Vitamin D in obesity

Vitamin D deficiency in relation to different phenotypes of prediabetes: a population-based study

PURPOSE

Vitamin D deficiency is implicated in the development of prediabetes. However, it is unclear whether vitamin D deficiency showed any relationship with different phenotypes of prediabetes. This study was designed to address this issue.

METHODS

We included participants from the National Health and Nutrition Examination Survey 2011-2016. Prediabetes is classified into the following phenotypes: an isolated defect (that is, impaired fasting glucose [IFG], impaired glucose tolerance [IGT], or impaired hemoglobin A1c[IA1c]), two defects (that is, IFG+IGT, IFG+IA1c, or IGT+IA1c), or three defects (that is, IFG+IGT+IA1c). Multivariate logistic regression analysis was used to obtain the odds ratio (OR) and 95% confidence intervals (CIs).

RESULTS

A total of 4126 participants (2332 with prediabetes and 1794 with normal glycemia) were included in this study. Multivariate logistic regression analysis showed that prediabetes was associated with an increased odds of vitamin D deficiency than normal glycemia (OR 1.216, 95% CI 1.023-1.444). Further analysis showed that prediabetes phenotypes of IGT+IFG (OR 1.549, 95% CI 1.050-2.283) and IFG+IGT + IA1c (OR 1.507, 95% CI 1.062-2.138) had an increased odds of vitamin D deficiency. The odds of vitamin D deficiency was higher in individuals with glucose-defined prediabetes, but not in those with HbA1c-defined prediabetes when compared with individuals with normal glycemia.

CONCLUSION

Prediabetes was associated with an increased odds of vitamin D deficiency, and glucose-defined prediabetes might be a better predictor of vitamin D deficiency.

Obesity: pathophysiology and therapeutic interventions

Over the past few decades, obesity has transitioned from a localized health concern to a pressing global public health crisis affecting over 650 million adults globally, as documented by WHO epidemiological surveys. As a chronic metabolic disorder characterized by pathological adipose tissue expansion, chronic inflammation, and neuroendocrine dysregulation that disrupts systemic homeostasis and impairs physiological functions, obesity is rarely an isolated condition; rather, it is frequently complicated by severe comorbidities that collectively elevate mortality risks. Despite advances in nutritional science and public health initiatives, sustained weight management success rates and prevention in obesity remain limited, underscoring its recognition as a multifactorial disease influenced by genetic, environmental, and behavioral determinants. Notably, the escalating prevalence of obesity and its earlier onset in younger populations have intensified the urgency to develop novel therapeutic agents that simultaneously ensure efficacy and safety. This review aims to elucidate the pathophysiological mechanisms underlying obesity, analyze its major complications-including type 2 diabetes mellitus (T2DM), cardiovascular diseases (CVD), non-alcoholic fatty liver disease (NAFLD), obesity-related respiratory disorders, obesity-related nephropathy (ORN), musculoskeletal impairments, malignancies, and psychological comorbidities-and critically evaluate current anti-obesity strategies. Particular emphasis is placed on emerging pharmacological interventions, exemplified by plant-derived natural compounds such as berberine (BBR), with a focus on their molecular mechanisms, clinical efficacy, and therapeutic advantages. By integrating mechanistic insights with clinical evidence, this review seeks to provide innovative perspectives for developing safe, accessible, and effective obesity treatments.

25(OH)D concentrations are not associated with adiposity indicators, but with the stage of immunodeficiency in people with HIV/AIDS

Introduction

Objective: this study assessed the association between serum 25(OH)D concentrations and anthropometric indicators of adiposity in people living with HIV/AIDS taking highly active antiretroviral therapy. Methods: the study included 244 people living with HIV/AIDS who received outpatient care at the Institute of Tropical Diseases in the city of Teresina, Brazil. Sociodemographic, clinical, anthropometric and laboratory characteristics were examined. Serum 25(OH)D was analyzed by high-performance liquid chromatography in accordance with the Vitamin D Standardization Program. Multiple linear regression analysis adjusted for gender, age, disease stage and duration of highly active antiretroviral therapy was performed to assess the association between 25(OH)D concentrations and adiposity indicators. Results: the study included 142 (58.2 %) men and 102 (41.8 %) women, with a mean (± SD) age of 39.13 (± 10.83) years. A proportion of 57.8 per cent of the participants had insufficient concentrations of 25(OH)D below 30 ng/mL. Individuals in more advanced stages of immunodeficiency had lower concentrations of 25(OH)D (30.30 ± 16.10 ng/mL) compared to those with mild immunodeficiency or no immunodeficiency. There was no significant association between 25(OH)D concentrations and any of the adiposity indicators considered in this study. Conclusion: vitamin D concentrations in people living with HIV/AIDS using antiretroviral therapy are related to the degree of immunosuppression, but not to the individual's adiposity status.

The Impact of Vitamin D in the Prevention of Influenza, COVID-19, and Dengue: A Review

Since its discovery, vitamin D (VD) has been known for its implications in maintaining bone homeostasis. However, in recent years it has been discovered that the vitamin D receptor is expressed on different cells of the immune system and that these cells can locally produce the active form of this molecule, calcitriol, strongly suggesting that this vitamin might play a key role in both branches of the immune system, innate and adaptive. Recent evidence has demonstrated that VD participates in the different protective phases of the immune system against invading microorganisms, including in the activation and production of antimicrobial peptides, in the inactivation of replication of infectious agents, in the prevention of the exposure of cellular receptors to microbial adhesion, and, more importantly, in the modulation of the inflammatory response. In recent years, the world has witnessed major outbreaks of an ancient infectious disease, dengue fever; the emergence of a pandemic caused by an unknown virus, SARS-CoV-2; and the resurgence of a common respiratory infection, influenza. Despite belonging to different viral families, the etiological agents of these infections present a common trait: their capacity to cause complications not only through their cytopathic effect on target tissues but also through the excessive inflammatory response produced by the human host against an infection. This review outlines the current understanding of the role that vitamin D plays in the prevention of the aforementioned diseases and in the development of their complications through its active participation as a major modulator of the immune response.

Impact of weight loss and lifestyle intervention on vitamin D in men with obstructive sleep apnea: The INTERAPNEA trial

INTRODUCTION

Vitamin D deficiency is commonly found among patients with obstructive sleep apnea (OSA). We aimed to determine the effect of an eight-week interdisciplinary weight loss and lifestyle intervention on circulating vitamin D levels in patients with moderate-to-severe OSA.

METHODS

89 men were assigned to a usual-care group (n = 49) or an 8-week interdisciplinary weight loss and lifestyle intervention combined with usual-care (n = 40). Evaluations were conducted at baseline, intervention endpoint (i.e., 8 weeks), and 6 months post-intervention. Serum 25-hydroxyvitamin D (25(OH)D) was determined using a chemiluminescence immunoassay. Sleep (i.e., sleep efficiency, apnea-hypopnea index [AHI], and oxygen desaturation index) and body weight and composition (i.e., fat mass, and visceral adipose tissue) variables were also determined.

RESULTS

Serum 25(OH)D concentrations showed an insufficient vitamin D status at baseline, which significantly increased (all p ≤ 0.034) at intervention endpoint (19 %) and at 6 months after intervention (45 %) in the intervention group to the point of potentially resolving vitamin D deficiency. Higher serum 25(OH)D concentrations were related to increased sleep efficiency and reduced AHI, oxygen desaturation index, and body weight and composition variables (all p < 0.001) from baseline to 6 months and from 8 weeks to 6 months after intervention. These results were also noted from baseline to 8 weeks, except for body composition (all p ≤ 0.007).

CONCLUSION

The intervention improved and potentially resolved vitamin D deficiency. Together with the improvement of adverse sleep patterns and body composition parameters, it may be considered as a promising approach in the treatment of OSA.

CLINICAL TRIAL REGISTRATION

(ClinicalTrials.gov NCT03851653).

Retrospective real world study on vitamin D supplementation: Looking for the most effective molecule and its frequency of use

BACKGROUND & AIMS

There is still uncertainty regarding the optimal serum levels 25-Hydroxy-vitamin D [25(OH)D] and the most effective supplementation strategies, including the choice of molecule and its dosing frequency. The aim of the study is to compare the effects of calcifediol versus two different frequencies of cholecalciferol administration on vitamin D supplementation, and to identity the key parameters that predict response to treatment.

METHODS

This retrospective, real-world cohort study included 105 patients, who were divided into three groups. Group 1 (n = 21) received cholecalciferol 50,000 international units (UI) once a month, Group 2 (n = 27) received cholecalciferol 25,000 UI every two weeks, and Group 3 (n = 57) received calcifediol 0.266 mg (mg) once a month. The primary outcome measured was the delta increase in 25(OH)D levels after 6 months of treatment, compared to pre-treatment levels.

RESULTS

The study revealed a significant greater delta increase in 25(OH)D levels in Group 1, which received cholecalciferol 50,000 IU once a month, compared to the other two groups. However, multiple regression analysis indicated that neither the type of molecule nor the frequency of administration independently influenced the treatment outcome. Only pre-treatment serum 25(OH)D levels were found to significantly affect the outcome. Based on the receiver operating characteristic curve, serum 25(OH)D levels below 19.5 ng/dL were predictive of a doubling of pre-treatment values, with high sensitivity and specificity.

CONCLUSION

Pre-treatment serum 25(OH)D levels are valuable for selecting patients who should undergo supplementation. This finding suggests the importance of tailoring therapy according to the degree of vitamin D deficiency.

Vitamin D receptor gene polymorphisms in patients with relapsing multiple sclerosis

The relationship between the Vitamin D Receptor (VDR) gene and many pathogenic pathways in Relapsing-Remitting Multiple Sclerosis (RRMS) remains unclear. Given the significance of the topic, we conducted this study to explore the correlation between vitamin D receptor gene polymorphisms and clinical and inflammatory factors in patients suffering from relapsing-remitting multiple sclerosis. The current research is a case/control study conducted based on the Helsinki Ethical Principles. RRMS disease was confirmed based on history, clinical symptoms, radiological signs and neurologist diagnosis. The research population consisted of healthy people and patients with RRMS who were referred to Hazrat Rasool Akram Hospital between 2021 and 2023. For each person participating in the study (RRMS patient and healthy), five milliliters of peripheral blood containing the anticoagulant EDTA was collected. Polymerase chain reaction was performed using two specific and appropriate oligonucleotide primers. The restriction fragment length polymorphism technique was used, one of the standard methods for identifying polymorphisms. Statistical analysis was performed using SPSS software version 23. The odds ratio and 95% confidence limits were calculated. The SNP Analyzer software was used to analyze the allele frequency of each polymorphism in healthy and RRMS individuals and compare the values. Prism version 5 software was used to draw diagrams. In the present study, a statistically significant difference was observed between the percentage of FokI genotypes in RRMS patients and healthy individuals. FokI polymorphism showed a significantly increased risk with an odds ratio of 7.28 in patients with the FF genotype compared to healthy individuals. ApaI, TaqI, and BsmI were not significantly different between the two groups. Based on the findings of the present study, FokI polymorphism showed a significant risk increase in RRMS patients with FF genotype compared to healthy individuals.

The Sunshine Paradox: Unraveling Risk Factors for Low Vitamin D Status Among Non-Pregnant Women in Lebanon

Background/Objectives: Vitamin D-crucial for bone health, immune function, and hormone regulation-is deficient worldwide, affecting around half the population, particularly women. The study aims to determine the prevalence and risk factors of vitamin D deficiency and hypovitaminosis D in non-pregnant women in Lebanon. Methods: A national cross-sectional survey sampled households across Lebanon, covering 2803 non-pregnant women aged 15 to 49. Demographic information and dietary habits were collected, and anthropometric measurements and serum analyses, including 25-hydroxyvitamin D (25(OH)D) concentrations, were conducted. Multivariable Poisson regressions were constructed to calculate the adjusted prevalence ratio (aPR) for vitamin D deficiency and hypovitaminosis D of variables. Results: The prevalence of vitamin D deficiency (<30 nmol/L) among non-pregnant women in Lebanon was 37.9%, while 69.2% had hypovitaminosis D (<50 nmol/L). Wearing a veil (hijab) was identified as the most significant risk factor for both vitamin D deficiency (aPR = 3.76) and hypovitaminosis D (aPR = 1.47). Additionally, olive skin and dark skin were both associated with an increased prevalence of vitamin D deficiency (olive skin: aPR = 1.14; dark skin: aPR = 1.28), while only dark skin color was associated with hypovitaminosis D (aPR = 1.10). In contrast, protective factors against vitamin D deficiency and hypovitaminosis D included daily sun exposure exceeding one hour (aPR = 0.83-0.91) and vitamin D supplementation (aPR = 0.30-0.55). Anemia, folate deficiency, and vitamin B12 deficiency were significantly associated with a higher prevalence of vitamin D deficiency, hypovitaminosis D, or both. BMI was not significantly associated with vitamin D deficiency; however, women with underweight (aPR = 1.13) and obesity (aPR = 1.12) exhibited a higher prevalence of hypovitaminosis D. Conclusions: Vitamin D deficiency and hypovitaminosis D affect a significant portion of non-pregnant women in Lebanon, with veiling (hijab wearing), limited sun exposure, and lack of supplementation as primary risk factors. Future work should focus on tailoring recommendations for vitamin D supplementation, sun exposure, and food fortification to effectively address the diverse risk factors in the population.

Serum klotho concentration, vitamin D concentration and cardiovascular diseases risk: Evidence from the NHANES database 2007-2016

BACKGROUND AND AIM

Epidemiologic studies have shown that serum vitamin D (VD) deficiency is associated with an increased risk of cardiovascular diseases (CVDs) and CVDs-mortality. Klotho is a well-recognized anti-aging protein. However, it is limited understanding the role of Klotho on the association of serum VD and CVDs risk. This study aimed to explore the role of serum Klotho on the association between serum VD and CVDs risk.

METHODS AND RESULTS

Totally 12,634 subjects were included from NHANES (2007-2016), of whom 1365 (10.80 %) had CVDs. Subjects were divided into serum VD deficient group sufficient group with the cutoff value of 50 nmol/L. Serum Klotho concentrations were detected by ELISA kit. Weighted univariate and multivariate were utilized to explore the association of serum Klotho, serum VD and CVDs risk, with odds ratios (ORs) and 95 % confidence intervals (CIs). Subjects with deficient serum VD had a 56 % increase in CVDs risk (OR = 1.56, 95%CI: 1.21-2.00); subjects with deficient serum VD and low serum Klotho have the highest CVDs risk (OR = 1.58, 95%CI: 1.19-2.11). We further found the association of low serum VD and CVDs risk was only observed in low serum Klotho concentration (OR = 1.74, 95%CI: 1.27-2.39), these results suggested serum Klotho concentration play a moderating effect on the association of serum VD concentration and CVDs risk. The results of subgroup analyses suggested these moderating effects were more prominent in subjects with overweight/obese (OR = 1.85, 9 %%CI: 1.25-2.72), and with the history of hypertension (OR = 1.87, 9 %%CI: 1.32-2.65) and dyslipidemia (OR = 1.81, 95%CI: 1.32-2.49).

CONCLUSIONS

Low serum VD was associated with high CVDs risk and high serum Klotho may play a moderating effect on the association between serum VD and CVDs risk.

Vitamin D on the susceptibility of gestational diabetes mellitus: a mini-review

Gestational diabetes mellitus (GDM), which refers to diabetes mellitus or abnormal glucose tolerance of any degree occurring during pregnancy, is a distinct type within the diabetes classification. 25-hydroxyvitamin D deficiency has been associated with an increased risk of maternal glycaemia, insulin resistance and gestational diabetes. There is no consensus on the definition of vitamin D deficiency, but most scientists define vitamin D deficiency as less than 20 ng/mL (50 nmoL/L) of 25-hydroxyvitamin D. Vitamin D deficiency is common in women during pregnancy. Vitamin D can regulate the course of gestational diabetes, which may be related to regulation of insulin gene transcription, insulin secretion, intracellular and cytosolic calcium balance, inhibition of oxidative stress and inflammatory responses and alteration of glucose metabolism. This is a review article that aims to analyze the possible mechanism of vitamin D regulation of GDM, which provides a theoretical basis for clinical researchers in the future management of patients with GDM.

Prevalence of metabolic syndrome with different serum vitamin D levels in middle-aged and older adults

BACKGROUND

The relationship between serum vitamin D levels and metabolic syndrome (MetS) has been controversial. This study focused on the relationship between the prevalence of MetS and serum vitamin D levels in middle-aged and elderly people.

METHODS

This study included middle-aged and older adults who participated in the 2023 Zhejiang Provincial Nutrition and Health Survey, which was conducted in 90 districts and counties in Zhejiang Province, China.

RESULTS

A total of 11,305 participants were included in this study. MetS was prevalent in 31.7% of participants. Vitamin D and vitamin D3 concentrations were inversely associated with MetS prevalence (Ptrend<0.05), but not with vitamin D2, regardless of whether logistic regression models were adjusted for confounding factors. After adjusting for age, sex, physical activity level, smoking status, education level, annual per capita household income, and body mass index residuals, the highest tertile (Q3) of vitamin D (odds ratio [OR], 0.779; 95% confidence interval [CI], 0.702-0.865) and vitamin D3 (OR, 0.787; 95% CI, 0.709-0.875) concentrations had a lower risk of MetS than the lowest tertile (Q1). We found that vitamin D and D3 levels were correlated with age (Pinteraction<0.05). When age-stratified analyses were performed, vitamin D and vitamin D3 levels were significantly negatively associated with MetS in older adults but not in middle-aged adults.

CONCLUSIONS

Low total serum vitamin D and vitamin D3 levels were associated with a higher risk of MetS in adults aged 60 years and older.

Obesity Affects Disease Activity and Progression, Cognitive Functioning, and Quality of Life in People With Multiple Sclerosis

BACKGROUND AND OBJECTIVES

While obesity is a known risk factor of the development of multiple sclerosis (MS), its impact on MS disease progression remains unclear. We aimed to investigate the influence of body mass index (BMI) on disease activity and progression, cognitive performance, and health-related quality of life in patients with MS.

METHODS

Patients from an incident population-based case-control study (n = 3,249) were categorized based on BMI status at diagnosis and followed up after diagnosis through the Swedish MS registry. Outcomes included changes in the Expanded Disability Status Scale (EDSS), Multiple Sclerosis Impact Scale 29, and Symbol Digit Modalities Test. The mean follow-up time was 10.6 years (SD 6.1). Linear mixed models were used to analyze long-term changes while Cox regression models assessed the risk of 24-week confirmed disability worsening, time to reach EDSS score 3 and EDSS score 4, the appearance of new lesions on MRI, patient-reported physical and psychological worsening, and processing speed worsening.

RESULTS

Obesity, compared with healthy weight, was associated with a 0.02-point faster annual increase in the EDSS score (β for EDSS score x time 0.02, 95% CI 0.00-0.04). In addition, obesity was linked to a higher risk of reaching EDSS score 3 (HR 1.43, 95% CI 1.17-1.75) and EDSS score 4 (HR 1.40, 95% CI 1.07-1.73) and an increased risk of physical and psychological worsening. New lesions on MRI were more frequent among those with overweight and obesity, compared with those with healthy weight (HR 1.21, 95% CI 1.02-1.44 and HR 1.29, 95% CI 1.03-1.62, respectively). Among those who had not changed BMI group during follow-up, the associations between obesity and unfavorable outcomes became more pronounced, and the HR of cognitive disability worsening was 1.51 (95% CI 1.09-2.09) among those with obesity, compared with nonobese participants.

DISCUSSION

In participants with MS, obesity was associated with faster disease progression, poorer health-related quality of life, and more rapid cognitive decline. Both overweight and obesity were associated with higher MRI activity.

Nutritional Deficiencies Before and After Metabolic and Bariatric Surgery in Patients Above 50.0 kg/m2: A Single Center Study

Purpose

Metabolic and bariatric surgery (MBS) is an effective treatment for patients with body mass index (BMI) above 50.0 kg/m2 but nutritional deficiencies (ND) may arise. This study aimed to assess if patients with BMI above 50.0 kg/m2 have more ND and require more supplementation after MBS compared to patients in lower BMI groups.

Materials and Methods

Retrospective single center study including all patients submitted to MBS from 2019-2020. Several parameters were collected. Statistical analysis was performed to compare ND between BMI groups (<40.0 kg/m2; 40.0 to 49.9 kg/m2; ≥50.0 kg/m2), and between surgeries (Roux-en-Y gastric bypass [RYGB] vs. sleeve gastrectomy [SG]) in the group with BMI ≥50.0 kg/m2.

Results

We identified 951 patients, 85 (9.0%) with BMI ≥50.0 kg/m2, with RYGB performed in 644 (68.4%) patients. Pre-operatively, vitamin D deficiency was observed in 80.0% of patients with BMI ≥50.0 kg/m2, with significant differences between BMI groups. At follow-up there were no significant differences in ND according to BMI groups. In patients with BMI ≥50.0 kg/m2, vitamin B12 deficiency was more frequent after RYGB. At 2-year follow-up, 95.4% patients were taking multivitamin supplementation, and 52.4% required additional supplements, namely vitamin D.

Conclusion

ND are common in patients with BMI ≥50.0 kg/m2, even before MBS. After surgery, patients with BMI ≥50.0 kg/m2 may not have increased risk for ND, compared to other BMI groups. In these patients, RYGB resulted in an increased risk for vitamin B12 deficiency. Adequate supplementation and clinical follow-up are essential to mitigate these complications.

A bibliometric analysis and visualization of literature on the relationship between vitamin D and obesity over the last two decades

OBJECTIVE

The purpose of this study was to employ bibliometric analysis to visualize hot spots and evolving trends in the studies on the relationship between vitamin D and obesity.

METHODS

From the Web of Science Core Collection database, articles on vitamin D and obesity from 2001 to 2021 were retrieved. For the bibliometric visualization analysis, CiteSpace was employed. Some of the figures were created using GraphPad software.

RESULTS

4454 pieces of articles and reviews were found, with an average citation of 30.68 times. There are many more published papers in the area of "nutrition dietetics" (1166, 26.179 %). The United States possesses the largest number of publications (1297, 29.12 %) and demonstrates definitive leadership in this field. The League of European Research Universities generates a higher percentage of publications (256, 5.748 %) than other institutions. Major studies are funded by the United States Department of Health and Human Services (531, 11.922 %) and the National Institutes of Health, USA (528, 11.855 %). The top five keywords with the highest co-occurrence frequency are "obesity" (1260), "vitamin d" (943), "insulin resistance" (651), "risk" (642), and "d deficiency" (636). The biggest keyword cluster was #0 "adolescent" among the 18 keyword clusters. The three latest keywords in the keyword burst were "mineral density"、"d insufficiency" and "25 hydroxyvitamin d concentration".

CONCLUSION

This bibliometric analysis shows an overview of the current status of the research on the association between vitamin D and obesity. The prevalence of vitamin D deficiency and the relationship between vitamin D and metabolic syndrome in obese individuals remains hot topics. We speculate that the effect of obesity on vitamin D levels and bone mineral density, and the influence of vitamin D insufficiency on various body systems in obese populations will be future trends.

[Changes in weight, body composition, metabolic parameters and vitamin D in subjects with grade 3 and 4 obesity treated with liraglutide 3 mg]

Introduction

Introduction: grade 3 and 4 obesity is a chronic and progressive disease. Liraglutide 3 mg could be an effective adjuvant therapy in these subjects. Objectives: to evaluate changes in weight loss, body composition, metabolic parameters and vitamin D levels in subjects with grade 3 and 4 obesity treated for 8 months with liraglutide 3 mg. Methods: a total of 67 subjects with a BMI ≥ 40 kg/m2 had anthropometric parameters, body composition, metabolic parameters and vitamin D levels determined at baseline and after 8 months of treatment with liraglutide 3 mg. Results: a significant reduction in weight, BMI and abdominal circumference was evident after 8 months of treatment with liraglutide (p < 0.001), with a mean percentage of weight loss of 13.04 % and a mean weight loss of 14.99 kg at the end of the intervention. The final body composition data showed a significant improvement in the percentage of fat and fat mass (kg) (p < 0.001). The average loss of muscle mass was 2.02 kg (p = 0.213). The healthy visceral fat index (VGI) (< 13) increased to 67.17 % (p < 0.001) at 8 months. There was a significant reduction in blood pressure (p < 0.001) and an improvement in the biochemical variables studied. There was a significant increase in 25-OH vitamin D (p < 0.001) at the end of the intervention. Conclusions: Treatment with liraglutide was safe and effective in patients with obesity with a positive impact on weight loss, vitamin D levels and other cardiovascular risk factors.

Correlation between hyperlipidemia and serum vitamin D levels in an adult Chinese cohort

Vitamin D deficiency has emerged as a significant concern in public health due to its potential association with various metabolic disorders. This study aimed to investigate the relationship between serum vitamin D levels and the susceptibility to hyperlipidemia among adults. Using a multi-stage sampling approach, we recruited a cohort of 2072 eligible individuals aged over 18 years. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured alongside glucolipid metabolic markers, and comprehensive demographic and physical data were collected. The cohort exhibited a hyperlipidemia prevalence of 42.18%, with 19.88% demonstrating vitamin D deficiency. Notably, 23.68% of individuals with vitamin D deficiency also presented hyperlipidemia. Statistical analysis revealed a significantly higher prevalence of hyperlipidemia among those with vitamin D deficiency compared to those with sufficient levels (23.68% vs. 17.11%, P < 0.05). After adjusting for various factors including age, geographical region, exercise status, BMI, fasting glucose level, and blood pressure, lower serum 25(OH)D concentrations were found to significantly increase the risk of hyperlipidemia (Odds Ratio [OR] = 1.41; 95% CI: 1.057, 1.885; P < 0.05). Further stratification of the hyperlipidemic cohort revealed that vitamin D deficiency was associated with 1.459- and 1.578-times higher risks for total cholesterol and triglyceride abnormalities, respectively, compared to those with sufficient vitamin D levels. Moreover, each 10 ng/mL decrease in serum vitamin D level corresponded to an increased risk of total cholesterol (OR = 0.82; 95% CI: 0.728, 0.974; P < 0.05) and triglyceride abnormalities (OR = 0.79; 95% CI: 0.678, 0.927; P < 0.05). However, there were no significant differences observed between vitamin D-sufficient and-deficient groups regarding Low-Density Lipoprotein (LDL) and High-Density Lipoprotein (HDL) abnormalities. These findings underscore the potential role of serum vitamin D deficiency as an independent risk factor contributing to the elevated prevalence of hyperlipidemia in the adult population.

The effect of vitamin D2 on lipid profile, anthropometric indices, blood pressure, and inflammatory and glycemic biomarkers in humans: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND AND AIM

Even though the role of D2 (ergocalciferol) on cardiovascular disease risk components has been studied, conflicting results have been reported. Moreover, no single study has studied all these parameters and the role of vitamin D2 individually has not been assessed; hence, this systematic review and meta-analysis of randomized controlled trials was conducted to assess the effect of vitamin D2 supplementation on lipid profile, anthropometric indices, blood pressure, and inflammatory and glycemic biomarkers in humans.

METHODS

Web of Science, Scopus, PubMed/Medline, and Embase were searched from database inception to July 2024, and the random effects model, according to the DerSimonian and Laird method, was used to generate combined estimates of the intervention's effect on the outcomes.

RESULTS

After full-text analysis, 11 eligible articles were included in our meta-analyses. No statistically significant association was observed between vitamin D2 administration and BMI, WC, TC, HDL-C, LDL-C, TG, DBP or SBP; however, a statistically significant decrease in CRP (WMD: - 1.92 mg/dL, 95 % CI: - 3.30 to - 0.54, P = 0.006) and HbA1c levels (WMD: - 0.37 %, 95 % CI: - 0.66 to - 0.09, P = 0.009), and a non-statistically significant decrease in FBG (WMD: - 4.61 mg/dL, 95 % CI: - 14.71 to 5.47, P = 0.370, I2 = 90 %, P ˂ 0.001) and HOMA-IR (WMD: - 0.10, 95 % CI: - 0.17-0.03, P = 0.002) were detected.

CONCLUSION

In summary, our systematic review and meta-analysis discovered that vitamin D2 administration was associated with a statistically significant decrease in CRP and HbA1c levels, without a significant correlation with other outcomes.

Vitamin D Levels and Depressive Symptoms during Pregnancy: A Prospective Pregnancy Cohort Study

Objective

Depressive symptoms during pregnancy increase the risk for adverse outcomes in women and children. Lower vitamin D levels are suggested to be associated with higher depressive symptoms in nonpregnant populations. We studied if the level of or change in serum of 25-hydroxyvitamin D (25(OH)D) concentration was associated with the levels of depressive symptoms during pregnancy.

Methods

The participants of this prospective longitudinal study came from the Prediction and Prevention of Preeclampsia and Intrauterine Growth Restriction (PREDO) study. The analytic sample comprised 307 women (mean age = 32.5 (range 20.3-44.3)) who reported depressive symptoms concurrently with serum 25(OH)D measurements at a median of 13.0, 19.3, and 27.0 gestational weeks. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Linear and mixed-model regression analyses were used to study the associations.

Results

The 25(OH)D levels were not associated with depressive symptoms cross-sectionally (p values > 0.58) or across the three assessment points during pregnancy (B = -0.05; 95% CI, -0.12, 0.01; and p = 0.12). Yet, a higher increase in 25(OH)D during pregnancy was associated with lower levels of depressive symptoms (B = -1.41; 95% CI, -2.75, -0.07; and p = 0.04) but not after adjusting for covariates (p = 0.08).

Conclusions

The 25(OH)D levels and depressive symptoms were not associated among pregnant women throughout the pregnancy. However, there is a need for randomized controlled trials to fully exclude the possibility of vitamin D supplementation in the prevention of depression during pregnancy.

Advances in biomedical applications of vitamin D for VDR targeted management of obesity and cancer

BACKGROUND

1,25(OH)2D3 is a fat-soluble vitamin, involved in regulating Ca2+ homeostasis in the body. Its storage in adipose tissue depends on the fat content of the body. Obesity is the result of abnormal lipid deposition due to the prolonged positive energy balance and increases the risk of several cancer types. Furthermore, it has been associated with vitamin D deficiency and defined as a low 25(OH)2D3 blood level. In addition, 1,25(OH)2D3 plays vital roles in Ca2+-Pi and glucose metabolism in the adipocytes of obese individuals and regulates the expressions of adipogenesis-associated genes in mature adipocytes.

SCOPE AND APPROACH

The present contribution focused on the VDR mediated mechanisms interconnecting the obese condition and cancer proliferation due to 1,25(OH)2D3-deficiency in humans. This contribution also summarizes the identification and development of molecular targets for VDR-targeted drug discovery.

KEY FINDINGS AND CONCLUSIONS

Several studies have revealed that cancer development in a background of 1,25(OH)2D3 deficient obesity involves the VDR gene. Moreover, 1,25(OH)2D3 is also known to influence several cellular processes, including differentiation, proliferation, and adhesion. The multifaceted physiology of obesity has improved our understanding of the cancer therapeutic targets. However, currently available anti-cancer drugs are notorious for their side effects, which have raised safety issues. Thus, there is interest in developing 1,25(OH)2D3-based therapies without any side effects.

Vitamin D status of pregnant women with obesity in the UK and its association with pregnancy outcomes: a secondary analysis of the UK Pregnancies Better Eating and Activity Trial (UPBEAT) study

Prenatal vitamin D deficiency is widely reported and may affect perinatal outcomes. In this secondary analysis of the UK Pregnancies Better Eating and Activity Trial, we examined vitamin D status and its relationship with selected pregnancy outcomes in women with obesity (BMI ≥ 30 kg/m2) from multi-ethnic inner-city settings in the UK. Determinants of vitamin D status at a mean of 17 ± 1 weeks' gestation were assessed using multivariable linear regression and reported as percent differences in serum 25-hydroxyvitamin D (25(OH)D). Associations between 25(OH)D and clinical outcomes were examined using logistic regression. Among 1089 participants, 67 % had 25(OH)D < 50 nmol/l and 26 % had concentrations < 25 nmol/l. In fully adjusted models accounting for socio-demographic and anthropometric characteristics, 25(OH)D was lower among women of Black (% difference = -33; 95 % CI: -39, -27), Asian (% difference = -43; 95 % CI: -51, -35) and other non-White (% difference = -26; 95 % CI: -35, -14) ethnicity compared with women of White ethnicity (n 1086; P < 0·001 for all). In unadjusted analysis, risk of gestational diabetes was greater in women with 25(OH)D < 25 nmol/l compared with ≥ 50 nmol/l (OR = 1·58; 95 % CI: 1·09, 2·31), but the magnitude of effect estimates was attenuated in the multivariable model (OR = 1·33; 95 % CI: 0·88, 2·00). There were no associations between 25(OH)D and risk of preeclampsia, preterm birth or small for gestational age or large-for-gestational-age delivery. These findings demonstrate low 25(OH)D among pregnant women with obesity and highlight ethnic disparities in vitamin D status in the UK. However, evidence for a greater risk of adverse perinatal outcomes among women with vitamin D deficiency was limited.

Impact of body mass index elevation, Vitamin D receptor polymorphisms and antipsychotics on the risk of Vitamin D deficiency in schizophrenia patients

Antipsychotics with weight gain as side effect and vitamin D receptor dysfunction associated with single nucleotide polymorphisms (VDR SNPs) may have different effects on vitamin D status. Hence, present study aimed to investigate the relationship between vitamin D with body mass index (BMI), antipsychotics and VDR SNPs (rs2228570, rs1544410, rs7975232 and rs731236) in Malaysian patients with schizophrenia. Serum vitamin D level was measured using competitive enzyme-linked immunosorbent assay kit. VDR SNPs were analyzed using polymerase chain reaction-restriction fragment length polymorphism. We found significantly lower serum vitamin D level in patients with schizophrenia (p < 0.01), especially those taking atypical antipsychotics (p = 0.02) and combined antipsychotics (p = 0.02) and obese (BMI ≥27.5 kg/m2) patients (p = 0.04) after adjustment for covariates. For VDR SNPs, the CT genotype of rs1544410, CA genotype of rs7975232, and AA and AG genotypes of rs731236 may contribute to the significant decreased serum vitamin D level in patients (p < 0.05). Nevertheless, these relationships may differ by populations or medical conditions. The hypotheses of volumetric dilution and sequestration of vitamin D may explain the lower vitamin D level in obese patients. In addition, lifestyle factors such as poor diet and lack of physical activity with less sunlight exposure may cause reduced vitamin D level among patients. As patients in present study were prescribed with various antipsychotics, the effect of each antipsychotic on vitamin D level could not be determined. Thus, future studies should investigate the effect of different types of antipsychotics and obesity on vitamin D level in schizophrenia.

Consequences of Maternal Vitamin D Deficiency on Newborn Health

BACKGROUND AND OBJECTIVES

Maternal-fetal gestational pathology is one of the biggest challenges in the field of health at this moment. The current study is designed to determine the effects of vitamin D on pregnancy, starting with the idea that impairment of vitamin D status is thought to be correlated with impairment of the newborn's health.

MATERIALS AND METHODS

In this retrospective study, we tried to establish the link between vitamin D deficiency and maternal characteristics and also how it impacted the clinical status of the newborn. We analyzed a group of 260 patients: 130 pregnant women and 130 newborns, in whom vitamin D status was detected using the serum levels of 25-hydroxyvitamin D (25-(OH)D).

RESULTS

The results showed that vitamin D deficiency has a high incidence among pregnant women, as was presented in many important international studies. Our study also showed a positive, direct correlation between the mother's and newborn's vitamin D status.

CONCLUSIONS

Taking into consideration that vitamin D deficiency has been correlated with many complications, both in maternal and newborn health, a serum level determination of 25-(OH)D is necessary in the first trimester of pregnancy, and after that, adequate supplementation is necessary in order to prevent any negative effects.

High-Volume Liposuction in Lipedema Patients: Effects on Serum Vitamin D

Background: Lipedema is a subcutaneous adipose tissue disorder characterized by increased pathological adipocytes mainly in the extremities. Vitamin D is stored in adipocytes, and serum levels inversely correlate with BMI. As adipocytes are removed during liposuction, lipedema patients might be prone to further substantial vitamin D loss while their levels are already decreased. Therefore, we examined the effect of liposuction on perioperative serum 25-hydroxyvitamin D levels. Methods: In patients undergoing lipedema liposuction, blood samples were obtained pre- and postoperatively. Statistical analyses were performed to correlate the volume of lipoaspirate, patients' BMI and number of sessions to vitamin D levels. Results: Overall, 213 patients were analyzed. Mean liposuction volume was 6615.33 ± 3884.25 mL, mean BMI was 32.18 ± 7.26 kg/m2. mean preoperative vitamin D levels were 30.1 ± 14.45 ng/mL (borderline deficient according to the endocrine society) and mean postoperative vitamin D levels were 21.91 ± 9.18 ng/mL (deficient). A significant decrease in serum vitamin D was seen in our patients (p < 0.001) of mean 7.83 ng/mL. The amount of vitamin D loss was not associated with BMI or aspiration volume in our patients (p > 0.05). Interestingly, vitamin D dynamics showed a steady drop regardless of volume aspirated or preoperative levels. Conclusions: Many lipedema patients have low vitamin D levels preoperatively. Liposuction significantly reduced these levels additionally, regardless of aspirated volume or BMI. However, vitamin D loss was constant and predictable; thus, patients at risk are easily identified. Overall, lipedema patients undergoing liposuction are prone to vitamin D deficiency, and the long-term effects in this population are currently unknown.

Vitamins in Gynecologic Malignancies

The combination of vitamin A and D derivatives with classical chemotherapeutic treatments results in more satisfactory outcomes. The use of drug combinations, such as 9cUAB130 with carboplatin and cisplatin with TAC-101, shows enhanced cytotoxic effects and reductions in ovarian tumor volume compared to single-drug treatments. Combining cisplatin with calcitriol and progesterone increases VDR expression, potentially enhancing the effectiveness of anticancer therapy in ovarian cancer. The effectiveness of vitamin derivatives in anticancer treatment may vary depending on the characteristics of the tumor and the cell line from which it originated. An increase in thiamine intake of one unit is associated with an 18% decrease in HPV infection. Higher intake of vitamin C by 50 mg/day is linked to a lower risk of cervical neoplasia. Beta-carotene, vitamin C, and vitamin E are associated with risk reductions of 12%, 15%, and 9% in endometrial cancer, respectively. A balanced daily intake of vitamins is important, as both deficiency and excess can influence cancer development. It has been observed that there is a U-shaped relationship between group B vitamins and metabolic markers and clinical outcomes.

Vitamin D Inadequacy and Its Relation to Body Fat and Muscle Mass in Adult Women of Childbearing Age

To assess the correlation between vitamin D status and body composition variables in adult women of childbearing age, a cross-sectional study was conducted involving women aged 20-49 years. The participants were categorized based on their vitamin D status and further divided according to body mass index (BMI). Anthropometric and biochemical data were collected to compute body composition indices, specifically body fat and muscle mass. The sample included 124 women, with 63.70% exhibiting vitamin D inadequacy. Women with inadequate vitamin D status demonstrated a higher waist-to-height ratio (WHtR) and body adiposity index (BAI), along with a lower BMI-adjusted muscle mass index (SMI BMI), compared to those with adequate levels of vitamin D (p = 0.021; p = 0.019; and p = 0.039, respectively). A positive correlation was observed between circulating concentrations of 25(OH)D and SMI BMI, while a negative correlation existed between circulating concentrations of 25(OH)D and waist circumference (WC), WHtR, conicity index (CI), fat mass index (FMI), body fat percentage (% BF), and fat-to-muscle ratio (FMR). These findings suggest that inadequate vitamin D status may impact muscle tissue and contribute to higher body adiposity, including visceral adiposity. It is recommended that these variables be incorporated into clinical practice, with a particular emphasis on WHtR and SMI BMI, to mitigate potential metabolic consequences associated with vitamin D inadequacy.

Prevalence of vitamin D insufficiency in early pregnancies- a Singapore study

Vitamin D plays an essential role in bone and mineral metabolism. There is increased interest in understanding prevalence of Vitamin D deficiency in pregnancy as many studies report association of low vitamin D levels with obstetric complications and neonatal sequelae. There is a paucity of studies in Singapore evaluating levels of vitamin D levels during the first trimester of pregnancies. We aim to study the prevalence of vitamin D insufficiency in this population. Our study assessed vitamin D levels in these women. Vitamin D (Plasma 25(OH)D concentration) levels in multiracial women during the first trimester were collected via venepuncture at their booking antenatal visit. They were stratified into sufficient ≥30ng/ml, insufficient ≥20ng/ml and <30ng/ml, moderately deficient ≥10ng/ml and <20ng/ml and severely deficient <10ng/ml. 93 women were included in this study. Only 2.2% of our study population had sufficient vitamin D levels. In women who had insufficient levels, the heavier the weight, the more likely to be vitamin D deficient. Interestingly, we also note that the older the patient, the less likely they are to be deficient. In women with periconceptual multivitamin supplementation, the average vitamin D level for those with supplementation was 2.10ng/ml higher than those without. Majority of patients were recruited from a single study member's patient pool who were mostly Chinese. Prevalence of Vitamin D deficiency in general obstetric patients with higher BMI and darker skinned patients may be even lower in Singapore. The high prevalence of Vitamin D insufficiency in our patients prove that it is a prominent problem in our population. We aim to implement screening of vitamin D levels as part of antenatal investigations in the first trimester and recommend supplementation as required. We also hope to evaluate the association of low vitamin D levels with obstetric or neonatal complications further understanding its implications.

A review of dairy food intake for improving health among black adults in the US

The adult life stage encompasses a range of new experiences, opportunities, and responsibilities that impact health and well-being. During this life stage, health disparities continue to increase for Black Americans, with Black adults having a disproportionate burden of obesity, chronic diseases, comorbidities, and worse treatment outcomes compared to their White peers. While many of the underlying factors for these disparities can be linked to longstanding sociopolitical factors such as systemic racism, food insecurity, and poor access to healthcare, there are also several modifiable risk factors that are known to significantly impact health outcomes, such as improving diet quality, increasing physical activity, and not smoking. Of all the modifiable risk factors known to impact health, improving dietary habits is the factor most consistently associated with better outcomes for body weight and chronic disease. Of the major food groups recommended by the 2020-2025 Dietary Guidelines for Americans (DGA) for achieving healthier dietary patterns, dairy foods have a nutrient profile which matches most closely to what Black Americans are inadequately consuming (e.g., vitamin A, vitamin D, calcium, magnesium). However, Black adults tend to consume less than half the recommended daily servings of dairy foods, in part, due to issues with lactose intolerance, making higher intake of dairy foods an ideal target for improving diet quality and health in this population. This review examines the current body of evidence exploring the links between dairy intake, obesity, cardiometabolic disease risk, chronic kidney disease, and the most common types of cancer, with a special focus on health and disparities among Black adults. Overall, the evidence from most systematic reviews and/or meta-analyses published in the last decade on dairy intake and health outcomes has been conducted on White populations and largely excluded research on Black populations. The findings from this extensive body of research indicate that when teamed with an energy-restricted diet, meeting or exceeding the DGA recommended 3 daily servings of dairy foods is associated with better body weight and composition outcomes and lower rates of most common chronic diseases than lower intake (<2 servings per day). In addition to the number of daily servings consumed, the specific types (e.g., milk, yogurt, cheese) and subtypes (e.g., low-fat, fermented, fortified) consumed have also been shown to play major roles in how these foods impact health. For example, higher intake of fermented dairy foods (e.g., yogurt) and vitamin D fortified dairy products appear to have the most protective effects for reducing chronic disease risk. Along with lactose-free milk and cheese, yogurt is also generally low in lactose, making it an excellent option for individuals with lactose intolerance, who are trying to meet the DGA recommendations for dairy food intake.

Unraveling the complex interplay between obesity and vitamin D metabolism

Vitamin D deficiency and obesity are a worldwide health issue. Obesity refers to the accumulation of excessive fats in the body which could lead to the development of diseases. Obese people have low vitamin D levels for several reasons including larger volume of distribution, vitamin D tightly bound in fatty tissues, reduced absorption, and diets with low vitamin D. Accurately measuring vitamin D metabolites is challenging. The Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) method was developed and validated for the analysis of vitamin D metabolites in the serum. Blood samples were collected from 452 subjects which consisted of baseline (vitamin D deficient obese subjects), follow-up (supplemented obese subjects), and healthy volunteers. The vitamin D metabolites were separated adequately by the developed UHPLC-MS/MS method. Moreover, the validation criteria for the method were within an acceptable range. The baseline, follow-up and even healthy volunteers were deficient in 25OHD3 and 25OHD2. The baseline and healthy subjects had comparable concentration of vitamin D2 and D3. However, healthy subjects had a higher concentration of 25OHD and its epimer compared to the baseline subjects. The vitamin D3 was increased significantly in the follow- up subjects; therefore, the 25OHD3 was increased significantly compared to the baseline as well; however, the increase was insufficient to achieve the optimal range. The UHPLC-MS/MS method test was applied successfully on estimation of vitamin D metabolites in subjects. This study indicates the significance of taking into account the metabolic and storage effects when evaluating the vitamin D status in obese subjects.

Vitamin D-A New Therapeutic Target in the Management of Type 2 Diabetes Patients

Background: Vitamin D is a fat-soluble vitamin that prevents cardiovascular diseases and diabetes mellitus (DM). The present research aimed to study the impact of 25-hydroxyvitamin D (25(OH)D) level on the health status of patients with type 2 DM (T2DM) hospitalized in the "Pius Brînzeu" Emergency Clinical County University Hospital in Timisoara, Romania. Methods: The study retrospectively included 160 patients with T2DM who were clinically and biologically evaluated during hospitalization. Results: 13.1% of patients had optimal, 23.1% insufficient, and 63.8% deficient 25(OH)D values. Patients with 25(OH)D deficiency presented poorer glycemic control and were older, with higher weight, but had altered renal function, anemia, and lower iron values. Also, patients with associated neoplasia, diabetic neuropathy, cardiovascular disease (CVD), dementia, and grade 3 arterial hypertension (HTN) had lower values of 25(OH)D. An age > 55 years (sensitivity 69.9, specificity 82.5, AUROC 0.786, p < 0.001) and an HbA1c > 7.7% (sensitivity 89.3, specificity 92.9, AUROC 0.938, p < 0.001) predict 25(OH)D deficiency in T2DM patients. Conclusions: Vitamin D influences almost every system and organ in the body, so it should be a routine test for all patients with DM to correct the deficiency and prevent other diseases and complications.

Physiological Evidence and Therapeutic Outcomes of Vitamin D on Cardiovascular Diseases

Vitamin D hormone is an important regulator of various physiological functions, and its deficiency is characterized by an imbalance in parathyroid hormone and calcium homeostasis. The role of vitamin D in cardiovascular physiology is well demonstrated in animal and humanbased studies. In this context, hyperlipidemia, increased atherogenic plaques, cardiac inflammation, hypertension, myocarditis, myocardial infarction, and heart failure are some of the commonest known conditions connected with vitamin D deficiency. Supplementation of vitamin D is recommended to achieve normal serum vitamin D concentrations, nonetheless, in clinical trials often seen discrepancies concerning the supplementation effects and effectiveness. This review summarizes the data on the role of vitamin D in cardiovascular health along with some recent clinical findings regarding the effects of vitamin D supplementation.

Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough?

Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.

Body composition phase angle: A potential predictor of vitamin D status in early pregnancy

Phase angle and vitamin D can reflect the state of the body cells, and the two may interact with each other. Therefore, this study was conducted to find out the relationship between PA and vitamin D. Taking women in early pregnancy as our study subjects, we found that PA had a positive effect on vitamin D levels. Body composition phase angle, as a noninvasive, easy-to-operate, and easy-to-monitor indicator, can be used an early screening index for vitamin D nutrition levels in early pregnancy, and the cutoff value was 4.95°.

Bariatric surgery and calcifediol treatment, Gordian knot of severe-obesity-related comorbidities treatment

Background

Obesity (OB) is a chronic metabolic disease with important associated comorbidities and mortality. Vitamin D supplementation is frequently administered after bariatric surgery (BS), so as to reduce OB-related complications, maybe including chronic inflammation.

Aim

This study aimed to explore relations between vitamin D metabolites and components of the inflammasome machinery in OB before and after BS and their relations with the improvement of metabolic comorbidities.

Patients and methods

Epidemiological/clinical/anthropometric/biochemical evaluation was performed in patients with OB at baseline and 6 months after BS. Evaluation of i) vitamin-D metabolites in plasma and ii) components of the inflammasome machinery and inflammatory-associated factors [NOD-like-receptors (NLRs), inflammasome-activation-components, cytokines and inflammation/apoptosis-related components, and cell-cycle and DNA-damage regulators] in peripheral blood mononuclear cells (PBMCs) was performed at baseline and 6 months after BS. Clinical and molecular correlations/associations were analyzed.

Results

Significant correlations between vitamin D metabolites and inflammasome-machinery components were observed at baseline, and these correlations were significantly reduced 6 months after BS in parallel to a decrease in inflammation markers, fat mass, and body weight. Treatment with calcifediol remarkably increased 25OHD levels, despite 24,25(OH)2D3 remained stable after BS. Several inflammasome-machinery components were associated with improvement in metabolic comorbidities, especially hypertension and dyslipidemia.

Conclusion

The beneficial effects of vitamin D on OB-related comorbidities after BS patients are associated with significant changes in the molecular expression of key inflammasome-machinery components. The expression profile of these inflammasome components can be dynamically modulated in PBMCs after BS and vitamin D supplementation, suggesting that this profile could likely serve as a sensor and early predictor of the reversal of OB-related complications after BS.

Evaluating the effect of body mass index and 25-hydroxy-vitamin D level on basal cell carcinoma using Mendelian randomization

Basal cell carcinoma (BCC) is the most common cancer with a rising incidence among white-skinned individuals. A number of epidemiological studies have suggested that obesity and serum 25-hydroxy-vitamin D (25(OH)D) levels may affect the arising of BCC. To address this, we selected 443 and 96 single nucleotide polymorphisms (SNPs) associated with body mass index (BMI) and serum level of 25(OH)D from large-scale genome-wide association studies (GWAS), respectively. The univariable and multivariable two-sample Mendelian randomization (MR) analyses were conducted with a series of sensitivity analyses to ensure the results were reliable and reproducible. The results of univariable two-sample MR analysis showed that higher BMI was related to lower risk for BCC (Odds ratio(OR) = 0.90; 95% confidence interval (CI),[0.81,0.99]; p = 0.02). In addition, this causal effect of BMI on BCC still remained (OR = 0.88; 95%CI,[- 0.22, - 0.03], p-value = 0.008) after adjusting for 25(OH)D level in the multivariable MR analysis. However, the results suggested that 25(OH)D level was not associated with BCC(OR = 1.02; 95%CI, [0.94,1.09], p-value = 0.67). In conclusion, similar to the conclusions of retrospective observational studies, the MR results indicate that high BMI is an independent protective factor for BCC. Meanwhile, vitamin D levels may not be causally associated with the risk of basal cell carcinoma and increasing vitamin D supplementation is unlikely to reduce the risk.

Does maternal vitamin D status influence placental weight or vascular and inflammatory pathology? Secondary analysis from the Kellogg Pregnancy Study

INTRODUCTION

Positive effects of vitamin D (vitD) supplementation on comorbidities of pregnancy (COP) have been explored; however, few studies have elucidated the pathophysiology behind the development of these COP and the potential relationship with derangements in placental development and morphology. Additionally, it is known that placentas weighing 10th-90th % for gestational age are associated with better outcomes. Therefore, the objective of this study was to assess the impact of resulting circulating serum 25(OH)D concentrations associated with intake of high or low doses of supplementary vitD on placental development and morphology in women who participated in a randomized double blind, placebo-controlled trial of vitD supplementation. We hypothesized that if maternal serum 25(OH)D concentration (vitD status marker) is insufficient/deficient, then placental weight and % for gestational age (GA) will be smaller and will correlate with increased vascular and inflammatory placental pathologic findings.

METHODS

The findings of the present study are a secondary analysis of data generated from a previously reported randomized controlled trial (RCT), the Kellogg Vitamin D Pregnancy Study. Pregnant women (n = 297) in this RCT (January 2013 - April 2018) were randomly assigned to 400 IU vs. 4400 IU vitD/day (10-14 weeks' gestational age) and followed to delivery. 132 placentas were analyzed by pathologists blinded to treatment, and the 2016 Amsterdam Consensus Criteria were used to categorize grouping/grading of placental pathology and weight. Total [25(OH)D] was measured using radioimmunoassay (ng/mL). Chi-square and Student's t-test were used to show the difference in maternal characteristics by treatment group and by placental weight. Chi-square analysis was used to determine differences between the percent pathology findings by treatment group. Students t-test was used to determine the differences in vitD status and the frequency of placental lesions. Association between [25(OH)D] area under the curve (AUC) and placental morphology were determined in a regression model that included maternal BMI ≥ 30 kg/m2, race/ethnicity, and vitD treatment group allocation. Data were analyzed using SAS v9.4 (Cary, NC) and statistical significance was indicated by p < 0.05.

RESULTS

The percent pathology findings by treatment group were not significantly different for each of the placental pathology categories as defined by the 2016 Amsterdam Consensus Criteria including placental weight. However, when using 25(OH)D as a biomarker for vitD status, linear regression model showed maternal serum [25(OH)D] AUC was significantly associated with greater placental weight (p = 0.023). Logistic regression models showed mothers with BMI ≥ 30 kg/m2 had larger placental weight (p = 0.046), and Hispanic and white/Caucasian mothers had greater placental weights than Black American mothers (p = 0.025). When placentas ≥ 90th % for GA, n = 7, were removed from the placental pool, Pearson correlation still showed a positive association between maternal serum 25(OH)D AUC and placental weight (p = 0.011). In a second linear regression model of placentas ≥ 90th % for GA (n = 7) vs. placentas < 90th % (n = 108), maternal serum 25(OH)D AUC was significantly greater in those placentas ≥ 90th % (p = 0.03); however, this was not associated with increased perinatal mortality. CONCLUSION FINDINGS: suggest increasing maternal serum [25(OH)D] via vitamin D supplementation during pregnancy did not adversely affect placental morphology; trends showed those in the treatment group had fewer placental lesions. Placental weight was found to be significantly associated with [25(OH)D] AUC, which represents maternal vitamin D status over the course of pregnancy; 7 placentas ≥ 90th % for GA were not associated with perinatal mortality.

Effect of vitamin D3 on lipid droplet growth in adipocytes of mice with HFD-induced obesity

Vitamin D-regulating action of PPARγ on obesity has been confirmed on adipocyte differentiation. However, it is not clear whether vitamin D affects the morphological size of mature adipocytes by influencing the expression of PPARγ in vivo. Our hypothesis was that Vitamin D3 (VitD3) inhibits the growth of adipocyte size by suppressing PPARγ expression in white adipocytes of obese mice. Five-week-old male C57BL/6J mice were randomly divided into normal diet and high-fat diet groups. After 10 weeks, the body weight between the two groups differed by 26.91%. The obese mice were randomly divided into a high-fat diet, solvent control, low-dose VitD3 (5000 IU/kg·food), medium-dose VitD3 (7500 IU/kg·food), high-dose VitD3 (10,000 IU/kg·food), and PPAR γ antagonist group, and the intervention lasted for 8 weeks. Diet-induced obesity (DIO) mice fed high-dose VitD3 exacerbated markers of adiposity (body weight, fat mass, fat mass rate, size of white and brown adipocytes, mRNA, and protein levels of ATGL and Fsp27), and the protein level of ATGL and Fsp27 decreased in the low-dose group. In conclusion, high-dose VitD3 possibly via inhibiting the ATGL expression, thereby inhibiting lipolysis, increasing the volume of adipocytes, and decreasing their fat-storing ability resulted in decreased Fsp27 expression. Therefore, long-term high-dose oral VitD3 may not necessarily improve obesity, and we need more clinical trials to explore the intervention dose and duration of VitD3 in the treatment of VitD3 deficiency in obese patients.

Vitamin D Concentration Changes after Bariatric Surgery

Introduction

Bariatric surgery causes physiological and anatomical changes in the gastrointestinal tract that interfere with intestinal absorption and, consequently, with the nutritional status, especially about vitamin D. The aim of the study was to evaluate the vitamin D levels and body composition of these patients in the Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) types of surgery.

Methods

The retrospective cohort study included a population of 120 patients aged between 18 and 65 years, with class II or III obesity, undergoing bariatric surgery procedures (VSG or RYGB-type). Data were collected on the degree of obesity, age, average time since surgery, and gender. The individuals underwent a complete physical examination, measuring blood pressure, weight, height, waist, and neck circumference. In addition to calculating the percentage of loss of body weight and assessing body fat, the food frequency and physical activity of these patients were evaluated. Blood was collected, and the insulin variables, hydroxyvitamin D (25OHD), were analyzed.

Results

There was a significant difference between groups only for PTH, total BMD, and insulin variables. A significant intragroup difference was found in the variables' body mass index (BMI) and vitamin D for the vertical sleeve gastrectomy group and BMI for the RYGB group.

Conclusion

The analysis between the groups of procedures, similarity in body composition and postsurgical vitamin D levels, with significant differences only for PTH, BMD, and insulin variables, demonstrates that both procedures are effective in reducing fat mass.

Impact of 12 Weeks of Vitamin D3 Administration in Parkinson's Patients with Deep Brain Stimulation on Kynurenine Pathway and Inflammatory Status

The current study aimed to investigate whether a 12-week Body Mass Index (BMI)-based (the higher the BMI, the higher the dosage) vitamin D3 administration may affect both the kynurenine pathway (KP) and the inflammatory state in Parkinson's disease (PD) patients with deep brain stimulation (DBS) and may be useful for developing novel therapeutic targets against PD. Patients were randomly assigned to two groups: supplemented with vitamin D3 (VitD, n = 15) and treated with vegetable oil (PL, n = 21). Administration lasted for 12 weeks. The isotope dilution method by LC-MS/MS was applied to measure KP and vitamin D metabolites. Serum concentrations of cytokines such as IL-6 and TNF-α were measured using ELISA kits. After administration, the serum concentration of TNF-α decreased in PD patients with DBS. Moreover, in KP: 3-hydroksykynurenine (3-HK) was increased in the PL group, picolinic acid was decreased in the PL group, and kynurenic acid tended to be higher after administration. Furthermore, a negative correlation between 3-HK and 25(OH)D3 and 24,25(OH)2D3 was noticed. Our preliminary results provide further evidence regarding a key link between the KP substances, inflammation status, and metabolites of vitamin D in PD patients with DBS. These findings may reflect the neuroprotective abilities of vitamin D3 in PD patients with DBS.

Is more prolonged sun exposure associated with healthier life habits and obesity indicators in Portuguese children?

OBJECTIVES

Sun exposure seems to have an indirect effect on the development of obesity through vitamin D synthesis in the skin, the primary source of this vitamin. The present study aimed to investigate associations among sun exposure time, obesity indicators, and lifestyle habits in children.

METHODS

A total of 4755 children (3-10 years; 49.86% boys) from the north, center and south-central Portugal were included in the present study. During 2016/2017 children's sun exposure time, screen time, time devoted to the practice of physical activity and active play were collected through standard questionnaires answered by parents. Statistical analyses were conducted to investigate differences among sun exposure time according to the sex, age, obesity indicators and lifestyle habits.

RESULTS

Linear regression analysis showed that sun exposure time presented a negative association with Body Mass Index (β = -0.09, 95% CI: -0.18; -0.003; p = .042), body fat % (β = -0.31, 95%; CI: -0.54; -0.07; p = .010), computer time (β = -0.08, 95% CI: -0.12; - 0.05; p < .0001) and a positive association with active play time (β = 0.22, 95% CI: 0.17; 0.27; p < .0001) and total time of physical activity practice (β = 10.01, 95% CI: 4.52; 15.20; p < .0001).

CONCLUSIONS

The results reinforce the need for future guidance on the ideal sun exposure time, especially in children, who are at risk for vitamin D deficiency. Standardization of criteria for classifying optimal sun exposure time in this age group, considering the parameters that affect vitamin D status, such as age and seasonality, should be considered when planning future guidelines.

Assessment, treatment and prevention of vitamin D deficiency

Vitamin D deficiency is prevalent among various groups in the UK, and can result from insufficient sunlight exposure and dietary intake. There is a population-wide recommendation of 10 micrograms (400 international units) of vitamin D per day, with a daily supplement advised. However, supplement use is often suboptimal, compounding the risk of deficiency. Long-term vitamin D deficiency can cause rickets in children and osteomalacia or osteoporosis in adults. Therefore, it is important that nurses recognise which groups are at increased risk of vitamin D deficiency and understand how to assess people's vitamin D status. Nurses also need to be able to support the prevention and treatment of low vitamin D levels, which typically involves supplementation and lifestyle changes.

A weighted quantile sum regression with penalized weights and two indices

Background

New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect.

Objectives

In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term.

Methods

To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data.

Results

The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively.

Discussion

Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.

Association between Vitamin D Deficiency and Clinical Parameters in Men and Women Aged 50 Years or Older: A Cross-Sectional Cohort Study

Vitamin D deficiency (VDD) is increasingly prevalent on a global scale and is connected to chronic health issues including diabetes, obesity, and inflammation. This study aimed to investigate the association between VDD and various clinical parameters including glycated hemoglobin (HbA1c), body mass index (BMI), and inflammatory markers. This cross-sectional cohort study included Korean men and women aged 50 years and older (290 men, 125 women); VDD was classified as serum 25-hydroxyvitamin D (25[OH]D) levels below 20 ng/mL. Vitamin D deficiency was more prevalent in men (64.5%) compared to that in women (35.2%). Men with VDD had higher fat mass and HbA1c levels, lower muscle strength, and worse physical performance. Among women, VDD was associated with higher BMI, HbA1c, tumor necrosis factor-alpha (TNF-α), and creatinine levels. In women, 25(OH)D levels exhibited an inverse relationship with HbA1c, BMI, and TNF-α concentrations. However, there were no differences in the levels of interleukin-6 and interleukin-1 beta according to vitamin D status in both men and women. Vitamin D deficiency is linked to higher HbA1c, BMI, and inflammatory markers in older Korean women, thus warranting the maintenance of sufficient vitamin D levels for overall health.

Influence of Vitamin D on the Incidence of Metabolic Syndrome and Hormonal Balance in Patients with Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder that affects 8-13% of women of reproductive age. It is one of the most common causes of infertility and is associated with hyperandrogenism in the form of hirsutism and acne, non-ovulatory cycles, and characteristic ovarian morphology. The available research on serum vitamin D deficiency in patients with PCOS and the appropriateness of vitamin D supplementation in this group of women is inconclusive, so we decided to investigate the influence of vitamin D on the incidence of metabolic syndrome and hormonal balance in patients with polycystic ovary syndrome. The study comprised 120 women aged between 18 and 42 years, who were divided into two groups: a group with diagnosed polycystic ovary syndrome (PCOS) and a group of regularly menstruating women without features of androgenisation, in whom polycystic ovary syndrome was excluded. Each patient underwent a history and physical examination, including a gynecological examination, anthropometric measurements were taken, including height, weight, waist, and hip circumference, and blood pressure was measured using the Korotkow method. In the female patients, the following parameters were also determined from the blood: follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, TSH, ft4, prolactin (PRL), total testosterone, DHEASO4, 17-hydroxyprogesterone (17-OHP), sex-hormone-binding globulin (SHBG), androstendione, 25(OH) vitamin D3 metabolite. The majority of the patients with polycystic ovary syndrome were found to have deficient or suboptimal serum vitamin D levels, and the effects of vitamin D on the SHBG levels and free-androgen indices in these patients was examined. The effects of vitamin D on the incidence of metabolic syndrome and BMI, waist-to-hip ratio, waist circumference, and blood pressure in patients with polycystic ovary syndrome were also found.

Vitamin D Deficiency in Chronic Childhood Disorders: Importance of Screening and Prevention

Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can result in rickets in children and osteomalacia in children and adults. Recent studies have demonstrated the pleiotropic action of vitamin D and identified its effects on multiple biological processes in addition to bone health. VDD is more prevalent in chronic childhood conditions such as long-standing systemic illnesses affecting the renal, liver, gastrointestinal, skin, neurologic and musculoskeletal systems. VDD superimposed on the underlying disease process and treatments that can adversely affect bone turnover can all add to the disease burden in these groups of children. The current review outlines the causes and mechanisms underlying poor bone health in certain groups of children and young people with chronic diseases with an emphasis on the proactive screening and treatment of VDD.

Effect of 12-Week BMI-Based Vitamin D3 Supplementation in Parkinson's Disease with Deep Brain Stimulation on Physical Performance, Inflammation, and Vitamin D Metabolites

Parkinson's disease (PD) is the second most common neurodegenerative disease. To manage motor symptoms not controlled adequately with medication, deep brain stimulation (DBS) is used. PD patients often manifest vitamin D deficiency, which may be connected with a higher risk of falls. We administered a 12-week vitamin D₃ supplementation based on BMI (with higher doses given to patients with higher BMI) to investigate its effects on physical performance and inflammation status in PD patients with DBS. Patients were randomly divided into two groups: treated with vitamin D₃ (VitD, n = 13), and supplemented with vegetable oil as the placebo group (PL, n = 16). Patients underwent functional tests to assess their physical performance three times during this study. The serum 25(OH)D₃ concentration increased to the recommended level of 30 ng/mL in the VitD group, and a significant elevation in vitamin D metabolites in this group was found. We observed significant improvement in the Up and Go and the 6 MWT in the VitD group. In inflammation status, we noticed a trend toward a decrease in the VitD group. To conclude, achieving the optimal serum 25(OH)D₃ concentration is associated with better functional test performance and consequently may have a positive impact on reducing falling risk in PD.

The Possible Influence of Vitamin D Levels on the Development of Atrial Fibrillation-An Update

Atrial fibrillation (AF) is a severe and most common supraventricular arrhythmia in humans, which, if left untreated or treated ineffectively, can lead to ischemic stroke or heart failure. It has been suggested that serum vitamin D (VitD) deficiency may be one of the critical factors influencing the onset of AF, especially in the period after cardiac surgery, such as coronary artery bypass grafting. Several papers have indicated that VitD supplementation reduces the risk of AF, significantly reducing the proportion of patients between the control and study groups in both the pre- and postoperative periods. Factors that increase the risk of AF from VitD deficiency are also further indicated, and these are age, gender, weight, season or comorbidities. In addition, the cardiodepressive mechanism of VitD is not fully understood; however, it is suggested that it acts through at least two pathways. The first indicates a direct effect of VitD on atrial muscle degradation, while the second is related to the modulation of cardiovascular depression factors. Despite many reports showing correlations between no VitD concentrations on the development of AF, this topic is still widely debated and the results from these papers are still subject to doubt. Therefore, this review aims at describing in detail the problem of correlation between VitD deficiency and the development of AF associated mainly with the postoperative period, i.e., after cardiac surgery, especially pathogenesis, and results of this correlation, taking into account recent studies, limitations and future perspectives. Due to the fact that this is still a topical problem, we believe that the collection of the latest reports and a detailed description of the problem is most appropriate in this case.

The Relationship Between Vitamin-D Deficiency and Protein Oxidation Among Obese Children

Aim: The aim of the study is to examine the relationship between obesity, Vitamin-D deficiency, and protein oxidation. Methods: Thiol-disulfide homeostasis, Vitamin-D, ischemia modified albumin, insulin, and lipid levels were compared among obese, pre-obese and normal-weight healthy children. Results: A total of 136 children (69 boys and 67 girls) were included in the study. The vitamin-D levels of obese children were lower than those of pre-obese and normal weight (p < 0.05). In the normal weight group, total thiol and native thiol were lower in the pubertal period than in adolescence; were higher in those with sufficient Vitamin-D level than those with insufficient and deficient Vitamin-D (p < 0.05). Vitamin-D level was lower in pre-obese girls than boys (p < 0.05). Those with high triglycerides had high disulfide/total thiol, disulfide, and disulfide/native thiol and low native thiol/total thiol (p < 0.05). Conclusion: Thiol-disulfide homeostasis is negatively affected by low vitamin D levels, pubertal period and high triglyceride levels.

Association of Vitamin D Receptor Gene Polymorphisms with Cardiometabolic Phenotypes in Hispanics: A Life Course Approach

The vitamin D receptor (VDR) is vital for maintaining calcium and phosphate balance and regulating bone metabolism. Recent research has suggested that VDR also plays an essential role in metabolic diseases. Previous studies on non-Hispanic whites have shown that VDR single nucleotide polymorphisms (SNP) are associated with cardiometabolic phenotypes. However, the association between VDR SNPs and cardiometabolic traits in Hispanics remains unclear. This study investigated the association between VDR SNPs and cardiometabolic phenotypic data in self-reported Hispanics (n = 1610) from the Arizona Insulin Resistance registry and Sangre Por Salud Biobank. The study population was predominantly female (66.4%) with a mean age of 40 ± 14 years (n = 121 <18 years) and an average body mass index (BMI) of 29.8 ± 6.3 kg/m2. We performed a genotyping association analysis of VDR SNPs (Taq1-rs731236, Fok1-rs2228570 and Apa1-rs7975232) with cardiometabolic traits using linear regression models. The results showed that Taq1 and Apa1 were strongly associated with systolic blood pressure (SBP) in children (<18 years), while Fok1 was associated with measures of adiposity, including fat mass, waist circumference, and BMI. In age-stratified adult (≥18 years) models, Taq1 was strongly associated with hemoglobin A1c, while Apa1 was associated with BMI and fasting glucose. Fok1 had no significant associations in the adult models. In conclusion, the VDR SNPs were associated with several cardiometabolic phenotypes in this Hispanic sample, but the type and strength of the associations varied by age group.