1
|
Konstantinidis C, Psoma O, Kotsias C, Panagiotopoulos V, Plakoutsis S, Tsiampas D, Vardakas D, Giotis D. Vitamin D Deficiency in Patients With Low-Energy Hip Fractures in Accordance With the Mediterranean Paradox. Cureus 2024; 16:e57583. [PMID: 38707155 PMCID: PMC11069122 DOI: 10.7759/cureus.57583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Vitamin D deficiency (VDD) is considered one of the leading causes of poor bone quality. It may also be related to severe muscular weakness, especially in the elderly, which leads to frequent falls. Thus, VDD might be associated with fragility fractures of the hip, wrist, and spine in this age category. In this cross-sectional study, our goal was to present vitamin D levels in an elderly Mediterranean population with hip fractures and to assess whether its levels are related to the incidence or prevention of such injuries. Methods Between January and December 2021, 140 patients aged 65 years or older were hospitalized in our department with a fracture involving the hip joint. Serum calcium and vitamin D level control was performed upon admission, as well as recording whether anti-osteoporosis medication had been prescribed. Only patients with low-energy fractures were included, whereas oncologic patients and those with high-energy trauma were excluded. Results Thirty-eight men and 102 women, with a mean age of 83.12 and 84.88 years, respectively, participated in our study. Intertrochanteric fractures were the most common injuries (50.72%). Low vitamin D levels (<30 ng/mL) were observed in 132 patients (94.28%). A bone density scan during the last year had been conducted by only seven patients (5%), whereas in 136 patients (97.14%), no anti-osteoporotic medication was given. Conclusion There is an excessive percentage of aged patients with hip fractures in Greece, demonstrating a significant vitamin D insufficiency despite the high annual frequency of sunny days in this Mediterranean region. Presumably, most of these patients neither perform the routine bone density scan nor do they take any kind of preventive pharmaceutical treatment, which might reveal devaluation of osteoporosis from this age group due to contingent comorbidities.
Collapse
Affiliation(s)
| | - Ourania Psoma
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, GRC
| | - Christos Kotsias
- Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
| | | | - Sotiris Plakoutsis
- Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
| | - Dimitrios Tsiampas
- Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
| | - Dimitrios Vardakas
- Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
| | - Dimitrios Giotis
- Orthopaedic Department, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
| |
Collapse
|
2
|
Berger K, Bradshaw PT, Poon V, Kharrazi M, Eyles D, Ashwood P, Lyall K, Volk HE, Ames J, Croen LA, Windham GC, Pearl M. Mixture of air pollution, brominated flame retardants, polychlorinated biphenyls, per- and polyfluoroalkyl substances, and organochlorine pesticides in relation to vitamin D concentrations in pregnancy. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122808. [PMID: 37923052 PMCID: PMC10841600 DOI: 10.1016/j.envpol.2023.122808] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/06/2023] [Accepted: 10/24/2023] [Indexed: 11/07/2023]
Abstract
Over two-thirds of pregnant women in the U.S. have insufficient 25(OH)D (Vitamin D) concentrations, which can adversely impact fetal health. Several pollutants have been associated with 25(OH)D, but have not been considered in the context of chemical co-exposures. We aimed to determine associations between a broad mixture of prenatal environmental chemical exposures and 25(OH)D concentrations in mid-pregnancy. Stored mid-pregnancy serum samples were assayed from 421 women delivering live births in Southern California in 2000-2003. 25(OH)D, six BFRs, eleven polychlorinated biphenyls (PCBs), six per- and polyfluoroalkyl substances, and two organochlorine pesticides were detected in ≥60% of specimens. Gestational exposures to airborne particulate matter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5), nitrogen monoxide (NO), nitrogen dioxide (NO2), and ozone concentrations were derived from monitoring station data. Bayesian Hierarchical Modeling (BHM) and Bayesian Kernel Machine Regression (BKMR) analyses estimated overall mixture and individual chemical associations accounting for co-exposures and covariates with mean 25(OH)D levels, and BHM was used to estimate associations with insufficient (<75 nMol/L) 25(OH)D levels. Non-mixture associations for each chemical were estimated with linear and logistic models. PM10 [BHM estimate: -0.133 nmol/l 95% Credible Interval (-0.240, -0.026)] was associated with lower 25(OH)D in BHM and BKMR. Higher quantiles of combined exposures were associated with lower 25(OH)D, though with wide credible intervals. In non-mixture models, PM10, PM2.5, NO, and NO2 were associated with lower concentrations, while O3 and PBDE153 were associated with higher 25(OH)D and/or lower insufficiency. While some chemicals were associated with increased and others with decreased 25(OH)D concentrations, the overall mixture was associated with lower concentrations. Mixture analyses differed from non-mixture regressions, highlighting the importance of mixtures approaches for estimating real-world associations.
Collapse
Affiliation(s)
| | - Patrick T Bradshaw
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | | | | | - Darryl Eyles
- Queensland Brain Institute and the Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, University of California, Davis, Davis, CA, USA
| | - Kristen Lyall
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Heather E Volk
- Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jenn Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Gayle C Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| | - Michelle Pearl
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA
| |
Collapse
|
3
|
Baranoglu Kilinc Y, Bolu S. The prevalence of vitamin D deficiency and the factors affecting vitamin D levels in children admitted to the outpatient clinic of pediatric endocrinology in Bolu Province. Arch Pediatr 2023; 30:580-585. [PMID: 37770256 DOI: 10.1016/j.arcped.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The present study aimed to determine the rate of vitamin D deficiency in children who presented to the pediatric endocrinology outpatient clinic in Bolu and to investigate the factors affecting vitamin D levels. METHODS Vitamin D levels of 1008 children and adolescents were retrospectively analyzed according to age group (0-1, 1-10, and 10-18 years), gender, season, month, obesity and other diseases, and deficiency category. Moreover, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels were evaluated. Comparisons and correlation analyses between related groups were performed. RESULTS The mean vitamin D level of the patients was 16.35±9.56 ng/mL and was lower in girls (14.90±9.56 ng/mL) than in boys (18.68±9.63 ng/mL, p<0.001). Overall, 18.3% of the children and adolescents had vitamin D insufficiency, 52.3% had vitamin D deficiency, and 3.5% had severe vitamin D deficiency. Vitamin D levels were lower in 10-18-year age group than in the other age groups (p<0.001), and levels were higher in summer and autumn than in winter and spring (p<0.001). Vitamin D levels of participants with obesity (14.3 ± 8.3 ng/mL) were significantly lower than normal-weight participants with no health problems (15.9 ± 8.3 ng/mL, p = 0.004). There was a negative correlation between vitamin D, alkaline phosphatase, and parathyroid hormone levels in the 1-10-year age group, but a positive correlation between vitamin D, alkaline phosphatase, and calcium levels in the 10-18-year age group. CONCLUSION The rate of vitamin D deficiency is high among children and adolescents who presented to the endocrine outpatient clinic in Bolu. The season appears to be an important factor affecting vitamin D levels as well as the relationship between vitamin D and parathyroid hormone. Obese children and adolescents living in this region may be advised to take vitamin D supplements in winter and spring.
Collapse
Affiliation(s)
| | - Semih Bolu
- Department of Pediatric Endocrinology, Bolu Abant Izzet Baysal University, Izzet Baysal Research and Training Hospital, Bolu, Turkey
| |
Collapse
|
4
|
Mustafa A, Shekhar C. Factors Associated with Vitamin D Deficiency and Their Relative Importance among Indian Adolescents: An Application of Dominance Analysis. Int J Endocrinol 2023; 2023:4209369. [PMID: 37881405 PMCID: PMC10597726 DOI: 10.1155/2023/4209369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 10/27/2023] Open
Abstract
Vitamin D deficiency is a serious issue in developing nations, including India. This study investigates the determinants of vitamin D deficiency among Indian adolescents and assesses their relative importance using dominance analysis. Data from the Comprehensive National Nutrition Survey (CNNS) conducted between 2016 and 2018 were utilized in this study. Vitamin D levels were assessed based on serum 25-hydroxyvitamin D concentration, with a sample size encompassing 13,065 adolescents aged between 10 and 19 years. Backward stepwise multivariate logistic regression was used to identify the correlates of vitamin D deficiency, and the relative importance of these factors was assessed using dominance analysis. The study identified nine predictors that were significantly associated with vitamin D deficiency at a 1% level of significance (α = 0.001). Among these factors, sex was found to be the most significant predictor, with female adolescents being 2.66 (95% CI: 95% CI: 2.39-2.96) times more likely to be vitamin D deficient compared to male adolescents. Lifestyle and behavioral factors, such as "sex," "wealth index," and "place of residence," were more dominant in predicting vitamin D deficiency than biological indicators like "BMI" and "serum creatinine." This underscores the vital role of sunlight exposure in maintaining sufficient vitamin D levels. In summary, this study sheds light on the multifaceted factors contributing to vitamin D deficiency among Indian adolescents, emphasizing the significance of targeted interventions and public health awareness campaigns to mitigate this pressing issue.
Collapse
Affiliation(s)
- Akif Mustafa
- International Institute for Population Sciences (IIPS), Mumbai, India
| | - Chander Shekhar
- Department of Fertility, International Institute for Population Sciences (IIPS), Mumbai, India
| |
Collapse
|
5
|
Karkenny AJ, Avarello J, Hanstein R, Lo Y, Burlage A, Crabb R, McNally K, Merwin S, Schulz JF, Poon S. Pediatric Fractures: Does Vitamin D Play a Role? J Pediatr Orthop 2023:01241398-990000000-00315. [PMID: 37390504 DOI: 10.1097/bpo.0000000000002462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
BACKGROUND Vitamin D (25-OHD) deficiency and insufficiency are reported in about half of all children. The literature on low 25-OHD and pediatric fracture risk presents inconsistent results. This study evaluates the association between pediatric fractures and 25-OHD, parathyroid hormone (PTH), and calcium. METHODS This is a prospective case-control study in 2 urban pediatric emergency departments (2014-2017). Patients aged 1 to 17 requiring intravenous access were enrolled. Demographics, nutrition, and activity information were recorded and levels of 25-OHD, calcium, and PTH were measured. RESULTS Two hundred forty-five subjects were enrolled: 123 fractures and 122 controls. Overall, the mean 25-OHD level was 23 ng/mL±8.5: 52 (21%) of patients were 25-OHD sufficient; 193 (79%) were not. Ninety-six percent of patients with lower extremity fractures had low 25-OHD versus 77% of patients with upper extremity fractures (P=0.024). The fracture cohort was younger (P=0.002), included more males (P=0.020), and spent more time playing outdoor sports (P=0.011) than the control cohort. The 25-OHD level (fracture 22.8 ng/mL±7.6 vs. nonfracture 23.5 ng/mL±9.3, P=0.494) and median calcium level (fracture 9.8 mg/dL vs. nonfracture 10.0 mg/dL, P=0.054) were similar between cohorts. The median PTH level was higher in the fracture than the control cohort (33 vs. 24.5 pg/mL; P<0.0005); PTH was elevated to hyperparathyroidism (>65 pg/mL) in 13% of fractures and 2% of controls (P=0.006). Matched subgroup analysis of 81 fracture patients and 81 controls by age, gender, and race showed that PTH was the only variable independently associated with increased odds of fracture (odds ratio=1.10, 95% CI, 1.01-1.19, P=0.021) in a model adjusted for vitamin D sufficiency and time spent playing outdoor sports. CONCLUSIONS Low 25-OHD is common in children with fractures but we found no difference in 25-OHD levels between fracture and nonfracture cohorts. This research can impact evidence-based guidelines on vitamin D level screening and/or supplementation after fracture. LEVEL OF EVIDENCE Diagnostic level IV-case-control study.
Collapse
Affiliation(s)
| | | | | | - Yungtai Lo
- Albert Einstein College of Medicine, Bronx
| | - Ashley Burlage
- Northwell Health Orthopaedic Institute at Huntington, Huntington
| | - Rocio Crabb
- Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY
| | | | | | | | - Selina Poon
- Shriners Hospital for Children, Pasadena, CA
| |
Collapse
|
6
|
Hu B, Chen J, Shi Y, Hou L. Association between serum 25(OH)D and risk of all-cause mortality in adults with prior cardiovascular disease: a cohort study from NHANES 2007-2018. BMC Cardiovasc Disord 2023; 23:240. [PMID: 37149586 PMCID: PMC10164325 DOI: 10.1186/s12872-023-03257-0] [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: 11/22/2022] [Accepted: 04/21/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Serum vitamin D deficiency is common in the patients with cardiovascular disease (CVD), but the association between serum vitamin D levels and risk of all-cause mortality in patients with CVD is controversial. OBJECTIVE This study aimed to understand better the association between serum 25(OH)D status and risk of all-cause mortality in patients with prior CVD. METHOD We conducted a cohort study using data from the National Health and Nutrition Examination Survey from 2007 to 2018 to investigate the association between serum 25(OH)D and the risk of all-cause mortality using multivariate Cox regression models, with further subgroup analyses and interactions smooth curve fitting to address possible nonlinearities. RESULT A total of 3220 participants with prior CVD were included in this study, with a total of 930 deaths over a median follow-up of 5.52 years, with multivariable-adjusted serum vitamin D levels after natural log transformation (4.31-4.5 ) as a reference in COX regression, and corrected HRs and 95% CIs of 1.81 (1.31, 2.50), 1.34 (1.07, 1.66), 1.28 (1.05, 1.56),1.00 (reference), 1.10 (0.89, 1.37) for all-cause mortality, respectively. Results remained robust in the stratified analysis of interactions, but a L-shaped relationship was detected. We identified an inflection point of 4.5 after multivariate adjustment through a two-stage linear regression model and recursive algorithm. CONCLUSION Our findings demonstrate that increasing serum 25(OH)D levels may have a L-shaped relationship with risk of all-cause mortality and that increases in serum 25(OH)D levels do not continue to reduce the risk of all-cause mortality.
Collapse
Affiliation(s)
- Ben Hu
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
- Anhui Medical University, Hefei, 230000, Anhui, China
| | - Jian Chen
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Yihang Shi
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China
| | - Linlin Hou
- Department of Cardiology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, 230011, Anhui, China.
| |
Collapse
|
7
|
Pérez-Alonso M, Calero-Paniagua I, Usategui-Martin R, Briongos LS, Ruiz-Mambrilla M, Olmos JM, González-Sagrado M, De Luis D, Dueñas-Laita A, Pérez-Castrillón JL. Genistein supplementation has no effects on vitamin D levels in healthy Spanish postmenopausal women. INT J VITAM NUTR RES 2023. [PMID: 36919425 DOI: 10.1024/0300-9831/a000781] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background: In vitro studies have shown that genistein inhibits the CYP240 enzyme, which is involved in the degradation of 1,25-dihydroxycholecalciferol and its precursor 25-hydroxycholecalciferol, and increases their plasma levels. However, no clinical studies have primarily assessed the synergistic effect of isoflavones on vitamin D levels. The aim of this study was to evaluate the possible additive effect of genistein supplementation on vitamin D levels, calcium metabolism and bone remodeling markers in healthy postmenopausal women during the spring-summer months. Patients and methods: We made a prospective, double-blind study with 150 healthy postmenopausal women that were randomized to three groups. One received placebo, another received calcium (1000 mg/day) and vitamin D (cholecalciferol, 800 U/day) and the third received calcium (1000 mg/day), vitamin D (cholecalciferol, 800 U/day) and genistein (90 mg/day). The study period was from May to September (spring-summer). Vitamin D, PTH, CTX and P1NP were determined by electrochemiluminescence at baseline and after 12 weeks. Results: Vitamin D levels increased in all groups: placebo (23±9 ng/ml vs. 29±10 ng/ml, p<0.05), calcium+vitamin D (26±10 ng/ml vs. 33±8 ng/ml, p<0.05) and calcium+vitamin D+genistein (24±9 ng/ml vs. 31±8 ng/l, p<0.05) without between-group differences. At study end, the percentage of women with vitamin D <20 ng/ml (11%) and <30 ng/ml (39%) had fallen without between-group differences. The effects on calcium metabolism and bone remodeling markers were similar between groups: rises in vitamin D were significantly linked to reductions in PTH, CTX and P1NP. Conclusion: Adding genistein to supplementation with calcium and vitamin D provided not additional changes in vitamin D levels, calcium metabolism or bone remodeling markers in healthy Spanish postmenopausal women during the spring-summer months.
Collapse
Affiliation(s)
| | | | - Ricardo Usategui-Martin
- Department of Cell Biology, Genetics, Histology and Pharmacology, University of Valladolid, Spain
| | | | | | - José-Manuel Olmos
- Department of Internal Medicine, Marques de Valdecilla University Hospital, University of Cantabria, Spain
| | | | - Daniel De Luis
- Department of Endocrinology, Valladolid University Hospital, Valladolid, Spain
| | - Antonio Dueñas-Laita
- Department of Medicine, University of Valladolid, Spain.,Department of Clinical Pharmacology, Río Hortega University Hospital, Valladolid, Spain
| | - José-Luis Pérez-Castrillón
- Department of Medicine, University of Valladolid, Spain.,Department of Internal Medicine, Río Hortega University Hospital, Valladolid, Spain
| |
Collapse
|
8
|
Na SY, Kim KB, Lim YJ, Song HJ. Vitamin D and Colorectal Cancer: Current Perspectives and Future Directions. J Cancer Prev 2022; 27:147-156. [PMID: 36258716 PMCID: PMC9537583 DOI: 10.15430/jcp.2022.27.3.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 11/03/2022] Open
Abstract
Vitamin D is considered to be the main mediator of the beneficial effects of sun exposure. In humans, highest expression of Vitamin D receptors is found in the intestinal tract. In addition, 1α,25-dihydroxyvitamin D3 (or calcitriol), the most active Vitamin D metabolite, plays important homeostatic roles in the intestine, particularly calcium absorption. Vitamin D deficiency is defined as a serum 25-hydroxyvitamin D [25(OH)D] level of < 20 ng/mL. Previous studies show that higher circulating 25(OH)D levels are associated with reduced risk of colorectal cancer (CRC) and improved survival. Most research to date has been conducted in animals, specifically mice. Although human studies have a limited number of participants, one study recruiting a large cohort of patients with advanced or metastatic CRC revealed that higher plasma 25(OH)D levels are associated with improved overall and progression-free survival. However, the effects of Vitamin D supplementation on incidence and mortality of CRC remain inconclusive. Although Vitamin D may help to prevent cancer, there is a paucity of research demonstrating conclusively that Vitamin D alters prognosis after chemotherapy. Here, we review the mechanisms by which Vitamin D affects CRC, as well as the results of clinical, epidemiological, and human intervention studies. We also discuss current perspectives and future directions regarding Vitamin D and CRC.
Collapse
Affiliation(s)
- Soo-Young Na
- Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Ki Bae Kim
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Yun Jeong Lim
- Department of Internal Medicine, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Korea,Correspondence to Yun Jeong Lim, E-mail: , https://orcid.org/0000-0002-3279-332X
| | - Hyun Joo Song
- Department of Internal Medicine, Jeju National University College of Medicine, Jeju, Korea,Hyun Joo Song, E-mail: , https://orcid.org/0000-0002-2561-555X
| |
Collapse
|
9
|
Garrahan M, Gehman S, Rudolph SE, Tenforde AS, Ackerman KE, Popp KL, Bouxsein ML, Sahni S. Serum 25-Hydroxyvitamin D is Associated With Bone Microarchitecture and Strength in a Multiracial Cohort of Young Adults. J Clin Endocrinol Metab 2022; 107:e3679-e3688. [PMID: 35766873 PMCID: PMC9387703 DOI: 10.1210/clinem/dgac388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine whether 25-hydroxyvitamin D (25-OH D) levels are associated with bone outcomes in a multiracial cohort of young adults. METHODS This cross-sectional study included 165 participants (83 men, 82 women, 18-30 years of age) who self-identified as Asian, Black, or White. We measured bone microarchitecture and strength of the distal radius and tibia using high-resolution peripheral quantitative computed tomography. We used linear regression to estimate the association between 25-OH D (ng/mL) and bone measurements, adjusting for race, sex, age, weight, height, calcium intake, physical activity, and season. RESULTS A total of 43.6% of participants were 25-OH D deficient (<20 ng/mL) with greater prevalence in Asian (38.9%) and Black (43.1%) compared with White (18.0%) participants (P < 0.001). At the distal radius, 25-OH D was positively associated with cortical area, trabecular density, cortical thickness, cortical porosity, and failure load (P < 0.05 for all). At the distal tibia, higher 25-OH D was associated with higher cortical area, trabecular density, trabecular number, failure load, and lower trabecular separation and cortical density (P < 0.05 for all). After multivariable adjustment, those with 25-OH D deficiency had generally worse bone microarchitecture than those with 25-OH D sufficiency. Black individuals had largely more favorable bone outcomes than Asian and White individuals, despite higher prevalence of 25-OH D deficiency. CONCLUSIONS We found a high prevalence of 25-OH D deficiency in a multiracial cohort of young adults. Lower 25-OH D was associated with worse bone outcomes at the distal radius and tibia at the time of peak bone mass, warranting further attention to vitamin D status in young adults.
Collapse
Affiliation(s)
- Margaret Garrahan
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sarah Gehman
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Sara E Rudolph
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Adam S Tenforde
- Harvard Medical School, Boston, MA 02215, USA
- Spaulding Rehabilitation Hospital, Cambridge, MA 02138, USA
| | - Kathryn E Ackerman
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02215, USA
- Boston Children’s Hospital, Boston, MA 02215, USA
| | - Kristin L Popp
- Endocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02215, USA
- United StatesArmy Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Mary L Bouxsein
- Correspondence: Mary L. Bouxsein, PhD, Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, RN115, 330 Brookline Avenue, Boston, MA 02215.
| | | |
Collapse
|
10
|
Fairfield KM, Murray KA, Anzalone AJ, Beasley W, Khodaverdi M, Hodder SL, Harper J, Santangelo S, Rosen CJ. Association of Vitamin D Prescribing and Clinical Outcomes in Adults Hospitalized with COVID-19. Nutrients 2022; 14:3073. [PMID: 35893927 PMCID: PMC9332080 DOI: 10.3390/nu14153073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/13/2022] Open
Abstract
It is unclear whether vitamin D benefits inpatients with COVID-19. Objective: To examine the relationship between vitamin D and COVID-19 outcomes. Design: Cohort study. Setting: National COVID Cohort Collaborative (N3C) database. Patients: 158,835 patients with confirmed COVID-19 and a sub-cohort with severe disease (n = 81,381) hospitalized between 1 January 2020 and 31 July 2021. Methods: We identified vitamin D prescribing using codes for vitamin D and its derivatives. We created a sub-cohort defined as having severe disease as those who required mechanical ventilation or extracorporeal membrane oxygenation (ECMO), had hospitalization >5 days, or hospitalization ending in death or hospice. Using logistic regression, we adjusted for age, sex, race, BMI, Charlson Comorbidity Index, and urban/rural residence, time period, and study site. Outcomes of interest were death or transfer to hospice, longer length of stay, and mechanical ventilation/ECMO. Results: Patients treated with vitamin D were older, had more comorbidities, and higher BMI compared with patients who did not receive vitamin D. Vitamin D treatment was associated with an increased odds of death or referral for hospice (adjusted odds ratio (AOR) 1.10: 95% CI 1.05−1.14), hospital stay >5 days (AOR 1.78: 95% CI 1.74−1.83), and increased odds of mechanical ventilation/ECMO (AOR 1.49: 95% CI 1.44−1.55). In the sub-cohort of severe COVID-19, vitamin D decreased the odds of death or hospice (AOR 0.90, 95% CI 0.86−0.94), but increased the odds of hospital stay longer >5 days (AOR 2.03, 95% CI 1.87−2.21) and mechanical ventilation/ECMO (AOR 1.16, 95% CI 1.12−1.21). Limitations: Our findings could reflect more aggressive treatment due to higher severity. Conclusion: Vitamin D treatment was associated with greater odds of extended hospitalization, mechanical ventilation/ECMO, and death or hospice referral.
Collapse
Affiliation(s)
- Kathleen M. Fairfield
- MaineHealth Institute for Research, Portland, ME 04074, USA; (K.A.M.); (S.S.); (C.J.R.)
- Department of Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Kimberly A. Murray
- MaineHealth Institute for Research, Portland, ME 04074, USA; (K.A.M.); (S.S.); (C.J.R.)
| | - A. Jerrod Anzalone
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - William Beasley
- Biomedical and Behavioral Methodology Core, University of Oklahoma, Norman, OK 73019, USA;
| | - Maryam Khodaverdi
- West Virginia Clinical and Translational Science Institute, West Virginia University School of Medicine, Morgantown, WV 26506, USA; (M.K.); (S.L.H.)
| | - Sally L. Hodder
- West Virginia Clinical and Translational Science Institute, West Virginia University School of Medicine, Morgantown, WV 26506, USA; (M.K.); (S.L.H.)
| | | | - Susan Santangelo
- MaineHealth Institute for Research, Portland, ME 04074, USA; (K.A.M.); (S.S.); (C.J.R.)
- Department of Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Clifford J. Rosen
- MaineHealth Institute for Research, Portland, ME 04074, USA; (K.A.M.); (S.S.); (C.J.R.)
- Department of Medicine, Tufts University School of Medicine, Boston, MA 02111, USA
| | | |
Collapse
|
11
|
Calvo MS, Whiting SJ. Perspective: School Meal Programs Require Higher Vitamin D Fortification Levels in Milk Products and Plant-Based Alternatives-Evidence from the National Health and Nutrition Examination Surveys (NHANES 2001-2018). Adv Nutr 2022; 13:1440-1449. [PMID: 35671093 PMCID: PMC9526833 DOI: 10.1093/advances/nmac068] [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: 03/02/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 01/28/2023] Open
Abstract
Poor vitamin D status impairs bone growth and immune defense in school-aged children and adolescents, particularly in minorities. Vitamin D insufficiency/deficiency increases the risk of acute viral respiratory infection, underscoring the need for adequate vitamin D intakes during school sessions when viral exposure may be greatest. We studied available vitamin D-related survey data and published findings based on NHANES (2001-2018) to assess the dependency of vitamin D status {25-hydroxyvitamin D [25(OH)D]; in nmol/L} on vitamin D intake (μg/d) in elementary school-aged children (4-8 y), middle school children (9-13 y), and high school adolescents (14-18 y). We sought evidence supporting the need for school programs to facilitate vitamin D adequacy. Usual vitamin D intakes from food and beverages by children/adolescents (NHANES 2015-2018) examined at the 50th percentile intake by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) showed all age groups consumed less than half of the Estimated Average Requirement (EAR) for vitamin D (10 μg/d), independent of race/ethnicity. NHANES (2001-2010) analyses show evidence of lower vitamin D status in school-aged children that is linked to lower intakes of fortified milk varying over race/ethnicity and age. Adolescents had lower vitamin D status and milk intake than younger children. A total of 22-44% of vitamin D intakes occurred away from home, with larger percentages of total intakes at breakfast and lunch, at times consistent with school meals. Ever-present inadequate vitamin D intakes with a large percentage consumed away from home together with well-established benefits to growth, bone, and immune defense from enriched vitamin D-fortified milk in school intervention trials provide strong justification to require enriched vitamin D-fortified foods in school meals. An easy to implement plan for improving vitamin D intakes is possible through the FDA's amendment allowing higher vitamin D fortification levels of dairy and plant-based milk alternatives that could increase vitamin D intakes beyond the EAR with just 2 daily servings.
Collapse
Affiliation(s)
- Mona S Calvo
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | |
Collapse
|
12
|
Peng J, Yang G, Huang Z. Vitamin D Deficiency Impacts Exposure and Response of Pravastatin in Male Rats by Altering Hepatic OATPs. Front Pharmacol 2022; 13:841954. [PMID: 35250587 PMCID: PMC8892078 DOI: 10.3389/fphar.2022.841954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to determine the effect of vitamin D (VD) deficiency on the efficacy and pharmacokinetics of pravastatin and clarify whether the effects are mediated by Organic anion-transporting polypeptides (OATPs). Experiments were conducted in rats to explore the effect of VD deficiency on the pharmacodynamics and pharmacokinetics of pravastatin. In the pharmacodynamic study, rats were fed a VD-free or VD-supplement high-fat diet for 25–30 days, and plasma 25(OH)VD was dynamically monitored. The response of pravastatin (changes in blood lipids) on rats were then examined after 15 days of pravastatin treatment. In the pharmacokinetic study, rats were fed a VD-free or VD-supplement diet for 25–30 days. The pharmacokinetics of single oral dose pravastatin was then studied, and intestinal and hepatic Oatp1a1 and Oatp2b1 expression was determined using quantitative polymerase chain reaction (qPCR) and western blot. Furthermore, OATP1B1 and OATP2B1 expression in Huh7 cells with or without 1.25(OH)2D were assessed via qPCR and western blot. For the pharmacodynamic study, the decrease of total cholesterol and increase of high-density lipoprotein cholesterol in VD-deficient rats were smaller than in VD-sufficient rats, indicating that VD deficiency reduced the response of pravastatin in rats. For the pharmacokinetic study, the plasma exposure slightly increased, and liver exposure decreased in VD-deficient rats, but not significantly. VD deficiency decreased the Oatp1a1 and Oatp2b1 expression in the liver, but not in the small intestine. Similarly, OATP1B1 and OATP2B1 protein levels in Huh7 cells were reduced when 1.25(OH)2D was absent. In conclusion, VD deficiency can decrease the response of pravastatin in rats by reducing the liver pravastatin exposure and expression of hepatic OATPs, consistent with the extended hepatic clearance model theory.
Collapse
Affiliation(s)
- Jinfu Peng
- Department of Pharmacy, The Third Xiangya Hospital, Central South University, Changsha, China
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jinfu Peng, ; Zhijun Huang,
| | - Guoping Yang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Zhijun Huang
- Center for Clinical Pharmacology, The Third Xiangya Hospital, Central South University, Changsha, China
- Department of Nephrology, The Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Jinfu Peng, ; Zhijun Huang,
| |
Collapse
|
13
|
The interplay of pineal hormones and socioeconomic status leading to colorectal cancer disparity. Transl Oncol 2022; 16:101330. [PMID: 34990909 PMCID: PMC8741600 DOI: 10.1016/j.tranon.2021.101330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Despite increased screening options and state-of-art treatments offered in clinics, racial differences remain in CRC. African Americans (AAs) are disproportionately affected by the disease; the incidence and mortality are higher in AAs than Caucasian Americans (CAs). At the time of diagnosis, AAs more often present with advanced stages and aggressive CRCs, primarily accounting for the racial differences in therapeutic outcomes and mortality. The early incidence of CRC in AAs could be attributed to race-specific gene polymorphisms and lifestyle choices associated with socioeconomic status (SES). Altered melatonin-serotonin signaling, besides the established CRC risk factors (age, diet, obesity, alcoholism, and tobacco use), steered by SES, glucocorticoid, and Vitamin D status in AAs could also account for the early incidence in this racial group. This review focuses on how the lifestyle factors, diet, allelic variants, and altered expression of specific genes could lead to atypical serotonin and melatonin signaling by modulating the synthesis, secretion, and signaling of these pineal hormones in AAs and predisposing them to develop more aggressive CRC earlier than CAs. Crosstalk between gut microbiota and pineal hormones and its impact on CRC pathobiology is addressed from a race-specific perspective. Lastly, the status of melatonin-focused CRC treatments, the need to better understand the perturbed melatonin signaling, and the potential of pineal hormone-directed therapeutic interventions to reduce CRC-associated disparity are discussed.
Collapse
|
14
|
Relationship between Serum 25OH-Vitamin D2 Level and Vitamin D Status of Children Aged 3-5 Years in China. Nutrients 2021; 13:nu13114135. [PMID: 34836390 PMCID: PMC8619457 DOI: 10.3390/nu13114135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Vitamin D deficiency is prevalent globally and there is lack of evidence as to how 25(OH)D2 contributes to vitamin D status. The aim of this study was to describe vitamin D status and to assess the role of vitamin D2, a dietary vitamin D source, against the vitamin D status of children aged 3–5 years in China. Methods: Data were extracted from the Chinese National Nutrition and Health Surveillance (CNNHS) in 2013. The concentration of serum 25(OH)D2 and 25(OH)D3 was measured by using LC-MS/MS. Results: A total of 1435 subjects were enrolled and serum 25(OH)D were analyzed. The prevalence of total serum 25(OH)D < 30 nmol/L was 8.9%. Serum 25(OH)D2 was detected in 10.9% of the studied children. After adjusting for confounding factors, total 25(OH)D concentration was 8.48 nmol/L lower and odds ratio of vitamin D deficiency was 4.20 times (OR (95%CI): 4.20 (1.64, 10.77)) in children without 25(OH)D2 than those with 25(OH)D2 detected. Conclusions: Vitamin D deficiency was common among children aged 3–5 years in China. Vitamin D2 may play a role in preventing vitamin D deficiency in Chinese children aged 3–5 years.
Collapse
|
15
|
Vitamin-D Binding Protein Gene Polymorphisms and Serum 25-Hydroxyvitamin-D in a Turkish Population. Metabolites 2021; 11:metabo11100696. [PMID: 34677411 PMCID: PMC8537126 DOI: 10.3390/metabo11100696] [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: 08/26/2021] [Revised: 09/18/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022] Open
Abstract
The rs7041 and rs4588 polymorphisms found in the GC gene, encoding vitamin D-binding protein (DBP), have distinct biochemical phenotypes. The aim of this study was to investigate vitamin D parameters with these polymorphisms, in individuals with possible vitamin D deficiency. The most common (49% of the cohort) genotype in rs7041 was GT, especially among individuals with high levels of free 25(OH)D calculated but with low levels of bioavailable 25(OH)D, and in rs4588 it was AC in particular among the individuals with low levels of bioavailable 25(OH)D. The most common phenotypes were Gc1s/2 (35.3%) and Gc1s/1s (31.4%), and Gc1f/1f was rare (5.9%). The variations in free and bioavailable 25(OH)D levels among healthy Turkish individuals may be attributed to the variations in total 25(OH)D as well as GC gene polymorphisms. The Turkish population shares a similarity for allele frequencies of rs7041 with the European population and similarity for allele frequencies of rs4588 with Gujarati Indians, and this may also be important in relation to certain ethnic populations showing associations between vitamin D and COVID-19.
Collapse
|
16
|
Abstract
BACKGROUND Vitamin D, along with parathyroid hormone (PTH) and calcitonin, is an important hormone that affects bone and calcium metabolism. OBJECTIVES To evaluate the vitamin D status and its seasonal variation in the adult population of Bursa. METHODS Since there is not enough information about vitamin D levels, 25 OH vitamin D levels were analysed retrospectively from the records of 11,734 adult subjects (9142 women, 2592 men) admitted to 24 family health centres located in different districts of Bursa between 1 December 2017 and 30 November 2018. Some tests that can affect vitamin D levels, demographic features, and accompanying comorbidities were also evaluated. A face-to-face questionnaire was administered to subjects who were willing to answer (n = 2965). RESULTS The mean serum vitamin D level was 16.6 ± 11.5 ng/mL in the entire population, 15.8 ± 11.7 ng/mL in women and 19.5 ± 9.9 ng/mL in men. The percentage of subjects with a vitamin D level <20 ng/mL was highest in March-May and lowest in the September-November period (80.7% and 69.9% for women, 77.5% and 32.9% for men, respectively). CONCLUSION Vitamin D levels <20 ng/mL are more prominent in women, and decline in spring, in the adult population of Bursa. These results are meaningful for the population living in Bursa, Turkey and the northern European region.
Collapse
Affiliation(s)
- Olgun Göktaş
- Family Practice Unit, Uludağ University Family Health Center, Bursa, Turkey
| | - Canan Ersoy
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ilker Ercan
- Department of Biostatistics, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Fatma Ezgi Can
- Department of Biostatistics, İzmir Katip Çelebi University Faculty of Medicine, İzmir, Turkey
| |
Collapse
|
17
|
Schleicher RL, Sternberg MR, Potischman N, Gahche JJ, Storandt RJ, Maw KL, Pfeiffer CM. Supplemental Vitamin D Increased Serum Total 25-Hydroxyvitamin D in the US Adult Population During 2007-2014. J Nutr 2021; 151:2446-2454. [PMID: 34036360 PMCID: PMC8349116 DOI: 10.1093/jn/nxab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/11/2021] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Data from the 2007-2010 NHANES suggested that vitamin D supplements contributed to increased serum concentrations of 25-hydroxyvitamin D [25(OH)D] in the US population. OBJECTIVES We sought to determine whether 25(OH)D continued to increase during NHANES 2011-2014 and whether associations of 25(OH)D with preselected covariates differed across time periods. METHODS For this study, 25(OH)D was measured in adults (≥20 y) using LC-MS/MS. Descriptive and regression analyses were stratified by survey period to investigate the effects of age, race-Hispanic origin, sex, season, BMI, dietary vitamin D, and vitamin D-containing supplements. A multiple linear regression model was used to assess 25(OH)D changes between two 4-y survey periods, namely 2007-2010 and 2011-2014. RESULTS We observed several significant concomitant increases between 2007-2010 and 2011-2014: unadjusted mean 25(OH)D increased by 2.7 nmol/L (95% CI: 0, 5.4 nmol/L; P = 0.048), the percentage of persons taking any vitamin D-containing supplements increased 2.9% (95% CI: 0.03, 5.5%; P = 0.0314), and the percentage of persons taking high-dose (≥1000 IU/d) vitamin D-containing supplements increased 8.6% (95% CI: 6.9, 9.9%; P < 0.0001). With covariate adjustment, the increase in 25(OH)D from 2007-2010 to 2011-2014 was no longer statistically significant [1.4 nmol/L (95% CI: -3.0, 0.23 nmol/L; P = 0.09)]. After adjustments, several large differences in 25(OH)D remained, namely non-Hispanic blacks had 25(OH)D 22 nmol/L lower than that of non-Hispanic whites, and users of vitamin D-containing supplements ≥1000 IU/d had 25(OH)D 31 nmol/L higher than that of nonusers. CONCLUSIONS After adjusting for vitamin D supplement dose, the overall adjusted increase in 25(OH)D was no longer statistically significant, suggesting that changes in US adults' 25(OH)D concentrations between NHANES periods 2007-2010 and 2011-2014 may primarily be associated with changes in vitamin D supplementation.
Collapse
Affiliation(s)
| | | | | | | | - Renee J Storandt
- National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - Khin L Maw
- National Center for Environmental Health, CDC, Atlanta, GA, USA
| | | |
Collapse
|
18
|
Palmer ND, Lu L, Register TC, Lenchik L, Carr JJ, Hicks PJ, Smith SC, Xu J, Dimitrov L, Keaton J, Guan M, Ng MCY, Chen YDI, Hanley AJ, Engelman CD, Norris JM, Langefeld CD, Wagenknecht LE, Bowden DW, Freedman BI, Divers J. Genome-wide association study of vitamin D concentrations and bone mineral density in the African American-Diabetes Heart Study. PLoS One 2021; 16:e0251423. [PMID: 34014961 PMCID: PMC8136717 DOI: 10.1371/journal.pone.0251423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/26/2021] [Indexed: 12/29/2022] Open
Abstract
Relative to European Americans, African Americans have lower 25-hydroxyvitamin D (25OHD) and vitamin D binding protein (VDBP) concentrations, higher 1,25-dihydroxyvitamin D (1,25(OH)2D3) concentrations and bone mineral density (BMD), and paradoxically reduced burdens of calcified atherosclerotic plaque (subclinical atherosclerosis). To identify genetic factors contributing to vitamin D and BMD measures, association analysis of >14M variants was conducted in a maximum of 697 African American-Diabetes Heart Study participants with type 2 diabetes (T2D). The most significant association signals were detected for VDBP on chromosome 4; variants rs7041 (β = 0.44, SE = 0.019, P = 9.4x10-86) and rs4588 (β = 0.17, SE = 0.021, P = 3.5x10-08) in the group-specific component (vitamin D binding protein) gene (GC). These variants were found to be independently associated. In addition, rs7041 was also associated with bioavailable vitamin D (BAVD; β = 0.16, SE = 0.02, P = 3.3x10-19). Six rare variants were significantly associated with 25OHD, including a non-synonymous variant in HSPG2 (rs116788687; β = -1.07, SE = 0.17, P = 2.2x10-10) and an intronic variant in TNIK (rs143555701; β = -1.01, SE = 0.18, P = 9.0x10-10), both biologically related to bone development. Variants associated with 25OHD failed to replicate in African Americans from the Insulin Resistance Atherosclerosis Family Study (IRASFS). Evaluation of vitamin D metabolism and bone mineral density phenotypes in an African American population enriched for T2D could provide insight into ethnic specific differences in vitamin D metabolism and bone mineral density.
Collapse
Affiliation(s)
- Nicholette D. Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail: (NDP); (BIF)
| | - Lingyi Lu
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Thomas C. Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - J. Jeffrey Carr
- Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Pamela J. Hicks
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - S. Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Jianzhao Xu
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Latchezar Dimitrov
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Jacob Keaton
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Meijian Guan
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Maggie C. Y. Ng
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Yii-der I. Chen
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Anthony J. Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Jill M. Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America
| | - Carl D. Langefeld
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Lynne E. Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Donald W. Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Barry I. Freedman
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Department of Internal Medicine-Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail: (NDP); (BIF)
| | - Jasmin Divers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| |
Collapse
|
19
|
Izzo M, Carrizzo A, Izzo C, Cappello E, Cecere D, Ciccarelli M, Iannece P, Damato A, Vecchione C, Pompeo F. Vitamin D: Not Just Bone Metabolism but a Key Player in Cardiovascular Diseases. Life (Basel) 2021; 11:life11050452. [PMID: 34070202 PMCID: PMC8158519 DOI: 10.3390/life11050452] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/03/2021] [Accepted: 05/13/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is the first item of drug expenditure for the treatment of osteoporosis. Its deficiency is a condition that affects not only older individuals but also young people. Recently, the scientific community has focused its attention on the possible role of vitamin D in the development of several chronic diseases such as cardiovascular and metabolic diseases. This review aims to highlight the possible role of vitamin D in cardiovascular and metabolic diseases. In particular, here we examine (1) the role of vitamin D in diabetes mellitus, metabolic syndrome, and obesity, and its influence on insulin secretion; (2) its role in atherosclerosis, in which chronic vitamin D deficiency, lower than 20 ng/mL (50 nmol/L), has emerged among the new risk factors; (3) the role of vitamin D in essential hypertension, in which low plasma levels of vitamin D have been associated with both an increase in the prevalence of hypertension and diastolic hypertension; (4) the role of vitamin D in peripheral arteriopathies and aneurysmal pathology, reporting that patients with peripheral artery diseases had lower vitamin D values than non-suffering PAD controls; (5) the genetic and epigenetic role of vitamin D, highlighting its transcriptional regulation capacity; and (6) the role of vitamin D in cardiac remodeling and disease. Despite the many observational studies and meta-analyses supporting the critical role of vitamin D in cardiovascular physiopathology, clinical trials designed to evaluate the specific role of vitamin D in cardiovascular disease are scarce. The characterization of the importance of vitamin D as a marker of pathology should represent a future research challenge.
Collapse
Affiliation(s)
- Marcello Izzo
- Department of Mathematics for Technology, Medicine and Biosciences Research Center, University of Ferrara, 44121 Ferrara, Italy
- Specialist Medical Center-Via Cimitile, 80035 Nola, Italy
- Correspondence:
| | - Albino Carrizzo
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (C.I.); (M.C.); (P.I.)
| | - Carmine Izzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (C.I.); (M.C.); (P.I.)
| | - Enrico Cappello
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
| | - Domenico Cecere
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (C.I.); (M.C.); (P.I.)
| | - Patrizia Iannece
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (C.I.); (M.C.); (P.I.)
| | - Antonio Damato
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
| | - Carmine Vecchione
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy; (C.I.); (M.C.); (P.I.)
| | - Francesco Pompeo
- IRCCS Neuromed, 86077 Pozzilli, Italy; (A.C.); (E.C.); (D.C.); (A.D.); (C.V.); (F.P.)
| |
Collapse
|
20
|
Qorbani M, Mahdavi Gorabi A, Ejtahed HS, Namazi N, Khoramdad M, Heshmat R, Kazemian E, Kelishadi R. Percentile values for serum levels of vitamins A and D in Iranian children and adolescents: The CASPIAN-V study. Nutrition 2021; 90:111307. [PMID: 34116487 DOI: 10.1016/j.nut.2021.111307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 04/18/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The reference values to determine vitamin A and D deficiency may vary based on ethnicity, age, and region of residence. The aim of this study was to determine the reference interval of circulating vitamin A and D levels among Iranian children and adolescents based on sex, age, and region of residence. METHODS This nationwide cross-sectional study was performed with 2596 students 7 to 18 y of age from the CASPIAN-V (Childhood and Adolescence Surveillance and Prevention of Adult Non- communicable disease) study. A parametric method was used to define the age-specific reference values by obtaining smooth centile curves and explicit formulae for the centile estimates and SD scores for both sexes and regions of residence. RESULTS Significant differences were found between the residents of rural and urban regions in terms of serum 25-hydroxyvitamin D [25(OH)D] and retinol concentration (P < 0.05). Boys (27 ± 8 versus 26.04 ± 10, P = 0.009). Children ages 7 to 12 y had higher serum 25(OH)D concentration than 13- to 18-y-old adolescents (26.96 ± 8 versus 26.04 ± 10, P = 0.007). The estimated reference interval for circulating 25(OH)D levels corresponding to the range between the 5th and 95th percentiles were 11.45 to 48.40 ng/mL in boys and 9.51 to 47.69 ng/mL in girls. Estimated reference intervals for serum retinol concentration among boys and girls corresponding to the 5th and 95th percentiles were 0.58 to 3.38 and 0.58 to 4.52, respectively. There were significant variations in both retinol and 25(OH)D concentrations across different age groups. CONCLUSION This study established the reference intervals for circulating 25(OH)D and retinol levels in Iranian adolescents and children in different age groups based on sex and region.
Collapse
Affiliation(s)
- Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran; Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi Gorabi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maliheh Khoramdad
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Kazemian
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
21
|
Pu Y, Zhu G, Xu Y, Zheng S, Tang B, Huang H, Wu IXY, Huang D, Liu Y, Zhang X. Association Between Vitamin D Exposure and Head and Neck Cancer: A Systematic Review With Meta-Analysis. Front Immunol 2021; 12:627226. [PMID: 33732250 PMCID: PMC7959800 DOI: 10.3389/fimmu.2021.627226] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/12/2021] [Indexed: 12/31/2022] Open
Abstract
Background Vitamin D deficiency is a well-described preventable cause of many cancers; the association of vitamin D use with the development of head and neck cancer (HNC) is not clear. We aim to conduct a systematic review of the studies assessing the relation between vitamin D exposure and the prevention and prognosis of the HNC using meta-analysis. Methods PubMed, EMBASE, Cochrane Library, Web of Science up to 1 January 2021, and reference lists of related studies were searched. We extracted observational studies reporting the association between vitamin D (vitamin D receptor gene polymorphisms, 25-hydroxyvitamin D concentrations, and vitamin D intake) and the outcomes of interest (HNC incidence and HNC mortality) in HNC patients aged 18 or older. Fixed effects models were used to calculate pooled effect sizes and 95% confidence intervals (CIs) by RevMan (version 5.3). Results Sixteen studies with a total of 81,908 participants were enrolled in our meta-analysis. Based on the pooled genomic analysis, comparing with participants with the genotypes of Ff + FF or FF, the pooled odds ratio (OR) of participants with the genotype of ff was 0.77 (95% CI: 0.61 to 0.97) and 0.75 (0.58 to 0.97), respectively. A similar trend was noted when comparing tt with Tt + TT or TT, in which OR (95% CI) was 0.70 (0.55 to 0.90) and 0.72 (0.55 to 0.95). No significant association was identified between BsmI polymorphism and HNC. Furthermore, the OR of HNC incidence was 0.77 (0.65 to 0.92) for participants with vitamin D intake over the ones with a regular diet. High concentrations of circulated 25-hydroxyvitamin D (25-OHD) significantly decreased by 32% of HNC incidence (OR (95% CI): 0.68 (0.59 to 0.78)) and increased HNC survival (pooled hazard ratio 1.13, 1.05 to 1.22) during a 4-5 years follow-up. High concentrations of circulating 25-OHD in patients with HNC led to a decreased risk of mortality to 0.75 (0.60 to 0.94) as the follow-up extends to 8-12 years. Conclusions Elevated activities of vitamin D by diet intake, genomic polymorphisms, or circulated 25-OHD may protect people from HNC and improve the prognosis of patients with HNC. Systematic Review Registration PROSPERO, identifier CRD42020176002 (https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=176002).
Collapse
Affiliation(s)
- Yuting Pu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China
| | - Gangcai Zhu
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yimin Xu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China
| | - Siyuan Zheng
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China
| | - Bin Tang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China
| | - Huimei Huang
- Department of Otolaryngology-Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Irene X Y Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Donghai Huang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (XiangYa Hospital), Changsha, China
| | - Yong Liu
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (XiangYa Hospital), Changsha, China
| | - Xin Zhang
- Department of Otolaryngology-Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Changsha, China.,Otolaryngology Major Disease Research Key Laboratory of Hunan Province, Changsha, China.,National Clinical Research Center for Geriatric Disorders (XiangYa Hospital), Changsha, China
| |
Collapse
|
22
|
Haase DR, Brown K, Templeton KJ. Adolescent Athlete Stress Fractures Associated with Vitamin D Insufficiency: Three Cases with Review of the Literature. JBJS Case Connect 2021; 11:01709767-202103000-00027. [PMID: 33617155 DOI: 10.2106/jbjs.cc.20.00367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE The authors present 3 adolescent athletes who presented with stress fractures in their lower extremities, initially diagnosed as tumors. All 3 patients received an inconclusive magnetic resonance imaging before referral; fractures were confirmed on radiographs and computed tomography. All were found to have vitamin D insufficiency. CONCLUSIONS Vitamin D insufficiency is a global epidemic mainly focused on adults and young-adult athletes. These case reports raise concerns about a growing prevalence of vitamin D insufficiency in adolescents, the potential risk of stress fracture, and the need for screening and possible supplementation in adolescent athletes to improve their bone health.
Collapse
Affiliation(s)
- Douglas R Haase
- Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas
| | - Kevin Brown
- Department of Radiology, University of Kansas Medical Center, Kansas City, Kansas
| | - Kimberly J Templeton
- Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas
| |
Collapse
|
23
|
Ho P, Zheng JQ, Wu CC, Hou YC, Liu WC, Lu CL, Zheng CM, Lu KC, Chao YC. Perspective Adjunctive Therapies for COVID-19: Beyond Antiviral Therapy. Int J Med Sci 2021; 18:314-324. [PMID: 33390800 PMCID: PMC7757136 DOI: 10.7150/ijms.51935] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 11/02/2020] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is the largest health crisis ever faced worldwide. It has resulted in great health and economic costs because no effective treatment is currently available. Since infected persons vary in presentation from healthy asymptomatic mild symptoms to those who need intensive care support and eventually succumb to the disease, this illness is considered to depend primarily on individual immunity. Demographic distribution and disease severity in several regions of the world vary; therefore, it is believed that natural inherent immunity provided through dietary sources and traditional medicines could play an important role in infection prevention and disease progression. People can boost their immunity to prevent them from infection after COVID-19 exposure and can reduce their inflammatory reactions to protect their organ deterioration in case suffering from the disease. Some drugs with in-situ immunomodulatory and anti-inflammatory activity are also identified as adjunctive therapy in the COVID-19 era. This review discusses the importance of COVID-19 interactions with immune cells and inflammatory cells; and further emphasizes the possible pathways related with traditional herbs, medications and nutritional products. We believe that such pathophysiological pathway approach treatment is rational and important for future development of new therapeutic agents for prevention or cure of COVID-19 infection.
Collapse
Affiliation(s)
- Ping Ho
- Division of General Surgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
| | - Jing-Quan Zheng
- Division of Pulmonary Medicine, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
| | - Chia-Chao Wu
- Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
| | - Yi-Chou Hou
- Division of Nephrology, Department of Medicine, Cardinal-Tien Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 234, Taiwan
| | - Wen-Chih Liu
- Division of Nephrology, Department of Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City 242, Taiwan
| | - Chien-Lin Lu
- Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, School of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan
| | - Cai-Mei Zheng
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Shuang Ho Hospital, 235 New Taipei City, Taiwan.,Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, 110 Taipei, Taiwan.,Taipei Medical University-Research Center of Urology and Kidney (TMU-RCUK), Taipei Medical University, 110 Taipei, Taiwan
| | - Kuo-Cheng Lu
- Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan
| | - You-Chen Chao
- Division of Gastroenterology, Department of Internal Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan.,School of Medicine, Tzu Chi University, Hualien 970, Taiwan
| |
Collapse
|
24
|
Sahasrabudhe N, Lee JS, Scott TM, Punnett L, Tucker KL, Palacios N. Serum Vitamin D and Depressive Symptomatology among Boston-Area Puerto Ricans. J Nutr 2020; 150:3231-3240. [PMID: 33025014 PMCID: PMC7726122 DOI: 10.1093/jn/nxaa253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/08/2020] [Accepted: 07/30/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Low vitamin D status, assessed using serum 25-hydroxyvitamin D [25(OH)D] concentration, has been associated with depression, but research among minority populations, such as Puerto Ricans is limited. We examined the association between serum 25(OH)D and self-reported depressive symptomatology across 3 waves of follow-up in a cohort of Puerto Rican adults residing in Massachusetts. OBJECTIVES We evaluated the cross-sectional and longitudinal associations between serum 25(OH)D and self-reported depressive symptoms in the Boston Puerto Rican Health Study (BPRHS) cohort. METHODS Participants of the BPRHS were evaluated for depressive symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D). Serum 25(OH)D was measured at baseline (n = 1434), year 2 (n = 1218), and year 5 (n = 914). We categorized serum 25(OH)D concentration as sufficient (≥20 ng/mL), insufficient (12 to <20 ng/mL), and deficient (<12 ng/mL). Multivariable linear regression was used for cross-sectional analyses at baseline, and repeated measures mixed effects modeling was used over 3 waves of follow-up for longitudinal analyses. We conducted sensitivity analyses in vitamin D supplement nonusers and participants with complete data on baseline serum 25(OH)D and CES-D at all 3 visits. RESULTS Serum 25(OH)D concentration was not associated with CES-D score in cross-sectional analysis [β = -0.85; 95% CI: -2.80, 1.10 for deficient compared with sufficient 25(OH)D; P-trend = 0.59] or in longitudinal analyses over 5 y [β = -0.41; 95% CI: -1.95, 1.13 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. Results were similar in sensitivity analyses restricted to vitamin D supplement nonusers (n = 1371) and in analyses conducted in participants with complete measures of baseline serum 25(OH)D and CES-D score at all 3 visits (n = 887) [β = -0.12; 95% CI: -1.98, 1.74 for deficient compared with sufficient 25(OH)D; P-trend = 0.93]. CONCLUSIONS We did not observe a significant association between serum 25(OH)D and depressive symptomatology in the BPRHS cohort.
Collapse
Affiliation(s)
- Neha Sahasrabudhe
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Jong Soo Lee
- Department of Mathematical Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Tammy M Scott
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Natalia Palacios
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
- Geriatric Research Education Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
- Department of Nutrition, Harvard University School of Public Health, Boston, MA, USA
| |
Collapse
|
25
|
Rabiee A, AboElsoud M, Seif El Nasr SM, Abouzeid S. Screening of serum 25-hydroxyvitamin D levels among elderly Egyptians admitted to the orthogeriatric unit by fracture hip. THE EGYPTIAN JOURNAL OF INTERNAL MEDICINE 2020. [DOI: 10.1186/s43162-020-00023-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Vitamin D deficiency increases muscle weakness and pain leading to reduced power and function, increased bone turnover and increased risk of falls and hip fractures in elderly. We postulated that vitamin D deficiency in sunny Egypt should be lower than western countries so we screen for prevalence of vitamin D deficiency among all elderly patient admitted to orthogeriatric unit by fracture hip.
Results
Our study showed that vitamin D deficiency is common in elderly Egyptian patients admitted to orthogeriatric unit with hip fractures.
Of the study group (n 290 patients) vitamin D levels were sufficient (30 ng/dl or more) in 24 patients (8.3%) and insufficient (between 20 ng and 30 ng) in 125 patients (43.1%) and deficient (less than 20) in 141 patients (48.7%). Among the study group, female patients had lower levels of vitamin D (18.8 ± 6.9) compared to males (20.5 ± 6.7) P value 0.034.
Although our study failed to link different levels of vitamin D with activity of daily life: P value was (0.116) in bathing, (0.058) in dressing, (0.115) in toileting and (054) in transfer.
A little difference was found in feeding (0.036) and previous fall (0.011) and cognitive impairment; MiniCOG < 3 P value 0.017. Both previous falls and cognitive decline are in turn linked to increased fracture risk
Conclusion
Hypovitaminosis D is common among older patients with hip fractures even in sunny Egypt remaining slightly lower than its prevalence in western countries. Although no direct significant correlations with activity of daily life, vitamin D deficiency was associated with higher risks of previous falls and cognitive impairment both in turn increases the risk of fractures.
Collapse
|
26
|
Vitamin D status in children and adults in Sweden: dietary intake and 25-hydroxyvitamin D concentrations in children aged 10-12 years and adults aged 18-80 years. J Nutr Sci 2020; 9:e47. [PMID: 33101664 PMCID: PMC7550965 DOI: 10.1017/jns.2020.40] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 08/13/2020] [Accepted: 09/04/2020] [Indexed: 01/26/2023] Open
Abstract
The study aimed to estimate vitamin D intake and plasma/serum 25-hydroxyvitamin D (25(OH)D) concentrations, investigate determinants of 25(OH)D concentrations and compare two 25(OH)D assays. We conducted two nationwide cross-sectional studies in Sweden with 206 school children aged 10-12 years and 1797 adults aged 18-80 years (n 268 provided blood samples). A web-based dietary record was used to assess dietary intake. Plasma/serum 25(OH)D was analysed by liquid chromatography-mass spectrometry (LC-MS) and immunoassay in adults and LC-MS/MS in children. Most participants reported a vitamin D intake below the average requirement (AR), 16 % of children and 33 % of adults met the AR (7⋅5 μg). In adults, plasma 25(OH)D below 30 and 50 nmol/l were found in 1 and 18 % of participants during the summer period and in 9 and 40 % of participants during the winter period, respectively. In children, serum 25(OH)D below 30 and 50 nmol/l were found in 5 and 42 % of participants (samples collected March-May), respectively. Higher 25(OH)D concentrations were associated with the summer season, vacations in sunny locations (adults), and dietary intake of vitamin D and use of vitamin D supplements, while lower concentrations were associated with a higher BMI and an origin outside of Europe. Concentrations of 25(OH)D were lower using the immunoassay than with the LC-MS assay, but associations with dietary factors and seasonal variability were similar. In conclusion, vitamin D intake was lower than the AR, especially in children. The 25(OH)D concentrations were low in many participants, but few participants had a concentration below 30 nmol/l.
Collapse
|
27
|
Thompson MJW, Jones G, Balogun SA, Aitken DA. Skin Photosensitivity is Associated with 25-Hydroxyvitamin D and BMD but not Fractures Independent of Melanin Density in Older Caucasian Adults. Calcif Tissue Int 2020; 107:335-344. [PMID: 32696106 DOI: 10.1007/s00223-020-00728-w] [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: 04/26/2020] [Accepted: 07/10/2020] [Indexed: 11/24/2022]
Abstract
Whether skin photosensitivity modulates sun exposure behaviours, consequent vitamin D status and skeletal health outcomes independently of constitutive pigmentation have not been systematically investigated. 1072 community-dwelling adults aged 50-80 years had skin photosensitivity quantified by questionnaire and melanin density by spectrophotometry. Bone mineral density (BMD), falls risk and 25-hydroxyvitamin D (25OHD) were measured using DXA, short form physiological profile assessment and radioimmunoassay, respectively. Sun exposure and symptomatic fractures were assessed by questionnaire. Participants were followed up at 2.5 (n = 879), 5 (n = 767) and 10 (n = 571) years. Higher resistance to sunburn and greater ability to tan were associated with reduced sun protection behaviours (RR 0.87, p < 0.001 & RR 0.88, p < 0.001), higher lifetime discretionary sun exposure in summer (RR 1.05, p = 0.001 & RR 1.07, p = 0.001) and winter (RR 1.07, p = 0.001 & RR 1.08, p = 0.02) and fewer lifetime sunburns (RR 0.86, p < 0.001 & RR 0.91, p = 0.001). Higher resistance to sunburn was associated with lower total body (β = - 0.006, p = 0.047) and femoral neck (β = - 0.006, p = 0.038) BMD, but paradoxically, fewer prevalent fractures (RR 0.94, p = 0.042). Greater ability to tan was associated with higher 25OHD (β = 1.43, p = 0.04), lumbar spine (β = 0.014, p = 0.046) and total body (β = 0.013, p = 0.006) BMD, but not fracture or falls risk. These associations were independent of constitutive melanin density. Cutaneous photosensitivity was associated with sun exposure behaviours, cutaneous sequelae and, consequently, 25OHD and BMD in older Caucasian adults independent of constitutive melanin density. There was no consistent association with fracture outcomes, suggesting environmental factors are at least as important.
Collapse
Affiliation(s)
- M J W Thompson
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia.
| | - G Jones
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
| | - S A Balogun
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
| | - D A Aitken
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St, Hobart, TAS, 7000, Australia
| |
Collapse
|
28
|
Teymoori-Rad M, Marashi SM. Vitamin D and Covid-19: From potential therapeutic effects to unanswered questions. Rev Med Virol 2020; 31:e2159. [PMID: 32856339 DOI: 10.1002/rmv.2159] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 12/12/2022]
Abstract
Evidence suggests that vitamin D supplementation could potentially be effective either in treatment or prevention of coronavirus disease 2019 (Covid-19). Indeed, several studies and trials have begun to investigate the impact of vitamin D supplementation on patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, we focus on the potential mechanisms of vitamin D in the pathogenesis of Covid-19. We consider whether deficiency of vitamin D may be one of the underlying biological factors that could explain the excess mortality seen among non-Caucasians. We also raise several important questions which need to be addressed to provide a clear picture of the extent to which vitamin D supplementation may benefit patients with Covid-19, particularly those with underlying risk factors.
Collapse
Affiliation(s)
- Majid Teymoori-Rad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Mahdi Marashi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
29
|
Martins YA, Cardinali CAEF, Ravanelli MI, Brunaldi K. Is hypovitaminosis D associated with fibromyalgia? A systematic review. Nutr Rev 2020; 78:115-133. [PMID: 31397485 DOI: 10.1093/nutrit/nuz033] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Recent findings have suggested a high prevalence of vitamin D deficiency or insufficiency in fibromyalgia (FM) patients despite the lack of clinical and pathophysiological evidence. OBJECTIVE A systematic review was conducted to examine the association between vitamin D status and FM, including the effect of vitamin D supplementation. DATA SOURCE PubMed, LILACS, Scopus, SciELO, Cochrane, and EMBASE were searched, from January 2000 to July 2018, using the descriptors "Fibromyalgia" and "Vitamin D." STUDY SELECTION Trials including FM patients in whom vitamin D levels were assessed were eligible for inclusion. DATA EXTRACTION Data comprised age, gender, country, aims, bias, diagnosis criteria, cutoff point, and status of vitamin D, together with FM symptoms and vitamin D supplementation protocol. RESULTS A total of 26 articles were selected. Most of the studies were found to present unreliable control groups and small samples. Experimental data on vitamin D supplementation indicated improvement in certain FM symptoms. CONCLUSION Prevalence of hypovitaminosis D in the FM population and the cause-effect relationship were inconclusive. Nevertheless, vitamin D supplementation may be considered as a co-adjuvant in FM therapy.
Collapse
Affiliation(s)
- Yandara A Martins
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Camila A E F Cardinali
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Maria Ida Ravanelli
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| | - Kellen Brunaldi
- Y.A. Martins, C.A.E.F. Cardinali, M.I. Ravanelli, and K. Brunaldi are with the Department of Physiological Sciences, State University of Maringa, Maringa, Parana, Brazil
| |
Collapse
|
30
|
Urbaneja P, Hurtado-Guerrero I, Hernández MÁ, Oliver-Martos B, Oreja-Guevara C, Ortega-Pinazo J, Alonso A, Barón-López FJ, Leyva L, Fernández Ó, Pinto-Medel MJ. Skin Phototype Could Be a Risk Factor for Multiple Sclerosis. J Clin Med 2020; 9:jcm9082384. [PMID: 32722577 PMCID: PMC7464407 DOI: 10.3390/jcm9082384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 11/30/2022] Open
Abstract
Environmental and genetic factors are assumed to be necessary for the development of multiple sclerosis (MS), however its interactions are still unclear. For this reason here, we have not only analyzed the impact on increased risk of MS of the best known factors (HLA-DRB1*15:01 allele, sun exposure, vitamin D levels, smoking habit), but we have included another factor (skin phototype) that has not been analyzed in depth until now. This study included 149 MS patients and 147 controls. A multivariate logistic regression (LR) model was carried out to determine the impact of each of the factors on the increased risk of MS. Receiver Operating Characteristics (ROC) analysis was performed to evaluate predictive value of the models. Our multifactorial LR model of susceptibility showed that females with light brown skin (LBS), smokers and who had HLA-DRB1*15:01 allele had a higher MS risk (LBS: OR = 5.90, IC95% = 2.39–15.45; smoker: OR = 4.52, IC95% = 2.69–7.72; presence of HLA-DRB1*15:01: OR = 2.39, IC95% = 1.30–4.50; female: OR = 1.88, IC95% = 1.08–3.30). This model had an acceptable discriminant value with an Area Under a Curve AUC of 0.76 (0.69–0.82). Our study indicates that MS risk is determined by complex interactions between sex, environmental factors, and genotype where the milieu could provide the enabling proinflammatory environment that drives an autoimmune attack against myelin by self-reactive lymphocytes.
Collapse
Affiliation(s)
- Patricia Urbaneja
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Isaac Hurtado-Guerrero
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Miguel Ángel Hernández
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Unit of Multiple Sclerosis, Department of Neurology, Hospital Universitario Ntra. Sra. de Candelaria, 38010 Santa Cruz de Tenerife, Spain
| | - Begoña Oliver-Martos
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Celia Oreja-Guevara
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Department of Neurology, Hospital Clínico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid (UCM), IdISSC, 28040 Madrid, Spain
| | - Jesús Ortega-Pinazo
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - Ana Alonso
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Francisco J Barón-López
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- Unit of Biostatistics, Deparment of Public Health, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Department of Nursing, Faculty of Health Sciences, University of Malaga, 29010 Málaga, Spain
| | - Laura Leyva
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
| | - Óscar Fernández
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- Department of Pharmacology, Faculty of Medicine, University of Malaga, 29010 Málaga, Spain
- Correspondence: (Ó.F.); (M.J.P.-M.)
| | - María Jesús Pinto-Medel
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29009 Málaga, Spain; (P.U.); (I.H.-G.); (B.O.-M.); (J.O.-P.); (A.A.); (F.J.B.-L.); (L.L.)
- UGC Neurociencias, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Red Temática de Investigación Cooperativa: Red Española de Esclerosis Múltiple REEM (RD16/0015/0010), 28049 Madrid, Spain; (M.Á.H.); (C.O.-G.)
- Correspondence: (Ó.F.); (M.J.P.-M.)
| |
Collapse
|
31
|
Morello M, Pieri M, Zenobi R, Talamo A, Stephan D, Landel V, Féron F, Millet P. The Influence of Vitamin D on Neurodegeneration and Neurological Disorders: A Rationale for its Physio-pathological Actions. Curr Pharm Des 2020; 26:2475-2491. [PMID: 32175837 DOI: 10.2174/1381612826666200316145725] [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: 01/30/2020] [Accepted: 03/11/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D is a steroid hormone implicated in the regulation of neuronal integrity and many brain functions. Its influence, as a nutrient and a hormone, on the physiopathology of the most common neurodegenerative diseases is continuously emphasized by new studies. This review addresses what is currently known about the action of vitamin D on the nervous system and neurodegenerative diseases such as Multiple Sclerosis, Alzheimer's disease, Parkinson's disease and Amyotrophic Lateral Sclerosis. Further vitamin D research is necessary to understand how the action of this "neuroactive" steroid can help to optimize the prevention and treatment of several neurological diseases.
Collapse
Affiliation(s)
- Maria Morello
- Clinical Biochemistry, Department of Experimental Medicine, Faculty of Medicine, University of Rome "Tor Vergata" and University Hospital of Tor Vergata, 00133 Rome, Italy
| | - Massimo Pieri
- Clinical Biochemistry, Department of Experimental Medicine, Faculty of Medicine, University of Rome "Tor Vergata" and University Hospital of Tor Vergata, 00133 Rome, Italy
| | - Rossella Zenobi
- Clinical Biochemistry, Department of Experimental Medicine, Faculty of Medicine, University of Rome "Tor Vergata" and University Hospital of Tor Vergata, 00133 Rome, Italy
| | - Alessandra Talamo
- Psychiatric Clinic, University Hospital of Tor Vergata, 00133 Rome, Italy
| | - Delphine Stephan
- Aix Marseille University, CNRS, INP, UMR 7051, Marseille, France
| | - Verena Landel
- Aix Marseille University, CNRS, INP, UMR 7051, Marseille, France
| | - François Féron
- Aix Marseille University, CNRS, INP, UMR 7051, Marseille, France
| | - Pascal Millet
- Aix Marseille University, CNRS, INP, UMR 7051, Marseille, France.,Association UNIVI (Agirc-Arrco), 75010 Paris, France.,Hôpital Gériatrique les Magnolias, Ballainvilliers, France
| |
Collapse
|
32
|
Prevalence of vitamin D deficiency and its predictors in the Portuguese population: a nationwide population-based study. Arch Osteoporos 2020; 15:36. [PMID: 32124071 DOI: 10.1007/s11657-020-0695-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/22/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D deficiency is prevalent worldwide, but its prevalence is unknown in adult Portuguese population. In Portugal, 66% of adults present Vitamin D insufficiency/deficiency. Winter, living in Azores, older age, and obesity were the most important risk factors. It highlights the need of strategies to prevent vitamin D deficiency in Portugal. OBJECTIVE To estimate the prevalence and risk factors of vitamin D deficiency in the adult Portuguese population. METHODS Adults (≥ 18 years old) from the EpiReumaPt Study (2011-2013) were included. Standardized questionnaires on socio-demographic and lifestyle features were obtained. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were evaluated using ADVIA Centaur VitD competitive immunoassay (Siemens Healthineers) in 2015-2017 as 25 (OH)D Level 0: ≤ 10 ng/mL; Level 1: 11-19 ng/mL; Level 2: 20-29 ng/mL, and Level 3: ≥ 30 ng/mL. Weighted multinomial regression analysis was conducted to evaluate the association between socio-demographic and lifestyle variables and vitamin D status. RESULTS Based on weighted analysis, the estimated prevalence of levels of 25(OH)D ≤ 10, < 20, and < 30 ng/mL was 21.2, 66.6, and 96.4%, respectively. The strongest independent predictors of serum 25 (OH)D ≤ 10 ng/mL were living in the Azores archipelagos (OR 9.39; 95%CI 1.27-69.6) and having the blood sample collection in winter (OR 18.53; 95%CI 7.83-43.87) or spring (11.55; 95%CI 5.18-25.74). Other significant predictors included older age (OR 5.65, 95%CI 2.08-15.35), obesity (OR 2.61; 95%CI 1.35-5.08), current smoking (OR 2.33; 95%CI 1.23-4.43), and female gender (OR 1.9, 95%CI 1.1-3.28). Conversely, physical exercise (OR 0.48, 95%CI 0.28-0.81) and occasional alcohol intake (OR 0.48, 95%CI 0.29-0.81) were associated with a lower risk of 25(OH)D ≤ 10 ng/mL. CONCLUSION Vitamin D deficiency/insufficiency [25(OH)D < 20 ng/ml] is highly prevalent in Portugal, affecting > 60% of all Portuguese adults, with strong geographical and seasonal variation. This study highlights the need to critically assess the relevance of vitamin D deficiency as a public health problem and the urgent need for a wide and scientifically robust debate about the most appropriate interventions at the individual and societal levels.
Collapse
|
33
|
Effects of vitamin D on drugs: Response and disposal. Nutrition 2020; 74:110734. [PMID: 32179384 DOI: 10.1016/j.nut.2020.110734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 12/29/2019] [Accepted: 01/01/2020] [Indexed: 12/11/2022]
Abstract
Vitamin D supplementation and vitamin D deficiency are common in clinical experience and in daily life. Vitamin D not only promotes calcium absorption and immune regulation, but also changes drug effects (pharmacodynamics and adverse reactions) and drug disposal in vivo when combined with various commonly used clinical drugs. The extensive physiological effects of vitamin D may cause synergism effects or alleviation of adverse reactions, and vitamin D's affect on drugs in vivo disposal through drug transporters or metabolic enzymes may also lead to changes in drug effects. Herein, the effects of vitamin D combined with commonly used drugs were reviewed from the perspective of drug efficacy and adverse reactions. The effects of vitamin D on drug transport and metabolism were summarized and analyzed. Hopefully, more attention will be paid to vitamin D supplementation and deficiency in clinical treatment and drug research and development.
Collapse
|
34
|
Yu M, Liu X, Li J. Factors Influencing Vitamin D Levels in Neonatal Umbilical Cord Blood: A Two-Center Study From Tibet and Shenyang. Front Pediatr 2020; 8:543719. [PMID: 33330264 PMCID: PMC7719748 DOI: 10.3389/fped.2020.543719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/26/2020] [Indexed: 02/02/2023] Open
Abstract
Objective: To investigate the factors influencing the levels of vitamin D (vitD) in the umbilical cord blood of neonates born in Naqu, Tibet (4,500 m above sea level), and Shenyang, Liaoning Province (500 m above sea level). Methods: This prospective study was conducted from June 2017 to October 2018 in Naqu (the plateau group) and Shenyang, (the non-plateau group). Healthy mothers that gave birth to healthy neonates of >2,000g after 38 weeks' gestation were enrolled in the study, as were their neonates. After separation of serum from the umbilical cord and mothers for routine biochemical tests, discarded samples were remained for analyses of vitD, calcium, phosphorus, alkaline phosphatase (ALP) and parathyroid hormone (PTH). Questionnaires were developed covering the demographic characteristics and possible risk factors for neonatal vitD deficiency of mothers. Statistical analysis was performed to identify associations between the calcium, phosphorus, ALP, PTH, maternal factors and neonatal vitD levels. Results: In total, 295 neonates and 225 mothers were enrolled in the study. VitD deficiency was common in neonates and mothers. The risk of vitD deficiency was higher in the plateau group than in the non-plateau group. The mean levels of 25-hydroxy vitD (25(OH)D) in mothers and neonates from the plateau group were 8.49 ± 4.12 ng/mL and 10.17 ± 5.07 ng/mL, respectively. Such levels were significantly lower than those in the non-plateau group (19.77 ± 9.57 ng/mL and 23.93 ± 11.01 ng/mL, respectively). The vitD levels of neonates and mothers were highest in the summer and lowest in the winter. Cord blood vitD was positively correlated with the vitD levels in mothers' serum (r = 0.75, P < 0.05). Increased PTH levels in mothers and decreased cord blood calcium levels were risk factors for neonatal vitD deficiency. A lack of vitD supplementation during pregnancy was associated with an 8.91-fold higher probability of neonatal vitD deficiency (OR = 8.91, 95% CI = 1.521-9.429, P < 0.001). Conclusions: The levels of neonatal and maternal vitD in the plateau group were generally lower than those in the non-plateau group. VitD supplementation during pregnancy could effectively reduce the risk of vitD deficiency in neonates.
Collapse
Affiliation(s)
- Mingli Yu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiuxiu Liu
- Department of Pediatrics, Naqu People's Hospital, Naqu, China
| | - Jiujun Li
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.,Plateau Medical Research Center of China Medical University, Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| |
Collapse
|
35
|
Kattakayam AJ, Reed D, Karakattu SM, Bailey B, Lamb MR, Lewis PO, Youssef D. Vitamin D Deficiency and Insufficiency in Northeast Tennessee. Health (London) 2020. [DOI: 10.4236/health.2020.129079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
36
|
Arnanz A, De Munck N, El Khatib I, Bayram A, Abdala A, Melado L, Lawrenz B, Coughlan C, Pacheco A, Garcia-Velasco JA, Fatemi HM. Vitamin D in Follicular Fluid Correlates With the Euploid Status of Blastocysts in a Vitamin D Deficient Population. Front Endocrinol (Lausanne) 2020; 11:609524. [PMID: 33584542 PMCID: PMC7874043 DOI: 10.3389/fendo.2020.609524] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/03/2020] [Indexed: 11/13/2022] Open
Abstract
CONTEXT The widespread distribution of the Vitamin D (VitD) receptor in reproductive tissues suggests an important role for VitD in human reproduction. The assessment of patient´s VitD is based on the 25-hydroxyvitamin D (25(OH)D) metabolite measurement. However, most of the circulating 25(OH)D is bound to either VitD-binding protein (VDBP) (88%) or albumin (12%) and less than 1% circulates free. OBJECTIVE To determine a possible correlation between VitD levels in serum (S) and follicular fluid (FF) and blastocyst ploidy status in patients undergoing infertility treatment. METHODS A prospective observational study was performed including couples planned for preimplantation genetic testing for aneuploidies (PGT-A) from ART Fertility Clinics. Patients were classified according to their 25(OH)D-Serum levels: VitD deficient group <20 ng/ml and insufficient/replete ≥20 ng/ml defined as VitD non-deficient group. RESULTS Serum samples and 226 FF from individual follicles were collected for 25(OH)D, bioavailable 25(OH)D, free 25(OH)D, and % free 25(OH)D measurement. 25(OH)D-Serum in VitD deficient and non-deficient were 13.2±4.0 ng/ml vs 32.3±9.2 ng/ml; p<0.001. FF from 40 and 74 biopsied blastocysts was analysed of which 52.5 and 60.8% were euploid (p = 0.428), respectively. In VitD deficient patients, mean 25(OH)D-FF, bioavailable 25(OH)D-FF, and free 25(OH)D-FF were higher in euploid vs aneuploid blastocysts (18.3±6.3 ng/ml vs 13.9±4.8 ng/ml; p = 0.040; 1.5±0.5 ng/ml vs 1.1±0.4 ng/ml; p = 0.015; 0.005±0.002 ng/ml vs 0.003±0.001 ng/ml; p = 0.023, respectively), whilst no differences were found in VitD non-deficient patients (37.9±12.3 ng/ml vs 40.6±13.7 ng/ml; p = 0.380; 3.1±1.1 ng/ml vs 3.3±1.2 ng/ml; p = 0.323; 0.01±0.003 ng/ml vs 0.01±0.004 ng/ml; p = 0.319, respectively). CONCLUSION VitD non-deficient patients have a significantly higher probability of obtaining a euploid blastocyst compared to VitD deficient patients (OR:33.36, p = 0.002).
Collapse
Affiliation(s)
- Ana Arnanz
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
- *Correspondence: Ana Arnanz, , orcid.org/0000-0003-2715-3480
| | | | | | - Aşina Bayram
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Andrea Abdala
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Laura Melado
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | - Barbara Lawrenz
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
- Obstetrical Department, Women’s University Hospital Tuebingen, Tuebingen, Germany
| | - Carol Coughlan
- ART Fertility Clinic, Abu Dhabi/Dubai, United Arab Emirates
| | | | - Juan A. Garcia-Velasco
- IVIRMA, Madrid, Spain
- Department of Reproductive Endocrinology and Infertility, Rey Juan Carlos University, Madrid, Spain
| | | |
Collapse
|
37
|
A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States. Sci Rep 2019; 9:19713. [PMID: 31873182 PMCID: PMC6928152 DOI: 10.1038/s41598-019-56297-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/09/2019] [Indexed: 12/26/2022] Open
Abstract
Vitamin D deficiency is a common health concern worldwide. We aim to compare the prevalence of vitamin D deficiency among older adults (65+) in China and the United States (US). We used data from the 2011 wave of Chinese Longitudinal Healthy Longevity Survey (CLHLS) in China (n = 2180), and 2011–2014 National Health and Nutrition Examination Survey (NHANES) in the US (n = 2283). Serum 25-hydroxyvitamin D [25(OH)D] was measured and a level of under 30/50 nmol/L was defined as vitamin D severe deficiency/deficiency. Risk factors of vitamin D deficiency were examined by multivariate regression models. We found that the mean 25(OH)D concentration was lower in China than in the US (45.1 vs. 83.5 nmol/L), with Chinese elderly lower than American elderly for every age group. 70.3% in China and 17.4% in the US were considered as vitamin D deficiency (30.6% and 3.4% were considered as severe deficiency). Older age, females, ethnic minorities, higher household income, self-rated “very bad” health, and never drinkers, were statistically significant in predicting lower serum 25(OH)D levels in China. In the US, males, ethnic minorities, lower income, self-rated “very bad” health, physically inactive, overweight, and obese were related to lower serum 25(OH)D levels. Our findings suggest that different interventional strategies are needed to improve vitamin D deficiency and its associated negative health outcomes in China and the US.
Collapse
|
38
|
Fonseca Valle D, Giannini DT. Correlation between vitamin D and blood pressure in adolescents. Int J Adolesc Med Health 2019; 32:/j/ijamh.ahead-of-print/ijamh-2017-0165/ijamh-2017-0165.xml. [PMID: 31562802 DOI: 10.1515/ijamh-2017-0165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 01/28/2018] [Indexed: 11/15/2022]
Abstract
Introduction Low serum levels of vitamin D have been associated with hypertension worldwide. Hypovitaminosis D has been observed even in countries with high incidence of sunlight all year round. Several studies demonstrated a high prevalence of deficiency/insufficiency of vitamin D in adolescents. Objective To investigate the association between the nutritional status of vitamin D with anthropometric measures and blood pressure in overweight adolescents. Methods This a descriptive and cross-sectional study with overweight adolescents of both sexes aged 12-19 years. The anthropometric data, biochemical profile, blood pressure and serum vitamin D dosage were analyzed. The chi-squared test for verification of association and Student's t-test to compare medians between variables were used. Results There were high frequencies of hypovitaminosis D (34%) and hypertension (43.3%) in overweight adolescents. We observed an inverse correlation between serum vitamin D levels and BP (r = -0.28, p = 0.005). Patients with desirable serum vitamin D had lower body mass index values (31.3 kg/m2 vs. 33.9 kg/m2; p < 0.02), waist circumference (95.2 cm vs. 101.1 cm; p < 0.03), waist-to-height ratio (0.58 vs. 0.61; p < 0.03) and systolic blood pressure (120 mm Hg vs. 127.6 mm Hg; p = 0.007). Conclusions High frequency of vitamin D deficiency is associated with increased BP and adiposity in overweight adolescents.
Collapse
Affiliation(s)
- Débora Fonseca Valle
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabe, Rio de Janeiro, Brazil
| | - Denise Tavares Giannini
- Universidade do Estado do Rio de Janeiro, Núcleo de Estudo da Saúde do Adolescente, Boulevard 28 de Setembro, 109 - Vila Isabel Rio de Janeiro, Brazil
| |
Collapse
|
39
|
Yan X, Zhang N, Cheng S, Wang Z, Qin Y. Gender Differences in Vitamin D Status in China. Med Sci Monit 2019; 25:7094-7099. [PMID: 31541605 PMCID: PMC6767943 DOI: 10.12659/msm.916326] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Vitamin D insufficiency is widespread in China. Various factors influence vitamin D level in the body. The present study investigated vitamin D status of residents in Jinzhong city, China, and analyzed the influence of gender on vitamin D status. Material/Methods In this cross-sectional study, 302 participants (176 men and 126 women) were recruited. Anthropometric data (body circumferences and height, weight) were collected, and serum vitamin D concentration was tested. Results Inadequate levels of vitamin D were found in 69% of men and 75% of women. Women’s 25(OH)D level (38.40±12.37 nmol/l) was substantially lower than that of the men (43.49±14.78 nmol/l) (p<0.01). The young women group had the lowest vitamin D level, which was even significantly below that of the elderly women group. Multiple linear regression analysis showed gender was significantly associated with vitamin D status (p<0.01). Conclusions Vitamin D deficiency is common in residents of Jinzhong during the winter. Compared to men, women are more prone to have inadequate vitamin D levels.
Collapse
Affiliation(s)
- Xiaoning Yan
- Shanxi Hospital of Integrated Traditional and Western Medicine, Clinical College of Chinese Integrative Medicine, Shanxi University of Chinese Medicine, Jinzhong, Shanxi, China (mainland)
| | - Na Zhang
- Department of Hematology, Shanxi Hospital of Traditional Chinese Medicine, Taiyuan, Shanxi, China (mainland)
| | - Shenghui Cheng
- Shanxi Hospital of Integrated Traditional and Western Medicine, Clinical College of Chinese Integrative Medicine, Shanxi University of Chinese Medicine, Jinzhong, Shanxi, China (mainland)
| | - Zhaolin Wang
- Department of Traditional Chinese Medicine, The Second Hospital, Shanxi Medical University, Taiyuan, Shanxi, China (mainland)
| | - Yanhong Qin
- Shanxi Hospital of Integrated Traditional and Western Medicine, Clinical College of Chinese Integrative Medicine, Shanxi University of Chinese Medicine, Jinzhong, Shanxi, China (mainland)
| |
Collapse
|
40
|
Calvo MS. Monitoring vitamin D status and intake in the US population: essential to understanding the role of vitamin D in health. Am J Clin Nutr 2019; 110:6-7. [PMID: 31075791 DOI: 10.1093/ajcn/nqz069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mona S Calvo
- Retired, Center for Food Safety and Applied Nutrition, US Food and Drug Administration, Silver Spring, MD
| |
Collapse
|
41
|
Half the Genetic Variance in Vitamin D Concentration is Shared with Skin Colour and Sun Exposure Genes. Behav Genet 2019; 49:386-398. [DOI: 10.1007/s10519-019-09954-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/01/2019] [Indexed: 01/05/2023]
|
42
|
Lee S, Lee E, Maneno MK, Johnson AA, Wutoh AK. Predictive Factors of Vitamin D Inadequacy among Older Adults in the United States. INT J VITAM NUTR RES 2019; 89:55-61. [PMID: 30816823 DOI: 10.1024/0300-9831/a000564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Optimal serum vitamin D levels are reported to be associated with many health benefits; however, few studies have determined predictive factors using national level data. An assessment of predictive factors for vitamin D inadequacy was conducted using National Health and Nutrition Examination Survey (NHANES) 2001-2006 data. Using the study sample including adults aged 40 years or more, data analysis was performed using the weighted multivariate logistic regression statistical procedure. The prevalence of vitamin D inadequacy (serum vitamin D <20 ng/ml) was 37.3%. Non-Hispanic Blacks were 6.4 times more likely to demonstrate vitamin D inadequacy compared to non-Hispanic Whites (ORadj=6.351; 95% CI 5.338, 7.555; p<0.0001). Also, female gender was a significant predictor of vitamin D inadequacy (ORadj=1.499; 95% CI 1.315, 1.708; p<0.0001) in multivariate models. Subjects who reported not taking vitamin D supplements in the past 30 days were more than twice as likely to be vitamin D inadequate compared with those who had taken dietary supplements containing vitamin D (ORadj=2.225; 95% CI 1.903, 2.601; p<0.0001). In conclusion, the strongest predictor of vitamin D inadequacy was non-Hispanic Black ethnicity. Other potential predictors included smoking, non-use of vitamin D supplements, abnormal BMI, collecting samples in winter, female gender, perception of own health condition as not excellent, lack of health care, and older age. More focused interventions targeting groups of United States residents with vitamin D inadequacy are needed.
Collapse
Affiliation(s)
- Sunkyung Lee
- 1Ph.D., M.Pharm., Department of Pharmacy, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Euni Lee
- 2Pharm.D., Ph.D., Professor, College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Mary K Maneno
- 3Ph.D., Associate Professor, Center for Minority Health Services Research, Department of Clinical and Administrative Pharmacy Sciences, College of Pharmacy, Howard University, Washington, DC 20059, United States
| | - Allan A Johnson
- 4Ph.D., FASAHP., Professor, Department of Nutritional Sciences, Division of Allied Health Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC 20059, United States
| | - Anthony K Wutoh
- 5Wutoh, Ph.D., R.Ph., Provost and Chief Academic Officer and Professor, Center for Minority Health Services Research, College of Pharmacy, Howard University, Washington, DC 20059, United States
| |
Collapse
|
43
|
Moore LW, Suki WN, Lunsford KE, Sabek OM, Knight RJ, Gaber AO. Cross-sectional evaluation of the relationship between vitamin D status and supplement use across levels of kidney function in adults. BMJ Open 2019; 9:e022471. [PMID: 30798303 PMCID: PMC6398648 DOI: 10.1136/bmjopen-2018-022471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 10/16/2018] [Accepted: 10/19/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess vitamin D status of US non-pregnant adults using a standardised assay across 15 mL/min/1.73 m2 increments of kidney function, report the use of dietary supplements containing vitamin D and assess relationships between vitamin D and markers of bone resorption. DESIGN This study is a cross-sectional evaluation. SETTING The study is from the US National Health and Nutrition Evaluation Survey in 2001-2012. PARTICIPANTS The participants were non-institutionalised, non-pregnant adults, age ≥20 years. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was serum 25OHD evaluated using liquid chromatography-tandem mass spectroscopy traceable to international reference standards. Secondary outcome measures were use of dietary supplements containing vitamin D and the serum intact parathyroid hormone and bone-specific alkaline phosphatase in a subset of participants. RESULTS The median 25OHD concentration in 27 543 US non-pregnant adults was 25.7 ng/mL (range, 2.2-150.0 ng/mL). Vitamin D supplements were used by 38.0%; mean (SE)=757 (43) international units/day. The range of 25OHD concentration across groups, stratified by kidney function, was 23.0-28.1 ng/mL. The lowest concentration of 25OHD observed was in people with higher kidney function (23.0 ng/mL for estimated glomerular filtration rate >105 mL/min/1.73 m2). Only 24% of people not taking a dietary supplement had a 25OHD concentration >30 ng/mL. Serum intact parathyroid hormone inversely correlated with 25OHD within all kidney function groups. Bone-specific alkaline phosphatase was also negatively associated with 25OHD concentration. CONCLUSIONS These data indicate that 25OHD concentrations and supplement use may be suboptimal in a significant proportion of the population, across all kidney function levels. The response of bone resorption markers further suggests that 25OHD levels could be improved. Together, these data support a re-evaluation of the 25OHD concentration associated with health in adults.
Collapse
Affiliation(s)
- Linda W Moore
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Center for Outcomes Research, Houston Methodist Research Institute, Houston, TX, USA
| | - Wadi N Suki
- Department of Medicine, Houston Methodist Hospital, Houston, Texas, USA
| | - Keri E Lunsford
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Omaima M Sabek
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - Richard J Knight
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| | - A Osama Gaber
- Department of Surgery, Houston Methodist Hospital, Houston, Texas, USA
- Department of Surgery, Weill Cornell Medical College, Houston, Texas, USA
| |
Collapse
|
44
|
Sochorová L, Hanzlíková L, Černá M, Vosátková M, Grafnetterová AP, Fialová A, Kubínová R. Assessment of vitamin D status in Czech children. Cent Eur J Public Health 2019; 26:260-264. [PMID: 30660135 DOI: 10.21101/cejph.a5386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Vitamin D deficiency is a global health problem. The aim of this study was to determine the proportion of Czech children with vitamin D deficiency and examine related factors. METHODS The study subjects were 419 healthy children aged 5 and 9 years. Severe vitamin D deficiency was defined as a serum 25(OH)D level of < 25 nmol/L (3% of children), deficiency as that of 25-50 nmol/L (24% of children), insufficiency as that of 50-75 nmol/L (40% of children) and sufficiency as that of > 75 nmol/L (34% of children). RESULTS Serum 25(OH)D levels varied mainly with season. The highest levels of 25(OH)D were reached in autumn (median: 79.0 nmol/L), followed by summer (median: 67.8 nmol/L) and winter (median: 56.0 nmol/L). The lowest median value (49.8 nmol/L) was detected in spring. CONCLUSION Children with sufficiency 25(OH)D levels were more frequently exposed to the sun and exposed a larger part of their body to the sun while spending time outdoors. Levels of 25(OH)D were also associated with using vitamin D supplements within six weeks before sampling.
Collapse
Affiliation(s)
| | | | - Milena Černá
- National Institute of Public Health, Prague, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Alena Fialová
- National Institute of Public Health, Prague, Czech Republic.,Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | | |
Collapse
|
45
|
Khan MA, Dar HA, Baba MA, Shah AH, Singh B, Shiekh NA. Impact of Vitamin D Status in Chronic Liver Disease. J Clin Exp Hepatol 2019; 9:574-580. [PMID: 31695247 PMCID: PMC6823692 DOI: 10.1016/j.jceh.2019.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 03/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is extremely common in chronic liver disease (CLD) patients. Up to 93% of these patients have some degree of vitamin D insufficiency. Liver plays an important role in the metabolism and pleiotropic functions of vitamin D. Vitamin D deficiency has been associated with increased mortality, bacterial infections, portal hypertension complications, and fibrosis severity. We aimed to determine the impact of vitamin D level in CLD. METHODS One hundred fifty individuals consisting of 75 cirrhotic patients (cases) and 75 respective attendants (controls) were enrolled between July 2015 and July 2017. A detailed clinical and laboratory evaluation was done along with estimation of vitamin D level. Unpaired t-test and analysis of variance was used to compare difference in the level of continuous variables between different groups. Linear regression analysis was performed to analyze the correlation between vitamin D deficiency and severity of liver disease. RESULTS The age of patients ranged from 18 years to 69 years with mean of 48.85 ± 13.6 years in the case group and 46.57 ± 17.24 years in the control group. Out of 75 CLD patients, vitamin D deficiency (<20 ng/dl) was found in 31 (41.4%) patients, out of which 14(18.7%) suffered from severe vitamin D deficiency (<10 ng/ml). On applying analysis of variance test, there was significant difference in vitamin D level and serum albumin and serum bilirubin (P < 0.05). On linear regression, vitamin D level showed significant negative correlation with Child-Pugh score (r = -0.7379, P < 0.0001) and Model For End-Stage Liver Disease score (r = -0.6671, P < 0.0001). CONCLUSION Our study concluded that CLD is associated with a significantly low level of vitamin D, which was independent to patient's gender, body mass index, residence, and education level. The findings of our study suggest that awareness of serum vitamin D level in patients with CLD is important. Further studies are required to validate the importance of vitamin D levels and impact of vitamin D supplementation on CLD.
Collapse
Affiliation(s)
| | - Hilal A. Dar
- Address for correspondence: Dr Hilal Ahmad Dar, Department of Gastroenterology Sher- i- Kashmir Institute of Medical Sciences, Srinagar, Kashmir, 190011, India. Tel.: +194 2401013x2270, +919419313331(mobile).
| | | | | | | | | |
Collapse
|
46
|
Dadra A, Aggarwal S, Kumar P, Kumar V, Dibar DP, Bhadada SK. High prevalence of vitamin D deficiency and osteoporosis in patients with fragility fractures of hip: A pilot study. J Clin Orthop Trauma 2019; 10:1097-1100. [PMID: 31708635 PMCID: PMC6834936 DOI: 10.1016/j.jcot.2019.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is a major cause of poor bone health that could lead to fragility fractures, however, there is paucity of literature on prevalence of VDD and associated bone mass in patients of fragility fractures. Hip and spine are the commonest region affected by these fractures and the present study was conceptualised to ascertain the prevalence of VDD and bone mass in patients of hip fragility fractures (proximal femur) to evaluate their role in incidence of these fractures. METHODS AND MATERIALS Between January 2013 and December 2013, 66 patients of fragility fractures around hip with age more than 50 years presented to our out patient department. Baseline evaluation of calcium profile, renal function tests, parathyroid hormone and 25(OH)D were done. All patients underwent DXA scan of the non -fractured hip. RESULTS Total number of male patients was 29 and females was 37, with mean age of 64.1 and 70.3 years, respectively. Intertrochanteric femur fractures were the most common type with 35 cases. Fall in bathroom was the most common mode of injury with 36 cases (54.5%). VDD was found in 74.2% of all patients. Prevalence of secondary hyperparathyroidism was observed in 27 patients. Osteopenia, osteoporosis and severe osteoporosis were observed in 15.2%, 62.1% and 18.2% of patients respectively. Sun light exposure was inadequate in 59% of patients with only 1 female patient having adequate exposure. CONCLUSION Prevalence of Vitamin D deficiency is very high in patients with hip fragility (proximal femur) fractures with secondary hyperparathyroidism and osteoporosis commonly associated. These fractures in our part of the world, occur at a younger age group as compared to the Western population. Majority of the patients sustain in-house fractures.
Collapse
|
47
|
Koop AH, Mousa OY, Pham LE, Corral-Hurtado JE, Pungpapong S, Keaveny AP. An Argument for Vitamin D, A, and Zinc Monitoring in Cirrhosis. Ann Hepatol 2018; 17:920-932. [PMID: 30600288 DOI: 10.5604/01.3001.0012.7192] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Malnutrition is prevalent in cirrhosis. Vitamin and mineral deficiencies, including vitamin D, vitamin A, and zinc, are common and have been shown to correlate with survival. Our aim was to review the mechanisms of vitamin D, vitamin A, and zinc deficiencies in cirrhosis and the clinical assessment of affected patients, their outcomes based on the current literature, and management. This is a narrative review including the relevant literature for cirrhosis and vitamin D, vitamin A, and zinc deficiencies. Vitamin D deficiency has important effects in cirrhosis, regardless of the cause of chronic liver disease.These effects include associations with fibrosis and outcomes such as infections, hepatocellular carcinoma, and mortality. Vitamin A deficiency is associated with liver disease progression to cirrhosis and clinical decompensation, including occurrence of ascites or hepatic encephalopathy. Zinc deficiency can lead to hepatic encephalopathy and impaired immune function. Such deficiencies correlate with patient survival and disease severity. Caution should be applied when replacing vitamin D, vitamin A, and zinc to avoid toxicity. Identification and appropriate treatment of vitamin and mineral deficiencies in cirrhosis may reduce specific nutritional and cirrhosis-related adverse events. Routine monitoring of vitamin A, vitamin D and zinc levels in cirrhosis should be considered.
Collapse
Affiliation(s)
- Andree H Koop
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Omar Y Mousa
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Ly Elaine Pham
- Department of Internal Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | | | - Surakit Pungpapong
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| | - Andrew P Keaveny
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA
| |
Collapse
|
48
|
Ellis SD, Kelly ST, Shurlock JH, Hepburn ALN. The role of vitamin D testing and replacement in fibromyalgia: a systematic literature review. BMC Rheumatol 2018; 2:28. [PMID: 30886978 PMCID: PMC6390590 DOI: 10.1186/s41927-018-0035-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 08/29/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Fibromyalgia is a debilitating condition, characterized by extensive muscular pain and fatigue. Vitamin D is essential for overall health, with ubiquitous involvement in various inflammatory and pain pathways. Little is known about its role in fibromyalgia. We performed a systematic literature review to determine if vitamin D contributes to the pathology and disability of patients with fibromyalgia, and to assess the role of vitamin D supplementation in disease management. METHODS We searched Medline, EMBASE and the Cochrane Library for clinical studies and randomized controlled trials published in English during January 2000 to June 2017, using the terms vitamin D or hypovitaminosis D combined with fibromyalgia or FMS. References were reviewed manually and articles were only included if they were specific in their diagnosis of fibromyalgia and used appropriate control groups. RESULTS Four hundred and sixty-six studies were retrieved, of which fourteen fulfilled the inclusion criteria. Six studies, of which two had the best quality evidence, found that patients with fibromyalgia have low levels of vitamin D compared to healthy controls. Conflicting results were obtained on the effect of vitamin D on pain or symptom control, with no clear consensus as to the role of supplementation in the management of fibromyalgia. CONCLUSIONS Our results highlight an association between vitamin D deficiency and fibromyalgia. However, its role in the pathophysiology of fibromyalgia and the clinical relevance of identifying and treating this requires further elucidation with appropriately controlled studies.
Collapse
Affiliation(s)
- Shawn D. Ellis
- Department of Oncology, Royal Berkshire Hospital, Reading, RG1 5AN UK
| | - Sam T. Kelly
- Department of Medicine, Royal Sussex County Hospital, Brighton, BN2 5BE UK
| | | | | |
Collapse
|
49
|
Bolland MJ, Grey A, Avenell A. Assessment of research waste part 2: wrong study populations- an exemplar of baseline vitamin D status of participants in trials of vitamin D supplementation. BMC Med Res Methodol 2018; 18:101. [PMID: 30285729 PMCID: PMC6171194 DOI: 10.1186/s12874-018-0555-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 09/10/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Research waste can occur when trials are conducted in the wrong populations. Vitamin D deficient populations are most likely to benefit from vitamin D supplementation. We investigated waste attributable to randomised controlled trials (RCTs) of supplementation in populations that were not vitamin D deficient. METHODS In December 2015, we searched Pubmed, recent systematic reviews, and three trial registries for RCTs of vitamin D with clinical endpoints in adults, and 25-hydroxvitamin D (25OHD) survey data relevant to large (N ≥ 1000) RCTs. We investigated the proportion of RCTs that studied vitamin D deficient populations, temporal trends in baseline 25OHD, and whether investigators in large RCTs considered relevant 25OHD survey data or systematic reviews in their trial justifications. RESULTS Of 137 RCTs of vitamin D with clinical endpoints, 118 (86%) reported baseline mean/median 25OHD, which was < 25, 25-49, 50-74, and ≥ 75 nmol/L in 12 (10%), 62 (53%), 36 (31%), and 8 (7%) RCTs, respectively. In 70% of RCTs, baseline 25OHD was > 40 nmol/L. Baseline 25OHD increased over time. Before 2006, 38%, 62%, 0% and 0% of RCTs had baseline 25OHD < 25, 25-49, 50-74, and ≥ 75 nmol/L respectively; in 2011-15, the respective proportions were 9%, 49%, 37%, and 6%. Of 12 RCTs with baseline 25OHD < 25 nmol/L, 8 had neutral findings. Of 25 large RCTs (18 completed, 7 ongoing), 1 was undertaken in a vitamin D deficient population, 3 in vitamin D insufficient populations, and 17 had, or probably will have, baseline 25OHD > 40 nmol/L. 44% (8/18) of large completed RCTs cited relevant prior population 25OHD data, and only 3/10 (30%) relevant prior systematic reviews. CONCLUSIONS Up to 70% of RCTs of vitamin D with clinical endpoints, 71% of large completed RCTs, and 100% of ongoing large RCTs could be considered research waste because they studied cohorts that were not vitamin D deficient.
Collapse
Affiliation(s)
- Mark J. Bolland
- Department of Medicine, Bone and Joint Research Group, University of Auckland, Private Bag 92 019, Auckland, 1142 New Zealand
| | - Andrew Grey
- Department of Medicine, Bone and Joint Research Group, University of Auckland, Private Bag 92 019, Auckland, 1142 New Zealand
| | - Alison Avenell
- Health Services Research Unit, University of Aberdeen, Foresterhill, Aberdeen, AB25 2ZD Scotland
| |
Collapse
|
50
|
Nakano S, Suzuki M, Minowa K, Hirai S, Takubo N, Sakamoto Y, Ishijima M, Hoshino E, Tokita A, Shimizu T. Current Vitamin D Status in Healthy Japanese Infants and Young Children. J Nutr Sci Vitaminol (Tokyo) 2018; 64:99-105. [PMID: 29710038 DOI: 10.3177/jnsv.64.99] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aimed to characterize serum 25-hydroxyvitamin D (25OH-D) values among Japanese children aged ≤48 mo. The study included 290 healthy infants and young children aged 0-48 mo (males/females=166/124) living in Shizuoka or Tokyo. The subjects were divided into three groups by age (Low Age: 0-5, Middle Age: 6-15, High Age: 16-48 mo). The vitamin D deficient state was defined as 25OH-D <12 ng/mL, the insufficient state as 12-20 ng/mL, and the sufficient state as >20 ng/mL. The seasonal variation of serum 25OH-D levels was also analyzed. The median serum 25OH-D levels in each group were: Low Age (n=50), 19 ng/mL; Middle Age (n=94), 30 ng/mL; and High Age (n=146), 30 ng/mL. The serum 25OH-D level was significantly lower in the Low Age group than in the other groups (p<0.01). Serum 25OH-D levels in summer and autumn (n=149) were significantly higher than in winter and spring (n=141) (33 vs. 25 ng/mL, p<0.01). In the Low Age group, there was a significant difference in serum 25OH-D levels between breast-fed infants (n=26) and formula-fed or mixed-fed infants (n=19) (12 vs. 32 ng/mL, p<0.01). However, there were no significant differences in 25OH-D levels between the two season classifications in either breast-fed or formula-fed and mixed-fed infants. Although clinical symptoms were not available, more than 75% of the breast-fed infants and 14.6% of infants and young children to whom food had been introduced were defined as having a vitamin D deficient or insufficient state. Breastfeeding seems one of the contributing factor to lower serum 25 OH-D levels among infants ≤5 mo of age.
Collapse
Affiliation(s)
- Satoshi Nakano
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | | | - Kei Minowa
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Saeko Hirai
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Noriyuki Takubo
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | - Yuko Sakamoto
- Department of Orthopedic Surgery, Juntendo University Nerima Hospital
| | - Muneaki Ishijima
- Department of Orthopedics Surgery, Juntendo University Faculty of Medicine
| | - Eri Hoshino
- Graduate School of Public Health, St. Luke International University
| | | | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine
| |
Collapse
|