1
|
De la Cruz-Góngora V, Palazuelos-González R, Domínguez-Flores O. Micronutrient Deficiencies in Older Adults in Latin America: A Narrative Review. Food Nutr Bull 2024; 45:S26-S38. [PMID: 38146136 DOI: 10.1177/03795721231214587] [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] [Indexed: 12/27/2023]
Abstract
BACKGROUND The population in Latin America and Caribbean (LAC) has experienced a major demographic transition with increased numbers of older adults (OA). This change brings opportunities in the public health sector to implement health prevention interventions and delay the onset of geriatric syndromes. Micronutrients play an important role in the maintenance of biological function which contributes to longevity. Micronutrient deficiencies (MD) in OA increase the risk for onset of chronic comorbidities and geriatric syndromes. AIM To review and summarize the existing data on micronutrient status in OA in the LAC region and discuss the gaps and challenges in public health approaches to address deficiencies. METHODS Literature review in Medline for records describing nutritional biomarkers in older adults (≥ 60y) from community dwelling and population-based studies in LAC. RESULTS Few countries (including Chile, Ecuador, Costa Rica, Brazil, and Mexico) have documented one or more nutritional deficiencies for OA in national health surveys, however across the entire region, evidence of micronutrient levels is scarce. Some surveys have documented a high prevalence and large heterogeneity in the prevalence of vitamin D followed by B12 deficiency, being the 2 MDs most studied due their effects on cognition, frailty, and bone mineral density in the OA population. Other MD including C, E, A, copper, zinc, iron, and selenium have also been reported. CONCLUSION Information on the micronutrient status in OA from LAC is poorly documented. Research and capacity building initiatives in the region are crucial to develop tailored strategies that address the specific nutritional needs and challenges faced by the ageing population in Latin America.
Collapse
Affiliation(s)
- Vanessa De la Cruz-Góngora
- Center for Evaluation and Survey Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
- Global Brain Health Institute, Trinity College, Dublin, Ireland
| | | | - Omar Domínguez-Flores
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| |
Collapse
|
2
|
Yamamoto ALC, Corrêa MDP, Torres RR, Martins FB, Godin-Beekmann S. Projected changes in ultraviolet index and UV doses over the twenty-first century: impacts of ozone and aerosols from CMIP6. Photochem Photobiol Sci 2024; 23:1279-1294. [PMID: 38762827 DOI: 10.1007/s43630-024-00594-7] [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: 01/30/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
This study evaluated the health-related weighted ultraviolet radiation (UVR) due to the total ozone content (TOC) and the aerosol optical depth (AOD) changes. Clear-sky Ultraviolet Index (UVI), daily doses, and exposure times for erythema induction (Dery and Tery) and vitamin D synthesis (DvitD and TvitD) were computed by a radiative transfer estimator. TOC and AOD data were provided by six Earth System Models (ESMs) from the Coupled Model Intercomparison Project Phase 6 (CMIP6). For projections, we consider four Shared Socioeconomic Pathways scenarios-SSPs (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5)-and two time-slices (near: 2041-2060 and far future: 2081-2100). UVR projections showed pronounced changes for the summer hemispheres in the far future. TOC increases in mid- and high latitudes of the Southern Hemisphere caused decreases in UVR at the summer solstice. However, projections did not indicate sun-safe exposure conditions in South America, Australia, and Southern Africa. On the contrary, exposure around solar noon from 10 to 20 min will still be sufficient to induce erythema in skin type III individuals throughout this century. In southern Argentina and Chile, the UVR insufficiency for vitamin D synthesis at solar noon in skin type III remains the same during this century at the winter solstice. In the Northern Hemisphere, UVI and Dery at the summer solstice should remain high (UVI ≥ 8; Dery ~ 7.0 kJ m-2) in highly populated locations. Above 45 °N, UVR levels cannot be enough to synthesize vitamin D in skin type III during the boreal winter. Our results show that climate change will affect human health through excess or lack of solar UVR availability.
Collapse
Affiliation(s)
| | - Marcelo de Paula Corrêa
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
| | - Roger Rodrigues Torres
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
| | - Fabrina Bolzan Martins
- Natural Resources Institute, Federal University of Itajubá, Av. BPS, 1303, Itajubá, MG, 37500-903, Brazil
| | | |
Collapse
|
3
|
Mendes MM, Gomes APO, Araújo MM, Coelho ASG, Carvalho KMB, Botelho PB. Prevalence of vitamin D deficiency in South America: a systematic review and meta-analysis. Nutr Rev 2023; 81:1290-1309. [PMID: 36882047 DOI: 10.1093/nutrit/nuad010] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
CONTEXT Vitamin D deficiency is considered a global public health issue, even in low-latitude countries where there is abundant sunlight radiation. Nevertheless, the prevalence of vitamin D insufficiency and deficiency in the South American continent has not been well characterized. OBJECTIVE The aim of this review was to estimate the prevalence of vitamin D deficiency (25-hydroxy-calciferol < 20 ng/mL) in South American populations. DATA SOURCES Seven electronic databases (MEDLINE, Web of Science, Embase, Biblioteca Virtual de Saúde, SciELO, Scopus, and Google Scholar) were searched systematically for observational studies published before July 1, 2021, and reporting vitamin D status of healthy adults in South America. DATA EXTRACTION Data were extracted using a standardized form. Risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence. All steps were conducted independently by two authors. Data were pooled using a random-effects model. Stratified meta-analysis and meta-regression were conducted (R software). DATA ANALYSIS Of 9460 articles identified, 96 studies with a total of 227 758 participants were included. The overall prevalence of vitamin D deficiency was 34.76% (79 studies; 95%CI, 29.68-40.21; I2 = 99%). There were significant differences in prevalence rates related to age, sex, country, latitude, season, and year of publication. CONCLUSION The prevalence of vitamin D deficiency is unexpectedly elevated in South American populations. Public health strategies should include efforts to prevent, detect, and treat vitamin D deficiency. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020169439.
Collapse
Affiliation(s)
- Marcela M Mendes
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Anna P O Gomes
- Department of Clinical Nutrition, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Maísa M Araújo
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Alexandre S G Coelho
- Department of Biology, Agronomy School, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Kênia M B Carvalho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Patrícia B Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| |
Collapse
|
4
|
Dey SK, Kumar S, Rani D, Maurya SK, Banerjee P, Verma M, Senapati S. Implications of vitamin D deficiency in systemic inflammation and cardiovascular health. Crit Rev Food Sci Nutr 2023; 64:10438-10455. [PMID: 37350746 DOI: 10.1080/10408398.2023.2224880] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Clinical, epidemiological, and molecular studies have sufficiently highlighted the vitality of vitamin D [25(OH)D and 1,25(OH)2D] in human health and wellbeing. Globally, vitamin D deficiency (VDD) has become a public health concern among all age groups. There is a very high prevalence of VDD per the estimates from several epidemiological studies on different ethnic populations. But, population-specific scales do not support these estimates to define VDD clinically and consistent genetic associations. However, clinical studies have shown the relevance of serum vitamin D screening and oral supplementation in improving health conditions, pointing toward a more prominent role of vitamin D in health and wellness. Routinely, the serum concentration of vitamin D is measured to determine the deficiency and is correlated with physiological conditions and clinical symptoms. Recent research points toward a more inclusive role of vitamin D in different disease pathologies and is not just limited to otherwise bone health and overall growth. VDD contributes to the natural history of systemic ailments, including cardiovascular and systemic immune diseases. Considering its significant impact on premature morbidity and mortality, there is a compelling need to comprehensively review and document the direct and indirect implications of VDD in immune system deregulation, systemic inflammatory conditions, and cardio-metabolism. The recommendations from this review call for furthering our research concerning vitamin D and its direct and indirect implications.
Collapse
Affiliation(s)
- Sanjay Kumar Dey
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India
| | - Shashank Kumar
- Department of Biochemistry, Central University of Punjab, Bathinda, Punjab, India
| | - Diksha Rani
- Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, India
| | | | - Pratibha Banerjee
- Immunogenomics Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
| | - Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bathinda, Punjab, India
| | - Sabyasachi Senapati
- Immunogenomics Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
| |
Collapse
|
5
|
Vitamin D as a Shield against Aging. Int J Mol Sci 2023; 24:ijms24054546. [PMID: 36901976 PMCID: PMC10002864 DOI: 10.3390/ijms24054546] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/02/2023] Open
Abstract
Aging can be seen as a physiological progression of biomolecular damage and the accumulation of defective cellular components, which trigger and amplify the process, toward whole-body function weakening. Senescence initiates at the cellular level and consists in an inability to maintain homeostasis, characterized by the overexpression/aberrant expression of inflammatory/immune/stress responses. Aging is associated with significant modifications in immune system cells, toward a decline in immunosurveillance, which, in turn, leads to chronic elevation of inflammation/oxidative stress, increasing the risk of (co)morbidities. Albeit aging is a natural and unavoidable process, it can be regulated by some factors, like lifestyle and diet. Nutrition, indeed, tackles the mechanisms underlying molecular/cellular aging. Many micronutrients, i.e., vitamins and elements, can impact cell function. This review focuses on the role exerted by vitamin D in geroprotection, based on its ability to shape cellular/intracellular processes and drive the immune response toward immune protection against infections and age-related diseases. To this aim, the main biomolecular paths underlying immunosenescence and inflammaging are identified as biotargets of vitamin D. Topics such as heart and skeletal muscle cell function/dysfunction, depending on vitamin D status, are addressed, with comments on hypovitaminosis D correction by food and supplementation. Albeit research has progressed, still limitations exist in translating knowledge into clinical practice, making it necessary to focus attention on the role of vitamin D in aging, especially considering the growing number of older individuals.
Collapse
|
6
|
Hypovitaminosis D in patients with type 2 diabetes: risk factors and association with glycemic control and established microvascular complications. REVISTA DE LA FACULTAD DE CIENCIAS MÉDICAS 2022; 79:235-240. [PMID: 36149074 PMCID: PMC9590833 DOI: 10.31053/1853.0605.v79.n3.35158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/09/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Several studies reported than vitamin D deficiency increases the risk of macrovascular and microvascular disease in patients with type 2 diabetes (T2DM). We investigated the plasma levels of 25OHD in adult patients T2DM, risk factors for 25OHD deficiency and the relationship between 25OHD, glycemic control and chronic complications of T2DM. METHODS A cross-sectional study was carried out, in which 25OHD levels were evaluated in adult patients (over 18 years) with T2DM. Correlation analyses were performed to evaluate the interdependence of the 25OHD with other continuous variables. A receiver operating characteristic analysis was also performed to identify cutoff values for diagnosing vitamin D deficiency. Logistic regression was performed to identify the independent association between vitamin D deficiency and the variables associated with lower 25OHD. RESULTS 208 patients were analyzed. The mean age of the patients was 62 years. The 25OHD level was 19 ng/ml (IQR 13.28-24.43), 59.78% had vitamin D deficiency, and 10.33% had severe deficiency. Glycemia, HbA1c, and BMI were negatively correlated with 25OHD. Cutoff point for vitamin D deficiency was 33.39 kg/m2 for body mass index (BMI), 123 mg/dl for glycemia, and 6.65% for HbA1c. In multivariate logistic regression, BMI>33.39 kg/m2, glycemia >123.5 mg/dl, and albuminuria presented higher odds of vitamin D deficiency. CONCLUSION Vitamin D deficiency was highly prevalent among patients with T2DM. Low levels were related to higher fasting plasma glucose, higher BMI, and diabetic nephropathy.
Collapse
|
7
|
Vinueza Veloz AF, Carpio Arias TV, Vargas Mejía JS, Tapia Veloz EC, Piedra Andrade JS, Nicolalde Cifuentes TM, Heredia Aguirre SI, Vinueza Veloz MF. Cognitive function and vitamin B12 and D among elders: A cross-sectional study. Clin Nutr ESPEN 2022; 50:270-276. [DOI: 10.1016/j.clnesp.2022.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022]
|
8
|
Barbier MP, Mingote E, Sforza N, Morosán Allo Y, Lotartaro M, Serrano L, Fossati MP, Meroño T, Faingold C, Sedlinsky C, Brenta G. Incidence and predictive factors of postoperative hypocalcaemia according to type of thyroid surgery in older adults. Endocrine 2022; 75:276-283. [PMID: 34350564 DOI: 10.1007/s12020-021-02840-9] [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: 06/06/2021] [Accepted: 07/28/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Transient hypocalcaemia after thyroid surgery and its possible predictors have not been extensively described in the elderly. This study aimed to establish the frequency of postsurgical transient hypocalcaemia according to the extent of thyroid surgery in older adults and to assess mineral metabolism biochemical parameters as its predictors. METHODS All patients ≥60 years undergoing thyroid surgery were prospectively included. Type of surgery (hemithyroidectomy(HT) or total thyroidectomy(TT)); and preoperative 25OH Vitamin D (25OHD) and pre and 6 (only TT), 24 h and 6 months postsurgical serum levels of calcium, magnesium, phosphate and parathormone (PTH) were considered. Postsurgical hypoparathyroidism (hPTpost) was defined at PTH levels ≤11 pg/mL. RESULTS Out of 46 patients (87% female), age (mean ± SD) 70.1 ± 6.2 years, 24 h postsurgical hypocalcaemia was found in ten patients (22%). In 25 (54%) TT patients, 36% and 16% had postsurgical hypocalcaemia at 6 and 24 h respectively; 28% hPTpost but no definitive hPT was recorded and 44% had 25OHD deficiency. Lower 24 h magnesium levels were found in those TT patients with 24 h hypocalcaemia (1.6 ± 0.1 vs 1.9 ± 0.1 mg/dL (p = 0.005)). Among 21 (46%) HT patients, 28.6% had 24 h postsurgical hypocalcaemia; 9.5% had hPTpost. A positive correlation was observed between preoperative 25OHD and 24 h calcaemia (r:0.51,p = 0.02). 43% of the patients were 25OHD deficient, in whom 55% had 24 h hypocalcaemia vs only 9% in the 25OHD sufficient group (p = 0.049). CONCLUSION Postsurgical hypocalcaemia was common in elderly thyroidectomized patients. After TT, lower magnesium levels were found in those patients with 24 h hypocalcaemia. In the HT group, preoperative 25OHD deficiency predicted lower postsurgical calcium levels.
Collapse
Affiliation(s)
- María Paz Barbier
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Evelin Mingote
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Noelia Sforza
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Yanina Morosán Allo
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Maximiliano Lotartaro
- Servicio de Cirugía General, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Leonardo Serrano
- Servicio de Cirugía General, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - María Pía Fossati
- Laboratorio Central, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Tomas Meroño
- Laboratorio de Biomarcadores y Nutrimetabolómica, Departamento de Nutrición, Ciencias de la Alimentación y Gastronomía, Red de Referencia en Tecnología de Alimentos (XaRTA), Instituto de Nutrición y Seguridad Alimentaria (INSA), Facultad de Farmacia y Ciencias de la Alimentación, Universidad de Barcelona, Barcelona, Spain
- CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Faingold
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Claudia Sedlinsky
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Gabriela Brenta
- Servicio de Endocrinología y Metabolismo, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina.
| |
Collapse
|
9
|
Kweder H, Eidi H. Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status. Avicenna J Med 2021; 8:139-146. [PMID: 30319955 PMCID: PMC6178567 DOI: 10.4103/ajm.ajm_20_18] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Introduction: Vitamin D (VD) deficiency is a major public health problem worldwide. In spite of its high prevalence, particularly among elderly people, VD deficiency is still underestimated by many physicians. Increasingly, VD deficiency is associated with several known geriatric syndromes. Methods: The study sample consisted of 125 patients, aged 75 years and older, admitted to the acute geriatric unit. The plausible association between the serum 25-hydroxyvitamin D [25(OH)D] level and patient age, sex, body mass index, renal function, cholecystectomy history, and the prescribed drugs had been investigated. The Fisher's exact test was used to conduct the statistical analysis of data. Results: Surprisingly, furosemide treatment was correlated with normal 25(OH)D levels and an increased incidence of secondary hyperparathyroidism. Unlike the other four parameters mentioned above, our data showed that only the patient sex exhibited a significant association with 25(OH)D level as elderly males suffered from a serious VD deficiency as compared to elderly females. Conclusion: Old age is an independent risk factor for VD deficiency. The supplementary dose of VD should be precisely defined to achieve the optimal serum 25(OH)D level in elderly people. The definition of the normal serum 25(OH)D threshold in elderly furosemide-treated patients is worth of further studies.
Collapse
Affiliation(s)
- Hasan Kweder
- Department of Geriatric Medicine, Hospital of Pierre Oudot, Bourgoin-Jallieu City, Isère Department, Region of Auvergne-Rhône-Alpes, France
| | - Housam Eidi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| |
Collapse
|
10
|
Moliterno P, Donangelo CM, Borgarello L, Pécora M, Olascoaga A, Noboa O, Boggia J. Association of Dietary Patterns with Cardiovascular and Kidney Phenotypes in an Uruguayan Population Cohort. Nutrients 2021; 13:nu13072213. [PMID: 34199124 PMCID: PMC8308311 DOI: 10.3390/nu13072213] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/21/2023] Open
Abstract
The impact of habitual diet on chronic diseases has not been extensively characterized in South America. We aimed to identify major dietary patterns (DP) in an adult cohort in Uruguay (Genotype Phenotype and Environment of Hypertension Study—GEFA-HT-UY) and to assess associations with metabolic, anthropometric characteristics, and cardiovascular and kidney phenotypes. In a cross-sectional study (n = 294), DP were derived by the principal component analysis. Blood and urine parameters, anthropometrics, blood pressure, pulse wave velocity, and glomerular filtration rate were measured. Multivariable adjusted linear models and adjusted binary logistic regression were used. Three DP were identified (Meat, Prudent, Cereal and Mate) explaining 22.6% of total variance in food intake. The traditional Meat DP, characterized by red and barbecued meat, processed meat, bread, and soft drinks, was associated with worse blood lipid profile. Prudent DP, characterized by vegetables, fish, and nuts, and lower loads for bread and crackers, was associated with reduced risk of vitamin D deficiency. Cereal and Mate DP, was characterized by higher loads of cereals, bread, and crackers, and mate infusion, with higher odds of excessive body weight. No direct associations of dietary patterns with hypertension, arterial stiffness, chronic kidney disease, and nephrolithiasis were found in the studied population, nor by age categories or sex.
Collapse
Affiliation(s)
- Paula Moliterno
- Departmento de Nutrición Clínica, Escuela de Nutrición, Universidad de la República, Montevideo CP 11600, Uruguay;
| | | | - Luciana Borgarello
- Laboratorio de Patología Clínica, Universidad de la República, Montevideo CP 11600, Uruguay; (L.B.); (A.O.)
| | - Matías Pécora
- Departmento de Fisiopatología, Universidad de la República, Montevideo CP 11600, Uruguay;
| | - Alicia Olascoaga
- Laboratorio de Patología Clínica, Universidad de la República, Montevideo CP 11600, Uruguay; (L.B.); (A.O.)
| | - Oscar Noboa
- Centro de Nefrología, Universidad de la República, Montevideo CP 11600, Uruguay;
| | - José Boggia
- Centro de Nefrología, Universidad de la República, Montevideo CP 11600, Uruguay;
- Correspondence:
| |
Collapse
|
11
|
Beer RJ, Herrán OF, Villamor E. Prevalence and correlates of vitamin D deficiency in a tropical setting: results from a nationally representative survey. Am J Clin Nutr 2020; 112:1088-1098. [PMID: 32729610 DOI: 10.1093/ajcn/nqaa197] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/25/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of vitamin D deficiency (VDD) may be high in countries with abundant sun exposure year-round, but nationally representative data are lacking. OBJECTIVE We examined the prevalence and distribution of VDD by individual and environmental characteristics in a nationally representative sample of Colombian children, pregnant women, and adult nonpregnant women. METHODS Using the 2015 Colombian National Nutrition Survey, we defined VDD and low vitamin D (LVD) as serum 25-hydroxyvitamin D [25(OH)D] <30 nmol/L and <50 nmol/L, respectively, in 31,841 children aged 1 to <18 y, 1262 pregnant women, and 7170 nonpregnant women aged 18-49 y. Within each group, we compared VDD and LVD prevalence by levels of sociodemographic, anthropometric, and geographic factors using adjusted prevalence ratios with 95% CIs from multivariable Poisson regression. RESULTS The mean ± SE 25(OH)D was 65.1 ± 0.4 nmol/L. The prevalence ± SE of VDD and LVD was 3.1% ± 0.3% and 23.9% ± 0.8%, respectively. Pregnant women had the highest VDD prevalence at 6.7% ± 1.5%, whereas toddlers had the highest prevalence of LVD at 42.5% ± 1.8%. Altitude was one of the strongest correlates of VDD and LVD, with every 100 m above sea level related to a 4% increase in LVD prevalence (P <0.0001). Among children, VDD was positively associated with BMI-for-age Z >1 and maternal education. Among pregnant women, VDD was positively related to education. Among adult nonpregnant women, VDD was associated with BMI and household wealth. CONCLUSION The prevalence of VDD and LVD in Colombian women and children is nonnegligible; some age groups are disproportionately affected. Altitude was a strong predictor of vitamin D status in this tropical setting. VDD was positively related to indicators of higher socioeconomic status.
Collapse
Affiliation(s)
- Rachael J Beer
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Oscar F Herrán
- Facultad de Salud, Universidad Industrial de Santander (Faculty of Health, Industrial University of Santander), Bucaramanga, Colombia
| | - Eduardo Villamor
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
12
|
Micronutrients that Affect Immunosenescence. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:13-31. [DOI: 10.1007/978-3-030-42667-5_2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
13
|
Decrease in Serum Vitamin D Level of Older Patients with Fatigue. Nutrients 2019. [PMID: 31635199 DOI: 10.3390/nu11102531.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fatigue is characterized by reduced energy level, decreased muscle strength, and a variable degree of cognitive impairment. Recent evidences seem to link vitamin D deficiency to fatigue. The aim of this study was to assess and compare vitamin D status in a cohort of older subjects with and without fatigue. We recruited a total of 480 subjects, 240 patients with fatigue and 240 controls without fatigue, from the Cannizzaro Hospital of Catania (Italy). Fatigue severity was measured by the fatigue severity scale, whereas mental and physical fatigue were measured through the Wessely and Powell fatigue scale, respectively. We also measured several blood parameters and 25-OH vitamin D. Subjects with fatigue showed lower levels of vitamin D as compared with those without fatigue. Blood levels of parameters related to fatigue were normal in both groups of subjects, however, platelet, hemoglobin, hematocrit (p < 0.05), mean corpuscular volume, C-reactive protein (CRP), iron, vitamin B12, and folic acid (p < 0.001) were significantly higher in the fatigue group with respect to the control group. Moreover, compared to controls, patients showed higher scores in the physical (p < 0.001), mental (p < 0.001), and severity (p < 0.001) fatigue scales. Finally, vitamin D inversely correlated with fatigue severity (r = -0.428, p < 0.01), whereas creatine kinase and CRP levels did not correlate with vitamin D. In conclusion, our data showed a direct link between vitamin D and fatigue in older subjects, suggesting translational implications in the diagnosis and management of these patients.
Collapse
|
14
|
Pennisi M, Malaguarnera G, Di Bartolo G, Lanza G, Bella R, Chisari EM, Cauli O, Vicari E, Malaguarnera M. Decrease in Serum Vitamin D Level of Older Patients with Fatigue. Nutrients 2019; 11:2531. [PMID: 31635199 PMCID: PMC6836014 DOI: 10.3390/nu11102531] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/15/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Fatigue is characterized by reduced energy level, decreased muscle strength, and a variable degree of cognitive impairment. Recent evidences seem to link vitamin D deficiency to fatigue. The aim of this study was to assess and compare vitamin D status in a cohort of older subjects with and without fatigue. We recruited a total of 480 subjects, 240 patients with fatigue and 240 controls without fatigue, from the Cannizzaro Hospital of Catania (Italy). Fatigue severity was measured by the fatigue severity scale, whereas mental and physical fatigue were measured through the Wessely and Powell fatigue scale, respectively. We also measured several blood parameters and 25-OH vitamin D. Subjects with fatigue showed lower levels of vitamin D as compared with those without fatigue. Blood levels of parameters related to fatigue were normal in both groups of subjects, however, platelet, hemoglobin, hematocrit (p < 0.05), mean corpuscular volume, C-reactive protein (CRP), iron, vitamin B12, and folic acid (p < 0.001) were significantly higher in the fatigue group with respect to the control group. Moreover, compared to controls, patients showed higher scores in the physical (p < 0.001), mental (p < 0.001), and severity (p < 0.001) fatigue scales. Finally, vitamin D inversely correlated with fatigue severity (r = -0.428, p < 0.01), whereas creatine kinase and CRP levels did not correlate with vitamin D. In conclusion, our data showed a direct link between vitamin D and fatigue in older subjects, suggesting translational implications in the diagnosis and management of these patients.
Collapse
Affiliation(s)
- Manuela Pennisi
- Department of Biomedical and Biotechnological Science, University of Catania, 95125 Catania, Italy.
| | - Giulia Malaguarnera
- Department of Biomedical and Biotechnological Science, University of Catania, 95125 Catania, Italy.
- Research Center "The Great Senescence", University of Catania, 95100 Catania, Italy.
| | - Giuseppe Di Bartolo
- Research Center "The Great Senescence", University of Catania, 95100 Catania, Italy.
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
- Oasi Research Institute-IRCCS, 94018 Troina, Italy.
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technology, Section of Neurosciences, University of Catania, Catania, Italy.
| | | | - Omar Cauli
- Department of Nursing, University of Valencia, 46010 Valencia, Spain.
| | - Enzo Vicari
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Michele Malaguarnera
- Research Center "The Great Senescence", University of Catania, 95100 Catania, Italy.
- Department of Nursing, University of Valencia, 46010 Valencia, Spain.
| |
Collapse
|
15
|
Pereda CA, Nishishinya MB, Roldan EJA. 25-Hydroxyvitamin D serum levels in rheumatic female patients in southeast Spain: The paradigm of daily optimal sunshine levels and inadequate vitamin D status. ENDOCRINOL DIAB NUTR 2019; 66:181-187. [PMID: 30541681 DOI: 10.1016/j.endinu.2018.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/19/2018] [Accepted: 08/23/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Almeria is a region in southeast Spain with optimal sunlight levels, along with low pluvial and pollution rates. If exposure to sunlight is sufficient to maintain adequate levels of vitamin D (25OHD), this population should display high serum levels. OBJECTIVES To describe 25OHD serum status in women from Almeria and evaluate the impact of long sunlight exposure along the seasons on 25OHD. METHODS Cross-sectional study, performed in women consecutively recruited from an outpatient rheumatology clinic. Serum levels of 25OHD were assessed in all patients and evaluated according to age (<48 yrs, 48-53 yrs, 54-60 yrs and >60 yrs), season, and presence or absence of menopause. Clinical and laboratory variables that could affect status of vitamin D were also considered. RESULTS The sample included 319 Caucasian female patients. Mean 25OHD were 30.2ng/ml with 195 (61.1%) exhibiting 25OHD inadequate serum levels. Season had a significant effect on 25OHD levels, with autumn being the season in which 25OHD serum levels remained well above 30ng/ml in all age bands, and winter the season with more levels of insufficiency. Menopause did not modify 25OH serum levels. Women whose age was below 48 and over 60 had inadequate levels of 25OHD during summer. CONCLUSIONS Optimal levels of sunlight could not overcome the problem of inadequate 25OHD serum levels, particularly in elderly and young female population. Vitamin D supplementation may be recommended predominantly in winter and summer in this population.
Collapse
Affiliation(s)
| | - María Betina Nishishinya
- Instituto Traumatológico Quirón, Barcelona, Spain; MD Programme in Education and Sport Sciences, Facultat de Psicologia, Ciències de l'Educació i de l'Esport Blanquerna, Barcelona, Spain
| | | |
Collapse
|
16
|
Healthy changes in some cardiometabolic risk factors accompany the higher summertime serum 25-hydroxyvitamin D concentrations in Iranian children: National Food and Nutrition Surveillance. Public Health Nutr 2018; 21:2013-2021. [PMID: 29580303 DOI: 10.1017/s1368980018000630] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate seasonal variations of vitamin D status at different latitudes and if these changes are accompanied by corresponding variations in certain health parameters in children living in a broad latitudinal range in Iran. DESIGN Longitudinal study. SUBJECTS In total, 530 apparently healthy children aged 5-18 years were randomly selected from six regions of Iran with a latitudinal gradient from 29°N to 37·5°N. All anthropometric and biochemical assessments were performed twice during a year (summer, winter). High BMI (Z-score >1), low HDL cholesterol (150 mg/dl) were considered cardiometabolic risk factors. RESULTS Serum 25-hydroxyvitamin D (25(OH)D) showed between-season variation, with significantly higher concentrations (mean (sd)) in summer v. winter (43 (29) v. 27 (18) nmol/l; P33°N v. <33°N: 4·5; 0·09, 9·0; P=0·04) were predictors of change of serum 25(OH)D between two seasons. CONCLUSIONS Summertime improvement of vitamin D status was accompanied by certain improved cardiometabolic risk factors, notably serum TAG, total cholesterol and BMI, in children.
Collapse
|
17
|
Vitamin D deficiency in older adults and its associated factors: a cross-sectional analysis of the Mexican Health and Aging Study. Arch Osteoporos 2017; 12:8. [PMID: 28028727 PMCID: PMC5497731 DOI: 10.1007/s11657-016-0297-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/06/2016] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D deficiency was common in older adults from a country with adequate sun exposure. The variables associated with this deficiency provide insight into the next steps needed to characterize older adults with this deficiency and to treat it accordingly. PURPOSE The aim of this study was to describe the prevalence of and factors associated with vitamin D deficiency among Mexican older adults. METHODS This was a secondary analysis of the last wave of the Mexican Health and Aging Study. Vitamin D levels along with other biomarkers were obtained from a sub-sample of Mexican adults older than 60 years. Prevalence was described by sex and age group, and a multivariate analysis was performed to test the factors associated with this condition. RESULTS Data from 1088 adults over the age of 60 years were analyzed. The mean serum vitamin D level was 23.1 ± 8.1 ng/mL and was significantly higher among men than women (25.6 ± 0.6 and 22.8 ± 0.5 ng/mL, respectively; p < 0.001). In total, 37.3% (n = 406) presented with vitamin D deficiency, 65% of whom were women. Low 25-(OH)-vitamin D levels were associated with female sex (OR 1.74, 95% CI 1.59-2.42), current smoking (OR 2.21, 95% CI 1.47-3.39), education (OR 1.1, 95% CI 1.06-1.13), physical activity (OR 1.74, 95% CI 1.31-2.23), and high levels of glycated hemoglobin (OR 1.16, 95% CI 1.07-1.25). CONCLUSIONS Vitamin D deficiency was highly prevalent in Mexican older adults and was associated with a number of factors, indicating the multifactorial causality of this deficiency.
Collapse
|
18
|
Wang H, Chen W, Li D, Yin X, Zhang X, Olsen N, Zheng SG. Vitamin D and Chronic Diseases. Aging Dis 2017; 8:346-353. [PMID: 28580189 PMCID: PMC5440113 DOI: 10.14336/ad.2016.1021] [Citation(s) in RCA: 247] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/21/2016] [Indexed: 12/31/2022] Open
Abstract
Vitamin D is one of the essential nutrients to sustain the human health. As a member of the steroid hormone family, it has a classic role in regulating metabolism of calcium and a non-classic role in affecting cell proliferation and differentiation. Epidemiological studies have shown that 25OHD deficiency is closely associated with common chronic diseases such as bone metabolic disorders, tumors, cardiovascular diseases, and diabetes. 25OHD deficiency is also a risk factor for neuropsychiatric disorders and autoimmune diseases. 25OHD deficiency is highly prevalent in the world. It is therefore necessary to know the adverse health effects of 25OHD deficiency, and to design interventions and early treatments for those who are likely to have low levels of 25OHD.
Collapse
Affiliation(s)
- Hanmin Wang
- 1Division of Endocrinology, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China.,2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China
| | - Weiwen Chen
- 1Division of Endocrinology, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China.,2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China
| | - Dongqing Li
- 1Division of Endocrinology, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China.,2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China
| | - Xiaoe Yin
- 1Division of Endocrinology, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China.,2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China
| | - Xiaode Zhang
- 2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China
| | - Nancy Olsen
- 3Division of Rheumatology, Milton S Hershey Medical Center at Penn State University, Hershey, PA17033, USA
| | - Song Guo Zheng
- 2Expert Workstation, Quqing First Hospital at Kunming Medical University, Qujing, Yunan 655400, China.,3Division of Rheumatology, Milton S Hershey Medical Center at Penn State University, Hershey, PA17033, USA
| |
Collapse
|
19
|
Pae M, Wu D. Nutritional modulation of age-related changes in the immune system and risk of infection. Nutr Res 2017; 41:14-35. [PMID: 28577789 DOI: 10.1016/j.nutres.2017.02.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/18/2017] [Accepted: 02/01/2017] [Indexed: 01/20/2023]
Abstract
The immune system undergoes some adverse alterations during aging, many of which have been implicated in the increased morbidity and mortality associated with infection in the elderly. In addition to intrinsic changes to the immune system with aging, the elderly are more likely to have poor nutritional status, which further impacts the already impaired immune function. Although the elderly often have low zinc serum levels, several manifestations commonly observed during zinc deficiency are similar to the changes in immune function with aging. In the case of vitamin E, although its deficiency is rare, the intake above recommended levels is shown to enhance immune functions in the elderly and to reduce the risk of acquiring upper respiratory infections in nursing home residents. Vitamin D is a critical vitamin in bone metabolism, and its deficiency is far more common, which has been linked to increased risk of infection as demonstrated in a number of observational studies including those in the elderly. In this review, we focus on zinc, vitamin E, and vitamin D, the 3 nutrients which are relatively well documented for their roles in impacting immune function and infection in the elderly, to discuss the findings in this context reported in both the observational studies and interventional clinical trials. A perspective will be provided based on the analysis of information under review.
Collapse
Affiliation(s)
- Munkyong Pae
- Department of Food and Nutrition, Chungbuk National University, Chungdae-ro 1, Seowon-gu, Cheongju 28644, Republic of Korea.
| | - Dayong Wu
- Nutritional Immunology Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St, Boston, MA 02111, USA.
| |
Collapse
|
20
|
Kokturk N, Baha A, Oh YM, Young Ju J, Jones PW. Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? a compherensive review for pulmonologists. CLINICAL RESPIRATORY JOURNAL 2017; 12:382-397. [PMID: 27925404 DOI: 10.1111/crj.12588] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 11/15/2016] [Accepted: 11/23/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Vitamin D deficiency and Chronic Obstructive Pulmonary Disease (COPD) are both under-recognized health problems, world-wide. Although Vitamin D has long been known for calcemic effects it also has less known noncalcemic effects. Recent data have shown that Vitamin D deficiency is highly prevalent in patients with COPD and correlates with forced expiratory volume in one second (FEV1 ) and FEV1 decline. The objective of this work was to review the current literature on vitamin D deficiency in relation with COPD. DATA SOURCE A literature search, using the words "vitamin D" and "COPD", was undertaken in Pubmed database. RESULTS The noncalcemic effects of vitamin D relating with COPD may be summarised as increasing antimicrobial peptide production, regulation of inflammatory response and airway remodelling. Vitamin D inhibits the production of several proinflammatory cytokines and leads to suppression Th1 and Th17 responses which may be involved in the pathogenesis of COPD. Vitamin D insufficiency may also contribute to chronic respiratory infections and airway colonization so returning vitamin D concentrations to an optimal range in patients with COPD might reduce bacterial load and concomitant exacerbations.Vitamin D is also important for COPD-related comorbodities such as osteoporosis, muscle weakness and cardiovascular diseases. Data about the effect of Vitamin D supplementation on those comorbidities in relation with COPD are been scarce. CONCLUSION Improving the blood level of Vitamin D into the desired range may have a beneficial effect bones and muscles, but more studies are needed to test to test that hypothesis.
Collapse
Affiliation(s)
- Nurdan Kokturk
- Department of Pulmonary Medicine, School of Medicine, Gazi University, Ankara, Turkey.,Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ayse Baha
- Department of Pulmonary Medicine, School of Medicine, Gazi University, Ankara, Turkey
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung Young Ju
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Paul W Jones
- Department of Pulmonology, School of Medicine, Clinical Science Center, St George University, London, UK
| |
Collapse
|
21
|
Valderrama-Hinds LM, Al Snih S, Rodriguez MA, Wong R. Association of arthritis and vitamin D insufficiency with physical disability in Mexican older adults: findings from the Mexican Health and Aging Study. Rheumatol Int 2016; 37:607-616. [PMID: 27904949 DOI: 10.1007/s00296-016-3622-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/23/2016] [Indexed: 12/19/2022]
Abstract
Arthritis and vitamin D insufficiency are prevalent in older adults and are risk factors for disability. The objective of this study was to examine the effect of co-occurring arthritis and vitamin D deficiency on upper-lower extremity functional limitations and disability in older adults. We examined 1533 participants aged ≥50 years from a subsample of the Mexican Health and Aging Study. Measures included sociodemographics, body mass index, comorbid conditions, falls, physical activity, physical function tests, functional limitations, activities of daily living (ADL), and vitamin D. Participants were categorized into four groups according to arthritis and vitamin D status: no vitamin D insufficiency and no arthritis (58.80%), vitamin D insufficiency only (27.49%), arthritis only (8.47%), and arthritis and vitamin D insufficiency (5.24%). Fourteen percent reported arthritis, and 31.2% had vitamin D insufficiency. The arthritis and vitamin D insufficiency group was associated with upper-lower extremity functional limitations [odds ratio (OR) 1.82, 95% confidence interval (CI) 1.06-3.15, and OR 1.90, 95% CI 1.00-3.62, respectively] and ADL disability (OR 3.00, 95% CI 1.63-5.51) when compared with the no vitamin D insufficiency and no arthritis group (reference group). The arthritis only group was three times more likely to report upper-lower extremity functional limitations and ADL disability. The vitamin D insufficiency only group was not significantly associated with functional limitations nor ADL disability. Arthritis and vitamin D insufficiency increased the risk of ADL disability in this population. However, the effect of arthritis and vitamin D insufficiency on upper-lower extremity functional limitations was not higher than the effect of arthritis only, but higher than the effect on vitamin D insufficiency alone.
Collapse
Affiliation(s)
- Luis M Valderrama-Hinds
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. .,Division of Rheumatology, Department of Internal Medicine, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela. .,Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
| | - Soham Al Snih
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA. .,Division of Rehabilitation Sciences, School of Health Professions, University of Texas Medical Branch, 301 University Blvd., Galveston, TX, 77555-0177, USA. .,Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.
| | - Martin A Rodriguez
- Division of Rheumatology, Department of Internal Medicine, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.,Centro Nacional de Enfermedades Reumáticas, Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, 77555-0177, USA.,Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
22
|
Zhang M, Shen F, Petryk A, Tang J, Chen X, Sergi C. "English Disease": Historical Notes on Rickets, the Bone-Lung Link and Child Neglect Issues. Nutrients 2016; 8:722. [PMID: 27854286 PMCID: PMC5133108 DOI: 10.3390/nu8110722] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 11/04/2016] [Accepted: 11/10/2016] [Indexed: 12/14/2022] Open
Abstract
Nutritional or classical rickets (here labeled as "rickets") is a worldwide disease involving mostly infants and young children having inadequate sunlight exposure, often associated with a low dietary intake of Vitamin D. Rickets targets all layers of society independently of economic status with historical information spanning more than two millennia. Vitamin D is critical for the absorption of calcium and prevention of rickets in children as well as osteomalacia in adults. The initial and misleading paradigm of the 19th and 20th centuries that rickets may have been the consequence of infection has been, indeed, reversed following the identification of the Vitamin D molecule's important role in the function of the immune system. Although traditionally considered limited to osteopathology, Vitamin D deficiency is now known to be linked to infection, inflammation, and carcinogenesis. In this review, we consider the key historical (Whistler, pre-Whistler and post-Whistler descriptors) and social facts around rickets; highlight the osteo-pathological features of rickets and the pathology of the upper and lower respiratory tract, stressing the fact that lungs remain the main secondary organ affected by Vitamin D deficiency; and emphasize the public health role in identifying the cases of child neglect or abuse based on the evaluation of the costochondral region.
Collapse
Affiliation(s)
- Mingyong Zhang
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan 430064, China.
| | - Fan Shen
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada.
| | - Anna Petryk
- Comprehensive Pediatric Bone Health Program, Div. Pediatric Endocrinology, University of Minnesota, Minneapolis, MN 55455, USA.
| | - Jingfeng Tang
- Membrane Protein Disease and Cancer Research Centre, Provincial Innovation Center, Hubei University of Technology, Wuhan 430068, China.
| | - Xingzhen Chen
- Membrane Protein Disease and Cancer Research Centre, Provincial Innovation Center, Hubei University of Technology, Wuhan 430068, China.
- Department of Physiology, University of Alberta, Edmonton, AB T6G 2R3, Canada.
| | - Consolato Sergi
- Department of Orthopedics, Tianyou Hospital, Wuhan University of Science and Technology, Wuhan 430064, China.
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2B7, Canada.
- Stollery Children's Hospital, University of Alberta Hospital, Edmonton, AB T6G 2B7, Canada.
| |
Collapse
|
23
|
Acevedo F, Pérez V, Pérez-Sepúlveda A, Florenzano P, Artigas R, Medina L, Sánchez C. High prevalence of vitamin D deficiency in women with breast cancer: The first Chilean study. Breast 2016; 29:39-43. [DOI: 10.1016/j.breast.2016.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 02/01/2023] Open
|
24
|
Low vitamin D status strongly associated with periodontitis in Puerto Rican adults. BMC Oral Health 2016; 16:89. [PMID: 27590456 PMCID: PMC5010763 DOI: 10.1186/s12903-016-0288-7] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 08/26/2016] [Indexed: 12/18/2022] Open
Abstract
Background Periodontitis and vitamin D deficiency are both highly prevalent in Puerto Rico. The aim of this pilot study was to evaluate the association between vitamin D levels and periodontal disease in Puerto Rican adults. Methods A sex-, age-, and BMI-matched case-control, cross-sectional study was conducted on 24 cases of moderate/severe periodontitis and 24 periodontally healthy controls aged 35 to 64 years. Each participant completed a socio-demographic questionnaire, underwent a full-mouth periodontal examination and provided blood sample to measure serum 25-hydroxyvitamin D (25 (OH) D) levels to assess vitamin D status. Results A total of 19 matched case-control pairs (28 females, 10 males) completed the study. Mean serum 25 (OH) D levels were significantly lower in cases (18.5 ± 4.6 ng/ml) than in controls (24.2 ± 7.1 ng/ml; p = 0.006). Lower odds of periodontal disease were observed per unit of 25 (OH) D level (OR 0.885; 95 % CI 0.785, 0.997; p < 0.05). Conclusions Lower serum vitamin D levels are significantly associated with periodontitis in Puerto Rican adults.
Collapse
|
25
|
Margulies SL, Kurian D, Elliott MS, Han Z. Vitamin D deficiency in patients with intestinal malabsorption syndromes--think in and outside the gut. J Dig Dis 2015; 16:617-33. [PMID: 26316334 DOI: 10.1111/1751-2980.12283] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 06/26/2015] [Accepted: 08/04/2015] [Indexed: 12/11/2022]
Abstract
There is a very high prevalence of vitamin D deficiency, which is defined by a serum level of 25-hydroxyvitamin D [25(OH)D] of lower than 20 ng/mL, in all populations of the world. Unfortunately, the prevalence of vitamin D deficiency in patients with intestinal malabsorption syndromes, including cystic fibrosis (CF), celiac disease (CD), short bowel syndrome and inflammatory bowel disease (IBD), is higher than that in the general population, indicating the presence of disease-specific causative factors. In this review, we aimed to present clinical findings to highlight the roles of insufficient exposure to sunlight and inflammation in the development of vitamin D deficiency in patients with intestinal malabsorption syndromes. Furthermore, we aimed to present experimental evidence that supported a role of vitamin D deficiency in the pathogenesis of IBD. Finally, we reviewed clinical intervention strategies aiming to normalize vitamin D status in and even to improve the conditions of patients and to discuss certain issues that needed to be addressed in future research.
Collapse
Affiliation(s)
- Samantha L Margulies
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Divya Kurian
- George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Mark S Elliott
- Department of Biochemistry and Molecular Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - Zhiyong Han
- Department of Biochemistry and Molecular Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| |
Collapse
|
26
|
Affiliation(s)
- Dheeraj Shah
- Department of Pediatrics, University College of Medical Sciences, Guru Tegh Bahadur (GTB) Hospital, Delhi, India
| | - Piyush Gupta
- Department of Pediatrics, University College of Medical Sciences, Guru Tegh Bahadur (GTB) Hospital, Delhi, India
| |
Collapse
|
27
|
Vitamin D: a review on its effects on muscle strength, the risk of fall, and frailty. BIOMED RESEARCH INTERNATIONAL 2015; 2015:953241. [PMID: 26000306 PMCID: PMC4427016 DOI: 10.1155/2015/953241] [Citation(s) in RCA: 162] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 03/01/2015] [Accepted: 03/01/2015] [Indexed: 02/05/2023]
Abstract
Vitamin D is the main hormone of bone metabolism. However, the ubiquitary nature of vitamin D receptor (VDR) suggests potential for widespread effects, which has led to new research exploring the effects of vitamin D on a variety of tissues, especially in the skeletal muscle. In vitro studies have shown that the active form of vitamin D, calcitriol, acts in myocytes through genomic effects involving VDR activation in the cell nucleus to drive cellular differentiation and proliferation. A putative transmembrane receptor may be responsible for nongenomic effects leading to rapid influx of calcium within muscle cells. Hypovitaminosis D is consistently associated with decrease in muscle function and performance and increase in disability. On the contrary, vitamin D supplementation has been shown to improve muscle strength and gait in different settings, especially in elderly patients. Despite some controversies in the interpretation of meta-analysis, a reduced risk of falls has been attributed to vitamin D supplementation due to direct effects on muscle cells. Finally, a low vitamin D status is consistently associated with the frail phenotype. This is why many authorities recommend vitamin D supplementation in the frail patient.
Collapse
|
28
|
Ramos-Trautmann G, González L, Díaz-Luquis G, Pérez CM, Palacios C. Inverse Association between Vitamin D Status and Diabetes in a Clinic Based Sample of Hispanic Adults in Puerto Rico. ACTA ACUST UNITED AC 2015; 1:5-11. [PMID: 28345061 DOI: 10.17140/droj-1-102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Vitamin D deficiency is a public health problem around the world. Diabetes has been associated with vitamin D deficiency. We aimed to examine the association between the vitamin D status and diabetes in a clinic based sample of Hispanic adults in Puerto Rico. METHODS Demographics and laboratory test results for serum 25(OH)D, Fasting Blood Glucose (FBG), and Haemoglobin A1C (HbAlc) were extracted from medical records. Vitamin D status was classified as deficient (<12 ng/ml); inadequate (12-20 ng/ml); insufficient (21-29 ng/ml) and optimal (≥30 ng/ml) using serum 25(OH)D levels. RESULTS A total of 716 records were included in the analyses. Most were females (63.3%), with mean age of 54.1±14.9 y, mean BMI 30.1±6.3 kg/m2 and mean serum 25(OH)D levels of 24.3±8.6 ng/ml. Most were classified as diabetics (41.1%). Those with diabetes had lower 25(OH)D levels compared to pre-diabetic and normal glucose status (p<0.05). Serum 25(OH) D levels were inversely correlated to FBG and HbA1c in the total sample and in men (p<0.05). After adjusting for age, gender, BMI and seasonality, there was a greater risk of diabetes, but not prediabetes, in those with serum 25(OH)D levels <30 ng/ml. This risk increased from 1.8 times in those with vitamin D insufficiency to 4.2 times in those with vitamin D deficiency (<12 ng/ml). CONCLUSION Diabetes risk significantly increased as serum 25(OH)D levels decreased in this group of Hispanic adults, underscoring the importance of routinely screening high risk individuals for vitamin D deficiency and offer supplementation to normalize serum levels.
Collapse
Affiliation(s)
- Grisel Ramos-Trautmann
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Lilliana González
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Giselle Díaz-Luquis
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Cynthia M Pérez
- Epidemiology Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Cristina Palacios
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
29
|
Orces CH. Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador. ScientificWorldJournal 2015; 2015:545297. [PMID: 26301259 PMCID: PMC4537767 DOI: 10.1155/2015/545297] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 07/15/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and its determinants among older adults in Ecuador. METHODS 25(OH)D deficiency and insufficiency prevalence rates were examined among participants in the National Survey of Health, Wellbeing, and Aging. Logistic regression models were used to evaluate demographic characteristics associated with 25(OH)D deficiency. RESULTS Of 2,374 participants with a mean age of 71.0 (8.3) years, 25(OH)D insufficiency and deficiency were present in 67.8% (95% CI, 65.3-70.2) and 21.6% (95% CI, 19.5-23.7) of older adults in Ecuador, respectively. Women (OR, 3.19; 95% CI, 3.15-3.22), self-reported race as Indigenous (OR, 2.75; 95% CI, 2.70-2.80), and residents in rural (OR, 4.49; 95% CI, 4.40-4.58) and urban (OR, 2.74; 95% CI, 2.69-2.80) areas of the Andes Mountains region were variables significantly associated with 25(OH)D deficiency among older adults. CONCLUSIONS Despite abundant sunlight throughout the year in Ecuador, 25(OH)D deficiency was significantly prevalent among older women, Indigenous subjects, and subjects residing in the Andes Mountains region of the country. The present findings may assist public health authorities to implement policies of vitamin D supplementation among older adults at risk for this condition.
Collapse
Affiliation(s)
- Carlos H. Orces
- Department of Medicine, Laredo Medical Center, 1700 East Saunders, Laredo, TX 78041, USA
- *Carlos H. Orces:
| |
Collapse
|
30
|
Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol 2014; 144 Pt A:138-45. [PMID: 24239505 PMCID: PMC4018438 DOI: 10.1016/j.jsbmb.2013.11.003] [Citation(s) in RCA: 766] [Impact Index Per Article: 69.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Revised: 09/17/2013] [Accepted: 11/05/2013] [Indexed: 12/26/2022]
Abstract
Vitamin D deficiency is a major public health problem worldwide in all age groups, even in those residing in countries with low latitude, where it was generally assumed that UV radiation was adequate enough to prevent this deficiency, and in industrialized countries, where vitamin D fortification has been implemented now for years. However, most countries are still lacking data, particularly population representative data, with very limited information in infants, children, adolescents and pregnant women. Since the number of recent publications is escalating, with a broadening of the geographic diversity, the objective of the present report was to conduct a more recent systematic review of global vitamin D status, with particular emphasis in at risk groups. A systematic review was conducted in PubMed/Medline in April-June 2013 to identify articles on vitamin D status worldwide published in the last 10 years in apparently healthy individuals. Only studies with vitamin D status prevalence were included. If available, the first source selected was population-based or representative samples studies. Clinical trials, case-control studies, case reports or series, reviews, validation studies, letters, editorials, or qualitative studies were excluded. A total of 103 articles were eligible and included in the present report. Maps were created for each age group, providing an updated overview of global vitamin D status. In areas with available data, the prevalence of low vitamin D status is a global problem in all age groups, in particular in girls and women from the Middle East. These maps also evidenced the regions with missing data for each specific population groups. There is striking lack of data in infants, children and adolescents worldwide, and in most countries of South America and Africa. In conclusion, vitamin D deficiency is a global public health problem in all age groups, particularly in those from the Middle East. This article is part of a Special Issue entitled '16th Vitamin D Workshop'.
Collapse
Affiliation(s)
- Cristina Palacios
- Nutrition Program, School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00935, Puerto Rico.
| | - Lilliana Gonzalez
- Nutrition Program, School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan 00935, Puerto Rico
| |
Collapse
|
31
|
González G. Vitamin D status among healthy postmenopausal women in South America. DERMATO-ENDOCRINOLOGY 2014; 5:117-20. [PMID: 24494044 PMCID: PMC3897579 DOI: 10.4161/derm.24807] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 04/09/2013] [Accepted: 04/25/2013] [Indexed: 11/24/2022]
Abstract
Vitamin D status has been extensively studied throughout the world. However, most of the studies are from North America, Europe and Oceania. This review describes published evidence on vitamin D status among healthy postmenopausal women in South America, where food is not fortified with vitamin D. A literature search identified ten studies from only three countries in the region: Argentina, Brazil and Chile. These studies reported a high prevalence of vitamin D deficiency, in spite of their location at latitudes with abundant sunlight throughout the year. In studies with proper design, a clear North-South gradient was revealed with higher 25(OH)D levels toward the equator. Seasonal changes in 25(OH)D were more likely to be detected in younger subjects. These results are very similar to what has been reported in the Northern Hemisphere and they emphasize the importance of recommendations for a higher vitamin D intake in this population from South America.
Collapse
Affiliation(s)
- Gilberto González
- Department of Endocrinology; School of Medicine; Pontificia Universidad Católica de Chile; Santiago, Chile
| |
Collapse
|
32
|
|
33
|
Clark P, Chico G, Carlos F, Zamudio F, Pereira RMR, Zanchetta J, Castillo J. Osteoporosis in Latin America: panel expert review. Medwave 2013. [DOI: 10.5867/medwave.2013.08.5791] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
34
|
Brito A, Cori H, Olivares M, Fernanda Mujica M, Cediel G, López de Romaña D. Less than adequate vitamin D status and intake in Latin America and the Caribbean:a problem of unknown magnitude. Food Nutr Bull 2013; 34:52-64. [PMID: 23767281 DOI: 10.1177/156482651303400107] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence of vitamin D deficiency in Latin America and the Caribbean is unknown. OBJECTIVE To examine the prevalence data available on vitamin D deficiency in Latin America and the Caribbean. METHODS A systematic review was conducted in 2011. Studies using biochemical biomarkers and dietary intake estimation were included. Studies conducted in apparently healthy individuals, independently of age, latitude, skin pigmentation, and season of the year at the time of blood collection, were included. RESULTS A total of 243 studies were identified. The final number of selected studies was 28, including two National Health Surveys (Mexico and Argentina). There are studies that report the vitamin D status of specific subgroups conducted in Argentina, Brazil, Chile, Colombia, Ecuador, Guatemala, and Mexico. However, the small sample sizes in these studies and thus the low national representativeness of the reported data do not allow for an accurate assessment of vitamin D status at the regional level. In the majority of the countries with available data, we observed that vitamin D insufficiency was classified as a mild, moderate, or severe public health problem. The only country with a nationally representative sample was Mexico, which found 24%, 10%, 8%, and 10% prevalence rates of vitamin D insufficiency (25-hydroxyvitamin D < 50 nmol/L) in preschoolers, schoolchildren, adolescents, and adults, respectively. The prevalence of vitamin D deficiency (25-hydroxyvitamin D < 20 nmol/L) was less than 1% for all groups. CONCLUSIONS There is some indication that vitamin D insufficiency may be a public health problem in Latin America and the Caribbean, but the exact magnitude is currently unknown.
Collapse
Affiliation(s)
- Alex Brito
- Micronutrients Laboratory, Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.
| | | | | | | | | | | |
Collapse
|
35
|
Litwic A, Edwards M, Cooper C, Dennison E. Geographic differences in fractures among women. WOMEN'S HEALTH (LONDON, ENGLAND) 2012; 8:673-84. [PMID: 23181532 PMCID: PMC3736314 DOI: 10.2217/whe.12.54] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Osteoporotic fracture is associated with considerable morbidity and mortality in women throughout the world. However, significant variation in hip fracture rates among women from different nations has been observed and is likely to represent a combination of real and apparent differences due to ascertainment bias. Higher rates are observed in Caucasian women, with lowest rates observed in black women and intermediate rates among Asian women. These differences are likely to represent a combination of genetic and environmental differences; for example, among European women, the highest fracture rates are observed in Scandinavian women where vitamin D insufficiency is common. In all groups, an increase in absolute fracture numbers is anticipated due to demographic changes.
Collapse
Affiliation(s)
- Anna Litwic
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - Mark Edwards
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
| | - Cyrus Cooper
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
- University of Oxford, UK
| | - Elaine Dennison
- The MRC Lifecourse Epidemiology Unit, (University of Southampton), Southampton General Hospital, Southampton SO16 6YD, UK
- Victoria University, Wellington, New Zealand
| |
Collapse
|
36
|
Abstract
Vitamin D has become increasingly recognized in the literature for its extra-skeletal roles, including an effect on inflammation and the immune response to infection. Our goal was to describe the role of vitamin D in the immune response and implications for the risk of influenza infection in humans. In this review, we first consider literature that provides molecular and genetic support to the idea that vitamin D is related to the adaptive and innate immune responses to influenza infection in vitro and in animal models. We then discuss observational studies and randomized controlled trials of vitamin D supplementation in humans. Finally, we consider some of the knowledge gaps surrounding vitamin D and immune response that must be filled.
Collapse
|
37
|
Palacios C, Gil K, Pérez CM, Joshipura K. Determinants of vitamin D status among overweight and obese Puerto Rican adults. ANNALS OF NUTRITION AND METABOLISM 2012; 60:35-43. [PMID: 22222318 DOI: 10.1159/000335282] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 11/19/2011] [Indexed: 01/09/2023]
Abstract
BACKGROUND/AIMS Low vitamin D status is highly prevalent worldwide, and the major determinants are sun exposure and vitamin D intake. We aimed to measure vitamin D status in a sample of overweight/obese adults in Puerto Rico, an area with plenty of sun exposure, and relate it to vitamin D intake, sun exposure and body composition. METHODS Serum 25(OH)D levels (liquid chromatography-tandem mass spectrometry), body weight and fat (bioimpedance), vitamin D intake and sun exposure (questionnaires) were assessed. Analysis included age-adjusted correlations and multivariate regression. RESULTS In 98 subjects (66% females; 40-65 years), median serum 25(OH)D levels were 30.7 ng/ml (25-75th percentile 25.0-37.3); 55% had levels >30 ng/ml, 31% had levels between 20 and 30 ng/ml and 14% had levels <20 ng/ml. Total vitamin D intake was 180 IU/day (45-615), and the sun exposure score was 22 (17-27). After adjusting for gender, 25(OH)D levels were significantly correlated with vitamin D intake (r = 0.24, p = 0.018), the sum of sun exposure and vitamin D intake indices (r = 0.34, p = 0.001) and percent body fat (r = -0.25, p = 0.01). After adjusting for age, gender and percent body fat, the sum of sun exposure and vitamin D intake indices remained statistically associated with 25(OH)D levels (β = 1.5, p < 0.01). CONCLUSIONS In this group of overweight and obese individuals, 25(OH)D was significantly related to vitamin D intake, sun exposure and vitamin D intake indices and percent body fat.
Collapse
Affiliation(s)
- Cristina Palacios
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, PR.
| | | | | | | |
Collapse
|
38
|
Abstract
The aim of the present study is to summarize existing literature on vitamin D levels in adults in different continents and different countries worldwide. The best determinant of vitamin D status is the serum concentration of 25-hydroxyvitamin D (25(OH)D). Most investigators agree that serum 25(OH)D should be higher than 50 nmol/l, but some recommend higher serum levels. Traditional risk groups for vitamin D deficiency include pregnant women, children, older persons, the institutionalized, and non-western immigrants. This chapter shows that serum 25(OH)D levels are not only suboptimal in specific risk groups, but also in adults in many countries. Especially, in the Middle-East and Asia, vitamin D deficiency in adults is highly prevalent.
Collapse
Affiliation(s)
- Natasja M van Schoor
- EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, The Netherlands.
| | | |
Collapse
|
39
|
Robinson PJ, Bell RJ, Lanzafame A, Kirby C, Weekes A, Piterman L, Davis SR. The prevalence of vitamin D deficiency and relationship with fracture risk in older women presenting in Australian general practice. Australas J Ageing 2011; 32:177-83. [PMID: 24028458 DOI: 10.1111/j.1741-6612.2011.00553.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AIM To investigate vitamin D status among older women and to explore relationships between vitamin D and fracture risk and vertebral fractures. METHODS A total of 267 general practitioners recruited 2466 women aged >70 years with no known osteoporosis or fragility fracture. Serum 25-hydroxy vitamin D (25(OH)D), bone mineral density by dual-energy X-ray absorptiometry (DXA) and vertebral fracture on thoracolumbar X-ray were determined. RESULTS A total of 2368 women, median age 76 years, provided data and of these 13% were on vitamin D supplements. 25(OH)D levels were available for 907 (44.1%) of those not taking vitamin D. 88.3% of these had a level below 75 nmol/L. Serum 25(OH)D was negatively associated with age (P = 0.003) and body mass index (P < 0.001), and positively associated with lower latitude, femoral neck DXA T-score (P = 0.044) and being Caucasian (P < 0.001). CONCLUSIONS The vitamin D status of community-dwelling older Australian women is inadequate, yet the use of supplements is low.
Collapse
Affiliation(s)
- Penelope J Robinson
- Women's Health Research Program, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia Servier Laboratories, Melbourne, Victoria, Australia School of Primary Health Care, Monash University, Melbourne, Victoria, Australia
| | | | | | | | | | | | | |
Collapse
|
40
|
Mastaglia SR, Seijo M, Muzio D, Somoza J, Nuñez M, Oliveri B. Effect of vitamin D nutritional status on muscle function and strength in healthy women aged over sixty-five years. J Nutr Health Aging 2011; 15:349-54. [PMID: 21528160 DOI: 10.1007/s12603-010-0287-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Vitamin D insufficiency is common in elderly adults, and leads to secondary hyperparathyroidism, bone loss, muscle weakness, and osteoporotic fractures. OBJECTIVE To evaluate the relation between vitamin D nutritional status and muscle function and muscle strength in women aged over 65 years. METHODS Fifty-four postmenopausal women from Buenos Aires (latitude 34° S), average age (X±DS) 71±4, were included in the study. Determinations of serum calcium, phosphate, 25 hydroxyvitamin D (25OHD), intact parathormone (iPTH) and calciuria / creatininuria ratio in 24-hour urine samples were performed. Muscle function was assessed by means of walking-speed test, standing balance, and sit-to-stand tests. Lower extremity muscle strength was determined using a manual dynamometer. RESULTS 25OHD levels ≥20 ng/ml were found to be associated with better lower extremity muscle function and strength. Forty- six % of participants had 25OHD levels ≥20 ng/ml. Women with 25OHD levels ≥20 ng/ml scored higher on the muscle function tests (11.2±0.9 vs.10.0±2.1; p<0.003) and had stronger knee extensor (13.4±2.7 vs.11.6±2.5 Kg.; p<0.03) and hip abductor (8.3±2.7 vs. 7.3±3.1 Kg; p<0.04) muscles; strength of their hip flexors tended to be higher but did not reach significantly different values (17.0±3.3 vs. 15.4±2.8 Kg.; 0.1>p>0.05). Negative correlation was observed between iPTH and muscle function (r= -0.436; p<0.02). CONCLUSION 25OHD levels ≥20 ng/ml are needed for a better muscle function and strength. Assessing vitamin D nutritional status in adults aged ≥ 65 years would allow correcting hypovitaminosis D and improve muscle function and strength.
Collapse
Affiliation(s)
- S R Mastaglia
- Sección Osteopatías Médicas, Hospital de Clínicas, Universidad de Buenos Aires, Buenos Aires, Argentina.
| | | | | | | | | | | |
Collapse
|
41
|
Salivary bone turnover markers in healthy pre- and postmenopausal women: daily and seasonal rhythm. Clin Oral Investig 2011; 16:651-7. [DOI: 10.1007/s00784-011-0538-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 03/01/2011] [Indexed: 01/20/2023]
|
42
|
Wittich A, Bagur A, Mautalen C, Cristofari A, Escobar O, Carrizo G, Oliveri B. Epidemiology of hip fracture in Tucuman, Argentina. Osteoporos Int 2010; 21:1803-7. [PMID: 19997904 DOI: 10.1007/s00198-009-1135-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 10/27/2009] [Indexed: 12/22/2022]
Abstract
UNLABELLED The incidence of osteoporotic hip fracture was studied previously in a central area of Argentina. Studying Tucuman (north area) was very useful to compare results of the different areas and detect a similar incidence in women and a slightly higher incidence in men compared with previous data for the central region. INTRODUCTION/METHODS Epidemiology of hip fracture was studied over a 1-year period in the city of San Miguel de Tucumán (SMT) and in the whole province of Tucumán, located in the northeast of Argentina (latitudes 26° and 28° south). The results were compared with previous studies performed in the central region of Argentina. RESULTS Two hundred and eighty-three patients (208 women and 75 men) aged 50 years or over in SMT suffered a hip fracture. The incidence in females and males was 334.9 and 163.8 hip fractures per 100,000 inhabitants per year, respectively (female/male ratio 2.0). A total of 498 hip fractures were recorded in Tucuman province (367 in women and 131 in men). The results in females and males were 276.5 and 114.7 hip fractures per 100,000 inhabitants per year, respectively. Average age of the female and male population was 78±9 and 77±9 years, respectively. CONCLUSIONS These results showed that the incidence of hip fracture in female and male populations in SMT was similar to previous studies performed in the central area of the country. Further studies on the south area of Argentina should be conducted to complete the information on a large country extending from latitudes 22° to 55°S.
Collapse
Affiliation(s)
- A Wittich
- Servicio de Endocrinología, Hospital Centro de Salud, Tucumán, Argentina
| | | | | | | | | | | | | |
Collapse
|
43
|
Arabi A, El Rassi R, El-Hajj Fuleihan G. Hypovitaminosis D in developing countries-prevalence, risk factors and outcomes. Nat Rev Endocrinol 2010; 6:550-61. [PMID: 20852586 DOI: 10.1038/nrendo.2010.146] [Citation(s) in RCA: 227] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Hypovitaminosis D is a prevalent disorder in developing countries. Clinical manifestations of hypovitaminosis D include musculoskeletal disorders, such as nonspecific muscle pain, poor muscle strength and low BMD, as well as nonmusculoskeletal disorders, such as an increased risk of respiratory infections, diabetes mellitus and possibly cardiovascular diseases. In developing countries, the prevalence of hypovitaminosis D varies widely by and within regions; prevalence ranges between 30-90%, according to the cut-off value used within specific regions, and is independent of latitude. A high prevalence of the disorder exists in China and Mongolia, especially in children, of whom up to 50% are reported to have serum 25-hydroxyvitamin D levels <12.5 nmol/l. Despite ample sunshine throughout the year, one-third to one-half of individuals living in Sub-Saharan Africa and the Middle East have serum 25-hydroxyvitamin D levels <25 nmol/l, according to studies published in the past decade. Hypovitaminosis D is also prevalent in children and the elderly living in Latin America. Risk factors for hypovitaminosis D in developing countries are similar to those reported in Western countries and include extremes of age, female sex, winter season, dark skin pigmentation, malnutrition, lack of sun exposure, a covered clothing style and obesity. Clinical trials to assess the effect of vitamin D supplementation on classical and nonclassical clinical outcomes in developing countries are needed.
Collapse
Affiliation(s)
- Asma Arabi
- Department of Internal Medicine, American University of Beirut, Lebanon
| | | | | |
Collapse
|
44
|
Abstract
The vitamin D status depends on the production of vitamin D3 in the skin under the influence of ultraviolet radiation and vitamin D intake through the diet or vitamin D supplements. The serum 25-hydroxyvitamin D (25(OH)D) concentration is the parameter of choice for the assessment of vitamin D status. Low serum levels of calcium and phosphate and an elevated level of alkaline phosphatase can also point to vitamin D deficiency. Usually, between 50% and 90% of vitamin D in the body is coming from the production in the skin and the remainder is from the diet. The production of vitamin D3 in the skin depends on sunshine exposure, latitude, skin-covering clothes, the use of sun block and skin pigmentation. In general, serum 25(OH)D is lower with higher latitudes and with darker skin types, but there are exceptions. Vitamin D deficiency (serum 25(OH)D<25 nmol/l) is highly prevalent in India and China while vitamin D status is better in Japan and South-East Asia. Vitamin D deficiency is very common in the Middle-East and there is a relationship with skin covering clothes and staying outside of the sun. A poor to moderate vitamin D status is also common in Africa, probably caused by the dark skin types and cultural habits of staying outside of the sunshine. Vitamin D status is much better in North America where vitamin D deficiency is uncommon but vitamin D insufficiency (serum 25(OH)D between 25 and 50 nmol/l) is still common. In the United States and Canada milk is usually supplemented with vitamin D and the use of vitamin supplements is relatively common. Vitamin D status in Latin America usually is reasonable but there are exceptions and vitamin D insufficiency still occurs quite often. In Australia and New Zealand a poor vitamin D status was seen in the elderly who were often vitamin D deficient and also in immigrants from Asia. Vitamin D deficiency also occurred in children when the mother was vitamin D deficient. Within Europe, vitamin D status usually is better in the Nordic countries than around the Mediterranean. This may be due to a lighter skin and sun seeking behaviour and a high consumption of cod liver oil in the Northern countries while in Southern Europe people stay out of the sunshine and have a somewhat darker skin. A very poor vitamin D status was observed in non-western immigrants, especially in pregnant women. In conclusion, vitamin D deficiency and insufficiency are globally still very common especially in risk groups such as young children, pregnant women, elderly and immigrants.
Collapse
Affiliation(s)
- P Lips
- VU University Medical Center, Department of Internal Medicine, Section Endocrinology, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| |
Collapse
|
45
|
Naves-Díaz M, Passlick-Deetjen J, Guinsburg A, Marelli C, Fernández-Martín JL, Rodríguez-Puyol D, Cannata-Andía JB. Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study. Nephrol Dial Transplant 2010; 26:1938-47. [PMID: 20513773 DOI: 10.1093/ndt/gfq304] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Mineral metabolism parameters may play a role in the survival of patients with chronic kidney disease (CKD). METHODS In the CORES Study, we analysed the association between calcium, phosphorus and PTH and mortality (all-cause and cardiovascular) in 16 173 haemodialysis (HD) patients over 18 years from six Latin American countries, who underwent haemodialysis up to 54 months. Unadjusted, case-mix-adjusted and time-dependent multivariable-adjusted hazard ratio (HR) of death were calculated for categories of serum albumin-corrected calcium (Ca(Alb)), phosphorus and PTH using as 'reference values' the range in which the lowest death rate was observed. Age, gender, vitamin D treatment, diabetes, vintage, vascular access, weight, blood pressure and laboratory variables (serum albumin, haemoglobin, creatinine, ferritin and Kt/V) were used as confounding variables. RESULTS Low (<9.5 mg/dL) and high (>10.5 mg/dL) Ca(Alb) increased the HR for all-cause mortality. Low (<9.0 mg/dL) Ca(Alb) increased the HR for cardiovascular mortality. High phosphorus (>5.5 mg/dL) increased the HR for both all-cause and cardiovascular mortality. Low phosphorus (<4.0 and <3.0 mg/dL) increased the HR for both all-cause and cardiovascular mortality. Furthermore, low (<150 pg/mL) and high (>500 and >300 pg/mL) PTH increased the HR for both all-cause and cardiovascular mortality. In addition, only phosphorus >6.0 mg/dL increased the HR for cardiovascular hospitalizations. No effect was observed with Ca(Alb) or PTH. CONCLUSIONS In summary, in 16,173 HD patients, elevated and reduced serum levels of albumin-corrected calcium, phosphorus and PTH levels were associated with increments in all-cause mortality. Similar results were obtained when only cardiovascular mortality was analysed.
Collapse
Affiliation(s)
- Manuel Naves-Díaz
- Bone and Mineral Research Unit, Hospital Universitario Central de Asturias, Universidad de Oviedo, Julián Claveria s/n, 33006 Oviedo, Spain
| | | | | | | | | | | | | |
Collapse
|
46
|
Mithal A, Wahl DA, Bonjour JP, Burckhardt P, Dawson-Hughes B, Eisman JA, El-Hajj Fuleihan G, Josse RG, Lips P, Morales-Torres J. Global vitamin D status and determinants of hypovitaminosis D. Osteoporos Int 2009; 20:1807-20. [PMID: 19543765 DOI: 10.1007/s00198-009-0954-6] [Citation(s) in RCA: 1039] [Impact Index Per Article: 64.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2009] [Accepted: 04/20/2009] [Indexed: 02/06/2023]
Abstract
UNLABELLED This review describes the vitamin D status in different regions of the world with the objective of understanding the scope of hypovitaminosis D and the factors related to its prevalence that may contribute to the pathogenesis of osteoporosis and fragility fractures. INTRODUCTION Vitamin D status has been linked to the pathogenesis of hip fractures as well as other skeletal and non-skeletal disorders. The purpose of this review is to provide a global perspective of vitamin D status across different regions of the world and to identify the common and significant determinants of hypovitaminosis D. METHODS Six regions of the world were reviewed-Asia, Europe, Middle East and Africa, Latin America, North America, and Oceania-through a survey of published literature. RESULTS The definition of vitamin D insufficiency and deficiency, as well as assay methodology for 25-hydroxyvitamin D or 25(OH)D, vary between studies. However, serum 25(OH)D levels below 75 nmol/L are prevalent in every region studied whilst levels below 25 nmol/L are most common in regions such as South Asia and the Middle East. Older age, female sex, higher latitude, winter season, darker skin pigmentation, less sunlight exposure, dietary habits, and absence of vitamin D fortification are the main factors that are significantly associated with lower 25(OH)D levels. CONCLUSION Reports from across the world indicate that hypovitaminosis D is widespread and is re-emerging as a major health problem globally.
Collapse
Affiliation(s)
- A Mithal
- Indraprastha Apollo Hospitals, Sarita Vihar, Delhi-Mathura Road, 110044 New Delhi, India.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Portela MLPM, Mónico A, Barahona A, Dupraz H, Sol Gonzales-Chaves MM, Zeni SN. Comparative 25-OH-vitamin D level in institutionalized women older than 65 years from two cities in Spain and Argentina having a similar solar radiation index. Nutrition 2009; 26:283-9. [PMID: 19819110 DOI: 10.1016/j.nut.2009.04.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Revised: 04/17/2009] [Accepted: 04/25/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The present study evaluated and compared vitamin D nutritional status and calcium-phosphorus metabolism in institutionalized women >65 y from two cities that have a similar sun irradiation index (heliophany). METHODS The study was carried out in women living in similar social-status institutions from geographic cities having a similar solar radiation index (Lleida, Spain, n=49, and suburban Buenos Aires, Argentina [BA], n=48) at the end of summer. RESULTS Fish consumption was higher in the Lleida group, as was red-meat consumption in the BA group. In both groups mean calcium intake was 800 mg/d. The daily intake of vitamin D was higher in the BA group (P<0.001). A total of 90% in Lleida and 86% in BA had 25-hydroxyvitamin D (25OHD) levels <20 ng/mL. A significant inverse correlation between individual 25OHD and parathyroid hormone (PTH) levels was observed in the two groups of women (r=-0.329, P=0.035). PTH levels >100 pg/mL were found in 24% and 20% of women in Lleida and BA, respectively. There was a marked increase in carboxy-terminal telopeptide cross-links of type I collagen levels and a decrease in 25OHD with an increase in PTH levels (P<0.05). Conversely, bone alkaline phosphatase increased significantly only when the PTH concentration duplicated the reference range. CONCLUSION Even at the end of summer, vitamin D deficiency/insufficiency was prevalent in the two studied institutionalized elderly women. In the narrow range of the dietary calcium intake (close to 800 mg/d) of both studied groups, secondary hyperparathyroidism was absent when 25OHD levels were >17 ng/dL, indicating changes in the regulation control of serum PTH and consequently the changes in this threshold. As a result, vitamin D deficiency must be reversed to avoid the increment in bone turnover and to ensure the endocrine and paracrine functions of vitamin D for overall health and well-being.
Collapse
|
48
|
van der Mei IAF, Ponsonby AL, Engelsen O, Pasco JA, McGrath JJ, Eyles DW, Blizzard L, Dwyer T, Lucas R, Jones G. The high prevalence of vitamin D insufficiency across Australian populations is only partly explained by season and latitude. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1132-9. [PMID: 17687438 PMCID: PMC1940076 DOI: 10.1289/ehp.9937] [Citation(s) in RCA: 159] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Accepted: 04/17/2007] [Indexed: 05/16/2023]
Abstract
BACKGROUND Inadequate sun exposure and dietary vitamin D intake can result in vitamin D insufficiency. However, limited data are available on actual vitamin D status and predictors in healthy individuals in different regions and by season. METHODS We compared vitamin D status [25-hydroxyvitamin D; 25(OH)D] in people < 60 years of age using data from cross-sectional studies of three regions across Australia: southeast Queensland (27 degrees S; 167 females and 211 males), Geelong region (38 degrees S; 561 females), and Tasmania (43 degrees S; 432 females and 298 males). RESULTS The prevalence of vitamin D insufficiency (<or= 50 nmol/L) in women in winter/spring was 40.5% in southeast Queensland, 37.4% in the Geelong region, and 67.3% in Tasmania. Season, simulated maximum daily duration of vitamin D synthesis, and vitamin D effective daily dose each explained around 14% of the variation in 25(OH)D. Although latitude explained only 3.9% of the variation, a decrease in average 25(OH)D of 1.0 (95% confidence interval, 0.7-1.3) nmol/L for every degree increase in latitude may be clinically relevant. In some months, we found a high insufficiency or even deficiency when sun exposure protection would be recommended on the basis of the simulated ultraviolet index. CONCLUSION Vitamin D insufficiency is common over a wide latitude range in Australia. Season appears to be more important than latitude, but both accounted for less than one-fifth of the variation in serum 25(OH)D levels, highlighting the importance of behavioral factors. Current sun exposure guidelines do not seem to fully prevent vitamin D insufficiency, and consideration should be given to their modification or to pursuing other means to achieve vitamin D adequacy.
Collapse
|
49
|
Fernández MC, Parisi MS, Díaz SP, Mastaglia SR, Deferrari JM, Seijo M, Bagur A, Micheli F, Oliveri B. A pilot study on the impact of body composition on bone and mineral metabolism in Parkinson's disease. Parkinsonism Relat Disord 2007; 13:355-8. [PMID: 17292656 DOI: 10.1016/j.parkreldis.2006.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2006] [Revised: 11/30/2006] [Accepted: 12/06/2006] [Indexed: 11/29/2022]
Abstract
The impact of body composition on bone and mineral metabolism in Parkinson's disease (PD) was evaluated. Body fat mass, lean mass, bone mineral content, and bone mineral density (BMD) were measured by DXA in 22 PD patients and 104 controls. Female patients exhibited reduced body mass index, fat mass, and BMD compared to controls (p<0.05). Significant positive correlation was found between 25 OHD levels and BMC. Diminished bone mass in women with PD was found to be associated with alterations in body composition and low 25 OHD levels.
Collapse
Affiliation(s)
- María C Fernández
- Department of Internal Medicine, Sección Osteopatías Médicas, Hospital de Clínicas, Universidad de Buenos Aires, Córdoba 2351, 8 piso, (1120) Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Przybelski RJ, Binkley NC. Is vitamin D important for preserving cognition? A positive correlation of serum 25-hydroxyvitamin D concentration with cognitive function. Arch Biochem Biophys 2007; 460:202-5. [PMID: 17258168 DOI: 10.1016/j.abb.2006.12.018] [Citation(s) in RCA: 140] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2006] [Revised: 12/15/2006] [Accepted: 12/15/2006] [Indexed: 12/15/2022]
Abstract
This study investigates the association of vitamin D status with cognitive function and discusses potential mechanisms for such an effect. The relationship of vitamin B12 with cognition was also assessed. A retrospective review of older adults presenting to a university-affiliated clinic providing consultative assessments for memory problems was performed. Charts of all patients (n=80) presenting for initial visits were reviewed to identify those who had serum 25-hydroxyvitamin D (25(OH)D), vitamin B12, and mini-mental state examination score (MMSE) all obtained on their first visit (n=32). Correlation analyses between MMSE and 25(OH)D and vitamin B12 levels were performed. Serum 25(OH)D concentration and MMSE showed a (p=0.006) positive correlation; no (p=0.875) correlation was observed between serum B12 concentration and MMSE. In conclusion, the positive, significant correlation between serum 25(OH)D concentration and MMSE in these patients suggests a potential role for vitamin D in cognitive function of older adults.
Collapse
Affiliation(s)
- Robert J Przybelski
- School of Medicine and Public Health, University of Wisconsin-Madison, 2870 University Avenue, Suite 100, Madison, WI 53705, USA.
| | | |
Collapse
|