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Malik D, Garg R, Sethi S, Mahendru R, Singh S. Serum Vitamin D Levels and Dry Eye Disease in Postmenopausal Women: A Case-Control Study at a Tertiary Care Center in Rural Haryana. Int J Appl Basic Med Res 2023; 13:83-88. [PMID: 37614839 PMCID: PMC10443445 DOI: 10.4103/ijabmr.ijabmr_637_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 04/13/2023] [Accepted: 06/20/2023] [Indexed: 08/25/2023] Open
Abstract
Background Despite the high prevalence of Vitamin-D insufficiency and high susceptibility to dry eye disease (DED) in postmenopausal women (PMW), correlation between DED and Vitamin D has not been explored in PMW in any Indian study. Aims and Objectives To explore the correlation between serum Vitamin D levels in PMW with and without DED, in a hospital-based population in rural Haryana. Materials and Methods Subjective (ocular surface disease index [OSDI] questionnaire) and objective clinical tests were undertaken for DED diagnosis. 25(OH) Vitamin D was measured in serum using enzyme-linked immunosorbent assay; insufficient (10-30 ng/ml) and deficient (<10 ng/ml). Descriptive statistics were analyzed by mean ± standard deviation for continuous and frequencies for the categorical variables; Student's t-test used to find out mean difference in Vitamin D levels; P < 0.05 was considered statistically significant. Results One hundred and forty PMW (60.1 ± 5.32 years) were included; Group-A (Controls; no DED; n: 70); Group-B (Cases; DED diagnosed by OSDI scores; n: 70); Subgroup-B1 (clinical tests negative; n: 30) and B2 (clinical tests positive; n: 40). There was no statistically significant difference in OSDI scores between B1 and B2. Significantly lower mean Vitamin D levels were found in cases (14.36 ± 4.08 ng/ml) as compared to controls (19.19 ± 6.4 ng/ml) (P = 0.001) and in B2 (13.15 ± 3.51 ng/ml) as compared to B1 (15.57 ± 4.66 ng/ml) (P = 0.01). Conclusion There were significantly low levels of Vitamin-D in clinically established DED. Evaluating Vitamin D levels as a part of the dry eye workup in PMW is recommended. OSDI scores were not aligned with the clinical test scores; questionnaire-based tests alone may not be sufficient for diagnosing DED.
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Affiliation(s)
- Diksha Malik
- BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Renu Garg
- BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Sumita Sethi
- BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Rajiv Mahendru
- BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India
| | - Sanjeet Singh
- BPS GMC for Women, Khanpur Kalan, Sonepat, Haryana, India
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Komarova TM, Vitovska OP, Komisarenko YI, Scholtz SK. VITAMIN D LEVEL AND ITS LINK WITH VISUAL ACUITY AND CONTRAST SENSITIVITY IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2023; 76:1173-1178. [PMID: 37364069 DOI: 10.36740/wlek202305206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE The aim: Determination of vitamin D level and its connection with visual functions in patients with age-related macular degeneration, dry form. PATIENTS AND METHODS Materials and methods: We analyzed the data of studies (25(OH)D3 levels (nmol/l), LogMAR visual acuity and Logarithmic contrast sensitivity) of 2 groups of women of postmenopausal age: 1 group (58 people - 58 eyes) - patients with age-related macular degeneration (dry form) - study group; 2 group (29 people - 29 eyes) - people without ophthalmic pathology - control group. RESULTS Results: In the study group, 37 patients (63,8%) had vitamin D deficiency, 21 people (36,2%) had vitamin D insufficiency. In the control group, these figures were 69% and 31%, respectively. These indicators were defined as low (the normal supply of vitamin D is considered to be 100 nmol/l and more). Visual acuity due to ETDRS chart in the study group was 0,22±0,04 (in patients with vitamin D deficiency) and 0,12±0,03 (in patients with vitamin D insuffi¬ciency), in the control group - 0,13±0,04 and 0,05±0,04 respectively. In the control group, the logarithmic values of contrast sensitivity (log CS) were 1,58±0,04 log CS (in patients with vitamin D deficiency) and 1,62±0,02 log CS (in patients with vitamin D insufficiency). For patients from the study group, these figures were reduced to 0,98±0,1 log CS and 1,10±0,06 log CS respectively. CONCLUSION Conclusions: Patients with age-related macular degeneration, dry form, have low levels of vitamin D, with a predominance of its deficiency. It has been determined that with age-related macular degeneration, functional losses are observed when perceiving objects of low contrast.
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Kostecka D, Schneider-Matyka D, Jurewicz A, Kamińska M, Barczak K, Grochans E. Body Composition Analysis in Perimenopausal Women Considering the Influence of Vitamin D, Menstruation, Sociodemographic Factors, and Stimulants Used. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15831. [PMID: 36497902 PMCID: PMC9736338 DOI: 10.3390/ijerph192315831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 06/17/2023]
Abstract
(1) The perimenopausal period and menopause are physiological stages of a woman's life, and they may result in the occurrence of many health problems. The aim of this study was to assess the impact of sociodemographic factors related to the use of stimulants and the presence of menstruation and vitamin D concentration in women's health based on the analysis of their body composition parameters. (2) The study was carried out among 191 women. The diagnostic poll method was used, the levels of serum vitamin D were tested, and a body composition analysis was carried out. (3) Correlations between the vitamin D serum concentration and the following factors were established: adipose tissue mass (%) (rho = -0.18; p = 0.011), visceral adipose tissue (rho = -0.18; p = 0.014), BMI (rho = -0.22; p = 0.002), muscle mass (rho = -0.19; p = 0.008), osseous tissue mass (rho = -0.18; p = 0.013), and the phase angle value (rho = -0.2; p = 0.005). A statistically significant correlation between adipose tissue mass (Mdn = 34.4 vs. 32.2; p = 0.018; η2 = 0.029), visceral adipose tissue (Mdn = 8 vs. 6; p = 0.000; η2 = 0.106), and metabolic age (Mdn = 49 vs. 42; p = 0.000; η2 = 0.098) exists. (4) The following conclusions were made: (i) Menstruating women were characterized by increased body composition parameters, especially adipose tissue mass, visceral adipose tissue, and metabolic age. Greater muscle and osseous masses were noted in regularly menstruating women. (ii) A correlation between the vitamin D concentration and body composition parameters in the studied women was observed.
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Affiliation(s)
- Dominika Kostecka
- First Department of Ophthalmology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Alina Jurewicz
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Magdalena Kamińska
- Subdepartment of Long-Term Care and Palliative Medicine, Department of Social Medicine, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, Powstańców Wlkp. 72 Av., 70-111 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
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Lee YB, Baek KH, Chung HY, Byun DW, Min YK. Raloxifene/Vitamin D Combination Therapy vs. Raloxifene Monotherapy on Serum 25-Hydroxy-Vitamin D Level among Postmenopausal Women with Osteoporosis or Osteopenia: A Randomized Controlled Trial. J Bone Metab 2022; 29:155-163. [PMID: 36153851 PMCID: PMC9511125 DOI: 10.11005/jbm.2022.29.3.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background We compared the efficacy of a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU to raloxifene 60 mg alone on vitamin D status, as indicated by change in serum 25-hydroxy-vitamin D (25[OH]D) levels. Methods In this 16-week, open-label, randomized, active controlled, multicenter clinical trial conducted in 4 university-affiliated hospitals in Korea, postmenopausal women aged 55 to 70 years with osteoporosis or osteopenia were randomly assigned in a 1:1 ratio to receive raloxifene 60 mg/cholecalciferol 800 IU combination therapy or raloxifene 60 mg monotherapy. Primary endpoint was change in serum 25(OH)D level from baseline to 16 weeks after the intervention. Results A total of 96 participants were randomly assigned to raloxifene/vitamin D combination therapy (N=49) and raloxifene monotherapy (N=47) groups. At week 16, serum 25(OH)D level increased from baseline, only in the raloxifene/vitamin D combination therapy group. Change in serum 25(OH)D level from baseline to week 16 was higher in the raloxifene/vitamin D combination therapy group (2.7±6.5 ng/mL) than in the raloxifene monotherapy (−1.7±6.2 ng/mL; P=0.0034) group. Proportions and number of adverse events (AEs) categorized by the System-Organ Class were not different between the groups. There was only one severe AE case (spondylolisthesis; raloxifene/vitamin D group), unlikely to be related to trial intervention. Conclusions Among postmenopausal women with osteoporosis or osteopenia, a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU showed superior efficacy in elevating serum 25(OH)D levels compared with raloxifene 60 mg alone during 16 weeks of follow-up. The safety of raloxifene/vitamin D combination was comparable to raloxifene alone.
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Affiliation(s)
- You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Yeon Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dong-Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Kim J, Park J, So WY. Association between Blood Vitamin D Levels and Regular Physical Activity in Korean Adolescents. Healthcare (Basel) 2022; 10:healthcare10071277. [PMID: 35885804 PMCID: PMC9320294 DOI: 10.3390/healthcare10071277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the relationship between vitamin D levels and physical activity in adolescents using data from the Korea National Health and Nutrition Survey (KNHANES). The serum vitamin D concentrations were measured between 2008 and 2014 and analyzed. Adolescents aged 13 to 18 years comprised 4527 of the 61,370 participants surveyed. A final dataset including 2811 adolescents was obtained after those with missing data were excluded. Those who did not participate or only participated in 1−3 days of intense physical activity (p < 0.001), moderate physical activity (p = 0.002), and muscular exercise (weight training) (p < 0.001) showed a higher level of vitamin D deficiency than those who performed the same activities 4−7 days per week. Our results showed that most of the adolescents (76%) were vitamin D-deficient, and the risk was higher among high school than middle school students (odds ratio (OR) = 1.70, 95% confidence interval (CI) = 1.40−2.06; p < 0.001) and higher in girls than boys (OR = 1.43, 95% CI = 1.18−1.72; p < 0.001). Reduced participation in physical activity was correlated with vitamin D deficiency. Furthermore, vitamin D deficiency was associated with a lower frequency of participation in all forms of physical activity, and the association increased significantly with an increase in body mass index.
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Affiliation(s)
- Jiyoun Kim
- Department of Exercise Rehabilitation, Gachon University, Incheon 21936, Korea;
| | - Jinho Park
- Gachon Biomedical Convergence Institute, Gachon University Gil Medical Center, Incheon 21565, Korea
- Correspondence: (J.P.); (W.-Y.S.); Tel.: +82-10-5797-4492 (J.P.); +82-43-841-5993 (W.-Y.S.); Fax: +82-32-460-3118 (J.P.); +82-43-841-5990 (W.-Y.S.)
| | - Wi-Young So
- Sports Medicine Major, College of Humanities and Arts, Korea National University of Transportation, Chungju-si 27469, Korea
- Correspondence: (J.P.); (W.-Y.S.); Tel.: +82-10-5797-4492 (J.P.); +82-43-841-5993 (W.-Y.S.); Fax: +82-32-460-3118 (J.P.); +82-43-841-5990 (W.-Y.S.)
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Jeenduang N, Plyduang T, Horpet D. Association of 25-hydroxyvitamin D levels and metabolic syndrome in Thai postmenopausal women. Diabetes Metab Syndr 2020; 14:1585-1590. [PMID: 32861147 DOI: 10.1016/j.dsx.2020.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Low serum 25-hydroxyvitamin D [25(OH)D] levels have been reported to be associated with metabolic syndrome (MetS). In this study, we aimed to investigate the association between serum 25(OH)D levels and MetS in Thai postmenopausal women. METHODS A total of 340 postmenopausal women were enrolled in the study. The concentration of 25(OH)D, lipid profiles, fasting blood glucose (FBG) levels, blood pressure, and demographic and anthropometric parameters were measured. Subjects were divided into the hypovitaminosis D and vitamin D sufficiency groups. The association of serum 25(OH)D levels with MetS in postmenopausal women was analyzed using multivariate regression analysis. RESULTS Waist circumference, total cholesterol levels, and triglyceride levels were significantly higher in hypovitaminosis D than in vitamin D sufficiency (p < 0.05). The prevalence of MetS, central obesity, and hypertriglyceridemia in hypovitaminosis D was significantly higher than in vitamin D sufficiency (p < 0.05). In the multivariable logistic regression model, hypovitaminosis D was associated with MetS (OR 1.85; 95% CI 1.12-3.04, p = 0.015), central obesity (OR 2.41; 95% CI 1.20-4.85, p = 0.014), and hypertriglyceridemia (OR 1.91; 95% CI 1.12-3.26, p = 0.018) compared with vitamin D sufficiency after adjusting for covariates. Serum vitamin D concentrations were significantly lower in the MetS group than in the non-MetS group (p = 0.016) and decreased with an increasing number of MetS components (p for trend = 0.034). CONCLUSIONS Hypovitaminosis D was associated with an increased risk of MetS, central obesity, and hypertriglyceridemia in Thai postmenopausal women.
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Affiliation(s)
- Nutjaree Jeenduang
- School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand.
| | - Thunyaluk Plyduang
- Center for Scientific and Technological Equipments, Walailak University, Nakhon Si Thammarat, Thailand
| | - Dararat Horpet
- Center for Scientific and Technological Equipments, Walailak University, Nakhon Si Thammarat, Thailand
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Lee LSH, Cheung PK, Fung CKW, Jim CY. Improving street walkability: Biometeorological assessment of artificial-partial shade structures in summer sunny conditions. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2020; 64:547-560. [PMID: 31838603 DOI: 10.1007/s00484-019-01840-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 11/21/2019] [Accepted: 11/24/2019] [Indexed: 06/10/2023]
Abstract
Recent rapid urbanization has rendered outdoor space a key quality-of-life factor, yet walkability studies especially in hot-humid climates have seldom considered human biometeorology. This site-level study investigated microclimatic functions of an overhead structure in improving walkability, and identified biometeorology-related factors influencing pedestrian behaviour. A walkway with overhead tinted glass cover, demarcated into sunny zone and shaded zone, was equipped with hanging aluminium fins. Human thermal sensation was approximated by physiologically equivalent temperature (PET) and universal thermal climate index (UTCI), both closely related to global solar radiation and black-globe temperature. Pedestrian flow was tallied by demographic factors to assess the choice between shaded or sunny zones. Compared with sunny zone, shaded zone slashed maximum global solar radiation by 432 W/m2 in full effect to achieve 90% solar radiation reduction. The maximum cooling in air and black-globe temperatures reached 0.8 °C and 6.1 °C respectively. The overhead structure imposed minimal effect on wind field in both zones. Contrast in maximum PET and UTCI between the two zones reached 8.2 °C and 5.3 °C respectively. In shaded zone, the dominant biometeorological condition was moderate heat stress or slightly warm sensation in contrast to strong heat stress or warm sensation in sunny zone. An overall preference for shaded zone was detected. Pedestrian gender and age, namely female and elderly, were significantly associated with shaded zone preference. The findings could inspire a biometeorological perspective in understanding walking behaviour and pedestrian-friendly facilities. Biometeorological-sensitive design of artificial shade could improve walkability in urban environment that increasingly demands climate change proofing.
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Affiliation(s)
- Louis S H Lee
- Department of Environment, Technological and Higher Education Institute of Hong Kong, Shing Tai Road, Chai Wan, Hong Kong, China
| | - Pui Kwan Cheung
- Department of Environment, Technological and Higher Education Institute of Hong Kong, Shing Tai Road, Chai Wan, Hong Kong, China
| | - Charmaine K W Fung
- Faculty of Education, University of Hong Kong, Pok Fu Lam, Hong Kong, China
| | - C Y Jim
- Department of Environment, Technological and Higher Education Institute of Hong Kong, Shing Tai Road, Chai Wan, Hong Kong, China.
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Chun H, Kim GD, Doo M. Differences in the Association Among the Vitamin D Concentration, Dietary Macronutrient Consumption, and Metabolic Syndrome Depending on Pre- and Postmenopausal Status in Korean Women: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2020; 13:3601-3609. [PMID: 33116711 PMCID: PMC7553659 DOI: 10.2147/dmso.s275847] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 09/03/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To assess whether the consumption of dietary macronutrient could change metabolic syndrome (MetS) related to vitamin D deficiency according to menopausal status. METHODS AND STUDY DESIGN In a cross-sectional study of 8326 Korean women from the Korean National Health and Nutrition Examination Survey V (2010-2012), we investigated the combined interaction effect of serum 25-hydroxyvitamin D [25(OH)D] concentration and menopausal status on MetS-related variables. RESULTS The prevalence rates of 25(OH)D deficiency (vitamin D <50 nmol/L) among premenopausal and postmenopausal women were 84.5% and 67.9%, respectively. Significant differences in MetS-related variables such as body mass index (P<0.001), waist circumference (P=0.005), fast glucose (P=0.048), triglycerides (P=0.001), and high-density lipoprotein cholesterol (P=0.027) based on 25(OH)D concentration were observed among postmenopausal women but not among premenopausal women. Among the postmenopausal women with high consumption of dietary carbohydrate, the adjusted odds ratios (ORs) [95% confidence intervals (95% CIs)] of MetS among participants with 25(OH)D deficiency increased 1.380-fold (95% CI = 1.086-1.753) using the 25(OH)D-sufficient group as a reference. In contrast, the participants with 25(OH)D deficiency showed an increased risk of MetS [OR (95% CI) = 1.313 (1.041-1.655)] with low-fat consumption. However, the aforementioned findings did not differ among premenopausal women. CONCLUSION Thus, MetS due to 25(OH)D deficiency among postmenopausal women may be modified by the consumption of dietary macronutrient.
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Affiliation(s)
- Hyejin Chun
- Department of Family Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi, 13496, Republic of Korea
| | - Gi Dae Kim
- Department of Food and Nutrition, Kyungnam University, Changwon, Gyeongnam51767, Republic of Korea
| | - Miae Doo
- Department of Food and Nutrition, Kunsan National University, Gunsan, Jeonbuk54150, Republic of Korea
- Correspondence: Miae Doo Department of Food and Nutrition, Kunsan National University, Daehak-Ro 558, Gunsan, Jeonbuk54150, Republic of KoreaTel +82-63-469-4635Fax +82-63-469-2085 Email
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Gopal K, Thevarajah M, Ng CM, Raja J. Effects of vitamin D on disease activity and serum interleukin‐6 in rheumatoid arthritis. Int J Rheum Dis 2019; 22:834-841. [DOI: 10.1111/1756-185x.13484] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 09/14/2018] [Accepted: 12/18/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Kumutha Gopal
- Division of Rheumatology, Department of Medicine University of Malaya Kuala Lumpur Malaysia
| | | | - Choung Min Ng
- Institute of Mathematical Sciences, Faculty of Science University of Malaya Kuala Lumpur Malaysia
| | - Jasmin Raja
- Division of Rheumatology, Department of Medicine University of Malaya Kuala Lumpur Malaysia
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Should clinicians pay more attention to the potential underdiagnosis of osteoporosis in patients with ankylosing spondylitis? A national population-based study in Taiwan. PLoS One 2019; 14:e0211835. [PMID: 30726282 PMCID: PMC6364934 DOI: 10.1371/journal.pone.0211835] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/21/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES There are limited studies describing the association between ankylosing spondylitis (AS) and osteoporosis. We conducted a nationwide retrospective cohort study to investigate this epidemiologic evidence. METHODS Data were obtained from the Taiwan National Health Insurance Research Database (NHIRD). Of 10,290 participants, 2,058 patients with AS and 8,232 patients without AS were enrolled from the NHIRD between 2000 to 2013. Cumulative incidences of osteoporosis were compared between 2 groups. Cox regression model was used to estimate the hazard ratio (HR) of developing osteoporosis after controlling for demographic and other co-morbidities, and subgroup analyses were conducted to examine the risk factors for osteoporosis in AS patients. RESULTS The incidence rate ratio (IRR) of osteoporosis in AS patients was 2.17 times higher than that non-AS group (95% confidence interval [CI], 1.83-2.57). The adjusted HRs of osteoporosis for AS patients after controlling for demographic characteristics and comorbid medical disorders was 1.99 (95% CI 1.68-2.36). Among AS group, after adjustment for major comorbidities, old age (≥65 years, HR 4.32, 95% CI 3.01-6.18), female sex (HR 2.48, 95% CI 1.87-3.28), dyslipidemia (HR 1.44, 95% CI 1.01-2.06) were risk factors associated with osteoporosis. CONCLUSIONS This cohort study demonstrated that patients with AS had a higher risk of developing osteoporosis, especially in those aged over 65, female sex and with dyslipidemia in this patient group.
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Factors Associated with Vitamin D Status Among Korean Female Adolescents. J Pediatr Nurs 2019; 44:e79-e83. [PMID: 30503251 DOI: 10.1016/j.pedn.2018.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/11/2018] [Accepted: 11/11/2018] [Indexed: 01/12/2023]
Abstract
PURPOSE The prevalence of vitamin D deficiency among female adolescents in South Korea is the highest in East Asia. Therefore, this study aims to identify factors associated with vitamin D status among female adolescents in South Korea. DESIGN AND METHODS This cross-sectional descriptive study was conducted using a data set from the fifth Korean National Health and Nutrition Examination Survey (2010-2012). Participants comprised 734 female adolescents aged 12-18 years. A general linear model using a complex samples design was employed. RESULTS The mean vitamin D level of the participants was 14.90 ng/mL. Among these participants, 87.6% had a vitamin D deficiency. As their age increased by one year, their vitamin D level decreased by 0.47 ng/mL. Female adolescents with a low household income had vitamin D levels lower by 1.88 ng/mL than those with a high household income. Vitamin D levels in female adolescents who skipped lunch was lower by 3.41 ng/mL than those who had lunch. CONCLUSION The prevalence of vitamin D deficiency among female adolescents in South Korea is considerable. The findings suggest that age, socioeconomic status, and skipping a meal were associated with vitamin D status in female adolescents, but physical activity was not. PRACTICE IMPLICATIONS As the findings of this study indicate, older female adolescents and those from lower household incomes may be at higher risk for lower levels of Vitamin D. Counseling female adolescents as to dietary measures to avoid vitamin D deficiency is advised. Preventive health for at risk female adolescents includes provision of health education and counseling.
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Contreras-Manzano A, Villalpando S, Robledo-Pérez R. Vitamin D status by sociodemographic factors and body mass index in Mexican women at reproductive age. SALUD PUBLICA DE MEXICO 2018; 59:518-525. [PMID: 29267648 DOI: 10.21149/8080] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 05/08/2017] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To describe the prevalence of Vitamin D deficiency (VDD) and insufficiency (VDI), and the main dietary sources of vitamin D (VD) in a probabilistic sample of Mexican women at reproductive age participating in Ensanut 2012, stratified by sociodemographic factors and body mass index (BMI) categories. MATERIALS AND METHODS Serum concentrations of 25-hydroxyvitamin-D(25-OH-D) were determined using an ELISA technique in 4162 women participants of Ensanut 2012 and classified as VDD, VDI or optimal VD status. Sociodemographic, anthropometric and dietary data were also collected. The association between VDD/VDI and sociodemographic and anthropometry factors was assessed adjusting for potential confounders through an estimation of a multinomial logistic regression model. RESULTS The prevalence of VDD was 36.8%, and that of VDI was 49.8%. The mean dietary intake of VD was 2.56 μg/d. The relative risk ratio (RRR) of VDD or VDI was calculated by a multinomial logistic regression model in 4162 women. The RRR of VDD or VDI were significantly higher in women with overweight (RRR: 1.85 and 1.44, p<0.05), obesity (RRR: 2.94 and 1.93, p<0.001), urban dwelling (RRR:1.68 and 1.31, p<0.06), belonging to the 3rd tertile of income (RRR: 5.32 and 2.22, p<0.001), or of indigenous ethnicity (RRR: 2.86 and 1.70, p<0.05), respectively. CONCLUSION The high prevalence of VDD/VDI in Mexican women calls for stronger actions from the health authorities, strengthtening the actual policy of food supplementation and recommending a reasonable amount of sun exposure.
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Affiliation(s)
- Alejandra Contreras-Manzano
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, Mexico
| | - Salvador Villalpando
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, Mexico
| | - Ricardo Robledo-Pérez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública. Cuernavaca Morelos, Mexico
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Dietary Acid Load, IGF-1 Single Nucleotide Polymorphism and Bone Resorption among Postmenopausal Chinese Women. Nutrients 2018; 10:nu10070915. [PMID: 30018240 PMCID: PMC6073430 DOI: 10.3390/nu10070915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/05/2018] [Accepted: 07/12/2018] [Indexed: 01/24/2023] Open
Abstract
The interaction of dietary and genetic factors may affect the development of bone deterioration. This study investigated whether the effects of dietary acid load (DAL) on bone loss in postmenopausal Chinese women were moderated by the insulin-like growth factor-1 (IGF-1) single nucleotide polymorphism, a known gene that plays a role in the regulation of bone formation and bone remodeling. A total of 217 healthy participants were recruited from the National Council of Senior Citizens Organizations Malaysia. Serum collagen type 1 cross-linked C-telopeptide was used as a surrogate bone marker to assess bone resorption and Agena® MassARRAY genotyping analysis was used to identify the signaling of IGF-1 rs35767. The dietary acid load was measured by potential renal acid load score while physical activity was ascertained using the Global Physical Activity Questionnaire. Hierarchical regression was applied to test the main and interaction effects of DAL and IGF-1 genotypes in bone resorption. The result supported the diet-dependent acid-base balance theory that higher DAL was positively associated with bone resorption (β = 0.152, p = 0.031, F(6,207) = 2.11, sig-F = 0.036, R² = 0.079). However, the results indicated that there was no significant correlation between IGF-1 and bone resorption, or any significant interaction between DAL and IGF-1. In conclusion, there was no moderating effect of IGF-1 on the relationship between DAL and bone resorption.
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Liao EY, Zhang ZL, Xia WB, Lin H, Cheng Q, Wang L, Hao YQ, Chen DC, Tang H, Peng YD, You L, He L, Hu ZH, Song CL, Wei F, Wang J, Zhang L. Calcifediol (25-hydroxyvitamin D) improvement and calcium-phosphate metabolism of alendronate sodium/vitamin D 3 combination in Chinese women with postmenopausal osteoporosis: a post hoc efficacy analysis and safety reappraisal. BMC Musculoskelet Disord 2018; 19:210. [PMID: 29970059 PMCID: PMC6030763 DOI: 10.1186/s12891-018-2090-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 05/15/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D (VD) insufficiency or deficiency is a frequent comorbidity in Chinese women with postmenopausal osteoporosis (PMO). The present study aimed to investigate 25-hydroxyvitamin D [25(OH) D] improvement and calcium-phosphate metabolism in Chinese PMO patients treated with 70 mg of alendronate sodium and 5600 IU of vitamin D3 (ALN/D5600). METHODS Chinese PMO women (n = 219) were treated with 12-month ALN/D5600 (n = 111) or calcitriol (n = 108). Changes in 25(OH) D at month 12 were post hoc analyzed by the baseline 25 (OH) D status using the longitudinal analysis. The main safety outcome measures included serum calcium and phosphate and 24-h urine calcium, and the repeated measures mixed model was used to assess the frequencies of the calcium-phosphate metabolic disorders. RESULTS Absolute change in mean serum 25(OH) D level was the greatest in VD-deficient patients and least in VD-sufficient patients at months six and 12 (both, P < 0.01). Serum calcium level remained significantly lower in the ALN/D5600 treatment group than in the calcitriol treatment group throughout the 12 months. Mean 24-h urine calcium slightly increased in the ALN/D5600 treatment group and significantly increased in the calcitriol treatment group (+ 1.1 and + 0.9 mmol/L at months six and 12; both, P < 0.05). Calcitriol treatment was associated with more frequent hypercalciuria at month six (9.4% vs. 18.5%, P = 0.05), but not at month 12 (12.3% vs. 13.0%). CONCLUSION Baseline VD status predicted 25(OH) D improvement in PMO patients on 12-month ALN/D5600 treatment. The daily use of 0.25 μg of calcitriol was associated with more frequent hypercalciuria at month six, compared to ALN/5600 treatment, necessitating the safety re-evaluation of calcitriol at a higher dosage.
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Affiliation(s)
- Er-Yuan Liao
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhen-Lin Zhang
- The Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wei-Bo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Wangfujing, Dongcheng District, Beijing, 100730 China
| | - Hua Lin
- Nanjing Drum Tower Hospital, Nanjing, China
| | - Qun Cheng
- Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Li Wang
- Tianjin Hospital, Tianjin, China
| | | | - De-Cai Chen
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Hai Tang
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | | | - Li You
- The First People’s Hospital, Shanghai, China
| | - Liang He
- Beijing Jishuitan Hospital, Beijing, China
| | - Zhao-Heng Hu
- Peking University People’s Hospital, Beijing, China
| | - Chun-Li Song
- Peking University Third Hospital, Beijing, China
| | - Fang Wei
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - Jue Wang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
| | - Lei Zhang
- Global Medical Affairs, Merck Sharp & Dohme China, Shanghai, China
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Prevalence and association of metabolic syndrome and vitamin D deficiency among postmenopausal women in a rural block of West Bengal, India. PLoS One 2017; 12:e0188331. [PMID: 29190744 PMCID: PMC5708804 DOI: 10.1371/journal.pone.0188331] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/03/2017] [Indexed: 12/17/2022] Open
Abstract
Background Prevalence of metabolic syndrome (MS) and vitamin D deficiency was reported among postmenopausal women (PMW) in India. However, no report is available regarding the association of MS and 25-hydroxyvitamin D [25(OH)D] among PMW in India. This study aimed to find out the prevalence of MS and 25(OH)D status as well as their association among rural PMW of West Bengal, India. Materials and methods This cross-sectional study was conducted among 222 randomly selected rural PMW in Singur Block, West Bengal, India. Serum 25(OH)D, Blood pressure (BP), waist circumference (WC), fasting blood glucose (FBG), triglycerides (TG) and high density lipoprotein cholesterol (HDL-C) were measured using standard procedures. MS was defined as per International Diabetes Federation, 2005 (for Asian-Indians) criteria. Statistical tests were done using SPSS software. Results Prevalence of metabolic syndrome was 46%. 51% and 19% PMW were vitamin D insufficient and deficient, respectively. 22% and 53% women having MS were vitamin D insufficient and deficient, respectively. Among the PMW, 21% and 47% with WC≥80cm; 22% and 62% with FBG≥110mg/dl; 21% and 54% with TG≥150mg/dl; 23% and 51% with HDL-C<50mg/dl, 15% and 55% with BP≥130/85mm of Hg were vitamin D insufficient and deficient, respectively. Significant statistical association between FBG and 25(OH)D status existed (p = 0.01). Significant positive correlation between WC and 25(OH)D level (p = 0.004) and significant negative correlation between FBG and 25(OH)D level observed (p = 0.02). WC was the only statistically significant predictor of the dependent variable. Odds of non-sufficient 25(OH)D level increased with decrease in WC. Conclusion High prevalence of MS as well as vitamin D insufficiency and deficiency existed among PMW of Singur block, West Bengal, India. 25(OH)D had significant inverse and direct relationship with FBG and WC. Low 25(OH)D may be one of the potential risk factors for developing MS in PMW or vice-versa.
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Kruger MC, Chan YM, Lau LT, Lau CC, Chin YS, Kuhn-Sherlock B, Todd JM, Schollum LM. Calcium and vitamin D fortified milk reduces bone turnover and improves bone density in postmenopausal women over 1 year. Eur J Nutr 2017; 57:2785-2794. [DOI: 10.1007/s00394-017-1544-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/20/2017] [Indexed: 11/29/2022]
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Kim HT, Kim JM, Kim JH, Lee MY, Won YS, Lee JY, Park KH. The Relationship between Vitamin D and Glaucoma: A Kangbuk Samsung Health Study. KOREAN JOURNAL OF OPHTHALMOLOGY 2016; 30:426-433. [PMID: 27980361 PMCID: PMC5156616 DOI: 10.3341/kjo.2016.30.6.426] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 04/28/2016] [Indexed: 01/30/2023] Open
Abstract
PURPOSE To investigate the relationship between vitamin D and glaucoma. METHODS This retrospective, cross-sectional study included subjects who underwent a health screening at the Health Screening Center of Kangbuk Samsung Hospital from August 2012 to July 2013. All fundus photographs were reviewed by ophthalmologists. The ophthalmologists determined if an eye was glaucomatous based on the criteria set forth by the International Society of Geographical and Epidemiological Ophthalmology and by the appearance of the retinal nerve fiber layer and optic disc. If the subjects previously underwent an ophthalmologic examination, they were enrolled based on the documented history. In addition to fundus photographs, each participant underwent a systemic examination including blood sampling and sociodemographic and behavioral questionnaires. The subjects were divided into five groups according to serum 25-hydroxyvitamin D (25(OH)D) level. Multivariate logistic regression models were constructed to assess possible associations between elevated glaucoma risk and systemic factors with a p < 0.2 on univariate analysis. RESULTS Of the 169,208 subjects older than 20 years, 123,331 were eligible for the study. There was no difference in the prevalence of glaucoma according to quintile of serum 25(OH)D level based on sex (p = 0.412 for males, p = 0.169 for females). According to the multivariable-adjusted logistic analysis, the odds ratio of glaucoma for the fourth quintile was significantly lower than that of the first quintile in females (odds ratio, 0.713; 95% confidence interval, 0.520 to 0.979). CONCLUSIONS Lower 25(OH)D level was significantly associated with an elevated risk of glaucoma in females compared with higher 25(OH)D level. Further evaluation is needed to investigate the relationship between glaucoma and vitamin D.
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Affiliation(s)
- Hyun Tae Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Mo Kim
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hoon Kim
- Department of Ophthalmology, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Mi Yeon Lee
- Department of Biostatistics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yu Sam Won
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae Yeun Lee
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
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Ock SY, Ha KH, Kim BK, Kim HC, Shim JS, Lee MH, Yoon YM, Kim DJ. Serum 25-Hydroxyvitamin D Concentration Is Independently Inversely Associated with Insulin Resistance in the Healthy, Non-Obese Korean Population. Diabetes Metab J 2016; 40:367-375. [PMID: 27535642 PMCID: PMC5069393 DOI: 10.4093/dmj.2016.40.5.367] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 01/26/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND We evaluated the associations between 25-hydroxyvitamin D (25(OH)D) concentrations in serum and insulin resistance in the healthy Korean population. METHODS We conducted this cross-sectional analysis in 1,807 healthy Korean people (628 men and 1,179 women) aged 30 to 64 years in the Cardiovascular and Metabolic Disease Etiologic Research Center study. All participants were assessed for 25(OH)D, fasting glucose, and insulin levels, and completed a health examination and lifestyle questionnaire according to standard procedures. Insulin resistance was defined as the homeostasis model assessment insulin resistance higher than the 75 percentile. RESULTS Compared to those in the highest tertile (≥14.3 ng/mL), the odds ratio (OR) for insulin resistance was 1.37 (95% confidence interval [CI], 1.01 to 1.86) for the 1st tertile (<9.7 ng/mL) and 1.19 (95% CI, 0.08 to 1.62) for the 2nd tertile (9.7 to 14.3 ng/mL) after adjusting for age, gender, waist circumference, alcohol consumption, smoking status, physical exercise, season, and cohort. After stratification of the subjects by adiposity, these associations remained only in non-obese subjects (lowest tertile vs. highest tertile, multivariable OR, 1.64; 95% CI, 1.05 to 2.56). CONCLUSION Serum 25(OH)D has an independent inverse association with insulin resistance in the healthy, non-obese Korean population, even among people with vitamin D insufficiency.
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Affiliation(s)
- So Young Ock
- Department of Endocrinology and Metabolism, Kosin University College of Medicine, Busan, Korea
| | - Kyoung Hwa Ha
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea
| | - Bu Kyung Kim
- Department of Endocrinology and Metabolism, Kosin University College of Medicine, Busan, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Seon Shim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Myung Ha Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Young Me Yoon
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
- Cardiovascular and Metabolic Disease Etiology Research Center, Ajou University School of Medicine, Suwon, Korea.
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Yun BH, Chon SJ, Choi YS, Cho S, Lee BS, Seo SK. The effect of prolonged breast-feeding on the development of postmenopausal osteoporosis in population with insufficient calcium intake and vitamin D level. Osteoporos Int 2016; 27:2745-2753. [PMID: 27048389 DOI: 10.1007/s00198-016-3585-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/27/2016] [Indexed: 01/21/2023]
Abstract
UNLABELLED Breast-feeding affects bone metabolism and calcium homeostasis, and prolonged breast-feeding may influence the development of postmenopausal osteoporosis, particularly in highly susceptible populations. The study determined that breast-feeding may be a risk factor for postmenopausal osteoporosis, especially in people with low calcium intakes and vitamin D deficiencies. INTRODUCTION The purpose of this study was to determine whether breast-feeding is a risk factor in the development of postmenopausal osteoporosis, especially in highly susceptible population. METHODS The study was performed using data from the 2010 to 2011 Korea National Health and Nutrition Examination Survey, and it included 1231 postmenopausal women who were aged between 45 and 70 years. Osteoporosis was defined using the World Health Organization's T-score criteria, namely, a T-score of ≤-2.5 at the femoral neck or the lumbar spine. The patients' ages, body mass indexes, daily calcium intakes, serum vitamin D levels, exercise levels, smoking histories, and reproductive factors relating to menarche, menopause, delivery, breast-feeding, hormone treatment, and oral contraceptive use were evaluated. Comparisons between the osteoporosis and non-osteoporosis groups were undertaken using Student's t test and the chi-square test, and logistic regression models were built. RESULTS A significant increase in the risk of osteoporosis was apparent in postmenopausal women with prolonged breast-feeding histories (≥24 months) (model 1: odds ratio [OR] = 2.489; 95 % confidence interval [CI] = 1.111 to 5.578, p = 0.027; model 2: OR = 2.503; 95 % CI = 1.118 to 5.602, p = 0.026; model 3: OR = 2.825; 95 % CI = 1.056 to 7.56, p = 0.039), particularly in those with inadequate serum vitamin D levels and calcium intakes (<800 mg/day). CONCLUSIONS Breast-feeding seems to increase the risk of postmenopausal osteoporosis; however, its impact may not be definitive in women with sufficient vitamin D levels and calcium intakes. Therefore, sufficient calcium intakes and adequate vitamin D levels may be important to prevent osteoporosis in postmenopausal women that is derived from breast-feeding.
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Affiliation(s)
- B H Yun
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - S J Chon
- Department of Obstetrics and Gynecology, Gil Hospital, Graduate School of Medicine, Gachon University of Medicine and Science, Incheon, South Korea
| | - Y S Choi
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - S Cho
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - B S Lee
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - S K Seo
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
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Koh JM, Chung DJ, Chung YS, Kang MI, Kim IJ, Min YK, Oh HJ, Park IH, Lee YS, Kravitz B, Waterhouse B, Nino A, Fitzpatrick LA. Assessment of Denosumab in Korean Postmenopausal Women with Osteoporosis: Randomized, Double-Blind, Placebo-Controlled Trial with Open-Label Extension. Yonsei Med J 2016; 57:905-14. [PMID: 27189284 PMCID: PMC4951467 DOI: 10.3349/ymj.2016.57.4.905] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/28/2015] [Accepted: 09/25/2015] [Indexed: 01/01/2023] Open
Abstract
PURPOSE The efficacy and safety of denosumab was compared with placebo in Korean postmenopausal women with osteoporosis in this phase III study. MATERIALS AND METHODS Women aged 60 to 90 years with a T-score of <-2.5 and ≥-4.0 at the lumbar spine or total hip were randomized to a single 60 mg subcutaneous dose of denosumab or placebo for the 6-month double-blind phase. Eligible subjects entered the 6-month open-label extension phase and received a single dose of denosumab 60 mg. RESULTS Baseline demographics were similar in the 62 denosumab- and 64 placebo-treated subjects who completed the double-blind phase. Treatment favored denosumab over placebo for the primary endpoint {mean percent change from baseline in lumbar spine bone mineral density (BMD) at Month 6 [3.2% (95% confidence interval 2.1%, 4.4%; p<0.0001)]}; and secondary endpoints (mean percent change from baseline in lumbar spine BMD at Month 1, total hip, femoral neck, and trochanter BMD at Months 1 and 6, and median percent change from baseline in bone turnover markers at Months 1, 3, and 6). Endpoint improvements were sustained over 12 months in the open-label extension (n=119). There were no new or unexpected safety signals. CONCLUSION Denosumab was well tolerated and effective in increasing BMD and decreasing bone turnover markers over a 12-month period in Korean postmenopausal women. The findings of this study demonstrate that denosumab has beneficial effects on the measures of osteoporosis in Korean postmenopausal women.
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Affiliation(s)
- Jung Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Dong Jin Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yoon Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Moo Il Kang
- Department of Endocrinology and Metabolism, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - In Ju Kim
- Department of Endocrinology and Metabolism, Pusan National University Hospital, Busan, Korea
| | - Yong Ki Min
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Han Jin Oh
- Department of Family Medicine, Cheil General Hospital, College of Medicine, Kwandong University, Seoul, Korea
| | - Il Hyung Park
- Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
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Yu HJ, Kwon MJ, Woo HY, Park H. Analysis of 25-Hydroxyvitamin D Status According to Age, Gender, and Seasonal Variation. J Clin Lab Anal 2016; 30:905-911. [PMID: 27075522 DOI: 10.1002/jcla.21955] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 12/11/2015] [Accepted: 01/11/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The effects of age, gender, and seasonal variation on human levels of 25-hydroxyvitamin D (25(OH)D) are not well understood. In this study, we aimed to investigate 25(OH)D status according to these factors in a Korean population. METHODS A total of 303,943 serum 25(OH)D levels were measured using an electrochemiluminescence immunoassay between October 2011 and May 2014. Potential participants were ineligible for the study if they had significant renal, hepatic, or thyroid dysfunction, as well as any major ongoing disease that could influence serum 25(OH)D levels. RESULTS A total of 95,137 subjects (49,662 men and 45,475 women) were included in this study. The mean 25(OH)D levels were higher in men (42.4 nmol/l) than in women (32.9 nmol/l, P < 0.001). Among the men and women, 73.0% and 88.9%, respectively, had 25(OH)D levels <50 nmol/l, whereas only 3.8% of men and 1.4% of women had levels >75 nmol/l. The highest mean 25(OH)D value was noted in individuals aged ≥70 for both genders. The proportion of those with 25(OH)D levels <50 nmol/l appeared to be higher among younger subjects (P < 0.001). Lastly, there were significant differences between 25(OH)D levels in individuals during summer to fall and winter to spring in both genders, indicating seasonal periodicity (P < 0.001). CONCLUSIONS Serum 25(OH)D status varied according to gender, age, and season. Therefore, analyses of vitamin D status require individualized gender, age, and seasonally adjusted thresholds. Clinicians should consider these factors when determining optimal serum 25(OH)D levels in clinical practice.
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Affiliation(s)
- Hui-Jin Yu
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Min-Jung Kwon
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Hee-Yeon Woo
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyosoon Park
- Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Mitra S, Nayak PK, Agrawal S, Sahoo JP, Kamalanathan S, Nanda R. Vitamin D Status and Cardio-Metabolic Risk in Indian Postmenopausal Women. J Clin Diagn Res 2016; 10:QC17-20. [PMID: 27134948 DOI: 10.7860/jcdr/2016/17839.7438] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 01/14/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of chronic and non-communicable health disorders like cardiovascular diseases and metabolic syndrome is increasing worldwide including in India. The various risk factors for these health issues need to be addressed. The role of vitamin D deficiency in the causation of all these abnormal health conditions among postmenopausal women is a matter of debate now-a-days. AIM To determine the correlation of serum vitamin D levels with various cardio-metabolic risk factors and metabolic syndrome (MetS) in postmenopausal women (PMW). MATERIALS AND METHODS Total of 64 PMW were included in this cross-sectional study. Clinical (waist circumference, body mass index, blood pressure) and biochemical (fasting plasma glucose, lipid profile and serum 25-hydroxyl vitamin D levels) parameters were measured. MetS was defined using modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) guidelines. Serum 25-hydroxyl vitamin D levels <50 nmol/l, between 52.5-72.5 nmol/l and >75 nmol/l were classified as deficient, insufficient and sufficient, respectively. RESULTS MetS was prevalent in 33 (52%) subjects. There were no differences in serum vitamin D levels or proportion of vitamin D deficient individuals in those with and without MetS. 33 women (52%) had vitamin D deficiency. Cardio-metabolic risk profile was similar in both vitamin D deficient and replete women. CONCLUSION Despite a high prevalence of vitamin D deficiency and MetS in Indian PMW, serum vitamin D concentrations do not correlate with the cardio-metabolic risk factors or MetS.
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Affiliation(s)
- Subarna Mitra
- Senior Resident, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Prasanta Kumar Nayak
- Assistant Professor, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Sarita Agrawal
- Professor, Department of Obstetrics & Gynecology, All India Institute of Medical Sciences , Raipur, India
| | - Jaya Prakash Sahoo
- Assistant Professor, Department of Endocrinology & Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Sadishkumar Kamalanathan
- Associate Professor, Department of Endocrinology & Metabolism, Jawaharlal Institute of Postgraduate Medical Education and Research , Puducherry, India
| | - Rachita Nanda
- Associate Professor, Department of Biochemistry, All India Institute of Medical Sciences , Raipur, India
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Kamineni V, Latha AP, Ramathulasi K. Association between serum 25-hydroxyvitamin D levels and bone mineral density in normal postmenopausal women. J Midlife Health 2016; 7:163-168. [PMID: 28096639 PMCID: PMC5192985 DOI: 10.4103/0976-7800.195694] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: This study was conducted with the objective of assessing serum 25-hydroxyvitamin D (25(OH)D) in postmenopausal women (PMW), to detect osteopenia or osteoporosis in PMW and to establish a correlation between serum 25(OH)D levels and bone mineral density (BMD). Materials and Methods: A total of 100 healthy PMW were selected, and a prospective observational study was conducted to correlate the BMD with serum 25(OH)D levels. Their laboratory investigations along with serum 25(OH)D levels were done. Their BMD was assessed with dual-energy X-ray absorptiometry at lumbar spine and neck of femur; T-scores were derived. Correlation analysis was done to investigate the relationship between serum 25(OH)D levels and BMD. Results: The proportion of osteoporosis at the hip was 31.9% in deficient group, 16.1% in insufficient, and 18.2% in sufficient group and at lumbar spine, it was 27.7%, 16.1%, and 22.7%, respectively. Forty-seven percent of PMW had deficient (<20 ng/ml) serum 25(OH)D levels and 31% had insufficiency. T-score at hip in deficient group was −2.05 ± 0.25, and in an insufficient group, it was −1.79 ± 0.13; T-score at lumbar spine was −1.92 ± 0.12 and −1.79 ± 0.12, respectively, but both were not statistically significant. Osteoporosis was seen in 24%, osteopenia in 55% at hip level and 23% and 59% respectively at lumbar spine. There was no association between serum 25(OH)D levels and BMD neither at hip nor at lumbar spine (P = 0.51 and P = 0.79 respectively). Conclusion: In this study, among our cohort of patients there was no correlation between serum 25(OH)D levels and BMD. However, Vitamin D deficiency coexists with low BMD. Vitamin D insufficiency is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.
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Affiliation(s)
- Vasundhara Kamineni
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | - Akkenapally Prasanna Latha
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
| | - K Ramathulasi
- Department of Obstetrics and Gynaecology, Kamineni Academy of Medical Sciences and Research Centre, Hyderabad, Telangana, India
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Lee A, Kim SH, Nam CM, Kim YJ, Joo SH, Lee KR. Prevalence of Vitamin D Deficiency and Insufficiency in Korean Children and Adolescents and Associated Factors. ACTA ACUST UNITED AC 2016. [DOI: 10.3343/lmo.2016.6.2.70] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Anna Lee
- Seoul Medical Science Institute, Yongin, Korea
| | - Se Hwi Kim
- Department of Biostatistics and Computing, The Graduate School of Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Soo-Ho Joo
- Seoul Medical Science Institute, Yongin, Korea
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Kondo M, Toyoda M, Miyatake H, Tanaka E, Koizumi M, Komaba H, Kimura M, Umezono T, Fukagawa M. The Prevalence of 25-hydroxyvitamin D Deficiency in Japanese Patients with Diabetic Nephropathy. Intern Med 2016; 55:2555-62. [PMID: 27629947 DOI: 10.2169/internalmedicine.55.6346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective The purpose of this study was to measure serum 25-hydroxyvitamin D [25(OH)D] levels in Japanese patients with diabetic nephropathy and determine the relationship between 25(OH)D concentrations and various factors. Methods The study subjects included 442 patients with type 2 diabetes. Their serum levels of creatinine, HbA1c, intact-parathyroid hormone, urinary albumin, 25(OH)D, and 1,25-dihydroxyvitamin D [1,25(OH)2D] were measured and their estimated glomerular filtration rate (eGFR) was determined. The patients were divided into four groups based on the risk for progression to chronic kidney disease (CKD): low, moderate, high, very high, based on their eGFR and their level of albuminuria. Results The median 25(OH)D level was 14.6 ng/mL; 11% of the patients had 25(OH)D deficiency (<10 ng/mL), and 2% of patients had active vitamin D deficiency, as defined by a 1,25(OH)2D level of <22 pg/mL. The serum 25(OH)D level was correlated with the serum 1,25(OH)2D level in patients with a very high risk for CKD, but not in those with a moderate or high risk for CKD. Conclusion Although the vitamin D levels of the Japanese patients with diabetic nephropathy and CKD were low, the prevalence of vitamin D deficiency, as defined by the 1,25(OH)2D level, was low. Albuminuria, younger age, and female gender were associated with a low 25(OH)D level. The serum level of 25(OH)D should be monitored to assess the vitamin D status of patients with nephropathy and CKD.
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Affiliation(s)
- Masumi Kondo
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Tokai University School of Medicine, Japan
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Zhang M, Li P, Zhu Y, Chang H, Wang X, Liu W, Zhang Y, Huang G. Higher visceral fat area increases the risk of vitamin D insufficiency and deficiency in Chinese adults. Nutr Metab (Lond) 2015; 12:50. [PMID: 26612998 PMCID: PMC4660664 DOI: 10.1186/s12986-015-0046-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/19/2015] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Visceral fat area (VFA), a novel sex-specific index for visceral fat obesity (VFO) might play a major role in the development of vitamin D deficiency. However, the association between VFA and vitamin D insufficiency and deficiency in Chinese population is less clear. The aim of this study was to explore the population-level association between VFA and vitamin D insufficiency and deficiency among Chinese men and women. METHODS This cross-sectional study involved 1105 adults aged 20-70 years living in Tianjin who were randomly selected and medically examined. All subjects underwent the bioelectrical impedance analysis (BIA) method to estimate the VFA. Serum 25-hydroxyvitamin D3 (25(OH) D3) level was assayed by the high-performance liquid chromatography (HPLC) method and defined insufficiency and deficiency following recommended cutoffs. The association between VFA and vitamin D insufficiency and deficiency was estimated using binary regression analysis. RESULTS The total prevalence of vitamin D insufficiency (25(OH) D3: 20-29 μg/L) and deficiency (25(OH) D3 < 20 μg/L) were 26.60 % and 24.89 %, respectively. Significant negative association was observed for VFA with serum 25(OH) D3 levels in men and pre-menopausal women (P < 0.05), not in post-menopausal women (P > 0.05). Moreover, increased VFA was observed to be associated with higher vitamin D insufficiency or deficiency risk with a positive dose-response trend (P for trend < 0.001). As compared to individuals with the lowest VFA, those who had the highest VFA were at 4.9-fold risk of vitamin D insufficiency and deficiency [95 % confidence interval (95 % CI): 1.792-13.365] in men and 1.8-fold risk of vitamin D insufficiency and deficiency (95 % CI: 1.051-3.210) in pre-menopausal women, but not in post-menopausal women [odds ratio (OR) (95 % CI): 2.326(0.903-5.991)]. CONCLUSIONS These results suggest that higher VFA increases the risk of vitamin D insufficiency and deficiency in men and pre-menopausal women, but not in post-menopausal women. VFA is a better and convenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of vitamin D insufficiency and deficiency in routine health examination.
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Affiliation(s)
- Meilin Zhang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Ping Li
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Yufeng Zhu
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Hong Chang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
- />Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, 300070 China
| | - Xuan Wang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Weiqiao Liu
- />Health Education and Guidance Center of Heping District, Tianjin, 300040 China
| | - Yuwen Zhang
- />Health Education and Guidance Center of Heping District, Tianjin, 300040 China
| | - Guowei Huang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
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Yoshimura N, Muraki S, Oka H, Tanaka S, Kawaguchi H, Nakamura K, Akune T. Factors affecting changes in the serum levels of 25-hydroxyvitamin D: a 3-year follow-up of the ROAD study. Osteoporos Int 2015; 26:2597-605. [PMID: 26089134 DOI: 10.1007/s00198-015-3184-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 05/19/2015] [Indexed: 01/09/2023]
Abstract
UNLABELLED In this 3-year population-based cohort study, among 1346 subjects, the mean annual change in the serum 25-hydroxyvitamin D levels was 7.6 %/year, which tended to increase during the 3-year period. Multivariate regression analysis indicated that the L2-4 bone mineral density and total daily energy intake were significant independent associated factors. INTRODUCTION The aim of this study was to clarify the change rate of the serum levels of 25-hydroxyvitamin D (25D) and the associated factors in a general Japanese population during a 3-year period. METHODS The baseline survey of Research on Osteoarthritis/osteoporosis Against Disability study (ROAD), a large-scale population-based cohort study, was performed between 2005 and 2007, and a follow-up survey was repeated 3 years later. Among 1690 participants at baseline, the change rate of the serum 25D levels were assessed in 1346 individuals (79.6 %; 458 men and 888 women) who completed measurements of 25D at both the baseline and follow-up examinations. The change rate was calculated, and the factors associated with the changes in the 25D levels were determined using multivariate regression analysis after adjustment for age, gender, body mass index, participated month, and regional differences at baseline. RESULTS The mean (standard deviation) change rate of the 25D levels in all subjects was 7.6 (13.3) %/year (men, 8.2 [12.4] %/year; women, 7.3 [13.7] %/year). Multivariate regression analysis indicated that higher bone mineral density at lumbar spine L2-4 (p = 0.05) and total daily energy intake (p = 0.04) were significantly associated with the change rate of the 25D levels. CONCLUSIONS The serum levels of 25D tended to increase over the 3-year period, and higher lumbar bone mineral density and daily energy intake were found to be associated with increases in the 25D levels over time.
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Affiliation(s)
- N Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - S Muraki
- Department of Clinical Motor System Medicine, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - S Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - H Kawaguchi
- JCHO Tokyo Shinjuku Medical Center, 5-1, Tsukudo-cho, Shinjyuku-ku, Tokyo, 162-8542, Japan
| | - K Nakamura
- National Rehabilitation Center for Persons with Disabilities, 1, Namiki 4-chome, Tokorozawa City, Saitama Prefecture, 359-8555, Japan
| | - T Akune
- National Rehabilitation Center for Persons with Disabilities, 1, Namiki 4-chome, Tokorozawa City, Saitama Prefecture, 359-8555, Japan
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Kruger MC, Chan YM, Kuhn-Sherlock B, Lau LT, Lau C, Chin YS, Todd JM, Schollum LM. Differential effects of calcium- and vitamin D-fortified milk with FOS-inulin compared to regular milk, on bone biomarkers in Chinese pre- and postmenopausal women. Eur J Nutr 2015; 55:1911-21. [PMID: 26264387 DOI: 10.1007/s00394-015-1007-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Accepted: 07/27/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To compare the effects of a high-calcium vitamin D-fortified milk with added FOS-inulin versus regular milk on serum parathyroid hormone, and bone turnover markers in premenopausal (Pre-M) and postmenopausal (PM) women over 12 weeks. METHODS Premenopausal women (n = 136, mean age 41 (±5) years) and postmenopausal women [n = 121, mean age 59 (±4) years] were recruited, and each age group randomised into two groups to take two glasses per day of control = regular milk (500 mg calcium per day) or intervention (Int) = fortified milk (1000 mg calcium for pre-M women and 1200 mg calcium for PM women, 96 mg magnesium, 2.4 mg zinc, 15 µg vitamin D, 4 g FOS-inulin per day). At baseline, week 4 and week 12 serum minerals and bone biochemical markers were measured and bone density was measured at baseline. RESULTS Mean 25-hydroxyvitamin D [25(OH) vitamin D3] levels among groups were between 49 and 65 nmol/L at baseline, and over the 12 weeks of supplementation, the fortified milk improved vitamin D status in both Int groups. CTx-1 and PINP reduced significantly in both Pre-M and PM groups over the 12 weeks, with the changes in CTx-1 being significantly different (P < 0.035) between PM control and PM Int groups at week 12. Parathyroid hormone levels were significantly reduced in all groups over time, except for control PM group where levels increased at 12 weeks. CONCLUSION The overall pattern of responses indicates that while both regular milk and fortified milk reduce bone resorption in young and older women, fortified milk is measurably more effective.
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Affiliation(s)
- Marlena C Kruger
- School of Food and Nutrition, Massey Institute of Food Science and Technology, Massey University, Private Bag 11222, Palmerston North, 4442, New Zealand.
| | - Yoke Mun Chan
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia.,Institute of Gerontology, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Lee Ting Lau
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - ChinChin Lau
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Y S Chin
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | | | - Linda M Schollum
- Fonterra Research and Development Centre, Palmerston North, New Zealand
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Nakamura K, Kitamura K, Takachi R, Saito T, Kobayashi R, Oshiki R, Watanabe Y, Tsugane S, Sasaki A, Yamazaki O. Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone 2015; 74:10-7. [PMID: 25576673 DOI: 10.1016/j.bone.2014.12.064] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 12/19/2014] [Accepted: 12/31/2014] [Indexed: 12/19/2022]
Abstract
BACKGROUND Little is known about correlates of vitamin D status in Asian populations. In this study, we established the prevalence of vitamin D sufficiency in the Murakami region (latitude N38°13') in Niigata, Japan, and examined demographic, environmental, and lifestyle factors that might be associated with vitamin D sufficiency, with the aim of clarifying the relative contributions of previously described determinants of vitamin D status as well as identifying new determinants in this Japanese population. METHODS This study involved a cross-sectional analysis of baseline data obtained from a cohort study conducted in 2011-2013. Participants were 9084 individuals aged between 40 and 74 years who provided blood samples for the determination of plasma 25-hydroxyvitamin D [25(OH)D] concentrations. Lifestyle information was obtained from 8498 participants, with some missing values regarding different lifestyle factors. Multiple logistic regression analysis was used to obtain odds ratios for vitamin D sufficiency, which was defined as a plasma 25(OH)D concentration ≥ 75 nmol/L. RESULTS The prevalence of vitamin D sufficiency (i.e., plasma 25(OH)D concentration ≥ 75 nmol/L) was 9.1%, and significant associations were observed with male gender (P<0.0001; OR=2.37, 95% CI: 1.84-3.05), older age (P for trend <0.0001), lower BMI (P for trend <0.0001), higher METs score (P for trend=0.0138), higher vitamin D intake (P for trend=0.0467), summer season (P for trend <0.0001), longer duration outdoors (P for trend=0.0026), no sunscreen use (P=0.0135; OR=1.40, 95% CI: 1.07-1.82), higher salmon consumption (P for trend <0.0001), higher alcohol consumption (P for trend <0.0001), and lower coffee consumption (P for trend=0.0025). Unlike other populations previously reported, vitamin D sufficiency was associated with older age. CONCLUSIONS The prevalence of vitamin D sufficiency (i.e., 25[OH]D ≥ 75 nmol/L) was low (9.1%) in this Japanese population. A number of demographic, environmental, and lifestyle factors are associated with vitamin D sufficiency, and thus lifestyle modification may present an opportunity to achieve vitamin D sufficiency.
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Affiliation(s)
- K Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan.
| | - K Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - R Takachi
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - T Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata City 951-3198, Japan
| | - R Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata City 951-3198, Kita-ku, Japan
| | - R Oshiki
- Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Niigata City 951-3198, Kita-ku, Japan
| | - Y Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata City 951-8510, Japan
| | - S Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - A Sasaki
- Murakami Public Health Center, 10-15 Sakanamachi, Murakami, Niigata 958-0864, Japan
| | - O Yamazaki
- Niigata Prefectural Office, 4-1 Shinkocho, Chuo-ku, Niigata City 950-0965, Japan
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Hao Y, Ma X, Luo Y, Xu Y, Xiong Q, Zhu J, Bao Y, Jia W. Inverse association of serum vitamin D in relation to carotid intima-media thickness in Chinese postmenopausal women. PLoS One 2015; 10:e0122803. [PMID: 25822845 PMCID: PMC4378918 DOI: 10.1371/journal.pone.0122803] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 02/13/2015] [Indexed: 01/13/2023] Open
Abstract
Objective This study aimed to investigate the relationship between serum vitamin D level and carotid intima-media thickness (C-IMT) in Chinese postmenopausal women. Methods Nine hundred and twenty six Chinese postmenopausal women without carotid artery plaque or history of cardiovascular disease were selected for analysis. Measurements of serum 25 hydroxyvitamin D3 (25(OH)D3) concentration and C-IMT were made by electrochemiluminescence immunoassay and B-mode ultrasound, respectively. Trend analysis was conducted according to tertiles of C-IMT. Results The median serum 25(OH)D3 level was 11.03 ng/mL, with an interquartile range of 8.22–14.70. A decreasing trend of serum 25(OH)D3 level was accompanied by increased C-IMT tertiles (P for trend = 0.001). Correlation analysis found an inverse relationship between serum 25(OH)D3 level and C-IMT (r = –0.113, P = 0.001). After adjustment for confounding factors, multiple regression analysis showed that serum 25(OH)D3 level independently and negatively associated with C-IMT (Standard β = –0.112, P < 0.001). Moreover, the inverse correlation of serum 25(OH)D3 with C-IMT was also found in a subgroup of women with normal glucose tolerance, blood pressure and body mass index, and without undergoing lipid-lowering therapy (standard β = –0.140, P = 0.018). Conclusions Serum 25(OH)D3 level was inversely correlated with C-IMT in Chinese postmenopausal women.
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Affiliation(s)
- Yaping Hao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yuqi Luo
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Qin Xiong
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
| | - Jiaan Zhu
- Department of Ultrasound, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Institute of Ultrasound in Medicine, Shanghai 200233, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
- * E-mail:
| | - Weiping Jia
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital; Shanghai Clinical Center for Diabetes; Shanghai Key Clinical Center for Metabolic Disease; Shanghai Diabetes Institute; Shanghai Key Laboratory of Diabetes Mellitus, Shanghai 200233, China
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Ohta H, Hamaya E, Taketsuna M, Sowa H. Quality of life in Japanese women with postmenopausal osteoporosis treated with raloxifene and vitamin D: post hoc analysis of a postmarketing study. Curr Med Res Opin 2015; 31:85-94. [PMID: 25299349 DOI: 10.1185/03007995.2014.975339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To assess the effect of active vitamin D3 on quality of life (QOL) and pain in raloxifene-treated Japanese women with postmenopausal osteoporosis. RESEARCH DESIGN AND METHODS This is a post hoc analysis of a previous prospective postmarketing observational study conducted without a comparator group. This study was conducted in 60 Japanese hospitals from September 2007 to February 2009. We compared changes from baseline in QOL and pain in patients receiving raloxifene plus active vitamin D3 with those in patients receiving raloxifene monotherapy at 8 and 24 weeks after treatment. CLINICAL TRIAL REGISTRATION Japan Pharmaceutical Information Center (JapicCTI-070465). MAIN OUTCOME MEASURES QOL and pain were assessed using Short Form-8 (SF-8), European Quality of Life Instrument 5 Dimensions (EQ-5D), Japanese Osteoporosis Quality of Life Questionnaire (JOQOL), visual analogue pain scales (VAS pain), and pain frequency scores. RESULTS A total of 506 patients were included in the post hoc analysis. Both raloxifene monotherapy (RLX, n = 354) and active vitamin D3 cotreatment (COMBI, n = 152) significantly improved QOL and reduced pain from the baseline at Week 8 and Week 24. The COMBI group had significantly greater improvements in JOQOL total score and activity of daily living (total) domain at Week 24 and last observation carried forward (LOCF) than the RLX group. The COMBI group also had significantly greater improvements in SF-8 domains of general health (at Week 8, Week 24, and LOCF), role physical (at Week 24 and LOCF), and mental health (at LOCF) than the RLX group. The COMBI group also had significantly greater reduction in VAS pain at LOCF than the RLX group (mean [SD]: RLX = -0.99 [2.72], COMBI = -1.54 [2.21], P = 0.042). CONCLUSIONS Active vitamin D3 supplementation to raloxifene treatment for 24 weeks may have additional benefits in improving QOL and relieving pain in Japanese women with postmenopausal osteoporosis.
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Affiliation(s)
- Hiroaki Ohta
- Clinical Medical Research Center, International University of Health and Welfare, Women's Medical Center, Sanno Medical Center , Tokyo , Japan
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Urban-rural differences explain the association between serum 25-hydroxyvitamin D level and insulin resistance in Korea. Nutrients 2014; 6:5806-18. [PMID: 25514561 PMCID: PMC4277000 DOI: 10.3390/nu6125806] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 10/09/2014] [Accepted: 11/24/2014] [Indexed: 12/31/2022] Open
Abstract
An increasing number of studies report associations between low serum 25-hydroxyvitamin D [25(OH)D] level and insulin resistance; however, whether low vitamin D levels directly contribute to increased insulin resistance is unclear. We investigated the impact of residential area on the association between 25(OH)D and insulin resistance in elderly Koreans. Using data from the Korean Urban Rural Elderly study, we conducted cross-sectional analyses in 1628 participants (505 men and 1123 women). Serum 25(OH)D was analyzed as both continuous and categorized variables. Homeostasis model assessment for insulin resistance (HOMA-IR) was calculated using fasting blood glucose and insulin levels. In men, 25(OH)D level was inversely associated with HOMA-IR (standardized β = −0.133, p < 0.001) after adjustment for age, body mass index, waist circumference, smoking, alcohol intake, exercise, and study year. However, we noted significant urban-rural differences in 25(OH)D level (43.4 versus 65.6 nmol/L; p < 0.001) and HOMA-IR (1.2 versus 0.8 mmol·pmol/L2; p < 0.001). When we additionally adjusted for residential area, the association between 25(OH)D and HOMA-IR was attenuated (standardized β = −0.063, p = 0.115). In women, the association between 25(OH)D and HOMA-IR was not significant before or after adjustment for residential area. Environmental or lifestyle differences in urban and rural areas may largely explain the inverse association between serum 25(OH)D and insulin resistance.
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Siwamogsatham O, Ongphiphadhanakul B, Tangpricha V. Vitamin D deficiency in Thailand. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2014; 2:48-49. [PMID: 29159109 PMCID: PMC5685050 DOI: 10.1016/j.jcte.2014.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
| | | | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle NE, WMRB1301, Atlanta, GA, 30322, USA
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Shin DY, Kim S, Park S, Koh JS, Kim CH, Baek H, Yang SH, Na II. Serum 25-hydroxyvitamin D levels correlate with EGFR mutational status in pulmonary adenocarcinoma. Endocr Relat Cancer 2014; 21:715-21. [PMID: 25030993 DOI: 10.1530/erc-14-0259] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
There have been several epidemiological studies of the association between 25-hydroxyvitamin D (25(OH)D) level and lung cancer risk. We explored the potential association between serum 25(OH)D levels and mutations in epidermal growth factor receptor (EGFR) in patients with pulmonary adenocarcinoma. We analyzed clinical data from 135 patients whose serum 25(OH)D levels were measured and EGFR mutational status was tested at the time of diagnosis. The relationship between 25(OH)D and clinical factors such as EGFR mutational status and sex was examined. The median serum 25(OH)D level in patients with pulmonary adenocarcinoma was 16.8 ng/ml (range: 3.0-84.3 ng/ml). The level of 25(OH)D was lower in female patients than in male patients (P=0.03). Interestingly, 25(OH)D levels of patients with EGFR-mutated tumors were low compared with those with wild-type tumors (median 18.2 vs 14.7 ng/ml, P=0.011). After a dose-response relationship between EGFR mutations and 25(OH)D levels (as a continuous variable) was observed (OR=0.96, P=0.036), we categorized 25(OH)D levels as low (≤16.8 ng/ml) and high (>16.8 ng/ml). Multivariate analysis revealed the association between low 25(OH)D levels and a high incidence of EGFR mutations (adjusted OR=2.42, 95% CI: 1.11-5.26, P=0.026). The results from this study indicate that low 25(OH)D levels are associated with EGFR mutations in pulmonary adenocarcinoma.
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Affiliation(s)
- Dong-Yeop Shin
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Soyeun Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sunhoo Park
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Jae Soo Koh
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Cheol Hyeon Kim
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - HeeJong Baek
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sung Hyun Yang
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Im Il Na
- Division of Hematology/OncologyDepartment of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, 75 Nowon-gil, Nowon-gu, Seoul 139-706, Republic of KoreaDepartment of Family MedicineDepartment of PathologyDivision of PulmonologyDepartment of Internal MedicineDepartment of Thoracic SurgeryKorea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
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Hwang JS, Tsai KS, Cheng YM, Chen WJ, Tu ST, Lu KH, Hou SM, Yang SH, Cheng H, Lai HJ, Lei S, Chen JF. Vitamin D status in non-supplemented postmenopausal Taiwanese women with osteoporosis and fragility fracture. BMC Musculoskelet Disord 2014; 15:257. [PMID: 25069806 PMCID: PMC4118264 DOI: 10.1186/1471-2474-15-257] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Accepted: 07/14/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D is essential for calcium metabolism, Vitamin D deficiency can precipitate osteoporosis, cause muscle weakness and increase the risk of fracture. The aim of this study was to assess the prevalence of vitamin D inadequacy among non-supplemented postmenopausal women with osteoporosis and fragility fractures of the hip or vertebrae in Taiwan. METHODS This multi-center, cross-sectional, observational study analyzed the vitamin D inadequacy [defined as 25(OH) D level less than 30 ng/mL] in Taiwanese postmenopausal osteoporotic patients who suffered from a low trauma, non-pathological fragility hip or vertebral fracture that received post-fracture medical care when admitted to hospital or at an outpatient clinic. RESULTS A total of 199 patients were enrolled at 8 medical centers in Taiwan; 194 patients met the study criteria with 113 (58.2%) and 81 (41.8%) patients diagnosed with hip and vertebral fracture, respectively. The mean serum 25(OH) D level was 21.1 ± 9.3 ng/mL, resulting in a prevalence of vitamin D inadequacy of 86.6% of the patients. CONCLUSIONS High prevalence of vitamin D inadequacy across all age groups was found among non-supplemented women with osteoporosis and fragility hip or vertebral fracture in Taiwan.
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Affiliation(s)
- Jawl-Shan Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan
| | - Keh-Sung Tsai
- Department of Laboratory Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yuh-Min Cheng
- Department of Orthopaedic Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - Wen-Jer Chen
- Department of Orthopedics, Chang Gung Memorial Hospital, Chang Gung University, Linkou, Taiwan
| | - Shih-Te Tu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Ko-Hsiu Lu
- Department of Orthopedics, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Sheng-Mou Hou
- Department of Orthopedics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Shu-Hua Yang
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Henrich Cheng
- Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hung Jen Lai
- Medical Department, Merck Sharp & Dohme (I.A.) Corp. Taiwan Branch, Taipei, Taiwan
| | - Sharon Lei
- Medical Department, Merck Sharp & Dohme (I.A.) Corp. Taiwan Branch, Taipei, Taiwan
| | - Jung-Fu Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 123, Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung, Taiwan
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Kim KJ, Min YK, Koh JM, Chung YS, Kim KM, Byun DW, Kim IJ, Kim M, Kim SS, Min KW, Han KO, Park HM, Shin CS, Choi SH, Park JS, Chung DJ, Mok JO, Baek HS, Moon SH, Kim YS, Lim SK. Efficacy and safety of weekly alendronate plus vitamin D₃ 5600 IU versus weekly alendronate alone in Korean osteoporotic women: 16-week randomized trial. Yonsei Med J 2014; 55:715-24. [PMID: 24719139 PMCID: PMC3990072 DOI: 10.3349/ymj.2014.55.3.715] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 08/20/2013] [Accepted: 09/02/2013] [Indexed: 12/31/2022] Open
Abstract
Vitamin D (vit-D) is essential for bone health, although many osteoporosis patients have low levels of 25-hydroxy-vit-D [25(OH)D]. This randomized, open-label study compared the effects of once weekly alendronate 70 mg containing 5600 IU vit-D₃ (ALN/D5600) to alendronate 70 mg without additional vit-D (ALN) on the percent of patients with vit-D insufficiency [25(OH)D <15 ng/mL, primary endpoint] and serum parathyroid hormone (PTH, secondary endpoint) levels in postmenopausal, osteoporotic Korean women. Neuromuscular function was also measured. A total of 268 subjects were randomized. Overall, 35% of patients had vit-D insufficiency at baseline. After 16-weeks, there were fewer patients with vit-D insufficiency in the ALN/D5600 group (1.47%) than in the ALN group (41.67%) (p<0.001). Patients receiving ALN/D5600 compared with ALN were at a significantly decreased risk of vit-D insufficiency [odds ratio=0.02, 95% confidence interval (CI) 0.00-0.08]. In the ALN/D5600 group, significant increases in serum 25(OH)D were observed at weeks 8 (9.60 ng/mL) and 16 (11.41 ng/mL), where as a significant decrease was recorded in the ALN group at week 16 (-1.61 ng/mL). By multiple regression analysis, major determinants of increases in serum 25(OH)D were ALN/D5600 administration, seasonal variation, and baseline 25(OH)D. The least squares mean percent change from baseline in serum PTH in the ALN/D5600 group (8.17%) was lower than that in the ALN group (29.98%) (p=0.0091). There was no significant difference between treatment groups in neuromuscular function. Overall safety was similar between groups. In conclusion, the administration of 5600 IU vit-D in the ALN/D5600 group improved vit-D status and reduced the magnitude of PTH increase without significant side-effects after 16 weeks in Korean osteoporotic patients.
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Affiliation(s)
- Kwang Joon Kim
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Severance Executive Healthcare Clinic, Severance Hospital, Yonsei University Health System, Seoul, Korea
- Severance Check-up, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung-Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea
| | - Kyoung Min Kim
- Division of Endocrinology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Dong-Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - In Joo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mikyung Kim
- Division of Endocrinology, Department of Internal Medicine, Maryknoll Medical Center, Busan, Korea
| | - Sung-Soo Kim
- Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Kyung Wan Min
- Department of Endocrinology and Metabolism, Eulji University College of Medicine, Seoul, Korea
| | - Ki Ok Han
- Division of Endocrinology, Department of Internal Medicine, Cheil General Hospital and Woman's Health Center, Kwandong University School of Medicine, Seoul, Korea
| | - Hyoung Moo Park
- Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jong Suk Park
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Jin Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Ji Oh Mok
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Hong Sun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Seong-Hwan Moon
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Soo Kim
- MSD Korea Ltd., Global Medical Affairs, Seoul, Korea
| | - Sung-Kil Lim
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Yoo TK, Oh E, Hong S. Is vitamin D status associated with open-angle glaucoma? A cross-sectional study from South Korea. Public Health Nutr 2014; 17:833-43. [PMID: 24476947 PMCID: PMC10282225 DOI: 10.1017/s1368980013003492] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/13/2013] [Accepted: 11/18/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Open-angle glaucoma (OAG) is one of the major chronic diseases involving the optic nerve. However, little is known about the association between vitamin D and OAG. The present study was conducted to test the hypothesis that lower vitamin D status is associated with greater prevalence of OAG. DESIGN Cross-sectional study. Multivariable logistic regression was performed to examine the relationship between serum 25-hydroxyvitamin D (25(OH)D) and OAG after adjusting for traditional potential confounders. OAG was defined by the criteria of the International Society for Geographical and Epidemiological Ophthalmology. SETTING The Fifth Korean National Health and Nutrition Examination Survey conducted in 2010-2011. SUBJECTS Six thousand and ninety-four adult participants randomly selected from 192 surveys in 131 locations in South Korea. RESULTS Multivariable-adjusted odds ratios of OAG across quintiles of decreasing 25(OH)D were 1.26, 1.00 (reference), 1.31, 1.36 and 1.69 (P for quadratic trend <0.01). The odds ratio for the lowest 25(OH)D quintile was significantly higher than that for the second quintile (P < 0.01). In addition, we discovered that the predictors for worsening of OAG, such as intraocular pressure or vertical and horizontal cup-to-disc ratios, had a significant relationship with 25(OH)D level. CONCLUSIONS There was a reverse J-shaped association between 25(OH)D levels and the risk of OAG, with significantly elevated risk at lower 25(OH)D. The findings of this research suggest that vitamin D deficiency should be considered as a potential risk factor for the development of OAG. To our knowledge, the present study is the first one that shows an association between vitamin D status and OAG.
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Affiliation(s)
- Tae Keun Yoo
- Department of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
- Department of Medical Engineering, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ein Oh
- Department of Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Republic of Korea
| | - Samin Hong
- Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Republic of Korea
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Cheung E, Bow C, Loong C, Lee KK, Ho AYY, Soong C, Chan YY, Tan KCB, Kung AWC. A secular increase in BMD in Chinese women. J Bone Miner Metab 2014; 32:48-55. [PMID: 23636506 DOI: 10.1007/s00774-013-0463-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 03/19/2013] [Indexed: 02/04/2023]
Abstract
Population-based studies have revealed a decline in the incidence of age-adjusted hip fractures in southern Chinese women during the past decade. To determine whether there was a secular change in population characteristics that accounted for this decline, we compared the bone mineral density (BMD) and lifestyle habits of two cohorts of women who were more than 50 years of age and who were recruited from 1995 to 2000 and 2005 to 2010. The BMD levels in the 2005-2010 cohort were significantly higher at the spine and hip and ranged from 3.6 to 17.8% among the different age groups. Additionally, a significantly lower prevalence of subjects with osteoporosis and osteopenia was observed. Longer reproductive years, higher levels of physical activity, higher estradiol and 25(OH) vitamin D levels, and lower alkaline phosphatase levels were found in the 2005-2010 cohort. After adjusting for bone-determining factors, significant differences were detected in the BMD levels at the lumbar spine, femoral neck, and total hip (4.17, 9.02, and 9.34%, respectively) in women >50 years of age but not in women ≤50 years of age. The secular increase in BMD and healthier lifestyles most likely led to the decline in the incidence of age-adjusted fractures.
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Affiliation(s)
- Elaine Cheung
- Department of Medicine, The University of Hong Kong and Queen Mary Hospital, Hospital Authority, Hong Kong, China
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Yoshimura N, Muraki S, Oka H, Morita M, Yamada H, Tanaka S, Kawaguchi H, Nakamura K, Akune T. Profiles of vitamin D insufficiency and deficiency in Japanese men and women: association with biological, environmental, and nutritional factors and coexisting disorders: the ROAD study. Osteoporos Int 2013; 24:2775-87. [PMID: 23673463 DOI: 10.1007/s00198-013-2372-z] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 04/09/2013] [Indexed: 12/12/2022]
Abstract
UNLABELLED Assessments of serum 25-hydroxyvitamin D levels in 1,683 Japanese from a population-based cohort revealed prevalences of vitamin D insufficiency and deficiency were 81.3 and 1.2%, respectively. Vitamin D deficiency was significantly associated with female sex, examined month, current smoking, lack of regular walking, higher intact parathyroid hormone (iPTH), and poor daily vitamin D intake. INTRODUCTION To clarify the characteristics of subjects with vitamin D insufficiency and deficiency among men and women in the general Japanese population. METHODS We initiated research on osteoarthritis/osteoporosis against disability (ROAD), a large-scale population-based cohort study, in 2005-2007. Blood examination was performed to measure serum 25-hydroxyvitamin D (25D) and iPTH levels and biochemical markers of bone turnover in 1,683 participants (595 men, 1,088 women). Participants completed an interviewer-administered questionnaire, measurements of bone mineral density, and x-ray examination. Vitamin D deficiency and insufficiency were defined by serum 25D levels <10 and ≥10 but <30 ng/mL, respectively. RESULTS The prevalence of vitamin D insufficiency and deficiency was 81.3 and 1.2%, respectively. Multinominal logistic regression analyses using potentially confounding variables revealed vitamin D insufficiency was significantly associated with age (+1 year, relative risk ratio, 0.98; 95% confidence interval, 0.96-0.99), gender (women vs. men, 2.28; 1.59-3.30), residing areas (coastal area vs. mountainous area, 0.58; 0.41-0.81), examined month (October, November, December vs. January, 0.51; 0.34-0.76), and serum levels of iPTH (+1 pg/mL, 1.02; 1.01-1.03). Vitamin D deficiency was significantly characterised by female sex (20.5; 3.1-136.7), examined month (0.28; 0.09-0.95), current smoking habit (6.39; 1.78-23.0), lack of regular outside walking (3.96; 1.34-11.7), higher iPTH (1.02; 1.01-1.03) and poor daily vitamin D intake (+10 μg/day, 0.48; 0.24-0.93). CONCLUSIONS A high prevalence of vitamin D insufficiency and a low prevalence of vitamin D deficiency were found in Japanese men and women, and the characteristics of vitamin D status were clarified.
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Affiliation(s)
- N Yoshimura
- Department of Joint Disease Research, 22nd Century Medical and Research Center, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,
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Current daily glucocorticoid use and serum creatinine levels are associated with lower 25(OH) vitamin D levels in Thai patients with systemic lupus erythematosus. J Clin Rheumatol 2013; 19:121-5. [PMID: 23519176 DOI: 10.1097/rhu.0b013e318289bd16] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND OBJECTIVE Because vitamin D deficiency has been previously reported in patients with systemic lupus erythematosus (SLE), we decided to examine the prevalence of vitamin D deficiency in Thai SLE patients, to identify possible independent factors affecting serum 25-hydroxyvitamin D(2) and D(3) [25(OH)] vitamin D levels, and to examine the associations of serum 25(OH) vitamin D and disease activity and damage in Thai SLE patients. METHODS A cross-sectional study was performed in 101 SLE patients. Blood samples were prospectively collected. The levels of 25(OH) vitamin D were measured by radioimmunoassay. The cutoffs for vitamin D deficiency and insufficiency were 30 and 20 ng/mL, respectively. Demographic, clinical, and laboratory data were collected, and their associations with 25(OH) vitamin D level were examined by univariate and multivariate linear regression analyses. RESULTS The level of 25(OH) vitamin D (mean [SD]) was 27.9 (7.6). Seventeen patients (17%) had vitamin D deficiency, 41 patients (41%) had vitamin D insufficiency, and 43 patients (42%) had normal vitamin D levels. Two thirds of the patients were taking relatively low-dose vitamin D supplementations. Current daily glucocorticoid dose and serum creatinine levels were negatively correlated with vitamin D levels (β = -0.207, P = 0.023; and β = -3.770, P = 0.003, respectively). There were no associations between disease activity or damage and 25(OH) vitamin D levels. CONCLUSIONS Vitamin D deficiency and insufficiency are common in SLE patients despite more than half of them taking vitamin D supplementations. Higher serum creatinine level and higher current daily glucocorticoid dose are associated with lower serum 25(OH) vitamin D levels. These patients may require higher doses of vitamin D supplementations.
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Liu ZM, Woo J, Wu SH, Ho SC. The role of vitamin D in blood pressure, endothelial and renal function in postmenopausal women. Nutrients 2013; 5:2590-610. [PMID: 23839167 PMCID: PMC3738990 DOI: 10.3390/nu5072590] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Revised: 06/25/2013] [Accepted: 06/26/2013] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vitamin D is a pro-hormone that plays an essential role in the vasculature and in kidney function. AIMS To review the extra-skeletal effects of vitamin D on blood pressure, endothelial and renal function with emphasis on recent findings in postmenopausal women. METHODS Included in this review was a PubMed database search for English language articles through March 2013. This review discussed the physiology and definition of vitamin D deficiency, the recent evidence for the role vitamin D in blood pressure, vascular and renal function. RESULTS Experimental and epidemiological data suggest that vitamin D plays an important role in the vasculature and in kidney function. Low vitamin D concentrations appear to significantly associate with hypertension, endothelial and renal dysfunction. However, the results of clinical trials have generally been mixed. Studies specifically conducted among postmenopausal women are limited and findings are still inconsistent. CONCLUSIONS Definitive studies are warranted to elucidate the effects of vitamin D supplementation on vascular and renal function and a more detailed work is needed to outline the route, duration and optimal dose of supplementation. It is premature to recommend vitamin D as a therapeutic option in the improvement of vascular and renal function at the current stage.
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Affiliation(s)
- Zhao-Min Liu
- Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR, 999077, China; E-Mail:
| | - Jean Woo
- Department of Medicine & Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR, 999077, China; E-Mail:
| | - Sheng-Hui Wu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203-1738, USA; E-Mail:
| | - Suzanne C. Ho
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong SAR, 999077, China
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Hilmi I, Sunderesvaran K, Ananda V, Sarji SA, Arumugam K, Goh KL. Increased fracture risk and osteoporosis not associated with vitamin D levels in Malaysian patients with inflammatory bowel disease. J Clin Endocrinol Metab 2013; 98:2415-21. [PMID: 23553858 DOI: 10.1210/jc.2013-1147] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Osteoporosis and osteopenia are well-recognized complications of inflammatory bowel disease. Previous studies have suggested that vitamin D deficiency is an important risk factor for the development of osteoporosis. We hypothesized that low vitamin D levels is the main reason for reduced bone mineral density in patients with inflammatory bowel disease. We aimed to study its potential role in Malaysia, which is a tropical country with 3 large ethnic groups. We also sought to examine the relationship between fracture risk and bone mineral density in this group. METHODOLOGY Relevant history as well as 25-hydroxycholecalciferol (vitamin D) levels and bone mineral density were obtained. Normal, inadequate, and low vitamin D levels were defined as 61-160 nmol/L (24-64 ng/mL), 30-60 nmol/L (12-24 ng/mL), and less than 30 nmol/L (<12 ng/mL), respectively. RESULTS Seventy-two patients were recruited. The prevalence of osteopenia and osteoporosis, respectively, were 58% and 17% in the spine and 51% and 14% in the hip. Mean vitamin D level in the group was low at 45.12 ± 17.4 nmol/L (18.05 ± 6.96 ng/mL), but there was no significant association between bone mineral density and vitamin D level. Twelve patients (16.7%) had a fragility fracture after the diagnosis of inflammatory bowel disease. The cumulative fracture incidence was 10% at 5 years and 35% at 10 years. There was a statistically significant association between osteoporosis of hip and a history of fracture (odds ratio 5.889; 95% confidence interval 1.41-24.53, P = .009). CONCLUSION Osteoporosis is prevalent among Malaysian patients with inflammatory bowel disease and is associated with a 6-fold increased risk of fractures. Most inflammatory bowel disease patients had inadequate or low vitamin D levels, but there was no association between vitamin D levels and BMD.
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Affiliation(s)
- Ida Hilmi
- Division of Gastroenterology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Lim S, Kim MJ, Choi SH, Shin CS, Park KS, Jang HC, Billings LK, Meigs JB. Association of vitamin D deficiency with incidence of type 2 diabetes in high-risk Asian subjects. Am J Clin Nutr 2013; 97:524-30. [PMID: 23364011 PMCID: PMC3578401 DOI: 10.3945/ajcn.112.048496] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Recent studies suggest an association between 25-hydroxyvitamin D [25(OH)D] and type 2 diabetes (T2D) risk. However, prospective studies investigating the relation between vitamin D inadequacy and incidence of T2D incorporating obesity and dynamic measures of insulin resistance (IR) and pancreatic β cell function are limited. OBJECTIVE We tested the hypothesis that baseline 25(OH)D is associated with the incidence of T2D in high-risk subjects for up to 5 y of follow-up, independently of obesity, baseline IR, and β cell function. DESIGN We recruited 1080 nondiabetic Korean subjects [mean ± SD age: 49.5 ± 11.4 y] based on the presence of one or more risk factors for T2D, including obesity, hypertension, dyslipidemia, and/or family history of T2D. We measured anthropometric and biochemical indicators, HOMA2-IR, and the insulinogenic index (IGI; calculated as change in insulin at 30 min/change in glucose at 30 min) from a 75-g oral-glucose-tolerance test. RESULTS Of the participants, 10.5% had a serum 25(OH)D deficiency (<10 ng/mL), 51.6% had an insufficiency (10.0-19.9 ng/mL), and 38.0% had a sufficiency (≥20 ng/mL), and the incidence of T2D at 32.3 ± 15.6 mo (±SD) declined accordingly: 15.9%, 10.2%, and 5.4%, respectively (P < 0.001). After adjustment for age, sex, blood pressure, lifestyles, family history, season, parathyroid hormone, and high-sensitivity C-reactive protein, the participants with 25(OH)D deficiency had an increased risk of T2D independently of BMI, HOMA2-IR, and IGI; the HRs were 2.06 (95% CI: 1.22, 3.49) for 25(OH)D 10-19.9 ng/mL compared with ≥20 ng/mL and 3.23 (95% CI: 1.66, 6.30) for 25(OH)D <10 ng/mL compared with ≥20 ng/mL. CONCLUSION The current prospective study suggests that vitamin D metabolism may play a role in T2D pathogenesis independently of known risk factors. This trial was registered at clinicaltrials.gov as NCT01508481.
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Affiliation(s)
- Soo Lim
- Seoul National University College of Medicine, Seongnam, Korea
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Wang C. Role of vitamin d in cardiometabolic diseases. J Diabetes Res 2013; 2013:243934. [PMID: 23671861 PMCID: PMC3647592 DOI: 10.1155/2013/243934] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/09/2013] [Accepted: 01/09/2013] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency is a highly prevalent condition. Low vitamin D levels have long been associated with bone diseases, such as rickets in children and osteomalacia and osteoporosis in adults. However, it has become apparent in recent years that adequate vitamin D levels are also important for optimal functioning of many organs and tissues throughout the body, including the cardiovascular system. Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). Studies have shown that low vitamin D levels are associated with hypertension, diabetes, metabolic syndrome, left ventricular hypertrophy, and chronic vascular inflammation, all of which are risk factors for CVD. This paper reviews the definition and pathophysiology of vitamin D deficiency, clinical evidence linking vitamin D and CVD risk, diabetes and its complications, and metabolic syndrome.
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Affiliation(s)
- Chaoxun Wang
- Department of Endocrinology, Shanghai Pudong Hospital, 2800 Gongwei Road, Huinan Town, Pudong, Shanghai 201399, China
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Qiao Z, Li-xing S, Nian-chun P, Shu-jing X, Miao Z, Hong L, Hui-jun Z, Ming-xian G, Song Z, Rui W, Ying H, Jing-lu Z, Shuang C. Serum 25(OH)D Level and Parathyroid Hormone in Chinese Adult Population: A Cross-Sectional Study in Guiyang Urban Community from Southeast of China. Int J Endocrinol 2013; 2013:150461. [PMID: 24065989 PMCID: PMC3771443 DOI: 10.1155/2013/150461] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 03/14/2013] [Accepted: 07/11/2013] [Indexed: 11/17/2022] Open
Abstract
Objective. To evaluate vitamin D status and serum parathyroid hormone (IPTH) of healthy adults living in Guiyang. Design and Participants. We conducted a cross-sectional evaluation in the General Community in Guiyang by cluster sampling method. The data was a part of 1510 participants (634 men, 876 women) aged 20-79 years median 45.2 years from November 2009 to February 2010 in Guiyang Health Measures Survey. Measurements. Aradioimmunoassay was used to measure the level of 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone (iPTH). Results.The mean serum 25(OH)D level was (20.4 ± 9.0) ng/mL and the highest level among participants aged 40-59 years (22.8 ng/mL). The mean serum PTH level was (32.1 ± 13.7) pg/mL and the lowest level among participants aged 40-50 years (30.8 ng/mL). Serum 25(OH)D was below 50 nmol/liter in 52.3%, below 75 nmol/liter in 84.6%, and above 75 nmol/liter in 15.4% of the respondents. Secondary hyperparathyroidism was 5.4% (5.4% among men and 4.6% among women). The prevalence of secondary hyperparathyroidism increased (5.8%, 6.5%, and 7.1%, resp.) with decreasing serum 25(OH)D levels among subjects who were 30 to 20, 19.9 to 10, and <10 ng/mL, respectively. Serum 25(OH)D was inversely associated with serum PTH. Conclusions. Vitamin D insufficiency and its complication of secondary hyperparathyroidism are common.
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Affiliation(s)
- Zhang Qiao
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Shi Li-xing
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
- *Shi Li-xing:
| | - Peng Nian-chun
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Xu Shu-jing
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Zhang Miao
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Li Hong
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Zhuang Hui-jun
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Gong Ming-xian
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Zhang Song
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Wang Rui
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Hu Ying
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Zhang Jing-lu
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
| | - Chen Shuang
- Department of Endocrinology, The Hospital Affiliated to Guiyang Medical College, Guiyang 550004, China
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Nguyen HTT, von Schoultz B, Nguyen TV, Dzung DN, Duc PTM, Thuy VT, Hirschberg AL. Vitamin D deficiency in northern Vietnam: prevalence, risk factors and associations with bone mineral density. Bone 2012; 51:1029-34. [PMID: 22878155 DOI: 10.1016/j.bone.2012.07.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 05/26/2012] [Accepted: 07/05/2012] [Indexed: 12/17/2022]
Abstract
PURPOSE Vitamin D deficiency has been linked to osteoporosis and also to the risk of cancer, autoimmune disorders and cardiovascular diseases. This study sought to determine the prevalence of, and risk factors for, vitamin D deficiency and its relationship with bone mineral density (BMD) in a Vietnamese population. METHODS This cross-sectional study involved 269 women and 222 men aged 13-83 years, who were randomly selected from urban and rural areas in northern Vietnam. Serum concentrations of 25-hydroxy-vitamin D [25(OH)D] and parathyroid hormone (PTH) were measured by electrochemiluminescence immunoassay. Vitamin D deficiency was defined as serum 25(OH)D levels below 20 ng/mL. BMD was measured by dual X-ray absorptiometry. RESULTS The prevalence of vitamin D deficiency in women was 30%, almost two-fold higher than in men (16%). Significant predictors of vitamin D deficiency in women were urban residency (p<0.01) and age less than 30 years (p<0.01), whereas use of contraceptive pills was protective (p<0.01). In men, winter season was the only significant predictor of vitamin D deficiency (p<0.01). In multiple linear regression analysis, serum levels of 25(OH)D were positively associated with BMD in both women (p<0.001) and men (p<0.001). CONCLUSIONS These data suggest that the prevalence of vitamin D deficiency is high in the Vietnamese population, and that part of this prevalence could be explained by low exposure to sunlight (urban residency and winter season). The high prevalence of vitamin D deficiency should raise the awareness of potentially important health issues such as osteoporosis within the Vietnamese society.
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Affiliation(s)
- Huong T T Nguyen
- Department of Women's and Children's Health, Karolinska Institutet, Sweden.
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Lee SH, Park SJ, Kim KM, Lee DJ, Kim WJ, Park RW, Joo NS. Effect of sunlight exposure on serum 25-hydroxyvitamin d concentration in women with vitamin d deficiency: using ambulatory lux meter and sunlight exposure questionnaire. Korean J Fam Med 2012; 33:381-9. [PMID: 23267424 PMCID: PMC3526721 DOI: 10.4082/kjfm.2012.33.6.381] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Accepted: 10/08/2012] [Indexed: 11/18/2022] Open
Abstract
Background Vitamin D is an important factor in human health. Yet, vitamin D deficiency is very common. We aimed to confirm serum 25-hydroxyvitamin D (25OHD) concentration change after sunlight exposure and to elucidate the relationship between the amount of sunlight exposure and serum 25OHD level change by ambulatory lux meter and sunlight exposure questionnaire. Methods Twenty healthy young women were enrolled. They were educated to obtain 20 minutes of sunlight exposure during weekdays from October to November, 2010, during which they were to wear an ambulatory lux meter on an arm. All subjects completed a one-week recall sunlight exposure questionnaire at the end of the study. Before and after sunlight exposure, serum 25OHD level was measured. Results Mean pre-exposure serum 25OHD concentration was 11.01 ng/mL. The mean change of pre- and post-exposure 25OHD level was -0.62 ng/mL, but it was not statistically significant. The mean personal sunlight exposure recorded by ambulatory lux meter, 292.6 lux/s, showed no significant relationship with average change of 25OHD and average weekly sunlight exposure score, 11.9, calculated by the sunlight exposure questionnaire. However, the mean change of serum 25OHD level and weekly sunlight exposure score showed significant negative correlation (r = -0.469, P = 0.037). Conclusion Change of serum 25OHD concentration after four weeks of sunlight exposure was not statistically significant in women with vitamin D deficiency. However, serum 25OHD concentration change was significantly negatively correlated with the sunlight exposure score by the questionnaire.
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Affiliation(s)
- Sang-Hoon Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
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Teriparatide therapy for bisphosphonate-associated osteonecrosis of the jaw in an elderly Japanese woman with severe osteoporosis. Clin Drug Investig 2012; 32:547-53. [PMID: 22734599 DOI: 10.1007/bf03261908] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
We report on the case of a severely osteoporotic elderly Japanese woman with bisphosphonate-associated osteonecrosis of the jaw (ONJ), who was treated successfully with teriparatide. A 79-year-old woman with severe osteoporosis and bisphosphonate-associated ONJ was treated with teriparatide after debridement of the necrotic tissue in the jaw bone. Computed tomography (CT) images revealed the bone defect in the mandible after debridement of the necrotic tissue associated with ONJ. According to the attending dentist, the ONJ healed after 2 months of therapy. After 3 months of treatment, a robust increase in the serum level of the bone formation marker, serum intact procollagen type 1 N-terminal propeptide, was noted and a repeat CT revealed improvement of the bone defect of the mandible. These results suggest the beneficial effects of teriparatide therapy in the severely osteoporotic elderly woman with ONJ.
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