p = 0.0463-3.2 × 10-13), requiring an additional 467-500 IU of vitamin D intake to maintain equivalent 25(OH)D. PGSs are a powerful predictive tool that could be leveraged for personalized vitamin D supplementation to prevent the negative downstream effects of 25(OH)D inadequacy.
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Affiliation(s)
- Kathryn E Hatchell
- Department of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, 53706, USA.
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, 53706, USA
| | - Scott J Hebbring
- Center for Human Genetics, Marshfield Clinic Research Institute, Marshfield, WI, 54449, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Alexis C Wood
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, 53706, USA
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11
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Meng X, Li X, Timofeeva MN, He Y, Spiliopoulou A, Wei WQ, Gifford A, Wu H, Varley T, Joshi P, Denny JC, Farrington SM, Zgaga L, Dunlop MG, McKeigue P, Campbell H, Theodoratou E. Phenome-wide Mendelian-randomization study of genetically determined vitamin D on multiple health outcomes using the UK Biobank study. Int J Epidemiol 2019; 48:1425-1434. [PMID: 31518429 PMCID: PMC6857754 DOI: 10.1093/ije/dyz182] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is highly prevalent across the globe. Existing studies suggest that a low vitamin D level is associated with more than 130 outcomes. Exploring the causal role of vitamin D in health outcomes could support or question vitamin D supplementation. METHODS We carried out a systematic literature review of previous Mendelian-randomization studies on vitamin D. We then implemented a Mendelian Randomization-Phenome Wide Association Study (MR-PheWAS) analysis on data from 339 256 individuals of White British origin from UK Biobank. We first ran a PheWAS analysis to test the associations between a 25(OH)D polygenic risk score and 920 disease outcomes, and then nine phenotypes (i.e. systolic blood pressure, diastolic blood pressure, risk of hypertension, T2D, ischaemic heart disease, body mass index, depression, non-vertebral fracture and all-cause mortality) that met the pre-defined inclusion criteria for further analysis were examined by multiple MR analytical approaches to explore causality. RESULTS The PheWAS analysis did not identify any health outcome associated with the 25(OH)D polygenic risk score. Although a selection of nine outcomes were reported in previous Mendelian-randomization studies or umbrella reviews to be associated with vitamin D, our MR analysis, with substantial study power (>80% power to detect an association with an odds ratio >1.2 for per standard deviation increase of log-transformed 25[OH]D), was unable to support an interpretation of causal association. CONCLUSIONS We investigated the putative causal effects of vitamin D on multiple health outcomes in a White population. We did not support a causal effect on any of the disease outcomes tested. However, we cannot exclude small causal effects or effects on outcomes that we did not have enough power to explore due to the small number of cases.
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Affiliation(s)
- Xiangrui Meng
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Xue Li
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Maria N Timofeeva
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Yazhou He
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Athina Spiliopoulou
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Aliya Gifford
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Hongjiang Wu
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Timothy Varley
- Public Health and Intelligence, NHS National Services Scotland, Edinburgh, UK
| | - Peter Joshi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Joshua C Denny
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Susan M Farrington
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Lina Zgaga
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Malcolm G Dunlop
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Paul McKeigue
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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12
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Abstract
Vitamin D plays an essential role in human health as it influences immune function, cell proliferation, differentiation and apoptosis. Vitamin D deficiency has been associated with numerous health outcomes, including bone disease, cancer, autoimmune disease, cardiovascular conditions and more. However, the causal role of vitamin D beyond its importance for bone health remains unclear and is under much debate. Twin and familial studies from past decades have demonstrated a nontrivial heritability of circulating vitamin D concentrations. Several large-scale genome-wide association studies (GWAS) have discovered associations of GC, NADSYN1/DHCR7, CYP2R1, CYP24A1, SEC23A, AMDHD1 with serum levels of vitamin D. A recent whole genome sequencing (WGS) study, combined with deep imputation of genome-wide genotyping, has identified a low-frequency synonymous coding variant at CYP2R1. Information on these genetic variants can be used as tools for downstream analysis such as Mendelian randomization. Here, we review the genetic determinants of circulating vitamin D levels by focusing on new findings from GWAS and WGS, as well as results from Mendelian randomization analyses conducted so far for vitamin D with various traits and diseases. The amount of variation in vitamin D explained by genetics is still small, and the putative causal relationship between vitamin D and other diseases remains to be demonstrated.
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Affiliation(s)
- Xia Jiang
- Program in Genetic Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Brookline, Boston 02115, USA; Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Nobels vagen 13, Stockholm 17177, Sweden.
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131, United States; Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02115, United States; Broad Institute of Harvard and Massachusetts Institute of Technology, Boston, MA 02142, United States
| | - Peter Kraft
- Program in Genetic Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Brookline, Boston 02115, USA
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13
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Bahrami A, Khayyatzadeh SS, Jaberi N, Tayefi M, Mohammadi F, Ferns GA, Sadeghnia HR, Ghayour-Mobarhan M. Common Polymorphisms in Genes Related to Vitamin D Metabolism Affect the Response of Cognitive Abilities to Vitamin D Supplementation. J Mol Neurosci 2019; 69:150-156. [PMID: 31313056 DOI: 10.1007/s12031-019-01344-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Accepted: 05/22/2019] [Indexed: 01/24/2023]
Abstract
It is possible that vitamin D acts as a neurosteroid and that vitamin D deficiency may have an adverse impact on brain function and cognitive function. There are a few reports that have demonstrated an association between polymorphisms of genes involved in vitamin D metabolism and neurodegenerative disease. We aimed to evaluate the relationship between common, functional vitamin D-associated gene variants and cognitive abilities and to investigate the effect size of this polymorphism on cognitive capabilities associated with high-dose vitamin D supplementation. A total of 319 healthy adolescents received a high dose of vitamin D (50,000 IU)/week for 9 weeks. A questionnaire was used to assess cognitive abilities at baseline and after treatment. The genotypes of the CYP2R1-rs10766197 and GC-rs4588 variants were determined using TaqMan genotyping techniques. At baseline, total cognitive ability scores were higher in the AA group who were homozygous for the uncommon allele, compared with the other (AG and GG) genotypes of the CYP2R1-rs10766197 polymorphism (104.9 ± 27.8 vs. 79.1 ± 38.8 vs. 73.1 ± 25.6; p < 0.001, respectively). During the supplementation period, cognitive ability scores increased in individuals with the AG and GG genotypes, while individuals with a AA genotype did not show significant change in total score after intervention (p = 0.17). For GC SNP (rs4588), no major differences at baseline and trial-net change of cognitive tasks score were observed between the genotypes under three genetic models (pSNP = 0.67). Vitamin D supplements have trait-dependent effects on cognitive performance that suggests a causal role for vitamin D in cognitive performance. The rs10766197 variant, near the CYP2R1 gene locus, significantly modified the efficacy of high-dose vitamin D3 supplementation for its effects on improving cognitive abilities indicate that some subjects might require a higher dose to benefit from in terms of cognitive performance.
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Affiliation(s)
- Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sayyed Saeid Khayyatzadeh
- Department of Nutrition, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Najmeh Jaberi
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Mohammadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Hamid Reza Sadeghnia
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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14
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Kuźma E, Hannon E, Zhou A, Lourida I, Bethel A, Levine DA, Lunnon K, Thompson-Coon J, Hyppönen E, Llewellyn DJ. Which Risk Factors Causally Influence Dementia? A Systematic Review of Mendelian Randomization Studies. J Alzheimers Dis 2019; 64:181-193. [PMID: 29865062 PMCID: PMC6004893 DOI: 10.3233/jad-180013] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Numerous risk factors for dementia are well established, though the causal nature of these associations remains unclear. Objective: To systematically review Mendelian randomization (MR) studies investigating causal relationships between risk factors and global cognitive function or dementia. Methods: We searched five databases from inception to February 2017 and conducted citation searches including MR studies investigating the association between any risk factor and global cognitive function, all-cause dementia or dementia subtypes. Two reviewers independently assessed titles and abstracts, full-texts, and study quality. Results: We included 18 MR studies investigating education, lifestyle factors, cardiovascular factors and related biomarkers, diabetes related and other endocrine factors, and telomere length. Studies were of predominantly good quality, however eight received low ratings for sample size and statistical power. The most convincing causal evidence was found for an association of shorter telomeres with increased risk of Alzheimer’s disease (AD). Causal evidence was weaker for smoking quantity, vitamin D, homocysteine, systolic blood pressure, fasting glucose, insulin sensitivity, and high-density lipoprotein cholesterol. Well-replicated associations were not present for most exposures and we cannot fully discount survival and diagnostic bias, or the potential for pleiotropic effects. Conclusions: Genetic evidence supported a causal association between telomere length and AD, whereas limited evidence for other risk factors was largely inconclusive with tentative evidence for smoking quantity, vitamin D, homocysteine, and selected metabolic markers. The lack of stronger evidence for other risk factors may reflect insufficient statistical power. Larger well-designed MR studies would therefore help establish the causal status of these dementia risk factors.
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Affiliation(s)
| | | | - Ang Zhou
- Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | | | - Alison Bethel
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Deborah A Levine
- University of Michigan and Veterans Affairs Center for Clinical Management Research, Ann Arbor, USA
| | | | - Jo Thompson-Coon
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Elina Hyppönen
- Centre for Population Health Research, University of South Australia, Adelaide, Australia
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15
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Byrn MA, Sheean PM. Serum 25(OH)D and Cognition: A Narrative Review of Current Evidence. Nutrients 2019; 11:nu11040729. [PMID: 30934861 PMCID: PMC6520924 DOI: 10.3390/nu11040729] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022] Open
Abstract
The effect of low serum 25(OH)D on cognitive function is difficult to determine owing to the many factors that can influence these relationships (e.g., measurements, study design, and obesity). The primary purpose of this review was to synthesize the current evidence on the association between serum 25(OH)D and cognition giving special consideration to specific influential factors. A search was conducted in PubMed for studies published between 2010 and 2018 using terms related to serum 25(OH)D and cognition. Only studies that used liquid chromatography tandem-mass spectrometry (LC-MS) were included, since this is considered the ‘gold standard method’, to measure serum 25(OH)D. Of the 70 articles evaluated, 13 met all inclusion criteria for this review. The majority of the observational and longitudinal studies demonstrate a significant association between low serum 25(OH)D and compromised cognition. However, two randomized controlled trials showed inconsistent results on the impact of vitamin D supplementation on cognitive function. The varied methodologies for ascertaining cognition and the inclusion or exclusion of confounding variables (e.g., obesity, sunlight exposure) in the statistical analyses make drawing conclusions on the association between serum 25(OH)D and cognitive functioning inherently difficult. Despite the known higher occurrence of serum 25(OH) deficiency among minority populations, the majority of studies were conducted in with White participants. In order to more clearly discern the relationship between serum 25(OH)D and cognitive functioning, future studies should target more diverse study populations and utilize comprehensive measures to reliably capture cognition, as well as important known determinants of serum 25(OH)D.
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Affiliation(s)
- Mary A Byrn
- School of Nursing, Loyola University Chicago, 1032 W Sheridan Rd, Chicago, IL 60660, USA.
| | - Patricia M Sheean
- School of Nursing, Loyola University Chicago, 1032 W Sheridan Rd, Chicago, IL 60660, USA.
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16
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Ates Bulut E, Soysal P, Yavuz I, Kocyigit SE, Isik AT. Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study. Am J Alzheimers Dis Other Demen 2019; 34:112-117. [PMID: 30599760 PMCID: PMC10852460 DOI: 10.1177/1533317518822274] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups (P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia (P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.
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Affiliation(s)
- Esra Ates Bulut
- Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
- Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
| | - Idil Yavuz
- Department of Statistics, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Suleyman Emre Kocyigit
- Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Ahmet Turan Isik
- Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
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17
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Nho K, Kueider-Paisley A, MahmoudianDehkordi S, Arnold M, Risacher SL, Louie G, Blach C, Baillie R, Han X, Kastenmüller G, Jia W, Xie G, Ahmad S, Hankemeier T, van Duijn CM, Trojanowski JQ, Shaw LM, Weiner MW, Doraiswamy PM, Saykin AJ, Kaddurah-Daouk R. Altered bile acid profile in mild cognitive impairment and Alzheimer's disease: Relationship to neuroimaging and CSF biomarkers. Alzheimers Dement 2019; 15:232-244. [PMID: 30337152 PMCID: PMC6454538 DOI: 10.1016/j.jalz.2018.08.012] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 08/03/2018] [Accepted: 08/21/2018] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Bile acids (BAs) are the end products of cholesterol metabolism produced by human and gut microbiome co-metabolism. Recent evidence suggests gut microbiota influence pathological features of Alzheimer's disease (AD) including neuroinflammation and amyloid-β deposition. METHOD Serum levels of 20 primary and secondary BA metabolites from the AD Neuroimaging Initiative (n = 1562) were measured using targeted metabolomic profiling. We assessed the association of BAs with the "A/T/N" (amyloid, tau, and neurodegeneration) biomarkers for AD: cerebrospinal fluid (CSF) biomarkers, atrophy (magnetic resonance imaging), and brain glucose metabolism ([18F]FDG PET). RESULTS Of 23 BAs and relevant calculated ratios after quality control procedures, three BA signatures were associated with CSF Aβ1-42 ("A") and three with CSF p-tau181 ("T") (corrected P < .05). Furthermore, three, twelve, and fourteen BA signatures were associated with CSF t-tau, glucose metabolism, and atrophy ("N"), respectively (corrected P < .05). DISCUSSION This is the first study to show serum-based BA metabolites are associated with "A/T/N" AD biomarkers, providing further support for a role of BA pathways in AD pathophysiology. Prospective clinical observations and validation in model systems are needed to assess causality and specific mechanisms underlying this association.
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Affiliation(s)
- Kwangsik Nho
- Department of Radiology and Imaging Sciences, Center for Computational Biology and Bioinformatics, and the Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Matthias Arnold
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Shannon L Risacher
- Department of Radiology and Imaging Sciences, Center for Computational Biology and Bioinformatics, and the Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Gregory Louie
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Colette Blach
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
| | | | - Xianlin Han
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Gabi Kastenmüller
- Institute of Bioinformatics and Systems Biology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany; German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Wei Jia
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Guoxiang Xie
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Leiden Academic Centre for Drug Research, Leiden University, RA Leiden, the Netherlands
| | | | - John Q Trojanowski
- Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Leslie M Shaw
- Department of Pathology & Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases, Department of Radiology, San Francisco VA Medical Center/University of California San Francisco, San Francisco, CA, USA
| | - P Murali Doraiswamy
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC, USA; Department of Medicine, Duke University, Durham, NC, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Center for Computational Biology and Bioinformatics, and the Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA; Duke Institute of Brain Sciences, Duke University, Durham, NC, USA; Department of Medicine, Duke University, Durham, NC, USA.
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18
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Effect of Genetically Low 25-Hydroxyvitamin D on Mortality Risk: Mendelian Randomization Analysis in 3 Large European Cohorts. Nutrients 2019; 11:nu11010074. [PMID: 30609725 PMCID: PMC6356674 DOI: 10.3390/nu11010074] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/13/2018] [Accepted: 12/24/2018] [Indexed: 12/19/2022] Open
Abstract
The aim of this study was to determine if increased mortality associated with low levels of serum 25-hydroxyvitamin D (25(OH)D) reflects a causal relationship by using a Mendelian randomisation (MR) approach with genetic variants in the vitamin D synthesis pathway. Individual participant data from three European cohorts were harmonized with standardization of 25(OH)D according to the Vitamin D Standardization Program. Most relevant single nucleotide polymorphisms of the genes CYP2R1 (rs12794714, rs10741657) and DHCR7/NADSYN1 (rs12785878, rs11234027), were combined in two allelic scores. Cox proportional hazards regression models were used with the ratio estimator and the delta method for calculating the hazards ratio (HR) and standard error of genetically determined 25(OH)D effect on all-cause mortality. We included 10,501 participants (50.1% females, 67.1±10.1 years) of whom 4003 died during a median follow-up of 10.4 years. The observed adjusted HR for all-cause mortality per decrease in 25(OH)D by 20 nmol/L was 1.20 (95% CI: 1.15⁻1.25). The HR per 20 nmol/L decrease in genetically determined 25(OH)D was 1.32 (95% CI: 0.80⁻2.24) and 1.35 (95% CI of 0.81 to 2.37) based on the two scores. In conclusion, the results of this MR study in a combined sample from three European cohort studies provide further support for a causal relationship between vitamin D deficiency and increased all-cause mortality. However, as the current study, even with ~10,000 participants, was underpowered for the study of the effect of the allele score on mortality, larger studies on genetics and mortality are needed to improve the precision.
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Hong J, Hatchell KE, Bradfield JP, Bjonnes A, Chesi A, Lai CQ, Langefeld CD, Lu L, Lu Y, Lutsey PL, Musani SK, Nalls MA, Robinson-Cohen C, Roizen JD, Saxena R, Tucker KL, Ziegler JT, Arking DE, Bis JC, Boerwinkle E, Bottinger EP, Bowden DW, Gilsanz V, Houston DK, Kalkwarf HJ, Kelly A, Lappe JM, Liu Y, Michos ED, Oberfield SE, Palmer ND, Rotter JI, Sapkota B, Shepherd JA, Wilson JG, Basu S, de Boer IH, Divers J, Freedman BI, Grant SFA, Hakanarson H, Harris TB, Kestenbaum BR, Kritchevsky SB, Loos RJF, Norris JM, Norwood AF, Ordovas JM, Pankow JS, Psaty BM, Sanghera DK, Wagenknecht LE, Zemel BS, Meigs J, Dupuis J, Florez JC, Wang T, Liu CT, Engelman CD, Billings LK. Transethnic Evaluation Identifies Low-Frequency Loci Associated With 25-Hydroxyvitamin D Concentrations. J Clin Endocrinol Metab 2018; 103:1380-1392. [PMID: 29325163 PMCID: PMC6276579 DOI: 10.1210/jc.2017-01802] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/03/2018] [Indexed: 01/08/2023]
Abstract
Context Vitamin D inadequacy is common in the adult population of the United States. Although the genetic determinants underlying vitamin D inadequacy have been studied in people of European ancestry, less is known about populations with Hispanic or African ancestry. Objective The Trans-Ethnic Evaluation of Vitamin D (TRANSCEN-D) genomewide association study (GWAS) consortium was assembled to replicate genetic associations with 25-hydroxyvitamin D [25(OH)D] concentrations from the Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits (SUNLIGHT) meta-analyses of European ancestry and to identify genetic variants related to vitamin D concentrations in African and Hispanic ancestries. Design Ancestry-specific (Hispanic and African) and transethnic (Hispanic, African, and European) meta-analyses were performed with Meta-Analysis Helper software (METAL). Patients or Other Participants In total, 8541 African American and 3485 Hispanic American (from North America) participants from 12 cohorts and 16,124 European participants from SUNLIGHT were included in the study. Main Outcome Measures Blood concentrations of 25(OH)D were measured for all participants. Results Ancestry-specific analyses in African and Hispanic Americans replicated single nucleotide polymorphisms (SNPs) in GC (2 and 4 SNPs, respectively). An SNP (rs79666294) near the KIF4B gene was identified in the African American cohort. Transethnic evaluation replicated GC and DHCR7 region SNPs. Additionally, the transethnic analyses revealed SNPs rs719700 and rs1410656 near the ANO6/ARID2 and HTR2A genes, respectively. Conclusions Ancestry-specific and transethnic GWASs of 25(OH)D confirmed findings in GC and DHCR7 for African and Hispanic American samples and revealed findings near KIF4B, ANO6/ARID2, and HTR2A. The biological mechanisms that link these regions with 25(OH)D metabolism warrant further investigation.
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Affiliation(s)
- Jaeyoung Hong
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
| | - Kathryn E Hatchell
- Department of Population Health Sciences, University of Wisconsin–Madison
School of Medicine and Public Health, Madison, Wisconsin
| | - Jonathan P Bradfield
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrew Bjonnes
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
| | - Alessandra Chesi
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Chao-Qiang Lai
- USDA-ARS Human Nutrition Research Center on Aging at Tufts University, Boston,
Massachusetts
| | | | - Lingyi Lu
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota,
Minneapolis, Minnesota
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson,
Mississippi
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, Maryland
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes
of Health, Bethesda, Maryland
| | - Cassianne Robinson-Cohen
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Jeffery D Roizen
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Endocrinology, Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts
Lowell, Lowell, Massachusetts
| | - Julie T Ziegler
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University
School of Medicine, Baltimore, Maryland
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of
Washington, Seattle, Washington
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston, Houston, Texas
| | - Erwin P Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
| | - Donald W Bowden
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Vicente Gilsanz
- Department of Radiology, Children’s Hospital of Los Angeles, Keck School of
Medicine, University of Southern California, Los Angeles, California
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric
Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s
Hospital Medical Center, Cincinnati, Ohio
| | - Andrea Kelly
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine at University of Pennsylvania, Philadelphia,
Pennsylvania
| | | | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences,
Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University
School of Medicine, Baltimore, Maryland
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Columbia
University Medical Center, New York, New York
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Department of
Pediatrics and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,
Torrance, California
| | - Bishwa Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma
| | - John A Shepherd
- University of California San Francisco School of Medicine, San Francisco,
California
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical
Center, Jackson, Mississippi
| | - Saonli Basu
- Division of Biostatistics, University of Minnesota, Minneapolis,
Minnesota
| | - Ian H de Boer
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Jasmin Divers
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Struan F A Grant
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Endocrinology, Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, Pennsylvania
| | - Hakon Hakanarson
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, Pennsylvania
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on
Aging, Bethesda, Maryland
| | - Bryan R Kestenbaum
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric
Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine
at Mount Sinai, New York, New York
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, University of
Colorado Denver, Aurora, Colorado
| | - Arnita F Norwood
- Department of Medicine, University of Mississippi Medical Center, Jackson,
Mississippi
| | - Jose M Ordovas
- Nutrition and Genomics, JM-USDA Human Nutrition Research Center on Aging at
Tufts University, Boston, Massachusetts
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota,
Minneapolis, Minnesota
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of
Washington, Seattle, Washington
- University of Washington and Department of Epidemiology and Health Sciences,
University of Washington, Seattle, Washington
- Kaiser Permanente Washington Health Research Institute, Seattle,
Washington
| | - Dharambir K Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma
- Department of Pharmaceutical Sciences, College of Pharmacy, University of
Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Oklahoma Center for Neuroscience, Oklahoma City, Oklahoma
| | | | - Babette S Zemel
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine at University of Pennsylvania, Philadelphia,
Pennsylvania
| | - James Meigs
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard
Medical School, Boston, Massachusetts
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
- National Heart, Lung, and Blood Institute’s Framingham Heart Study,
Framingham, Massachusetts
| | - Jose C Florez
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
- Programs in Metabolism and Medical & Population Genetics, Broad Institute,
Cambridge, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
| | - Corinne D Engelman
- Department of Population Health Sciences, University of Wisconsin–Madison
School of Medicine and Public Health, Madison, Wisconsin
| | - Liana K Billings
- NorthShore University HealthSystem, Evanston, Illinois
- University of Chicago Pritzker School of Medicine, Chicago, Illinois
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Goodwill AM, Szoeke C. A Systematic Review and Meta-Analysis of The Effect of Low Vitamin D on Cognition. J Am Geriatr Soc 2017; 65:2161-2168. [PMID: 28758188 DOI: 10.1111/jgs.15012] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND/OBJECTIVE With an aging population and no cure for dementia on the horizon, risk factor modification prior to disease onset is an urgent health priority. Therefore, this review examined the effect of low vitamin D status or vitamin D supplementation on cognition in midlife and older adults without a diagnosis of dementia. DESIGN Systematic review and random effect meta-analysis. SETTING Observational (cross-sectional and longitudinal cohort) studies comparing low and high vitamin D status and interventions comparing vitamin D supplementation with a control group were included in the review and meta-analysis. PARTICIPANTS Studies including adults and older adults without a dementia diagnosis were included. MEASUREMENTS Medline (PubMed), AMED, Psych INFO, and Cochrane Central databases were searched for articles until August 2016. The Newcastle-Ottawa Scale and Physiotherapy Evidence Database assessed methodological quality of all studies. RESULTS Twenty-six observational and three intervention studies (n = 19-9,556) were included in the meta-analysis. Low vitamin D was associated with worse cognitive performance (OR = 1.24, CI = 1.14-1.35) and cognitive decline (OR = 1.26, CI = 1.09-1.23); with cross-sectional yielding a stronger effect compared to longitudinal studies. Vitamin D supplementation showed no significant benefit on cognition compared with control (SMD = 0.21, CI = -0.05 to 0.46). CONCLUSION Observational evidence demonstrates low vitamin D is related to poorer cognition; however, interventional studies are yet to show a clear benefit from vitamin D supplementation. From the evidence to date, there is likely a therapeutic age window relevant to the development of disease and therefore vitamin D therapy. Longitudinal lifespan studies are necessary to depict the optimal timing and duration in which repletion of vitamin D may protect against cognitive decline and dementia in aging, to better inform trials and practice towards a successful therapy.
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Affiliation(s)
- Alicia M Goodwill
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
| | - Cassandra Szoeke
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia.,Department of Medicine (RMH), University of Melbourne, Parkville, Victoria, Australia
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Cass WA, Peters LE. Reduced ability of calcitriol to promote augmented dopamine release in the lesioned striatum of aged rats. Neurochem Int 2017; 108:222-229. [PMID: 28390950 DOI: 10.1016/j.neuint.2017.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/13/2017] [Accepted: 04/03/2017] [Indexed: 11/18/2022]
Abstract
Parkinson's disease (PD) is a progressive and debilitating neurodegenerative disorder that affects over one million people in the United States. Previous studies, carried out in young adult rats, have shown that calcitriol, the active metabolite of vitamin D, can be neuroprotective in 6-hydroxydopamine (6-OHDA) models of PD. However, as PD usually affects older individuals, the ability of calcitriol to promote dopaminergic recovery was examined in lesioned young adult (4 month old), middle-aged (14 month old) and aged (22 month old) rats. Animals were given a single injection of 12 μg 6-OHDA into the right striatum. Four weeks later they were administered vehicle or calcitriol (1.0 μg/kg, s.c.) once a day for eight consecutive days. In vivo microdialysis experiments were carried out three weeks after the calcitriol or vehicle treatments to measure potassium and amphetamine evoked overflow of DA from both the left and right striata. In control animals treated with 6-OHDA and vehicle there were significant reductions in evoked overflow of DA on the lesioned side of the brain compared to the contralateral side. The calcitriol treatments significantly increased evoked overflow of DA from the lesioned striatum in both the young adult and middle-aged rats. However, the calcitriol treatments did not significantly augment DA overflow in the aged rats. Postmortem tissue levels of striatal DA were also increased in the young and middle-aged animals, but not in the aged animals. In the substantia nigra, the calcitriol treatments led to increased levels of DA in all three age groups. Thus, the effects of calcitriol were similar in the young adult and middle-aged animals, but in the aged animals the effects of calcitriol were diminished. These results suggest that calcitriol may help promote recovery of dopaminergic functioning in injured nigrostriatal neurons; however, the effectiveness of calcitriol may be reduced in aging.
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Affiliation(s)
- Wayne A Cass
- Department of Anatomy and Neurobiology, University of Kentucky College of Medicine, Lexington, KY, USA.
| | - Laura E Peters
- Department of Anatomy and Neurobiology, University of Kentucky College of Medicine, Lexington, KY, USA
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