1
|
Zittermann A, Zelzer S, Herrmann M, Gummert JF, Kleber M, Trummer C, Theiler-Schwetz V, Keppel MH, Maerz W, Pilz S. Determinants of circulating calcitriol in cardiovascular disease. J Steroid Biochem Mol Biol 2024; 241:106528. [PMID: 38677380 DOI: 10.1016/j.jsbmb.2024.106528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/28/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
Circulating calcitriol may contribute to the risk of cardiovascular disease (CVD), but its regulation in patients with CVD is poorly characterized. We therefore aimed to assess determinants of circulating calcitriol in these patients. We analyzed 2183 independent samples from a large cohort of patients scheduled for coronary angiography and 1727 independent samples from different other cohorts from patients with a wide range of CVDs, including heart transplant candidates, to quantify the association of different parameters with circulating calcitriol. We performed univariable and multivariable linear regression analyses using the mathematical function that fitted best with circulating calcitriol. In the multivariable analysis of the large single cohort, nine parameters remained significant, explaining 30.0 % (32.4 % after exclusion of 22 potential outliers) of the variation in circulating calcitriol (r=0.548). Log-transformed 25-hydroxyvitamin D [25(OH)D] and log-transformed glomerular filtration rate were the strongest predictors, explaining 17.6 % and 6.6 %, respectively, of the variation in calcitriol. In the analysis of the combined other cohorts, including heart transplant candidates, the multivariable model explained a total of 42.6 % (46.1 % after exclusion of 21 potential outliers) of the variation in calcitriol (r=0.653) with log-transformed fibroblast growth factor-23 and log-transformed 25(OH)D explaining 29.0 % and 6.2 %, respectively. Circulating 25(OH)D was positively and FGF-23 inversely associated with circulating calcitriol. Although significant, PTH was only a weak predictor of calcitriol in both analyses (<2.5 %). In patients with CVD, FGF-23 and 25(OH)D are important independent determinants of circulating calcitriol. The relative importance of these two parameters may vary according to CVD severity. Future studies should focus on the clinical importance of regulating circulating calcitriol by different parameters.
Collapse
Affiliation(s)
- A Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz, und Diabeteszentrum NRW, Ruhr-University Bochum, Bad Oeynhausen, 32545, Germany.
| | - S Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz 8036, Austria
| | - M Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz 8036, Austria
| | - J F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz, und Diabeteszentrum NRW, Ruhr-University Bochum, Bad Oeynhausen, 32545, Germany
| | - M Kleber
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology, Lipidology), Medical Faculty Mannheim, University of Heidelberg, Mannheim 68167, Germany; SYNLAB MVZ Humangenetik Mannheim, Mannheim 68163, Germany
| | - C Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz 8036, Austria
| | - V Theiler-Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz 8036, Austria
| | - M H Keppel
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz 8036, Austria
| | - W Maerz
- Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology, Lipidology), Medical Faculty Mannheim, University of Heidelberg, Mannheim 68167, Germany; SYNLAB MVZ Humangenetik Mannheim, Mannheim 68163, Germany; SYNLAB Holding, Deutschland GmbH, Mannheim, Augsburg 68159, Germany
| | - S Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz 8036, Austria
| |
Collapse
|
2
|
Walker KC, Pristed SG, Thorsteinsdottir F, Specht IO, Cohen A, Heitmann BL, Kesmodel US. Vitamin D 3 among neonates born after in vitro fertilization compared with neonates from the general population. Acta Obstet Gynecol Scand 2024; 103:1329-1338. [PMID: 38637997 PMCID: PMC11168265 DOI: 10.1111/aogs.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 04/20/2024]
Abstract
INTRODUCTION Sufficient levels of vitamin D have been associated with higher chances for both clinical pregnancy and live birth among women undergoing assisted reproductive techniques, whereas low levels of maternal vitamin D have been associated with preeclampsia and late miscarriage. In Denmark, subgroups at risk for low vitamin D levels, including neonates and toddlers, are recommended to use supplementation. The aim was to study the level of vitamin D3 among neonates born after in vitro fertilization compared with neonates from the general population. MATERIAL AND METHODS In this cohort study a random sample of 1326 neonates representing the general population and 1200 neonates conceived by in vitro fertilization born in Denmark from 1995 to 2002 were identified from registries covering the whole Danish population. Information on use of assisted reproduction was collected from the Danish In Vitro Fertilization register, ICD-10 code: DZ358F. 25-Hydroxyvitamin D was measured from dried blood spots routinely collected by heel prick 48-72 h after birth and corrected according to the hematocrit fraction for capillary blood of neonates. Linear regression analysis was performed, both crude and adjusted, for predefined putative confounders, identified through directed acyclic graphs. RESULTS Vitamin D3 analysis could be performed from a total of 1105 neonates from the general population and 1072 neonates conceived by in vitro fertilization that were subsequently included in the study. The median vitamin D3 was 24.0 nmol/L (interquartile range [IQR] 14.1-39.3) and 33.0 nmol/L (IQR 21.3-48.8) among neonates from the general population and neonates conceived by in vitro fertilization, respectively. The adjusted mean difference between neonates from the general population and those conceived by in vitro fertilization was 6.1 nmol/L (95% confidence interval 4.1-8.1). CONCLUSIONS In this study, children born after in vitro fertilization have a higher vitamin D3 than a random sample of neonates in Denmark.
Collapse
Affiliation(s)
- Karen Christina Walker
- Research Unit for Dietary StudiesThe Parker Institute, Bispebjerg and Frederiksberg HospitalFrederiksbergDenmark
| | - Sofie Gry Pristed
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
- Program of Biomedical Laboratory ScienceUniversity College of Northern DenmarkAalborgDenmark
| | - Fanney Thorsteinsdottir
- Research Unit for Dietary StudiesThe Parker Institute, Bispebjerg and Frederiksberg HospitalFrederiksbergDenmark
- The Department of Public Health, Section for General PracticeUniversity of CopenhagenCopenhagenDenmark
| | - Ina Olmer Specht
- Research Unit for Dietary StudiesThe Parker Institute, Bispebjerg and Frederiksberg HospitalFrederiksbergDenmark
- The Department of Public Health, Section for General PracticeUniversity of CopenhagenCopenhagenDenmark
| | - Arieh Cohen
- Department for Congenital Disorders, Danish Center for Neonatal ScreeningStatens Serum InstituteCopenhagenDenmark
| | - Berit Lilienthal Heitmann
- Research Unit for Dietary StudiesThe Parker Institute, Bispebjerg and Frederiksberg HospitalFrederiksbergDenmark
- The Department of Public Health, Section for General PracticeUniversity of CopenhagenCopenhagenDenmark
- The Boden Institute of Obesity, Nutrition, Exercise & Eating DisordersThe University of SydneySydneyAustralia
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics and GynecologyAalborg University HospitalAalborgDenmark
- Department of Obstetrics and GynecologyHerlev University HospitalHerlevDenmark
| |
Collapse
|
3
|
Perales-Afán JJ, Aparicio-Pelaz D, López-Triguero S, Llorente E, Puente-Lanzarote JJ, Fabre M. Direct and indirect reference intervals of 25-hydroxyvitamin D: it is not a real vitamin D deficiency pandemic. Biochem Med (Zagreb) 2024; 34:020706. [PMID: 38882584 PMCID: PMC11177660 DOI: 10.11613/bm.2024.020706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/08/2024] [Indexed: 06/18/2024] Open
Abstract
Introduction Many studies report vitamin D (25-OH-D) deficiency, although there is no consensus among scientific societies on cut-offs and reference intervals (RI). The aim of this study is to establish and compare RI for serum 25-OH-D by direct and indirect methods. Materials and methods Two studies were performed in Zaragoza (Spain). A retrospective study (N = 7222) between January 2017 and April 2019 was used for RI calculation by indirect method and a prospective study (N = 312) with healthy volunteers recruited in August 2019 and February 2020 for direct method. Seasonal differences were investigated. Measurements were performed on Cobas C8000 (Roche-Diagnostics, Basel, Switzerland) using electrochemiluminescence immunoassay technology. Results Reference intervals (2.5-97.5 percentile and corresponding 95% confidence intervals, CIs) were as follows: by indirect method 5.6 ng/mL (5.4 to 5.8) - 57.2 ng/mL (55.2 to 59.8), in winter 5.4 ng/mL (5.2 to 5.7) - 55.7 ng/mL (53.6 to 58.4), while in summer 5.9 ng/mL (5.4 to 6.2) - 59.9 ng/mL (56.3 to 62.9). By direct method 9.0 ng/mL (5.7 to 9.5) - 41.4 ng/mL (37.6 to 48.0), in winter 7.4 ng/mL (3.9 to 8.6) - 34.6 ng/mL (30.6 to 51.5), while in summer 13.3 ng/mL (10.1 to 14.1) - 44.1 ng/mL (38.9 to 66.0). In both methods, RIs were higher in summer. A significant difference was observed in 25-OH-D median values between the two methods (P < 0.001). Conclusions Reference interval calculation according to the studied area may be a useful tool to adapt the deficiency cut-offs for 25-OH-D. Our data support 25-OH-D values over 12.0 ng/mL for healthy population as sufficient, therefore current recommendations should be updated. In addition, differences in seasonality should be taken into account.
Collapse
Affiliation(s)
- Juan José Perales-Afán
- Clinical Biochemistry Department, Lozano Blesa University Hospital, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| | - Diego Aparicio-Pelaz
- Clinical Biochemistry Department, Lozano Blesa University Hospital, Zaragoza, Spain
| | | | - Elena Llorente
- Clinical Biochemistry Department, Lozano Blesa University Hospital, Zaragoza, Spain
| | | | - Marta Fabre
- Clinical Biochemistry Department, Lozano Blesa University Hospital, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón, Zaragoza, Spain
| |
Collapse
|
4
|
Thompson M, Jones G, Venn A, Balogun S, Cicuttini F, Ragaini B, Aitken D. Prior nonmelanoma skin cancer is associated with fewer fractures, more vitamin D sufficiency, greater bone mineral density and improved bone microarchitecture in older adults. Am J Med 2024:S0002-9343(24)00350-4. [PMID: 38866304 DOI: 10.1016/j.amjmed.2024.05.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/21/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Prior nonmelanoma skin cancer (NMSC), a biomarker of cumulative lifetime sun exposure, is associated with reduced fracture risk later in life. The mechanism is unknown. METHODS Prospective cohort analysis of 1,099 community-dwelling adults aged 50-80 years with baseline and 10 year follow up assessments. Histopathologically-confirmed NMSC diagnosis was established by linkage with the Tasmanian Cancer Registry. Bone mineral density (BMD) and vertebral deformity were quantified by DXA, 25(OH)D by radioimmunoassay, bone microarchitecture by high resolution peripheral quantitative CT, melanin density by spectrophotometry and skin photosensitivity and clinical fracture by questionnaire. 25(OH)D <50 nmol/L was considered deficient. RESULTS Participants with a NMSC reported prior to baseline were less likely to sustain an incident vertebral deformity over 10 years (RR=0.74, p=0.036). There were similar reductions for other fracture types but these did not reach significance. Prior NMSC was associated with baseline (RR=1.23, p=0.005) and 10 year longitudinal (RR=5.9, p=0.014) vitamin D sufficiency and greater total body BMD (β=0.021g/cm2, p=0.034), but not falls risk or muscle strength. The relationship between prior NMSC and bone microarchitecture was age dependent (pinteraction<0.05). In the oldest age tertile, prior NMSC was associated with greater volumetric BMD (β=57.8-62.6, p=0.002-0.01) and less porosity (β= -4.6 - -5.2, p=0.002-0.009) at cortical, compact cortical and outer transitional zones. CONCLUSION Prior NMSC was associated with fewer incident fractures in community-dwelling older adults. This protective association is most likely mediated by modifiable fracture risk factors associated with an outdoor lifestyle, including 25(OH)D, BMD and bone microarchitecture.
Collapse
Affiliation(s)
- Michael Thompson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia; Department of Endocrinology, Royal Hobart Hospital, Hobart, TAS, Australia.
| | - Graeme Jones
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Saliu Balogun
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Flavia Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bruna Ragaini
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Dawn Aitken
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| |
Collapse
|
5
|
Harvey NC, Ward KA, Agnusdei D, Binkley N, Biver E, Campusano C, Cavalier E, Clark P, Diaz-Curiel M, Fuleihan GEH, Khashayar P, Lane NE, Messina OD, Mithal A, Rizzoli R, Sempos C, Dawson-Hughes B. Optimisation of vitamin D status in global populations. Osteoporos Int 2024:10.1007/s00198-024-07127-z. [PMID: 38836946 DOI: 10.1007/s00198-024-07127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 05/10/2024] [Indexed: 06/06/2024]
Abstract
Vitamin D is important for musculoskeletal health. Concentrations of 25-hydroxyvitamin D, the most commonly measured metabolite, vary markedly around the world and are influenced by many factors including sun exposure, skin pigmentation, covering, season and supplement use. Whilst overt vitamin D deficiency with biochemical consequences presents an increased risk of severe sequelae such as rickets, osteomalacia or cardiomyopathy and usually warrants prompt replacement treatment, the role of vitamin D supplementation in the population presents a different set of considerations. Here the issue is to keep, on average, the population at a level whereby the risk of adverse health outcomes in the population is minimised. This position paper, which complements recently published work from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, addresses key considerations regarding vitamin D assessment and intervention from the population perspective. This position paper, on behalf of the International Osteoporosis Foundation Vitamin D Working Group, summarises the burden and possible amelioration of vitamin D deficiency in global populations. It addresses key issues including screening, supplementation and food fortification.
Collapse
Affiliation(s)
- N C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
| | - K A Ward
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - N Binkley
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - E Biver
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - C Campusano
- Internal Medicine Department, Clínica Universidad de los Andes and Universidad de los Andes, Santiago, Chile
| | - E Cavalier
- Department of Clinical Chemistry, University of Liege, CIRM, CHU de Liège, Liège, Belgium
| | - P Clark
- Clinical Epidemiology Unit, Hospital Infantil Federico Gómez-Facultad de Medicina UNAM, Mexico, Mexico
| | - M Diaz-Curiel
- Fundacion Jimenez Diaz, Autonoma University, Madrid, Spain
| | - G E-H Fuleihan
- Calcium Metabolism and Osteoporosis Program, Division of Endocrinology, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut, Beirut, Lebanon
| | - P Khashayar
- International Institute for Biosensing, University of Minnesota, Minneapolis, USA
| | - N E Lane
- Division of Rheumatology, Department of Medicine, U.C. Davis Health, Sacramento, CA, USA
| | - O D Messina
- IRO Medical Research Centre, Collaborating Centre WHO, Buenos Aires, Argentina
| | - A Mithal
- Institute of Endocrinology and Diabetes, Max Healthcare, Delhi, India
| | - R Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Sempos
- Vitamin D Standardization Program (VDSP), Havre de Grace, MD, USA
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| |
Collapse
|
6
|
Gorini F, Tonacci A. Vitamin D: An Essential Nutrient in the Dual Relationship between Autoimmune Thyroid Diseases and Celiac Disease-A Comprehensive Review. Nutrients 2024; 16:1762. [PMID: 38892695 PMCID: PMC11174782 DOI: 10.3390/nu16111762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Revised: 05/29/2024] [Accepted: 06/03/2024] [Indexed: 06/21/2024] Open
Abstract
Autoimmune thyroid diseases (AITD) are among the most frequent autoimmune disorders, with a multifactorial etiology in which both genetic and environmental determinants are probably involved. Celiac disease (CeD) also represents a public concern, given its increasing prevalence due to the recent improvement of screening programs, leading to the detection of silent subtypes. The two conditions may be closely associated due to common risk factors, including genetic setting, changes in the composition and diversity of the gut microbiota, and deficiency of nutrients like vitamin D. This comprehensive review discussed the current evidence on the pivotal role of vitamin D in modulating both gut microbiota dysbiosis and immune system dysfunction, shedding light on the possible relevance of an adequate intake of this nutrient in the primary prevention of AITD and CeD. While future technology-based strategies for proper vitamin D supplementation could be attractive in the context of personalized medicine, several issues remain to be defined, including standardized assays for vitamin D determination, timely recommendations on vitamin D intake for immune system functioning, and longitudinal studies and randomized controlled trials to definitely establish a causal relationship between serum vitamin D levels and the onset of AITD and CeD.
Collapse
Affiliation(s)
- Francesca Gorini
- Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy;
| | | |
Collapse
|
7
|
Shah VP, Nayfeh T, Alsawaf Y, Saadi S, Farah M, Zhu Y, Firwana M, Seisa M, Wang Z, Scragg R, Kiely ME, Lips P, Mitchell DM, Demay MB, Pittas AG, Murad MH. A Systematic Review Supporting the Endocrine Society Clinical Practice Guidelines on Vitamin D. J Clin Endocrinol Metab 2024:dgae312. [PMID: 38828942 DOI: 10.1210/clinem/dgae312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Indexed: 06/05/2024]
Abstract
CONTEXT Low vitamin D status is common and is associated with various common medical conditions. OBJECTIVE To support the development of the Endocrine Society's Clinical Practice Guideline on Vitamin D for the Prevention of Disease. METHODS We searched multiple databases for studies that addressed 14 clinical questions prioritized by the guideline panel. Of the 14 questions, 10 clinical questions assessed the effect of vitamin D vs no vitamin D in the general population throughout the lifespan, during pregnancy, and in adults with prediabetes; 1 question assessed dosing; and 3 questions addressed screening with serum 25-hydroxyvitamin D (25[OH]D). The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess certainty of evidence. RESULTS Electronic searches yielded 37 007 citations, from which we included 151 studies. In children and adolescents, low-certainty evidence suggested reduction in respiratory tract infections with empiric vitamin D. There was no significant effect on select outcomes in healthy adults aged 19 to 74 years with variable certainty of evidence. There was a very small reduction in mortality among adults older than 75 years with high certainty of evidence. In pregnant women, low-certainty evidence suggested possible benefit on various maternal, fetal, and neonatal outcomes. In adults with prediabetes, moderate certainty of evidence suggested reduction in the rate of progression to diabetes. Administration of high-dose intermittent vitamin D may increase falls, compared to lower-dose daily dosing. We did not identify trials on the benefits and harms of screening with serum 25(OH)D. CONCLUSION The evidence summarized in this systematic review addresses the benefits and harms of vitamin D for the prevention of disease. The guideline panel considered additional information about individuals' and providers' values and preferences and other important decisional and contextual factors to develop clinical recommendations.
Collapse
Affiliation(s)
| | - Tarek Nayfeh
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Yahya Alsawaf
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Samer Saadi
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Magdoleen Farah
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Ye Zhu
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Mohammed Firwana
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Mohamed Seisa
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Zhen Wang
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland 1023, New Zealand
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences and INFANT Research Centre, University College Cork, Cork T12 Y337, Ireland
| | - Paul Lips
- Internal Medicine, Endocrine Section, Amsterdam University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Deborah M Mitchell
- Pediatric Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Marie B Demay
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Anastassios G Pittas
- Divisions of Endocrinology, Diabetes and Metabolism, Tufts-New England Medical Center, Boston, MA 02116, USA
| | | |
Collapse
|
8
|
McCartney CR, McDonnell ME, Corrigan MD, Lash RW. Vitamin D Insufficiency and Epistemic Humility: An Endocrine Society Guideline Communication. J Clin Endocrinol Metab 2024:dgae322. [PMID: 38828961 DOI: 10.1210/clinem/dgae322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Indexed: 06/05/2024]
Abstract
A long-held precept is that vitamin D supplementation primarily, if not exclusively, benefits individuals with low circulating 25-hydroxyvitamin D (25[OH]D) concentrations at baseline. However, the most appropriate 25(OH)D threshold to distinguish unacceptably low vs reliably adequate concentrations remains controversial. Such threshold proposals have largely been based on observational studies, which provide less robust evidence compared to randomized clinical trials (RCTs). Since the Endocrine Society's first vitamin D-related guideline was published in 2011, several large vitamin D-related RCTs have been published, and a newly commissioned guideline development panel (GDP) prioritized 4 clinical questions related to the benefits and harms of vitamin D supplementation in generally healthy individuals with 25(OH)D levels below a threshold. The GDP determined that available clinical trial evidence does not permit the establishment of 25(OH)D thresholds that specifically predict meaningful benefit with vitamin D supplementation. The panel noted important limitations in the available evidence, and the panel's overall certainty in the available evidence was very low. Nonetheless, based on the GDP's analyses and judgments, the Endocrine Society no longer endorses its previously proposed definition of vitamin D "sufficiency" (ie, at least 30 ng/mL [75 nmol/L]) or its previously proposed definition of vitamin D "insufficiency" (ie, greater than 20 ng/mL [50 nmol/L] but lower than 30 ng/mL [75 nmol/L]). The Endocrine Society's rationale for such is the subject of this Guideline Communication.
Collapse
Affiliation(s)
- Christopher R McCartney
- Division of Endocrinology and Metabolism, Department of Medicine, West Virginia University, Morgantown, WV 26506, USA
| | - Marie E McDonnell
- Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | | | | |
Collapse
|
9
|
Dwimartutie N, Setiati S, Tamin TZ, Prijanti AR, Harahap AR, Purnamasari D, Harimurti K, Pramantara IDP, Suwarto S, Kojima T. Effect of cholecalciferol supplementation on hand grip strength, walking speed, and expression of vitamin D receptor, interleukin-6, and insulin-like growth factor-1 in monocyte in pre-frail older adults: A randomized double-blind placebo-controlled trial. Geriatr Gerontol Int 2024; 24:554-562. [PMID: 38644647 DOI: 10.1111/ggi.14881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/23/2024]
Abstract
AIM To investigate the effect of cholecalciferol supplementation on hand grip strength, walking speed, and expression of vitamin D receptor (VDR), interleukine-6 (IL-6) and insulin-like growth factor-1 (IGF-1) in monocyte in pre-frail older adults. METHODS We conducted a randomized double-blinded placebo-controlled clinical trial for 12 weeks, involving 120 pre-frail older adults who were randomized to the cholecalciferol group (cholecalciferol 4000 IU/day) or the placebo group. All subjects were given calcium lactate 500 mg/day. Hand grip strength and walking speed, as primary outcomes, were analyzed using intention-to-treat analysis. The expression of VDR, IGF-1 and IL-6 in monocytes, as secondary outcomes, were analyzed using per-protocol analysis. RESULTS After a 12-week intervention, there was a significant increase in serum 25(OH)D levels in both groups, with the increase being higher in the cholecalciferol group than in the placebo group (49.05 vs. 24.01 ng/mL; P < 0.001). No statistically significant differences were observed in hand grip strength (P = 0.228) and walking speed (P = 0.734) between the groups. There were no differences in the expression of VDR (P = 0.513), IL-6 (P = 0.509), and IGF-1 (P = 0.503) monocytes between the groups. CONCLUSIONS Cholecalciferol supplementation for 12 weeks increased serum 25(OH)D levels among pre-frail older adults. However, it did not improve hand grip strength and walking speed, and nor did it change the expression of VDR, IL-6, and IGF-1 in monocytes. Geriatr Gerontol Int 2024; 24: 554-562.
Collapse
Affiliation(s)
- Noto Dwimartutie
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Siti Setiati
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Tirza Z Tamin
- Division of Musculoskeletal Rehabilitation, Department of Physical Medicine and Rehabilitation, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Ani Retno Prijanti
- Department of Biochemistry and Molecular Biology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Alida R Harahap
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Dyah Purnamasari
- Division of Endocrine and Metabolic, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Kuntjoro Harimurti
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - I Dewa Putu Pramantara
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Sardjito Hospital, Yogyakarta, Indonesia
| | - Suhendro Suwarto
- Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
10
|
Llombart R, Mariscal G, Barrios C, de la Rubia Ortí JE, Llombart-Ais R. Does vitamin D deficiency affect functional outcomes in hip fracture patients? A meta-analysis of cohort studies. J Endocrinol Invest 2024; 47:1323-1334. [PMID: 38112912 DOI: 10.1007/s40618-023-02266-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/30/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Vitamin D deficiency is common in patients with hip fractures and may negatively affect functional recovery and quality of life (QOL). OBJECTIVE This study aimed to conduct a meta-analysis to quantify the effects of vitamin D deficiency on physical function and quality of life after hip fractures. METHODS The PubMed, EMBASE, Scopus, and Cochrane Library databases were searched for relevant studies. The inclusion criteria were hip fracture, comparison between vitamin D deficiency and normal vitamin D levels in patients with hip fracture, and functional outcome as the primary outcome. The exclusion criteria were case reports, reviews, duplicates, studies with a high risk of bias, and non-comparable or missing data. Two independent reviewers selected studies, extracted data, assessed bias, and performed meta-analyses using the Review Manager. Heterogeneity and publication bias were also assessed. Two independent reviewers selected the studies, extracted data, and assessed the risk of bias. We performed a meta-analysis using Review Manager and assessed heterogeneity and publication bias. RESULTS Seven studies with 1,972 patients were included. Vitamin D deficiency was defined as a 25(OH)D level < 20 ng/mL. There were no significant differences in the ability to walk (OR 0.68, 95% CI 0.31-1.53, I2 = 69%) or length of hospital stay (MD 2.27 days, 95% CI - 2.47 to 7.01, I2 = 93%) between patients with and without vitamin D deficiency. However, patients with vitamin D deficiency had significantly worse functional ability and quality of life (SMD - 1.50, 95% CI - 2.88 to - 0.12, I2 = 96%). CONCLUSIONS Despite the limitations of this study, such as small sample size, heterogeneous outcome assessments, and variable vitamin D measurement techniques, the results demonstrated that screening for vitamin D status and optimizing levels through supplementation could facilitate rehabilitation, promote lifestyle changes, aid in the recovery of independence, and help reduce long-term burdens.
Collapse
Affiliation(s)
- R Llombart
- Orthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain
| | - G Mariscal
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain.
| | - C Barrios
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
| | - J E de la Rubia Ortí
- Department of Basic Medical Sciences, Catholic University of Valencia, 46001, Valencia, Spain
| | - R Llombart-Ais
- Institute for Research on Musculoskeletal Disorders, School of Medicine, Valencia Catholic University, Valencia, Spain
- Traumacenter, Casa de Salud Hospital, Valencia, Spain
| |
Collapse
|
11
|
Santos-Mena A, González-Muñiz OE, Jacobo-Delgado YM, Rivas-Santiago B. Shedding light on vitamin D in tuberculosis: A comprehensive review of clinical trials and discrepancies. Pulm Pharmacol Ther 2024; 85:102300. [PMID: 38723942 DOI: 10.1016/j.pupt.2024.102300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/27/2023] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
Over the past few decades, there has been extensive research on the use of vitamin D as an adjunctive therapy in the treatment and prevention of tuberculosis. In vitro studies have provided valuable insights into the mechanisms by which vitamin D activates the immune response to combat Mycobacterium tuberculosis. These encouraging findings have spurred clinical investigations globally to assess the effectiveness of vitamin D as a preventive measure and as an adjunctive treatment for tuberculosis. However, the results from these clinical studies have been contradictory, with some demonstrating clear efficacy while others report only modest or no activity. In this review, we aim to analyze the clinical studies on vitamin D and examine the possible discrepancies observed in their outcomes.
Collapse
Affiliation(s)
- Alan Santos-Mena
- Biomedical Research Unit Zacatecas-IMSS, Instituto Mexicano Del Seguro Social, Zacatecas, Mexico
| | - Oscar E González-Muñiz
- Biomedical Research Unit Zacatecas-IMSS, Instituto Mexicano Del Seguro Social, Zacatecas, Mexico
| | - Yolanda M Jacobo-Delgado
- Biomedical Research Unit Zacatecas-IMSS, Instituto Mexicano Del Seguro Social, Zacatecas, Mexico
| | - Bruno Rivas-Santiago
- Biomedical Research Unit Zacatecas-IMSS, Instituto Mexicano Del Seguro Social, Zacatecas, Mexico.
| |
Collapse
|
12
|
Percival MA, Anderson KB, Pasco JA, Hosking SM, Williams LJ, Holloway-Kew KL, Wark JD, Hyde NK. Gestational vitamin D and offspring fracture risk: do associations persist into mid adolescence? Eur J Clin Nutr 2024; 78:515-520. [PMID: 38429375 PMCID: PMC11182745 DOI: 10.1038/s41430-024-01421-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Previous studies report that maternal vitamin D exposure during pregnancy is associated with offspring later-life bone health. A study in the Vitamin D in Pregnancy (VIP) cohort reported sexually dimorphic effects of maternal 25-hydroxyvitamin-D (25(OH)D) and offspring fracture profiles at 10 years of age. We, therefore, aimed to determine associations between maternal 25(OH)D status and offspring fracture risk at 16 years of age in this cohort. METHODS In total, 475 mother-child pairs were recruited to the VIP study in southeastern Australia. Maternal serum samples were obtained at recruitment (<16 weeks' gestation) and/or 28-32 weeks' gestation and analysed for 25(OH)D. Radiologically-confirmed incident fractures in children were ascertained from date of birth (2002-2004) until July 16, 2019. Cox proportional hazard models were used to determine associations between maternal 25(OH)D and childhood fracture risk, and final models included maternal age at recruitment, offspring sex, birth weight, gestation length and season of 25(OH)D sample. RESULTS Data were available for 400 children (mean age 16.1 years). There were 122 (30.5%) children who sustained at least one fracture. Higher maternal 25(OH)D (per 10 nmol/L) in early gestation was associated with a decreased fracture risk in boys (HR 0.87; 95% CI: 0.77, 0.99); the pattern was reversed in girls (HR 1.10; 95% CI 1.00, 1.22). At late gestation, higher maternal 25(OH)D was associated with an increased fracture risk in girls (HR 1.14; 95% CI: 1.04, 1.24). CONCLUSIONS While our findings must be interpreted within the constraints of our limitations, we report that the contradictory risk profiles observed at early childhood in this cohort remain in adolescence.
Collapse
Affiliation(s)
- Mia A Percival
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia.
| | - Kara B Anderson
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Julie A Pasco
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
- Barwon Health, Geelong, VIC, 3220, Australia
- Department of Medicine-Western Health, The University of Melbourne, St Albans, VIC, 3021, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, VIC, 3181, Australia
| | - Sarah M Hosking
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Lana J Williams
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - Kara L Holloway-Kew
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| | - John D Wark
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, 3050, Australia
- Bone and Mineral Medicine, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
- Department of Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, VIC, 3050, Australia
| | - Natalie K Hyde
- Deakin University, IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, 3220, Australia
| |
Collapse
|
13
|
Bakkar NAALH, Bakr AY, Alhusseini AH, Alourfi ZH. The relationship between serum 25-hydroxy vitamin D status and hypertension in Syrian population: retrospective cohort study. Ann Med Surg (Lond) 2024; 86:3222-3226. [PMID: 38846846 PMCID: PMC11152839 DOI: 10.1097/ms9.0000000000001989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/08/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Vitamin D is a liposoluble steroid hormone that plays a crucial role in the maintenance of bone metabolism and calcium homoeostasis. Many studies on the effects of vitamin D on general health have been significantly increased, driven by new findings concerning the systemic and extraskeletal effects of this hormone. This study was performed to determine whether low levels of vitamin D were associated with hypertension in Syrian people. Materials and methods This retrospective cohort study consisted of 207 subjects, including 83 (40.1%) patients suffering from essential hypertension and 124 (59.9%) patients with normal blood pressure. Aged older than 18 years, who was referred to the endocrinology clinic from September 2022 to September 2023. The data were analysed by using SPSS (version 25). Logistic regression analyses were performed with adjustments for age, sex, and waist circumference. Results Hypertension rates were 73%, 20%, and 5% in 25-hydroxyvitamin D groups less than 12 ng/ml, 12-20 ng/mL, and greater than or equal to 20 ng/ml, respectively. Odds ratios (95% CIs) for hypertension adjusting for age, sex, and waist circumference were 178.6 (30.5_1045.6), 5.13 (0.9_26.5) for 25-hydroxyvitamin D levels less than 12 ng/ml, and 12-20 ng/ml, respectively, compared with the greater than or equal to 20 ng/ml group. Conclusions This study has shown a high prevalence of low vitamin D levels (25OHVD/20 ng/ml) among a sample of Syrian people (78.3%). The lowest 25OHVD group was associated with a higher prevalence of hypertension, which refers to an adverse association between vitamin D level and essential hypertension. Further research is needed to confirm this relationship.
Collapse
|
14
|
Donangelo CM, Cornes R, Sintes C, Bezerra FF. Combined Oral Contraceptives: Association with Serum 25-Hydroxyvitamin D and Calcium and Bone Homeostasis. J Womens Health (Larchmt) 2024; 33:805-815. [PMID: 38417038 DOI: 10.1089/jwh.2023.0657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Background: Use of combined oral contraceptives (COCs) has been found to increase serum 25-hydroxyvitamin D [25(OH)D] but effects on calcium and bone homeostasis are unclear. Materials and Methods: Serum 25(OH)D, parathyroid hormone (PTH), alkaline phosphatase (ALK) and estradiol, dietary intake of bone-related nutrients and foods, bone mineral density (BMD), and body fat were compared in adult women (20-35 years; body mass index 21.5 ± 2.3 kg/m2) users (+COC, n = 32) and nonusers (-COC, n = 20) of COC. Biochemical markers were measured by automated assays. BMD at total body (TB), lumbar spine (LS), femoral neck (FN) and trochanter (TR), and body fat, were measured by dual-energy X-ray absorptiometry. Dietary intake was assessed by a food frequency questionnaire. Results: Intake of calcium, dairy foods, and fruits and vegetables, were adequate and did not differ by COC. Mean 25(OH)D was 35% higher in +COC (110.4 ± 27.3 nmol/L, 44.2 ± 1.8 ng/mL) compared with -COC (81.7 ± 22.8 nmol/L, 32.7 ± 2.3 ng/mL; p < 0.001). Mean PTH, ALK, and estradiol were 28%, 12%, and 62% lower, respectively, in +COC compared with -COC (p ≤ 0.05). Mean BMD z-scores (all sites) were adequate and did not differ by COC. There were no correlations between 25(OH)D and dietary, biochemical, and body composition variables. PTH was inversely correlated with TR-BMD z-score in -COC (r = -0.47; p = 0.04), and ALK was inversely correlated with TB-, TR-, and LS-BMD z-scores in -COC (r ≤ -0.43; p ≤ 0.04), but not in +COC. Conclusions: Increased serum 25(OH)D with COC use was paralleled by expected physiologic adjustments in calcium and bone homeostasis, and adequate bone mass status, in nonobese young adult women consuming bone-healthy diets.
Collapse
Affiliation(s)
| | - Rafael Cornes
- Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Celia Sintes
- Escuela de Nutrición, Universidad de la República, Montevideo, Uruguay
| | - Flavia F Bezerra
- Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
15
|
Lautatzis ME, Keya FK, Al Mahmud A, Tariq U, Lam C, Morris SK, Stimec J, Zlotkin S, Ahmed T, Harrington J, Roth DE. Maternal Vitamin D Supplementation and Infantile Rickets: Secondary Analysis of a Randomized Trial. Pediatrics 2024; 153:e2023063263. [PMID: 38726565 DOI: 10.1542/peds.2023-063263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The role of maternal vitamin D supplementation in the prevention of infantile rickets is unknown, particularly in low- and middle-income countries without routine infant vitamin D supplementation. Through secondary analysis of a randomized, placebo-controlled trial in Bangladesh, we examined the dose-ranging effects of maternal vitamin D supplementation on the risk of biochemical rickets at 6 to 12 months of age. METHODS Pregnant women (n = 1300) were randomized into 5 groups: placebo, or vitamin D 4200 IU/week, 16 800 IU/week, or 28 000 IU/week from second trimester to delivery and placebo until 6 months postpartum; or 28 000 IU/week prenatally and until 6 months postpartum. Infants underwent biochemical rickets screening from 6 to 12 months of age (n = 790). Relative risks (RR) and 95% confidence intervals (95% CI) of biochemical rickets were estimated for each group versus placebo. RESULTS Overall, 39/790 (4.9%) infants had biochemical rickets. Prevalence was highest in the placebo group (7.8%), and the risk was significantly lower among infants whose mothers received combined prenatal and postpartum vitamin D at 28 000 IU/week (1.3%; RR, 0.16; 95% CI, 0.03-0.72). Risks among infants whose mothers received only prenatal supplementation (4200 IU, 16 800 IU, 28 000 IU weekly) were not significantly different from placebo: 3.8% (RR, 0.48; 95% CI, 0.19-1.22), 5.8% (RR, 0.74; 95% CI, 0.33-1.69), and 5.7% (RR, 0.73; 95% CI, 0.32-1.65), respectively. CONCLUSIONS Maternal vitamin D supplementation (28 000 IU/week) during the third trimester of pregnancy until 6 months postpartum reduced the risk of infantile biochemical rickets. Further research is needed to define optimal postpartum supplementation dosing during lactation.
Collapse
Affiliation(s)
- Maria-Elena Lautatzis
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- The Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Farhana K Keya
- Technical Training Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Abdullah Al Mahmud
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ulaina Tariq
- The Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Carol Lam
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Shaun K Morris
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- The Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jennifer Stimec
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
| | - Stanley Zlotkin
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- The Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Tahmeed Ahmed
- Centre for Nutrition and Food Security, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Jennifer Harrington
- Division of Endocrinology, Women's and Children's Health Network, North Adelaide, Australia
- Department of Paediatrics, University of Adelaide, Adelaide, Australia
| | - Daniel E Roth
- Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada
- The Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| |
Collapse
|
16
|
Amrein K, de Man AME, Dizdar OS, Gundogan K, Casaer MP, Lepp HL, Rezzi S, van Zanten AR, Shenkin A, Berger MM. LLL 44 - 2 - Micronutrients in clinical nutrition: Vitamins. Clin Nutr ESPEN 2024; 61:427-436. [PMID: 38777465 DOI: 10.1016/j.clnesp.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 05/25/2024]
Abstract
Vitamins are essential organic molecules, which are required in the diet in relatively small amounts in any form of nutrition (oral, enteral, parenteral). Despite the small amounts that are required, the vitamins are essential both for maintenance of health, growth, and treatment of disease. After reminding about the principal function of all the vitamins, their needs and the clinical consequences of their deficit, the text present some common clinical problems: the impact of inflammation on the assessment of status. The reasons and diseases which cause increased requirements are presented, with the indications to monitoring of blood levels which remain the classical way to assess status in clinical settings. The text summarises the most relevant clinical manifestations of vitamins depletion and deficiency, the difficulties in assessing status, and makes recommendations for provision for medical nutrition therapy.
Collapse
Affiliation(s)
- Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Angélique M E de Man
- Amsterdam UMC, Location Vrije Universiteit, Department of Intensive Care, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands.
| | - Oguzhan S Dizdar
- Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | | | - Serge Rezzi
- Swiss Nutrition and Health Foundation, Epalinges, Switzerland.
| | - Arthur Rh van Zanten
- Gelderse Vallei Hospital, Ede and Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland.
| |
Collapse
|
17
|
Pouladi F, Nozari E, Hosseinzadeh F, Hashemi S. The protective association of dairy intake and the adverse impact of iron on gestational diabetes risk. INT J VITAM NUTR RES 2024; 94:354-364. [PMID: 38229511 DOI: 10.1024/0300-9831/a000803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
Background: Gestational diabetes (GDM) is a pregnancy-related glucose intolerance with significant implications for maternal and fetal health. Calcium is essential for insulin secretion and metabolism, while iron intake may also impact GDM. This case-control study was conducted to investigate the relationship between calcium and iron intake with the risk of GDM. Methods: GDM was defined as Fasting Blood Sugar>92mg/dL or 75g Oral-Glucose-Tolerance-Test 120-minutes>153mg/dL. A 168-Item food-frequency-questionnaire was used to collect dietary calcium and iron intake from 24-40 weeks of gestation. The impact of total iron, red, processed/unprocessed meat consumption, calcium, and dairy intake on GDM were investigated. Results: A total of 229 GDM and 205 non-GDM women (18-45 years) participated. GDM group had higher pre-pregnancy weight, weight gain, and pre-pregnancy BMI. Across all models, GDM risk significantly increased in the third and fourth quartiles of iron intake. The fourth quartile had an Odds Ratio (OR) of 2.68 (CI 95%, 4.89-1.56; P<0.001) compared to the reference. Heme-iron consumption in the fourth quartiles increased GDM risk. In the second calcium intake model, ORs for the second, third, and fourth quartiles were 0.51 (CI 95%, 0.91-0.25), 0.43 (CI 95%, 0.77-0.24), and 0.35 (CI 95%, 0.63-0.19), respectively (P<0.001 all), reducing GDM risk by 50-65% compared to the first quartile. Dairy consumption in all quartiles of the first and second models was associated with lower GDM risk. Conclusions: Consumption of heme-iron through red and processed meat associated with an increased chance of developing GDM. Dairy intake reduces the chances of developing GDM in pregnant women.
Collapse
Affiliation(s)
- Fatemeh Pouladi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Nozari
- School of Public Health, Tehran University of Medical Sciences, Iran
| | - Fahimeh Hosseinzadeh
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Shokuh Hashemi
- Research Committee, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
18
|
Zerouga I, Valeur J, Sommer C, Cvancarova Småstuen M, Medhus AW, Lund C, Johansen I, Cetinkaya RB, Bengtson MB, Torp R, Hovde Ø, Huppertz-Hauss G, Detlie TE, Aabrekk TB, Ricanek P, Frigstad SO, Hopstock LA, Opheim R, Kristensen VA, Høivik ML, Hauger Carlsen M, Aas AM. Dietary intake and nutritional status in patients with newly diagnosed inflammatory bowel disease: insights from the IBSEN III study. Scand J Gastroenterol 2024; 59:652-660. [PMID: 38356408 DOI: 10.1080/00365521.2024.2313056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Dietary recommendations in inflammatory bowel disease (IBD) are inconclusive, and patients may follow restrictive diets with increased risk of malnutrition. The aim of this study was to compare dietary intakes and nutritional status in men and women with newly diagnosed IBD with a general population sample, and to investigate whether intakes were in line with the Nordic Nutrition Recommendations. METHODS This was a cross-sectional study including adults≥ 40 years with IBD from the Inflammatory Bowel Disease in South-Eastern Norway (IBSEN) III cohort study. A validated food frequency questionnaire (FFQ) was used in dietary data collection, and a sample from the seventh survey of the Tromsø Study was included as a comparison group. RESULTS A total of 227 men and women with IBD were included. IBD patients had higher intake of grain products, sweetened beverages, energy, fat and polyunsaturated fat (PUFA), but lower intake of dairy products, alcohol and iodine compared to adults from the comparison sample (p < 0.01). Intakes of saturated fat and carbohydrates in both genders, and vitamin D in women were not within recommended levels. Anemia and hypoalbuminemia were more prevalent in IBD patients than in the comparison sample. CONCLUSIONS Dietary intakes in newly diagnosed IBD patients were mostly in line with Nordic Nutrition Recommendations. Higher proportion of IBD patients exceeded recommended allowances of fat and added sugar than the comparison sample. Insufficient micronutrient intake, anemia and hypoalbuminemia are present challenges in IBD patients that require monitoring.
Collapse
Affiliation(s)
- Insaf Zerouga
- Department of Clinical Service, Section of Nutrition and Dietetics, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jørgen Valeur
- Unger-Vetlesens Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Milada Cvancarova Småstuen
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Department of Public Health, Oslo Metropolitan University, Oslo, Norway
| | - Asle Wilhelm Medhus
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Charlotte Lund
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | - Ingunn Johansen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Health Sciences, Østfold University College, Fredrikstad, Norway
| | | | | | - Roald Torp
- Medical department, Innlandet Hospital Trust, Hamar, Norway
| | - Øistein Hovde
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Innlandet Hospital Trust, Gjøvik, Norway
| | | | - Trond Espen Detlie
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Tone Bergene Aabrekk
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Medical department, Vestfold Hospital Trust, Tønsberg, Norway
| | - Petr Ricanek
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Svein Oskar Frigstad
- Department of Medicine, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
| | - Laila Arnesdatter Hopstock
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromso, Norway
- Department of Nutrition, Faculty of Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Randi Opheim
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marte Lie Høivik
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Gastroenterology, Oslo University Hospital, Oslo, Norway
| | | | - Anne-Marie Aas
- Department of Clinical Service, Section of Nutrition and Dietetics, Division of Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
19
|
Zhao S, Qian F, Wan Z, Chen X, Pan A, Liu G. Vitamin D and major chronic diseases. Trends Endocrinol Metab 2024:S1043-2760(24)00112-7. [PMID: 38824035 DOI: 10.1016/j.tem.2024.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 06/03/2024]
Abstract
Numerous observational studies have demonstrated a significant inverse association between vitamin D status and the risk of major chronic disease, including type 2 diabetes (T2D), cardiovascular disease (CVD), and cancer. However, findings from Mendelian randomization (MR) studies and randomized controlled trials (RCTs) suggest minimal or no benefit of increased vitamin D levels. We provide an overview of recent literature linking vitamin D to major chronic diseases. Because emerging evidence indicates a potential threshold effect of vitamin D, future well-designed studies focused on diverse populations with vitamin D deficiency or insufficiency are warranted for a more comprehensive understanding of the effect of maintaining sufficient vitamin D status on the prevention of major chronic diseases.
Collapse
Affiliation(s)
- Shiyu Zhao
- School of Public Health, and Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Frank Qian
- Section of Cardiovascular Medicine, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xue Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, and Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Gang Liu
- School of Public Health, and Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| |
Collapse
|
20
|
Moura SSD, de Menezes-Júnior LAA, Rocha AMS, Batista AP, Sabião TDS, de Menezes MC, Machado-Coelho GLL, Carraro JCC, Meireles AL. Vitamin D deficiency and VDR gene polymorphism FokI (rs2228570) are associated with diabetes mellitus in adults: COVID-inconfidentes study. Diabetol Metab Syndr 2024; 16:118. [PMID: 38812030 PMCID: PMC11137993 DOI: 10.1186/s13098-024-01328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/03/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Diabetes mellitus is a chronic and multifactorial condition, including environmental risk factors such as lifestyle habits and genetic conditions. OBJECTIVE We aimed to evaluate the association of VDR gene polymorphism (rs2228570) FokI and vitamin D levels with diabetes in adults. METHODS Cross-sectional population-based study in adults, conducted from October to December 2020 in two Brazilian cities. The outcome variable was diabetes, defined as glycated hemoglobin ≥ 6.5% or self-report medical diagnosis or use of oral hypoglycemic drugs. Vitamin D (25-hydroxyvitamin D) was measured by indirect electrochemiluminescence, and classified as deficiency when 25(OH)D < 20 ng/mL. All participants were genotyped for VDR FokI polymorphism by qPCR and classified as homozygous mutant (ff or GG), heterozygous (Ff or AG), or homozygous wild (FF or AA). A combined analysis between the FokI polymorphism and vitamin D levels with diabetes was also examined. A directed acyclic graph (DAG) was used to select minimal and sufficient adjustment for confounding variables by the backdoor criterion. RESULTS The prevalence of DM was 9.4% and vitamin D deficiency (VDD) was 19.9%. The genotype distribution of FokI polymorphism was 9.9% FF, 44.8% Ff, and 45.3% ff. It was possible to verify a positive association between vitamin D deficiency and DM (OR = 2.19; 95% CI: 1.06-4.50). Individuals with the altered allele (ff) had a 1.78 higher prevalence of DM (OR: 1.78; 95% CI; 1.10-2.87). Combined analyses, individuals with vitamin D deficiency and one or two copies of the altered FokI allele had a higher prevalence of DM (Ff + ff: OR: 1.67; 95% CI; 1.07-2.61; ff: OR: 3.60; 95% CI; 1.40-9.25). CONCLUSION Our data suggest that vitamin D deficiency and FokI polymorphism are associated with DM.
Collapse
Affiliation(s)
- Samara Silva de Moura
- School of Nutrition, Postgraduate Program in Health and Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
- Epidemiology Laboratory, Medical School, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Luiz Antônio Alves de Menezes-Júnior
- School of Nutrition, Postgraduate Program in Health and Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
- Epidemiology Laboratory, Medical School, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Ana Maria Sampaio Rocha
- Epidemiology Laboratory, Medical School, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Aline Priscila Batista
- School of Nutrition, Postgraduate Program in Health and Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
- Postgraduate Program in Biological Sciences, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Thaís da Silva Sabião
- School of Nutrition, Postgraduate Program in Health and Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
- Epidemiology Laboratory, Medical School, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Mariana Carvalho de Menezes
- Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
| | - George Luiz Lins Machado-Coelho
- School of Nutrition, Postgraduate Program in Health and Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
- Epidemiology Laboratory, Medical School, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - Júlia Cristina Cardoso Carraro
- Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil
| | - Adriana Lúcia Meireles
- Department of Clinical and Social Nutrition, Research and Study Group on Nutrition and Public Health (GPENSC), School of Nutrition, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro, 35400- 000, Ouro Preto, Minas Gerais, Brazil.
- , R. Diogo de Vasconcelos, 122, Ouro Preto, MG, Brazil.
| |
Collapse
|
21
|
Wimalawansa SJ. Physiology of Vitamin D-Focusing on Disease Prevention. Nutrients 2024; 16:1666. [PMID: 38892599 PMCID: PMC11174958 DOI: 10.3390/nu16111666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Vitamin D is a crucial micronutrient, critical to human health, and influences many physiological processes. Oral and skin-derived vitamin D is hydroxylated to form calcifediol (25(OH)D) in the liver, then to 1,25(OH)2D (calcitriol) in the kidney. Alongside the parathyroid hormone, calcitriol regulates neuro-musculoskeletal activities by tightly controlling blood-ionized calcium concentrations through intestinal calcium absorption, renal tubular reabsorption, and skeletal mineralization. Beyond its classical roles, evidence underscores the impact of vitamin D on the prevention and reduction of the severity of diverse conditions such as cardiovascular and metabolic diseases, autoimmune disorders, infection, and cancer. Peripheral target cells, like immune cells, obtain vitamin D and 25(OH)D through concentration-dependent diffusion from the circulation. Calcitriol is synthesized intracellularly in these cells from these precursors, which is crucial for their protective physiological actions. Its deficiency exacerbates inflammation, oxidative stress, and increased susceptibility to metabolic disorders and infections; deficiency also causes premature deaths. Thus, maintaining optimal serum levels above 40 ng/mL is vital for health and disease prevention. However, achieving it requires several times more than the government's recommended vitamin D doses. Despite extensive published research, recommended daily intake and therapeutic serum 25(OH)D concentrations have lagged and are outdated, preventing people from benefiting. Evidence suggests that maintaining the 25(OH)D concentrations above 40 ng/mL with a range of 40-80 ng/mL in the population is optimal for disease prevention and reducing morbidities and mortality without adverse effects. The recommendation for individuals is to maintain serum 25(OH)D concentrations above 50 ng/mL (125 nmol/L) for optimal clinical outcomes. Insights from metabolomics, transcriptomics, and epigenetics offer promise for better clinical outcomes from vitamin D sufficiency. Given its broader positive impact on human health with minimal cost and little adverse effects, proactively integrating vitamin D assessment and supplementation into clinical practice promises significant benefits, including reduced healthcare costs. This review synthesized recent novel findings related to the physiology of vitamin D that have significant implications for disease prevention.
Collapse
|
22
|
Zhang Y, Yang E, Liu Q, Zhang J, Feng C. Combined full-length transcriptomic and metabolomic analysis reveals the molecular mechanisms underlying nutrients and taste components development in Primulina juliae. BMC Genom Data 2024; 25:46. [PMID: 38783179 PMCID: PMC11112898 DOI: 10.1186/s12863-024-01231-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/16/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Primulina juliae has recently emerged as a novel functional vegetable, boasting a significant biomass and high calcium content. Various breeding strategies have been employed to the domestication of P. juliae. However, the absence of genome and transcriptome information has hindered the research of mechanisms governing the taste and nutrients in this plant. In this study, we conducted a comprehensive analysis, combining the full-length transcriptomics and metabolomics, to unveil the molecular mechanisms responsible for the development of nutrients and taste components in P. juliae. RESULTS We obtain a high-quality reference transcriptome of P. juliae by combing the PacBio Iso-seq and Illumina sequencing technologies. A total of 58,536 cluster consensus sequences were obtained, including 28,168 complete protein coding transcripts and 8,021 Long Non-coding RNAs. Significant differences were observed in the composition and content of compounds related to nutrients and taste, particularly flavonoids, during the leaf development. Our results showed a decrease in the content of most flavonoids as leaves develop. Malate and succinate accumulated with leaf development, while some sugar metabolites were decreased. Furthermore, we identified the different accumulation of amino acids and fatty acids, which are associated with taste traits. Moreover, our transcriptomic analysis provided a molecular basis for understanding the metabolic variations during leaf development. We identified 4,689 differentially expressed genes in the two developmental stages, and through a comprehensive transcriptome and metabolome analysis, we discovered the key structure genes and transcription factors involved in the pathways. CONCLUSIONS This study provides a high-quality reference transcriptome and reveals molecular mechanisms associated with the development of nutrients and taste components in P. juliae. These findings will enhance our understanding of the breeding and utilization of P. juliae as a vegetable.
Collapse
Affiliation(s)
- Yi Zhang
- Jiangxi Provincial Key Laboratory of ex situ Plant Conservation and Utilization, Lushan Botanical Garden, Chinese Academy of Sciences, Zhiqing Rd, No. 9, Jiujiang, 332900, China
- College of Life Science, Nanchang University, Nanchang, China
| | - Endian Yang
- Jiangxi Provincial Key Laboratory of ex situ Plant Conservation and Utilization, Lushan Botanical Garden, Chinese Academy of Sciences, Zhiqing Rd, No. 9, Jiujiang, 332900, China
- College of Life Science, Nanchang University, Nanchang, China
| | - Qin Liu
- Jiangxi Provincial Key Laboratory of ex situ Plant Conservation and Utilization, Lushan Botanical Garden, Chinese Academy of Sciences, Zhiqing Rd, No. 9, Jiujiang, 332900, China
- College of Life Science, Nanchang University, Nanchang, China
| | - Jie Zhang
- Jiangxi Provincial Key Laboratory of ex situ Plant Conservation and Utilization, Lushan Botanical Garden, Chinese Academy of Sciences, Zhiqing Rd, No. 9, Jiujiang, 332900, China
| | - Chen Feng
- Jiangxi Provincial Key Laboratory of ex situ Plant Conservation and Utilization, Lushan Botanical Garden, Chinese Academy of Sciences, Zhiqing Rd, No. 9, Jiujiang, 332900, China.
| |
Collapse
|
23
|
Hung M, Patel H, Lee S, Nguyen J, Mohajeri A. The Influence of Vitamin D Levels on Dental Caries: A Retrospective Study of the United States Population. Nutrients 2024; 16:1572. [PMID: 38892506 PMCID: PMC11174693 DOI: 10.3390/nu16111572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: This study examines vitamin D's impact on dental caries to inform prevention strategies, given its critical role in bone and calcium regulation, vital for dental health. (2) Methods: Data from 18,683 participants of the National Health and Nutrition Examination Survey (NHANES) 2011-2016 were analyzed. NHANES collects U.S. population data through interviews, physical exams, and tests, including vitamin D levels and dental health assessed using both the decayed, missing, and filled teeth (DMFT) index and the presence of untreated dental caries. Vitamin D levels were measured according to serum 25(OH)D concentrations, and the analyses adjusted for confounders such as body mass index (BMI) and socioeconomic status (SES) using Chi-square, Mann-Whitney U, Kruskal-Wallis tests, as well as logistic and Poisson regression. (3) Results: This study found a mean DMFT score of 7.36 and a 33.2% prevalence of untreated dental caries. A higher caries prevalence was correlated with a lower SES (p < 0.001), the male gender (p < 0.001), and a higher BMI (p < 0.001). Severe vitamin D deficiency (<25 nmol/L) doubled the risk of dental caries, with odds ratios of 2.261 and 1.953 after adjusting for demographic factors and BMI. (4) Conclusions: Our study confirms a significant relationship between low vitamin D levels and an increased risk of dental caries nationwide, even after accounting for sociodemographic factors, emphasizing the importance of maintaining sufficient vitamin D levels for preventing caries.
Collapse
Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
- Department of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT 84108, USA
- George E. Wahlen Department, Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Himani Patel
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Samantha Lee
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Justin Nguyen
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| | - Amir Mohajeri
- College of Dental Medicine, Roseman University of Health Sciences, 10894 S. River Front Parkway, South Jordan, UT 84095, USA
| |
Collapse
|
24
|
Ghosh A, S M, Sunny AS, Diwakar L, Issac TG. Prevalence and patterns of vitamin D deficiency and its role in cognitive functioning in a cohort from South India. Sci Rep 2024; 14:11215. [PMID: 38755311 PMCID: PMC11099011 DOI: 10.1038/s41598-024-62010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024] Open
Abstract
Vitamin D (VitD) is a naturally occurring, fat-soluble vitamin which regulates calcium and phosphate homeostasis in the human body and is also known to have a neuroprotective role. VitD deficiency has often been associated with impaired cognition and a higher risk of dementia. In this study, we aimed to explore the relationship between levels of VitD and cognitive functioning in adult individuals. 982 cognitively healthy adults (≥ 45 years) were recruited as part of the CBR-Tata Longitudinal Study for Aging (TLSA). Addenbrooke's cognitive examination-III (ACE-III) and Hindi mental status examination (HMSE) were used to measure cognitive functioning. 25-hydroxyvitamin D [25(OH)D] levels were measured from the collected serum sample and classified into three groups- deficient (< 20 ng/ml), insufficient (20-29 ng/ml) and normal (≥ 30 ng/ml). Statistical analysis was done using IBM SPSS software, version 28.0.1.1(15). The mean age of the participants was 61.24 ± 9 years. Among 982 participants, 572 (58%) were deficient, 224 (23%) insufficient and only 186 (19%) had normal levels of VitD. Kruskal-Wallis H test revealed a significant difference in age (p = 0.015) and education (p = 0.021) across VitD levels and the Chi-square test revealed a significant association between gender (p = 0.001) and dyslipidemia status (p = 0.045) with VitD levels. After adjusting for age, education, gender and dyslipidemia status, GLM revealed that individuals with deficient (p = 0.038) levels of VitD had lower scores in ACE-III verbal fluency as compared to normal. Additionally, we also found that 91.2% individuals who had VitD deficiency were also having dyslipidemia. It is concerning that VitD deficiency impacts lipid metabolism. Lower levels of VitD also negatively impacts verbal fluency in adult individuals. Verbal fluency involves higher order cognitive functions and this result provides us with a scope to further investigate the different domains of cognition in relation to VitD deficiency and other associated disorders.
Collapse
Affiliation(s)
- Aishwarya Ghosh
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Monisha S
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Albert Stezin Sunny
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Latha Diwakar
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India
| | - Thomas Gregor Issac
- Centre for Brain Research, Indian Institute of Science Campus, CV Raman Avenue, Bangalore, 560012, India.
| |
Collapse
|
25
|
Yamashita H, Mori Y, Sato S, Shindo H, Yoshimoto K, Tachibana S, Fukuda T, Takahashi H. Significant role of 1,25-dihydroxyvitamin D on serum calcium levels after total thyroidectomy: a prospective cohort study. Front Endocrinol (Lausanne) 2024; 15:1360464. [PMID: 38803480 PMCID: PMC11128608 DOI: 10.3389/fendo.2024.1360464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/29/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Although active vitamin D (VD) has been used both preoperatively and postoperatively to prevent hypocalcemia risk in patients undergoing total thyroidectomy, the role of 1,25-dihydroxyvitamin D (1,25(OH)2D) has not been examined. This study comprehensively investigated the effects of 1,25(OH)2D on calcium (Ca) concentrations after total thyroidectomy. Methods Serum Ca, parathyroid hormone (PTH), and 1,25(OH)2D levels were measured in 82 patients with thyroid disease before and after surgery. Results Serum Ca, PTH, and 1,25(OH)2D levels decreased significantly on the morning of the first postoperative day. Notably, the decrease in 1,25(OH)2D concentration was significantly lower than that of PTH concentration (10.5 ± 33.4% vs. 52.1 ± 30.1%, p<0.0001), with 28% of patients showing increases in 1,25(OH)2D. The only factor predicting a postoperative 1,25(OH)2D decrease was a high preoperative 1,25(OH)2D concentration. Postoperative 1,25(OH)2D concentrations, as well as the magnitude and rate of decrease from preoperative levels, showed strong positive correlations with preoperative 1,25(OH)2D concentrations (p<0.0001 for all three variables) but not with PTH concentrations. These findings suggest that 1,25(OH)2D concentrations after thyroidectomy were more strongly dependent on preoperative concentrations than on the effect of PTH decrease and were relatively preserved, possibly preventing sudden severe postoperative hypocalcemia. A high 1,25(OH)2D level was the most important preoperative factor for hypocalcemia (<2 mmol/L; p<0.05) on the first postoperative day; however, only PTH decrease was statistically significant (p<0.001) when intraoperative factors were added. In the PTH >10 pg/mL group, the decrease in 1,25(OH)2D levels was significantly associated with postoperative hypocalcemia (p<0.05). Similarly, in the PTH levels >15 pg/mL group, a decrease in 1,25(OH)2D concentration was a significant factor, and the amount of PTH decrease was no longer significant. Conclusion 1,25(OH)2D plays an important role in preventing sudden, severe hypocalcemia due to decreased PTH levels after total thyroidectomy, whereas high preoperative 1,25(OH)2D levels are a significant risk factor for postoperative hypocalcemia. Optimizing preoperative protocols to adjust Ca, PTH, and 1,25(OH)2D levels to improve the management of patients undergoing total thyroidectomy and to prevent extreme intraoperative PTH decreases may reduce the risk of hypocalcemia.
Collapse
Affiliation(s)
| | - Yusuke Mori
- Department of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan
| | - Shinya Sato
- Department of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan
| | - Hisakazu Shindo
- Department of Surgery, Yamashita Thyroid Hospital, Fukuoka, Japan
| | | | - Seigo Tachibana
- Department of Endocrinology, Yamashita Thyroid Hospital, Fukuoka, Japan
| | - Takashi Fukuda
- Department of Endocrinology, Yamashita Thyroid Hospital, Fukuoka, Japan
| | | |
Collapse
|
26
|
Fendler A, Stephan C, Ralla B, Jung K. Discordant Health Implications and Molecular Mechanisms of Vitamin D in Clinical and Preclinical Studies of Prostate Cancer: A Critical Appraisal of the Literature Data. Int J Mol Sci 2024; 25:5286. [PMID: 38791324 PMCID: PMC11120741 DOI: 10.3390/ijms25105286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Clinical and preclinical studies have provided conflicting data on the postulated beneficial effects of vitamin D in patients with prostate cancer. In this opinion piece, we discuss reasons for discrepancies between preclinical and clinical vitamin D studies. Different criteria have been used as evidence for the key roles of vitamin D. Clinical studies report integrative cancer outcome criteria such as incidence and mortality in relation to vitamin D status over time. In contrast, preclinical vitamin D studies report molecular and cellular changes resulting from treatment with the biologically active vitamin D metabolite, 1,25-dihydroxyvitamin D3 (calcitriol) in tissues. However, these reported changes in preclinical in vitro studies are often the result of treatment with biologically irrelevant high calcitriol concentrations. In typical experiments, the used calcitriol concentrations exceed the calcitriol concentrations in normal and malignant prostate tissue by 100 to 1000 times. This raises reasonable concerns regarding the postulated biological effects and mechanisms of these preclinical vitamin D approaches in relation to clinical relevance. This is not restricted to prostate cancer, as detailed data regarding the tissue-specific concentrations of vitamin D metabolites are currently lacking. The application of unnaturally high concentrations of calcitriol in preclinical studies appears to be a major reason why the results of preclinical in vitro studies hardly match up with outcomes of vitamin D-related clinical studies. Regarding future studies addressing these concerns, we suggest establishing reference ranges of tissue-specific vitamin D metabolites within various cancer entities, carrying out model studies on human cancer cells and patient-derived organoids with biologically relevant calcitriol concentrations, and lastly improving the design of vitamin D clinical trials where results from preclinical studies guide the protocols and endpoints within these trials.
Collapse
Affiliation(s)
- Annika Fendler
- Department of Urology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.F.); (B.R.)
- Berlin Institute for Urologic Research, 10115 Berlin, Germany
| | - Carsten Stephan
- Department of Urology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.F.); (B.R.)
- Berlin Institute for Urologic Research, 10115 Berlin, Germany
| | - Bernhard Ralla
- Department of Urology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.F.); (B.R.)
| | - Klaus Jung
- Department of Urology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (A.F.); (B.R.)
| |
Collapse
|
27
|
Grant WB. Cancer Incidence Rates in the US in 2016-2020 with Respect to Solar UVB Doses, Diabetes and Obesity Prevalence, Lung Cancer Incidence Rates, and Alcohol Consumption: An Ecological Study. Nutrients 2024; 16:1450. [PMID: 38794688 PMCID: PMC11123752 DOI: 10.3390/nu16101450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
This article reports the results of an ecological study of cancer incidence rates by state in the US for the period 2016-2020. The goals of this study were to determine the extent to which solar UVB doses reduced cancer risk compared to findings reported in 2006 for cancer mortality rates for the periods 1950-1969 and 1970-1794 as well as cancer incidence rates for the period 1998-2002 and to determine which factors were recently associated with cancer risk. The cancer data for non-Hispanic white (European American) men and women were obtained from the Centers for Disease Control and Prevention. Indices were obtained for solar UVB at the surface for July 1992, and alcohol consumption, diabetes, and obesity prevalence near the 2016-2020 period. Lung cancer incidence rates were also used in the analyses as a surrogate for smoking, diet, and air pollution. The cancers for which solar UVB is significantly associated with reduced incidence are bladder, brain (males), breast, corpus uteri, esophageal, gastric, non-Hodgkin's lymphoma, pancreatic, and renal cancer. Lung cancer was significantly associated with colorectal, laryngeal, and renal cancer. Diabetes was also significantly associated with breast, liver, and lung cancer. Obesity prevalence was significantly associated with breast, colorectal, and renal cancer. Alcohol consumption was associated with bladder and esophageal cancer. Thus, diet has become a very important driver of cancer incidence rates. The role of solar UVB in reducing the risk of cancer has been reduced due to people spending less time outdoors, wearing sunscreen that blocks UVB but not UVA radiation, and population increases in terms of overweight and obese individuals, which are associated with lower 25-hydroxyvitamin D concentrations and the generation of systemic inflammation, which is a risk factor for cancer. A dietary approach that would reduce the risk of diabetes, obesity, lung cancer, and, therefore, cancer, would be one based mostly on whole plants and restrictions on red and processed meats and ultraprocessed foods. Solar UVB exposure for a few minutes before applying sunscreen and taking vitamin D supplements would also help reduce the risk of cancer.
Collapse
Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, 1745 Pacific Ave., Suite 504, San Francisco, CA 94109, USA
| |
Collapse
|
28
|
Cavalier E, Makris K, Heijboer AC, Herrmann M, Souberbielle JC. Vitamin D: Analytical Advances, Clinical Impact, and Ongoing Debates on Health Perspectives. Clin Chem 2024:hvae056. [PMID: 38712647 DOI: 10.1093/clinchem/hvae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/19/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Vitamin D, acknowledged since the 1930s for its role in preventing rickets, gained additional prominence in relation to fragility fracture prevention in the late 1980s. From the early 2000s, connections between vitamin D deficiency and extra-skeletal pathologies emerged, alongside increased awareness of widespread deficits. This prompted crucial debates on optimal serum concentrations, expected to conclude when the outcomes of high-dose supplementation randomized controlled trials were available. Skepticism arose with inconclusive results from these trials. CONTENT This review begins with an exploration of vitamin D metabolism, followed by a detailed description of the measurement of vitamin D metabolites and the crucial role of standardization. Subsequent sections focus on the association of vitamin D with bone health and explore the extra-skeletal effects. The review concludes with a comprehensive discussion on the definition of vitamin D status and its implications for supplementation. SUMMARY Despite standardization efforts, assay variations and challenges still exist, especially in specific patient groups. Vitamin D supplementation has a significant impact on bone metabolism and optimal vitamin D status improves the efficacy of antiresorptive drugs such as bisphosphonates. The extra-skeletal effects of vitamin D remain debated, but may include potential benefits in conditions such as respiratory infections and cancer mortality, particularly in deficient individuals. The definition of vitamin D sufficiency is nuanced, especially when variations in population groups and analytical methods are taken into account. Despite ongoing debates and recent mega-trials tempering enthusiasm, vitamin D remains a complex and essential element in human health. Further research is needed to clarify its role in various health outcomes and guide supplementation strategies.
Collapse
Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CIRM, CHU de Liège, Liège, Belgium
| | | | - Annemieke C Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Amsterdam Gastroenterology & Metabolism, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Markus Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | | |
Collapse
|
29
|
Damani JJ, Oh ES, De Souza MJ, Strock NC, Williams NI, Nakatsu CH, Lee H, Weaver C, Rogers CJ. Prune Consumption Attenuates Proinflammatory Cytokine Secretion and Alters Monocyte Activation in Postmenopausal Women: Secondary Outcome Analysis of a 12-Mo Randomized Controlled Trial: The Prune Study. J Nutr 2024; 154:1699-1710. [PMID: 37984741 DOI: 10.1016/j.tjnut.2023.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 11/03/2023] [Accepted: 11/17/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Proinflammatory cytokines are implicated in the pathophysiology of postmenopausal bone loss. Clinical studies demonstrate that prunes prevent bone mineral density loss; however, the mechanism underlying this effect is unknown. OBJECTIVE We investigated the effect of prune supplementation on immune, inflammatory, and oxidative stress markers. METHODS A secondary analysis was conducted in the Prune Study, a single-center, parallel-arm, 12-mo randomized controlled trial of postmenopausal women (55-75 y old; n = 235 recruited; n = 183 completed) who were assigned to 1 of 3 groups: "no-prune" control, 50 g prune/d and 100 g prune/d groups. At baseline and after 12 mo of intervention, blood samples were collected to measure serum high-sensitivity C-reactive protein (hs-CRP), serum total antioxidant capacity (TAC), plasma 8-isoprostane, proinflammatory cytokines [interleukin (IL)-1β, IL-6, IL-8, monocyte chemoattractant protein-1, and tumor necrosis factor (TNF)-α] concentrations in plasma and lipopolysaccharide (LPS)-stimulated peripheral blood mononuclear cells (PBMCs) culture supernatants, and the percentage and activation of circulating monocytes, as secondary outcomes. RESULTS Prune supplementation did not alter hs-CRP, TAC, 8-isoprostane, and plasma cytokine concentrations. However, percent change from baseline in circulating activated monocytes was lower in the 100 g prune/d group compared with the control group (mean ± SD, -1.8% ± 4.0% in 100 g prune/d compared with 0.1% ± 2.9% in control; P < 0.01). Furthermore, in LPS-stimulated PBMC supernatants, the percent change from baseline in TNF-α secretion was lower in the 50 g prune/d group compared with the control group (-4.4% ± 43.0% in 50 g prune/d compared with 24.3% ± 70.7% in control; P < 0.01), and the percent change from baseline in IL-1β, IL-6, and IL-8 secretion was lower in the 100 g prune/d group compared with the control group (-8.9% ± 61.6%, -4.3% ± 75.3%, -14.3% ± 60.8% in 100 g prune/d compared with 46.9% ± 107.4%, 16.9% ± 70.6%, 39.8% ± 90.8% in control for IL-1β, IL-6, and IL-8, respectively; all P < 0.05). CONCLUSIONS Dietary supplementation with 50-100 g prunes for 12 mo reduced proinflammatory cytokine secretion from PBMCs and suppressed the circulating levels of activated monocytes in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT02822378.
Collapse
Affiliation(s)
- Janhavi J Damani
- The Intercollege Graduate Degree Program in Integrative and Biomedical Physiology, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States
| | - Ester S Oh
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States; Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Mary Jane De Souza
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Nicole Ca Strock
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Nancy I Williams
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Cindy H Nakatsu
- Department of Agronomy, Purdue University, West Lafayette, IN, United States
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Connie Weaver
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, United States
| | - Connie J Rogers
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, United States; Center for Molecular Immunology and Infectious Disease, The Pennsylvania State University, University Park, PA, United States; Department of Nutritional Sciences, University of Georgia, Athens, GA, United States.
| |
Collapse
|
30
|
Chen FP, Lin YC, Lin YJ, Huang MH, Chen JF, Lai PL, Chang CW, Yin TC. Relationship Between Serum 25-Hydroxyvitamin D and Bone Mineral Density, Fracture Risk, and Bone Metabolism in Adults With Osteoporosis/Fractures. Endocr Pract 2024:S1530-891X(24)00503-2. [PMID: 38692490 DOI: 10.1016/j.eprac.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE To evaluate the association of serum 25-hydroxyvitamin D (25(OH) D) levels with bone mineral density (BMD), fracture risk, and bone metabolism. METHODS This multicenter cross-sectional study recruited menopausal females and males greater than or equal to 50 year old with osteoporosis/fractures between September 2016 and September 2021. Assessment included clinical data, 25(OH)D, intact parathyroid hormone (iPTH), procollagen type 1 amino-terminal propeptide (P1NP), carboxy-terminal collagen crosslinks (CTX), lateral thoracolumbar spine x-rays, and BMD. RESULTS A total of 3003 individuals were stratified by 25(OH) D levels: 720 individuals (24%) <20 ng/mL, 1338 individuals (44.5%) 20 to 29 ng/mL, and 945 individuals (31.5%) ≥30 ng/mL. In unadjusted and multivariable models, BMD T-score, except spine, was significantly and positively associated with 25(OH)D levels. 25(OH) D levels were inversely associated with Fracture Risk Assessment Tool scores. Patients with 25(OH)D <20 ng/mL had significantly higher iPTH and bone turnover markers (P1NP and CTX) than patients with 25(OH)D ≧20 ng/mL in all models. When analyzing bone-related markers and BMD, total hip and femoral neck BMD T-scores were positively correlated with 25(OH)D concentrations and BMI but negatively correlated with iPTH, P1NP, CTX, and age. In multivariate models with all bone-related markers, only 25(OH)D levels were significantly associated with total hip and femoral neck BMD. CONCLUSION Vitamin D deficiency is significantly associated with decreased total hip and femoral neck BMD and increased fracture risk as assessed by Fracture Risk Assessment Tool. In those with osteoporosis/fractures, vitamin D is implicated in the causal relationship between bone remodeling and BMD. Assessing vitamin D status is imperative for those at risk for osteoporosis/fractures.
Collapse
Affiliation(s)
- Fang-Ping Chen
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan; Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; Department of Obstetrics and Gynecology, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan.
| | - Yu-Ching Lin
- Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; Department of Radiology, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
| | - Yu-Jr Lin
- Service Center for Health Information, Chang Gung University, Taoyuan City, Taiwan
| | - Mei-Huei Huang
- Department of Laboratory Medicine, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
| | - Jung-Fu Chen
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan; Department of Endocrinology and Metabolism, Osteoporosis Prevention and Treatment Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| | - Po-Liang Lai
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan; Department of Orthopaedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chia-Wei Chang
- Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan; Department of Orthopaedic Surgery, Keelung Chang Gung Memorial Hospital, Keelung City, Taiwan
| | - Tsung-Cheng Yin
- Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City, Taiwan
| |
Collapse
|
31
|
Giustina A, Bilezikian JP, Adler RA, Banfi G, Bikle DD, Binkley NC, Bollerslev J, Bouillon R, Brandi ML, Casanueva FF, di Filippo L, Donini LM, Ebeling PR, Fuleihan GEH, Fassio A, Frara S, Jones G, Marcocci C, Martineau AR, Minisola S, Napoli N, Procopio M, Rizzoli R, Schafer AL, Sempos CT, Ulivieri FM, Virtanen JK. Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows. Endocr Rev 2024:bnae009. [PMID: 38676447 DOI: 10.1210/endrev/bnae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Indexed: 04/28/2024]
Abstract
The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.
Collapse
Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - John P Bilezikian
- Department of Medicine, Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Giuseppe Banfi
- IRCCS Galeazzi Sant'Ambrogio Hospital, Milano 20161, Italy
- San Raffaele Vita-Salute University, Milan 20132, Italy
| | - Daniel D Bikle
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
- Department of Endocrinology, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | - Neil C Binkley
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium
| | - Maria Luisa Brandi
- Italian Foundation for the Research on Bone Diseases (F.I.R.M.O.), Florence 50129, Italy
| | - Felipe F Casanueva
- Department of Medicine, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario and CIBER de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Santiago de Compostela University, Santiago de Compostela 15706, Spain
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome 00161, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton 3168, Australia
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO CC for Metabolic Bone Disorders, Division of Endocrinology, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona 37129, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, ON K7L 3N6, Canada
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56126, Italy
| | - Adrian R Martineau
- Faculty of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Salvatore Minisola
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes Campus Bio-Medico, University of Rome, Rome 00128, Italy
| | - Massimo Procopio
- Division of Endocrinology, Diabetology and Metabolic Diseases, "Molinette" Hospital, University of Turin, Turin 10126, Italy
| | - René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva 1205, Switzerland
| | - Anne L Schafer
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio FI-70211, Finland
| |
Collapse
|
32
|
Timpmann S, Rips L, Olveti I, Mooses M, Mölder H, Varblane A, Lille HR, Gapeyeva H, Ööpik V. Seasonal Variation in Vitamin D Status Does Not Interfere with Improvements in Aerobic and Muscular Endurance in Conscripts during Basic Military Training. Nutrients 2024; 16:1306. [PMID: 38732553 PMCID: PMC11085734 DOI: 10.3390/nu16091306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024] Open
Abstract
Considering a lack of respective data, the primary objective of this study was to assess whether seasonal variation in vitamin D status (D-status) affects the extent of improvement in physical performance (PP) in conscripts during basic military training (BMT). D-status, PP and several blood parameters were measured repeatedly in conscripts whose 10-week BMT started in July (cohort S-C; n = 96) or in October (cohort A-C; n = 107). D-status during BMT was higher in S-C compared to A-C (overall serum 25(OH)D 61.4 ± 16.1 and 48.5 ± 20.7 nmol/L, respectively; p < 0.0001). Significant (p < 0.05) improvements in both aerobic and muscular endurance occurred in both cohorts during BMT. Pooled data of the two cohorts revealed a highly reliable (p = 0.000) but weak (R2 = 0.038-0.162) positive association between D-status and PP measures both at the beginning and end of BMT. However, further analysis showed that such a relationship occurred only in conscripts with insufficient or deficient D-status, but not in their vitamin D-sufficient companions. Significant (p < 0.05) increases in serum testosterone-to-cortisol ratio and decreases in ferritin levels occurred during BMT. In conclusion, a positive association exists between D-status and PP measures, but seasonal variation in D-status does not influence the extent of improvement in PP in conscripts during BMT.
Collapse
Affiliation(s)
- Saima Timpmann
- Institute of Sport Sciences and Physiotherapy, University of Tartu, 18 Ülikooli St., 50090 Tartu, Estonia; (S.T.); (M.M.)
| | - Leho Rips
- Sports Medicine and Rehabilitation Clinic, Tartu University Hospital, 1a L. Puusepa St., 50406 Tartu, Estonia;
- Department of Sports Medicine and Rehabilitation, Institute of Clinical Medicine, Faculty of Medicine, University of Tartu, 18 Ülikooli St., 50090 Tartu, Estonia
- Centre of Military Disaster Medicine, Estonian National Defense College, 12 Riia St., 51010 Tartu, Estonia;
| | - Indrek Olveti
- 2nd Infantry Brigade, Estonian Defense Forces, Sirgu Village, Luunja Parish, 62216 Tartu, Estonia;
| | - Martin Mooses
- Institute of Sport Sciences and Physiotherapy, University of Tartu, 18 Ülikooli St., 50090 Tartu, Estonia; (S.T.); (M.M.)
| | - Hanno Mölder
- Medical Centre of the 2nd Infantry Brigade CSS Battalion, Estonian Defense Forces, 3a Kose Road, 65603 Võru, Estonia;
| | - Ahti Varblane
- Joint Headquarters of the Estonian Defense Forces, 58 Juhkentali St., 15007 Tallinn, Estonia;
| | - Hele-Reet Lille
- Centre of Military Disaster Medicine, Estonian National Defense College, 12 Riia St., 51010 Tartu, Estonia;
| | - Helena Gapeyeva
- Clinic of Medical Rehabilitation, II Rehabilitation Department, East Tallinn Central Hospital, 104 Pärnu St., 11312 Tallinn, Estonia;
| | - Vahur Ööpik
- Institute of Sport Sciences and Physiotherapy, University of Tartu, 18 Ülikooli St., 50090 Tartu, Estonia; (S.T.); (M.M.)
| |
Collapse
|
33
|
Qiu L, Ren Y, Li J, Li M, Li W, Qin L, Zhang J, Gao F. The correlation of obesity status with serum 25-hydroxyvitamin D in US Asian adults: NHANES 2011-2018. PLoS One 2024; 19:e0301327. [PMID: 38626143 PMCID: PMC11020701 DOI: 10.1371/journal.pone.0301327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/14/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND There is a correlation between obesity and 25-hydroxyvitamin D (25OHD) that tends to be negative. However, this relationship varies among different races. In this study, Asian adults with and without obesity were compared in terms of their levels of 25OHD. METHODS We carried out a cross-sectional analysis on 2664 non-Hispanic Asian adults who participated in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. To examine the connection between obese status, body mass index (BMI), waist circumference (WC) and weight, and 25OHD, we ran multivariate linear regression models and multivariate logistic regression models. RESULTS After adjusting for all confounding factors, obesity status shows a significant positive correlation with vitamin D deficiency (model 3: OR = 2.318, 95% CI:1.317, 4.082). This positive correlation remains significant in males (males: OR = 2.713, 95% CI: -13.398, 5.217). In all three models, a negative association was observed between obesity status and 25OHD (model 1: β = -4.535, 95% CI: -6.987, -2.083; model 2 β = -4.249, 95% CI: -6.549, -2.039; model 3 β = -1.734, 95% CI: -7.285, 3.816). After controlling for covariates, there was a significant negative correlation between WC and 25OHD when stratified by gender and obesity status in both males with and without obesity (males with obesity: β = -1.461, 95% CI: -2.485, -0.436; males without obesity: β = -0.855. 95% CI: -1.499, -0.210). In males with obesity, there was a very strong positive connection between body weight and 25OHD (β = 0.912, 95% CI: 0.227, 1.597). In addition, neither gender's obese individuals showed a significant link between BMI and 25OHD. CONCLUSION This study demonstrated a positive correlation between obesity and vitamin D deficiency and a negative correlation between obesity and 25OHD in Asian American adults. Additionally, among male obese individuals, there was a significant negative correlation between WC and 25OHD, an observation that needs to be validated in further prospective studies.
Collapse
Affiliation(s)
- Linjie Qiu
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Ren
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jixin Li
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Meijie Li
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjie Li
- Graduate school, Shanxi University of Chinese Medicine, Shanxi, China
| | - Lingli Qin
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jin Zhang
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Feng Gao
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
34
|
Ramalingam L, Mabry B, Menikdiwela KR, Moussa H, Moustaid-Moussa N. Enhanced Metabolic Effects of Fish Oil When Combined with Vitamin D in Diet-Induced Obese Male Mice. Biomolecules 2024; 14:474. [PMID: 38672490 PMCID: PMC11048485 DOI: 10.3390/biom14040474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 03/30/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Vitamin D (vit D) and fish oil (FO) both offer unique health benefits, however, their combined effects have not been evaluated in obesity and nonalcoholic fatty liver disease (NAFLD). Hence, we hypothesized that vit D and FO supplementation would have additive effects in reducing obesity-associated inflammation and NAFLD. Male C57BL6 mice were split into four groups and fed a high fat (HF) diet supplemented with a low (HF; +200 IU vit D) or high dose of vitamin D (HF + D; +1000 IU vit D); combination of vit D and FO (HF-FO; +1000 IU vit D); or only FO (HF-FO; +200 IU vit D) for 12 weeks. We measured body weight, food intake, glucose tolerance, and harvested epididymal fat pad and liver for gene expression analyses. Adiposity was reduced in groups supplemented with both FO and vit D. Glucose clearance was higher in FO-supplemented groups compared to mice fed HF. In adipose tissue, markers of fatty acid synthesis and oxidation were comparable in groups that received vit D and FO individually in comparison to HF. However, the vit D and FO group had significantly lower fatty acid synthesis and higher oxidation compared to the other groups. Vit D and FO also significantly improved fatty acid oxidation, despite similar fatty acid synthesis among the four groups in liver. Even though we did not find additive effects of vit D and FO, our data provide evidence that FO reduces markers of obesity in the presence of adequate levels of vit D.
Collapse
Affiliation(s)
- Latha Ramalingam
- Nutrigenomics, Inflammation and Obesity Research Laboratory, Department of Nutritional Sciences, Texas Tech University (TTU), Lubbock, TX 79409, USA (K.R.M.)
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University (TTU), Lubbock, TX 79409, USA
| | - Brennan Mabry
- Nutrigenomics, Inflammation and Obesity Research Laboratory, Department of Nutritional Sciences, Texas Tech University (TTU), Lubbock, TX 79409, USA (K.R.M.)
| | - Kalhara R. Menikdiwela
- Nutrigenomics, Inflammation and Obesity Research Laboratory, Department of Nutritional Sciences, Texas Tech University (TTU), Lubbock, TX 79409, USA (K.R.M.)
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University (TTU), Lubbock, TX 79409, USA
| | - Hanna Moussa
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University (TTU), Lubbock, TX 79409, USA
- Department of Physics & Astronomy, College of Arts & Sciences, Texas Tech University (TTU), Lubbock, TX 79409, USA
| | - Naima Moustaid-Moussa
- Nutrigenomics, Inflammation and Obesity Research Laboratory, Department of Nutritional Sciences, Texas Tech University (TTU), Lubbock, TX 79409, USA (K.R.M.)
- Obesity Research Institute, Office of Research & Innovation, Texas Tech University (TTU), Lubbock, TX 79409, USA
| |
Collapse
|
35
|
Carboo JA, Dolman-Macleod RC, Malan L, Lombard MJ. High-dose oral vitamin D supplementation for prevention of infections in children aged 0 to 59 months: a systematic review and meta-analysis. Nutr Rev 2024; 82:579-599. [PMID: 37428896 PMCID: PMC11009788 DOI: 10.1093/nutrit/nuad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
CONTEXT Vitamin D plays an important role in immune function, and the deficiency thereof has been associated with several infections, most notably respiratory tract infections. However, data from intervention studies investigating the effect of high-dose vitamin D supplementation on infections have been inconclusive. OBJECTIVE The aim of this study was to evaluate the level of evidence regarding the efficacy of vitamin D supplementation above the standard dose (400 IU) in preventing infections in apparently healthy children < 5 years of age. DATA SOURCES PubMed, Scopus, Science Direct, Web of Science, Google Scholar, CINAHL, and MEDLINE electronic databases were searched between August 2022 and November 2022. Seven studies met the inclusion criteria. DATA EXTRACTION Meta-analyses of outcomes in more than one study were performed using Review Manager software. Heterogeneity was evaluated using the I2 statistic. Randomized controlled trials in which vitamin D was supplemented at > 400 IU compared with placebo, no treatment, or standard dose were included. DATA ANALYSIS Seven trials that enrolled a total of 5748 children were included. Odds ratios (ORs) with 95%CIs were calculated using random- and fixed-effects models. There was no significant effect of high-dose vitamin D supplementation on the incidence of upper respiratory tract infection (OR, 0.83; 95%CI, 0.62-1.10). There was a 57% (95%CI, 0.30-0.61), 56% (95%CI, 0.27-0.07), and 59% (95%CI, 0.26-0.65) reduction in the odds of influenza/cold, cough, and fever incidence, respectively, with daily supplementation of vitamin D > 1000 IU. No effect was found on bronchitis, otitis media, diarrhea/gastroenteritis, primary care visits for infections, hospitalizations, or mortality. CONCLUSION High-dose vitamin D supplementation provided no benefit in preventing upper respiratory tract infections (moderate certainty of evidence) but reduced the incidence influenza/cold (moderate certainty of evidence), cough, and fever (low certainty of evidence). These findings are based on a limited number of trials and should be interpreted with caution. Further research is needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42022355206.
Collapse
Affiliation(s)
- Janet Adede Carboo
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, North West Province, South Africa
| | - Robin Claire Dolman-Macleod
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, North West Province, South Africa
| | - Linda Malan
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, North West Province, South Africa
| | - Martani Johanni Lombard
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, North West Province, South Africa
| |
Collapse
|
36
|
Weiler HA, Bielecki A, Fu W, Demonty I, Brooks SP. Cholesterol Interference in the Assessment of Vitamin D Status: A Canadian Health Measures Survey Biobank Project. J Nutr 2024:S0022-3166(24)00173-1. [PMID: 38582388 DOI: 10.1016/j.tjnut.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/18/2024] [Accepted: 04/02/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Matrix effects are a known problem with immunoassays measuring serum 25-hydroxyvitamin D [25(OH)D]. OBJECTIVES To determine if the inverse association between serum 25(OH)D and serum cholesterol concentrations is a function of assay method: Diasorin Liaison 25(OH) Vitamin D Total Assay (Liaison Total Assay), an immunoassay, compared with liquid chromatography tandem mass spectrometry (LC-MS/MS). METHODS Canadian Health Measures Survey data and biobank serum (White males aged 20-79 y, n = 392) were evaluated for bias in serum 25(OH)D using Bland-Altman plots. Differences in serum 25(OH)D (Liaison Total Assay - LC-MS/MS) were compared among non-HDL-cholesterol <4.2 (n = 295) compared with ≥4.2 (n = 97) mmol/L and total cholesterol groups <5.2 (n = 256) compared with ≥5.2 (n = 136) mmol/L, and associations tested between 25(OH)D and non-HDL-cholesterol or total cholesterol concentrations, using regression. RESULTS Serum 25(OH)D measured using Liaison Total Assay ranged from 10.7 to 137.0 nmol/L and 14.4 to 137.9 nmol/L by LC-MS/MS. Liaison Total Assay - LC-MS/MS showed a negative bias of 5.5 (95% limits of agreement -23.8, 12.7) nmol/L. Differences in 25(OH)D were -4.0 ± 9.0 (±SD) nmol/L if non-HDL-cholesterol was <4.2 mmol/L and -10.2 ± 8.7 nmol/L if ≥4.2 mmol/L (P < 0.0001). Differences in 25(OH)D, if total cholesterol was <5.2 mmol/L, were -3.4 ± 8.6 nmol/L and -9.6 ± 9.3 nmol/L if ≥5.2 mmol/L (P < 0.0001). Serum non-HDL-cholesterol (beta -3.17, P = 0.0014) and total cholesterol (beta -2.77, P = 0.0046) were inversely associated with Liaison Total Assay 25(OH)D (adjusted for age, fasting, and body mass index), but not with LC-MS/MS measured 25(OH)D. Interference by these lipoproteins was not eliminated by standardization of the Liaison Total Assay. Similar associations were observed with triglycerides as for the lipoproteins. CONCLUSIONS Total cholesterol inversely associates with 25(OH)D, which is likely due to elevated non-HDL-cholesterol lipoprotein or triglyceride interference with the Liaison Total Assay. This is important as elevated cholesterol is common, and an underestimation of vitamin D status could be an unnecessary cause for concern.
Collapse
Affiliation(s)
- Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
| | - Agnieszka Bielecki
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Wen Fu
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Isabelle Demonty
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Stephen Pj Brooks
- Nutrition Research Division, Bureau of Nutritional Sciences, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| |
Collapse
|
37
|
Nekoukar Z, Manouchehri A, Zakariaei Z. Accidental vitamin D3 overdose in a young man. INT J VITAM NUTR RES 2024; 94:82-85. [PMID: 37975856 DOI: 10.1024/0300-9831/a000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Vitamin D3 (VD3) is a fat-soluble vitamin that can accumulate in the body and lead to toxicity by increasing 25(OH) D levels when consumed in large amounts. Maintaining 25(OH) D levels greater than 30 ng/mL is crucial for overall health due to the significant role of vitamin D in the body. The most common causes of VD3 intoxication are manufacturing errors or self-administration. Currently, there is no definitive data on the dose and duration of VD3 consumption that leads to toxicity. The maximum daily doses of VD3 that can be tolerated without causing adverse effects are not established. The maximum recommended amount for long-term supplementation is 2,000 units per day. Vitamin D3 toxicity (VDT) can present in various scenarios, ranging from asymptomatic to gastrointestinal, and in severe cases with neuropsychiatric and life-threatening symptoms. We report the case of a 29-year-old man who presented with symptoms of VDT following an accidental overdose of VD3 over 2 weeks.
Collapse
Affiliation(s)
- Zahra Nekoukar
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Aliasghar Manouchehri
- Department of Internal Medicine, Shahid Beheshti Hospital, Babol University of Medical Sciences, Babol, Iran
| | - Zakaria Zakariaei
- Toxicology and Forensic Medicine Division, Mazandaran Registry Center for Opioids Poisoning, Antimicrobial Resistance Research Centers, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
38
|
Thomson CA, Aragaki AK, Prentice RL, Stefanick ML, Manson JE, Wactawski-Wende J, Watts NB, Van Horn L, Shikany JM, Rohan TE, Lane DS, Wild RA, Robles-Morales R, Shadyab AH, Saquib N, Cauley J. Long-Term Effect of Randomization to Calcium and Vitamin D Supplementation on Health in Older Women : Postintervention Follow-up of a Randomized Clinical Trial. Ann Intern Med 2024; 177:428-438. [PMID: 38467003 DOI: 10.7326/m23-2598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Although calcium and vitamin D (CaD) supplementation may affect chronic disease in older women, evidence of long-term effects on health outcomes is limited. OBJECTIVE To evaluate long-term health outcomes among postmenopausal women in the Women's Health Initiative CaD trial. DESIGN Post hoc analysis of long-term postintervention follow-up of the 7-year randomized intervention trial of CaD. (ClinicalTrials.gov: NCT00000611). SETTING A multicenter (n = 40) trial across the United States. PARTICIPANTS 36 282 postmenopausal women with no history of breast or colorectal cancer. INTERVENTION Random 1:1 assignment to 1000 mg of calcium carbonate (400 mg of elemental calcium) with 400 IU of vitamin D3 daily or placebo. MEASUREMENTS Incidence of colorectal, invasive breast, and total cancer; disease-specific and all-cause mortality; total cardiovascular disease (CVD); and hip fracture by randomization assignment (through December 2020). Analyses were stratified on personal supplement use. RESULTS For women randomly assigned to CaD versus placebo, a 7% reduction in cancer mortality was observed after a median cumulative follow-up of 22.3 years (1817 vs. 1943 deaths; hazard ratio [HR], 0.93 [95% CI, 0.87 to 0.99]), along with a 6% increase in CVD mortality (2621 vs. 2420 deaths; HR, 1.06 [CI, 1.01 to 1.12]). There was no overall effect on other measures, including all-cause mortality (7834 vs. 7748 deaths; HR, 1.00 [CI, 0.97 to 1.03]). Estimates for cancer incidence varied widely when stratified by whether participants reported supplement use before randomization, whereas estimates on mortality did not vary, except for CVD mortality. LIMITATION Hip fracture and CVD outcomes were available on only a subset of participants, and effects of calcium versus vitamin D versus joint supplementation could not be disentangled. CONCLUSION Calcium and vitamin D supplements seemed to reduce cancer mortality and increase CVD mortality after more than 20 years of follow-up among postmenopausal women, with no effect on all-cause mortality. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute of the National Institutes of Health.
Collapse
Affiliation(s)
- Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (C.A.T.)
| | - Aaron K Aragaki
- Fred Hutchinson Cancer Center, Seattle, Washington (A.K.A., R.L.P.)
| | - Ross L Prentice
- Fred Hutchinson Cancer Center, Seattle, Washington (A.K.A., R.L.P.)
| | - Marcia L Stefanick
- Department of Medicine, Stanford School of Medicine, Stanford University, Palo Alto, California (M.L.S.)
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.E.M.)
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, Buffalo, New York (J.W.)
| | | | - Linda Van Horn
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (L.V.H.)
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (J.M.S.)
| | - Thomas E Rohan
- Albert Einstein College of Medicine, Bronx, New York (T.E.R.)
| | - Dorothy S Lane
- Renaissance School of Medicine, Stony Brook, New York (D.S.L.)
| | - Robert A Wild
- Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma (R.A.W.)
| | - Rogelio Robles-Morales
- Department of Clinical Translational Sciences, College of Medicine, University of Arizona, Tucson, Arizona (R.R.)
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, California (A.H.S.)
| | - Nazmus Saquib
- Clinical Sciences Department, College of Medicine, Sulaiman Alrajhi University, Al Bukayriyah, Saudi Arabia (N.S.)
| | - Jane Cauley
- University of Pittsburgh, Pittsburgh, Pennsylvania (J.C.)
| |
Collapse
|
39
|
Verbeke J, Laurent MR, Matthys C. Development and validation of an eight-item calcium screener to assess daily calcium intake of patients with osteoporosis in clinical practice. Eur J Clin Nutr 2024; 78:301-306. [PMID: 38158406 DOI: 10.1038/s41430-023-01390-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE To validate a short food frequency questionnaire (screener) estimating daily average calcium intake from dietary sources to guide calcium supplementation of patients with osteoporosis in clinical practice. METHODS An eight-item calcium screener was developed based on existing literature, food consumption data and expert opinion. Convergent validity was determined by comparison with 3-day food records using mean difference, Spearman's correlation coefficients (SCC) and Bland-Altman analysis. Test-retest reliability was assessed by SCC and intraclass correlation coefficients (ICC). We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to identify patients requiring calcium supplementation (<1200 mg dietary calcium intake/day). RESULTS Fifty-two patients filled out the eight-item calcium screener and the 3-day Food record (mean age of 66.8 ± 12.9 (SD)) and 38 patients filled out the screener twice for reliability analysis (mean age of 65.8 ± 12.8 (SD)). Dietary calcium intake between the calcium screener and food records showed a strong correlation (N = 52 patients, SCC = 0.53, p ≤ 0.001) and mean difference of 21 mg (p = 0.70). Bland-Altman analysis showed agreement within 95% confidence intervals for 49/52 comparisons (94%). Test-retest reliability of the calcium screener was excellent (SCC = 0.96, p ≤ 0.001; ICC = 0.99, p ≤ 0.001). CONCLUSION The calcium screener shows good convergent validity, reliability and feasibility to estimate daily calcium intake of patients with osteoporosis in routine clinical practice.
Collapse
Affiliation(s)
- Joke Verbeke
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Michaël R Laurent
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
- Department of Geriatrics, Imelda Hospital, Bonheiden, Belgium
| | - Christophe Matthys
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium.
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium.
| |
Collapse
|
40
|
Alzohily B, AlMenhali A, Gariballa S, Munawar N, Yasin J, Shah I. Unraveling the complex interplay between obesity and vitamin D metabolism. Sci Rep 2024; 14:7583. [PMID: 38555277 PMCID: PMC10981658 DOI: 10.1038/s41598-024-58154-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
Vitamin D deficiency and obesity are a worldwide health issue. Obesity refers to the accumulation of excessive fats in the body which could lead to the development of diseases. Obese people have low vitamin D levels for several reasons including larger volume of distribution, vitamin D tightly bound in fatty tissues, reduced absorption, and diets with low vitamin D. Accurately measuring vitamin D metabolites is challenging. The Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry (UHPLC-MS/MS) method was developed and validated for the analysis of vitamin D metabolites in the serum. Blood samples were collected from 452 subjects which consisted of baseline (vitamin D deficient obese subjects), follow-up (supplemented obese subjects), and healthy volunteers. The vitamin D metabolites were separated adequately by the developed UHPLC-MS/MS method. Moreover, the validation criteria for the method were within an acceptable range. The baseline, follow-up and even healthy volunteers were deficient in 25OHD3 and 25OHD2. The baseline and healthy subjects had comparable concentration of vitamin D2 and D3. However, healthy subjects had a higher concentration of 25OHD and its epimer compared to the baseline subjects. The vitamin D3 was increased significantly in the follow- up subjects; therefore, the 25OHD3 was increased significantly compared to the baseline as well; however, the increase was insufficient to achieve the optimal range. The UHPLC-MS/MS method test was applied successfully on estimation of vitamin D metabolites in subjects. This study indicates the significance of taking into account the metabolic and storage effects when evaluating the vitamin D status in obese subjects.
Collapse
Affiliation(s)
- Bashar Alzohily
- Department of Chemistry, College of Science, UAE University, 15551, Al Ain, UAE
| | - Asma AlMenhali
- Department of Biology, College of Science, UAE University, 15551, Al Ain, UAE
| | - Salah Gariballa
- Internal Medicine, Faculty of Medicine and Health Sciences, UAE University, 15551, Al Ain, UAE
| | - Nayla Munawar
- Department of Chemistry, College of Science, UAE University, 15551, Al Ain, UAE
| | - Javed Yasin
- Internal Medicine, Faculty of Medicine and Health Sciences, UAE University, 15551, Al Ain, UAE
| | - Iltaf Shah
- Department of Chemistry, College of Science, UAE University, 15551, Al Ain, UAE.
| |
Collapse
|
41
|
Weiler HA, Rana H, McCrea J, Loukine L, Bonvalot Y, Nguyen L, Hopperton K, Cooper M, Bertinato J, Vercammen K, Luo W, Nicholson C, Yuan J, Brule S. Adherence to Vitamin D Supplementation Recommendations for Breastfed Infants and Young Children: An Analysis of Canadian Community Health Survey Data Cycles From 2015 to 2018. J Nutr 2024:S0022-3166(24)00165-2. [PMID: 38527736 DOI: 10.1016/j.tjnut.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND In Canada, nutrition policy, as outlined in the Nutrition for Healthy Term Infants recommendations, includes a daily vitamin D supplement of 10 μg (400 IU) for breastfed infants and young children to support adequate vitamin D status. OBJECTIVES This study aimed to report on adherence to vitamin D supplementation recommendations for breastfed infants (≤12 months); and for children breastfed >12 mo. METHODS Canadian Community Health Survey (paired-cycles 2015/2016 and 2017/2018) maternal experiences data for infants born 2012-2018 who received any breastmilk formed the sample (n = 7079). Whether the infant was given a vitamin D supplement (yes/no) and the frequency (daily/almost every day, 1-2/wk, or <1/wk) were surveyed. Weighted data (95% CI) were summarized according to breastfeeding history (exclusive to 6 mo and continuing; partial to 6 mo and continuing; and stopped ≤6 mo). Correlates of supplement adherence were explored using logistic regression. RESULTS Overall, 87.1% (95% CI: 85.9%, 88.3%) of participants reported giving their infant (≤12 mo) a vitamin D supplement, and of these, 83.3% (95% CI: 81.9%, 84.7%) did so daily/almost every day, 12.4% (95% CI: 11.1%, 13.7%) did so 1-2/wk, and 4.3% (95% CI: 3.6%, 5.0%) did so <1/wk. Lower adjusted odds of adherence were observed among participants reporting: stopped breastfeeding ≤6 mo, lower education or income, recent immigration, and overweight prepregnancy body mass index; higher odds of adherence were observed in the western provinces. Regarding mothers of children >12 mo and breastfed (n = 2312), 58.0% (95% CI: 54.9%, 61.1%) gave a vitamin D supplement daily/almost every day. CONCLUSIONS Adherence to providing a vitamin D supplement to breastfed infants is high in Canada. Nonetheless, we estimate that ∼27% of mothers are nonadherent to daily/almost every day administration of a vitamin D supplement and that adherence declines in children breastfed >12 mo. Further promotion to support uptake of the current guidance may be necessary, particularly for parents of recent immigration or lower socioeconomic status.
Collapse
Affiliation(s)
- Hope A Weiler
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
| | - Huma Rana
- Office of Nutrition Policy and Promotion, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Jennifer McCrea
- Office of Nutrition Policy and Promotion, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Lidia Loukine
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Yvette Bonvalot
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Loan Nguyen
- Bureau of Food Surveillance and Science Integration, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Kathryn Hopperton
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Marcia Cooper
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Jesse Bertinato
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada
| | - Kelsey Vercammen
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Wei Luo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Carley Nicholson
- Maternal and Child Health Unit, Centre for Health Promotion, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Jane Yuan
- Centre for Population Health Data, Statistics Canada, Ottawa, Ontario, Canada
| | - Shawn Brule
- Centre for Population Health Data, Statistics Canada, Ottawa, Ontario, Canada
| |
Collapse
|
42
|
Damani JJ, Rogers CJ, Lee H, Strock NC, Koltun KJ, Williams NI, Weaver C, Ferruzzi MG, Nakatsu CH, De Souza MJ. Effects of Prune (Dried Plum) Supplementation on Cardiometabolic Health in Postmenopausal Women: An Ancillary Analysis of a 12-Month Randomized Controlled Trial, The Prune Study. J Nutr 2024:S0022-3166(24)00161-5. [PMID: 38490532 DOI: 10.1016/j.tjnut.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Estrogen withdrawal during menopause is associated with an unfavorable cardiometabolic profile. Prunes (dried plums) represent an emerging functional food and have been previously demonstrated to improve bone health. However, our understanding of the effects of daily prune intake on cardiometabolic risk factors in postmenopausal women is limited. OBJECTIVES We conducted an ancillary investigation of a randomized controlled trial (RCT), The Prune Study, to evaluate the effect of 12-mo prune supplementation on cardiometabolic health markers in postmenopausal women. METHODS The Prune Study was a single-center, parallel-design, 12-mo RCT in which postmenopausal women were allocated to no-prune control, 50 g/d prune, or 100 g/d prune groups. Blood was collected at baseline, 6 mo, and 12 mo/post to measure markers of glycemic control and blood lipids. Body composition was assessed at baseline, 6 mo, and 12 mo/post using dual-energy X-ray absorptiometry. Linear mixed-effects models were used to evaluate the effect of time, treatment, and their interaction on cardiometabolic health markers, all quantified as exploratory outcomes. RESULTS A total of 183 postmenopausal women (mean age, 62.1 ± 4.9 y) completed the entire 12-mo RCT: control (n = 70), 50 g/d prune (n = 67), and 100 g/d prune (n = 46). Prune supplementation at 50 g/d or 100 g/d did not alter markers of glycemic control and blood lipids after 12 mo compared with the control group (all P > 0.05). Furthermore, gynoid percent fat and visceral adipose tissue (VAT) indices did not significantly differ in women consuming 50 g/d or 100 g/d prunes compared with the control group after 12 mo of intervention. However, android total mass increased by 3.19% ± 5.5% from baseline in the control group, whereas the 100 g/d prune group experienced 0.02% ± 5.6% decrease in android total mass from baseline (P < 0.01). CONCLUSIONS Prune supplementation at 50 g/d or 100 g/d for 12 mo does not improve glycemic control and may prevent adverse changes in central adiposity in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT02822378.
Collapse
Affiliation(s)
- Janhavi J Damani
- The Intercollege Graduate Degree Program in Integrative and Biomedical Physiology, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, United States; Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Connie J Rogers
- Department of Nutritional Sciences, University of Georgia, Athens, GA, United States
| | - Hang Lee
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Nicole Ca Strock
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Kristen J Koltun
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States; Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Nancy I Williams
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States
| | - Connie Weaver
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, United States
| | - Mario G Ferruzzi
- Arkansas Children's Nutrition Center, Department of Pediatrics, University of Arkansas for Medical Science, Little Rock, AR, United States
| | - Cindy H Nakatsu
- Department of Agronomy, Purdue University, West Lafayette, IN, United States
| | - Mary Jane De Souza
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States.
| |
Collapse
|
43
|
Antwi MH, Sakyi SA, Appiah SCY, Buckman TA, Yorke J, Kwakye AS, Darban I, Agoba P, Addei AM. Investigation of serum level relationship of pro-inflammatory and anti-inflammatory cytokines with vitamin D among healthy Ghanaian population. BMC Res Notes 2024; 17:64. [PMID: 38439034 PMCID: PMC10913209 DOI: 10.1186/s13104-024-06721-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/14/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND The interplay between vitamin D status and inflammatory cytokines in a supposedly sufficient sunshine environment has not well been evaluated. The study sought to determine their association. METHODS This cross-sectional study involved 500 healthy adult blood donors from some selected hospitals in Ghana enrolled from June to November 2016. Venous blood samples were obtained from participants, 25(OH)D, TNF-alpha, IFN-gamma, and IL 10 were measured using enzyme linked immunosorbent assay (ELISA) technique. Serum levels of 25(OH)D < 20ng/ml were classified as being deficient or low. RESULTS The average age of the participants was 27.97 years. No statistically significant association was established between 25(OH) D status, mean age (p = 0.1693), and gender (p = 0.5461) of study participants. Similarly, the median 25(OH) D (p = 0.8392), IL-10 (p = 0.5355), TNF-alpha (p = 0.9740), and IFN-gamma (p = 0.6908) were not significantly different across gender. There was a significantly increased levels of TNF-alpha (p < 0.0001) and IFN-gamma (p < 0.0001) among participants with 25(OH) D deficiency compared to those without deficiency. Concurrently, participants with 25(OH)D deficiency had a significantly reduced levels of IL-10 (p < 0.0001) compared to those without 25 (OH) D deficiency. The most accurate biochemical markers for identifying 25 (OH) D deficiency were IFN-gamma (AUC = 0.879; p < 0.0001) followed by TNF-gamma (AUC = 0.849; p < 0.0001) and IL-10 (AUC = 0.707; p < 0.0001). CONCLUSION There was a significant association between vitamin D levels and pro-inflammatory cytokines (TNF-alpha, IFN-gamma) and anti-inflammatory cytokine (IL 10) among healthy Ghanaian populace.
Collapse
Affiliation(s)
- Maxwell Hubert Antwi
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Department of Medical Laboratory Science, Faculty of Health and Allied Sciences, Koforidua Technical University, Koforidua, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Tonnies Abeku Buckman
- Department of Molecular Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
- Department of Medical Laboratory Science, KAAF University College, Buduburam, Ghana.
| | - Joseph Yorke
- Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aaron Siaw Kwakye
- Department of Medical Laboratory Science, Faculty of Health and Allied Sciences, Koforidua Technical University, Koforidua, Ghana
| | - Isaac Darban
- Department of Medical Laboratory Science, Faculty of Health and Allied Sciences, Koforidua Technical University, Koforidua, Ghana
| | - Peter Agoba
- Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Akwasi Minnah Addei
- Department of Biological Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| |
Collapse
|
44
|
Tentolouris N, Achilla C, Anastasiou IA, Eleftheriadou I, Tentolouris A, Basoulis D, Kosta O, Lambropoulos A, Yavropoulou MP, Chatzikyriakidou A, Jude EB. The Association of Vitamin D Receptor Polymorphisms with COVID-19 Severity. Nutrients 2024; 16:727. [PMID: 38474855 DOI: 10.3390/nu16050727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Association studies of vitamin D receptor (VDR) polymorphisms with COVID-19 severity have produced inconsistent results in different populations. Herein we examined VDR gene polymorphisms in a Caucasian Greek cohort of COVID-19 patients. METHODS This was a case-control study in a tertiary university hospital in Greece including 137 COVID-19 patients with varying disease severities and 72 healthy individuals. In total 209 individuals were genotyped for the FokI (rs10735810), ApaI (rs7975232), TaqI (rs731236) and BsmI (rs1544410) single-nucleotide polymorphisms (SNP) of the VDR gene by polymerase chain reaction and restriction fragment length polymorphism analysis (PCR-RFLPs). Statistical analyses were performed to determine the association between genotype and disease severity, adjusting for various confounding factors. RESULTS Genotype distribution of the studied VDR SNPs in the control group was in Hardy-Weinberg equilibrium. The TaqI variant was differentially distributed between controls and COVID-19 patients according to the additive model (p = 0.009), and the CC genotype was significantly associated with an increased risk for severe COVID-19 according to the recessive model [OR: 2.52, 95%CI:1.2-5.29, p = 0.01]. Multivariate analysis demonstrated a robust association of COVID-19 severity and TaqI polymorphism in the recessive model even after adjusting for multiple confounders, including age, sex and CRP levels [Adj.OR:3.23, 95%CI:1.17-8.86, p = 0.023]. The distribution of FokI, ApaI and BsmI genotypes was similar between COVID-19 patients and controls. CONCLUSIONS The CC genotype of TaqI polymorphism is significantly associated with an increased risk for severe COVID-19 independently of age, sex or degree of inflammation.
Collapse
Affiliation(s)
- Nikolaos Tentolouris
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Charoula Achilla
- Laboratory of Medical Biology-Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Ioanna A Anastasiou
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Ioanna Eleftheriadou
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Anastasios Tentolouris
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Dimitrios Basoulis
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Ourania Kosta
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Alexandros Lambropoulos
- Laboratory of Medical Biology-Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Maria P Yavropoulou
- 1st Department of Propaedeutic and Internal Medicine, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Anthoula Chatzikyriakidou
- Laboratory of Medical Biology-Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| | - Edward B Jude
- Department of Diabetes and Endocrinology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne OL6 9RW, UK
- Division of Diabetes, Endocrinology and Gastroenterology, The University of Manchester, Manchester M13 9PL, UK
- Faculty of Science and Engineering, Manchester Metropolitan University, Manchester M15 6BH, UK
| |
Collapse
|
45
|
Nagaoka R, Katano S, Yano T, Numazawa R, Yamano K, Fujisawa Y, Honma S, Kamoda T, Sato K, Kouzu H, Ohori K, Katayose M, Hashimoto A, Furuhashi M. Optimal serum 25-hydroxyvitamin D level to prevent sarcopenia in patients with heart failure: Insights from a dose-response relationship. Nutr Metab Cardiovasc Dis 2024; 34:606-617. [PMID: 38000999 DOI: 10.1016/j.numecd.2023.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 08/09/2023] [Accepted: 10/04/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND AND AIMS Low serum 25-hydroxyvitamin D (25 [OH]D) levels have been associated with sarcopenia, frailty, and risk of cardiovascular disease, whereas high levels negatively impact clinical outcomes. We determined optimal serum 25(OH)D concentrations to minimise the probability of sarcopenia in patients with heart failure (HF) by examining the dose-dependent relationship between serum 25(OH)D levels and sarcopenia. METHODS AND RESULTS We enrolled 461 consecutive patients with HF (mean age, 72 ± 15 years; 39% female) who underwent dual-energy X-ray absorptiometry. Serum 25(OH)D levels were measured using a chemiluminescence immunoassay. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria. Overall, 49% of enrolled patients were diagnosed with sarcopenia. Adjusted logistic regression with restricted cubic spline function revealed that the odds ratio (OR) of sarcopenia increased in patients with HF presenting serum 25(OH)D levels <14.6 ng/ml or > 31.4 ng/ml, reaching the lowest OR at ∼20 ng/ml. Multivariate logistic regression revealed that a serum 25(OH)D level below 14.6 ng/mL was independently associated with the presence of sarcopenia (adjusted OR: 2.16, 95% confidence interval [CI]: 1.24-3.78). Incorporating serum 25(OH)D levels <14.6 ng/ml, but not <20.0 ng/ml, in the baseline model improved continuous net reclassification (0.334, 95% CI: 0.122-0.546) in patients with HF. CONCLUSION A U-shaped relationship exists between serum 25(OH)D levels and sarcopenia probability in patients with HF. Maintaining serum 25(OH)D levels between 14.6 and 31.4 ng/ml may help prevent sarcopenia in patients with HF.
Collapse
Affiliation(s)
- Ryohei Nagaoka
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Satoshi Katano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan; Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan.
| | - Toshiyuki Yano
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ryo Numazawa
- Graduate School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Kotaro Yamano
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Yusuke Fujisawa
- Division of Rehabilitation, Sapporo Medical University Hospital, Sapporo, Japan
| | - Suguru Honma
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan; Department of Rehabilitation, Sapporo Cardiovascular Hospital, Sapporo, Japan
| | - Tatsuki Kamoda
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Kohei Sato
- Graduate School of Health Sciences, Sapporo Medical University, Sapporo, Japan
| | - Hidemichi Kouzu
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Katsuhiko Ohori
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Masaki Katayose
- Second Division of Physical Therapy, Sapporo Medical University School of Health Science, Sapporo, Japan
| | - Akiyoshi Hashimoto
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan; Division of Health Care Administration and Management, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| |
Collapse
|
46
|
Li X, Chen C, Zhang Y, Wang J, Cui X, Xu L, Zhou J, Deng L, Zhang M, Lv Y, Yu Q, Shi X. Serum 25-Hydroxyvitamin D and Risk of Disability in Activities of Daily Living among the Oldest-Old: An Observational and Mendelian Randomization Study. J Nutr 2024; 154:1004-1013. [PMID: 38246357 DOI: 10.1016/j.tjnut.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Vitamin D deficiency and disability are both prevalent among older adults. However, the association between them has rarely been investigated in the oldest-old subjects (aged ≥80 y), and the causality remains unclear. OBJECTIVE This study aimed to elucidate the causal effect of vitamin D on the incident risk of disability in activities of daily living (ADL) among Chinese oldest-old based on the 2012-2018 Chinese Healthy Ageing and Biomarkers Cohort Study. METHODS Serum 25-hydroxyvitamin D [25(OH)D] concentrations and ADL status at baseline and follow-up interviews were documented. Cox regression models were applied among 1427 oldest-old (mean age, 91.2 y) with normal baseline ADL status. One sample Mendelian randomization (MR) analyses were performed on a subset of 941 participants with qualified genetic data, using a 25(OH)D-associated genetic risk score as the genetic instrument. RESULTS During a median follow-up of 3.4 y, 231 participants developed disability in ADL. Serum 25(OH)D concentration was inversely associated with the risk of disability in ADL [per 10 nmol/L increase hazard ratio (HR) 0.85; 95% CI: 0.75, 0.96]. Consistent results from MR analyses showed that a 10 nmol/L increment in genetically predicted 25(OH)D concentration corresponded to a 20% reduced risk of ADL disability (HR 0.80; 95% CI: 0.68, 0.94). Nonlinear MR demonstrated a monotonic declining curve, with the HRs exhibiting a more pronounced reduction among individuals with 25(OH)D concentrations below 50 nmol/L. Subgroup analyses showed that the associations were more distinct among females and those with poorer health conditions. CONCLUSIONS Our study supports an inverse causal relationship between serum 25(OH)D concentration and the risk of disability in ADL among Chinese oldest-old. This protective effect was more distinct, especially for participants with vitamin D deficiency. Appropriate measures for improving vitamin D might help reduce the incidence of physical disability in this specific age group.
Collapse
Affiliation(s)
- Xinwei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China; China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Chen Chen
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Yue Zhang
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Wang
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Xingyao Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China; China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Lanjing Xu
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China; Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jinhui Zhou
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Luojia Deng
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Min Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China; China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Yuebin Lv
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China
| | - Qiong Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
| | - Xiaoming Shi
- China Centers for Disease Control and Prevention (CDC) Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese CDC, Beijing, China.
| |
Collapse
|
47
|
Bowles SD, Basu S, Ranchordas MK, Simper T, Lynn A. Circulating total 25(OH)D and calculated free 25(OH)D in professional academy footballers at a northerly latitude in the UK. Biol Sport 2024; 41:201-208. [PMID: 38524830 PMCID: PMC10955734 DOI: 10.5114/biolsport.2024.131822] [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: 04/01/2023] [Revised: 07/30/2023] [Accepted: 08/27/2023] [Indexed: 03/26/2024] Open
Abstract
There is limited data on the vitamin D status of UK-based professional academy footballers. Therefore, the objective of this study was to report total 25(OH)D, free 25(OH)D and free 1, 25(OH)2D at the end of the winter (March) and summer periods (October) in a cohort (n = 27) of professional academy footballers in northern England. Blood samples were collected to measure total 25(OH)D, parathyroid hormone, vitamin D binding protein, albumin and calcium. Free 25(OH)D and 1, 25(OH)2D were calculated. Dietary vitamin D intake and retrospective summer sunlight exposure were also collected. At the end of winter, 2/27 (7.4%) players were vitamin D deficient (25(OH)D < 30 nmol/l) and 11/27 (40.7%) were insufficient (25(OH)D > 30 nmol/l < 50 nmol/l). By the end of summer, none were deficient but 3/14 (21.4%) were still insufficient. Median total 25(OH)D (82.2 nmol/l [IQR: 50.3-90.2] vs. 54.2 nmol/l [IQR: 36.8-71.9]; P = .02), free 25(OH)D (25.8 pmol/l [IQR: 15.1-33.1] vs. 13.2 pmol/l [IQR: 9.0-14.9]; P = .005) and free 1, 25(OH)2D (389 fmol/l [IQR: 209-594] vs. 212 fmol/l [IQR: 108-278]; P = .034) were significantly higher at the end of summer than the end of winter. At the end of winter, free 25(OH)D was lower (P = .003) in those vitamin D insufficient (8.8 pmol/l [IQR: 5.5-11.8]) vs. sufficient (13.7 pmol/l [IQR: 12.0-17.0]). There was a high prevalence of vitamin D insufficiency at the end of the winter. Free 25(OH)D was also lower at the winter timepoint and in players that were insufficient vs. sufficient.
Collapse
Affiliation(s)
- Simon D Bowles
- Food Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | | | - Mayur K Ranchordas
- Academy of Sport & Physical Activity, Faculty of Health & Wellbeing, Sheffield Hallam University, Sheffield, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University, UK
| | - Trevor Simper
- Food Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
| | - Anthony Lynn
- Food Group, Sheffield Business School, Sheffield Hallam University, Sheffield, UK
- Advanced Wellbeing Research Centre, Sheffield Hallam University, UK
| |
Collapse
|
48
|
Berger MM, Shenkin A, Dizdar OS, Amrein K, Augsburger M, Biesalski HK, Bischoff SC, Casaer MP, Gundogan K, Lepp HL, de Man AME, Muscogiuri G, Pietka M, Pironi L, Rezzi S, Schweinlin A, Cuerda C. ESPEN practical short micronutrient guideline. Clin Nutr 2024; 43:825-857. [PMID: 38350290 DOI: 10.1016/j.clnu.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 01/27/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with deficiencies significantly impacting the outcome. OBJECTIVE This short version of the guideline aims to provide practical recommendations for clinical practice. METHODS An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL for the initial guideline. The search focused on physiological data, historical evidence (for papers published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. RESULTS The limited number of interventional trials prevented meta-analysis and led to a low level of evidence for most recommendations. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90 % of votes. Altogether the guideline proposes 3 general recommendations and specific recommendations for the 26 MNs. Monitoring and management strategies are proposed. CONCLUSION This short version of the MN guideline should facilitate handling of the MNs in at-risk diseases, whilst offering practical advice on MN provision and monitoring during nutritional support.
Collapse
Affiliation(s)
- Mette M Berger
- Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland.
| | - Alan Shenkin
- Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK.
| | - Oguzhan Sıtkı Dizdar
- Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey.
| | - Karin Amrein
- Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria.
| | - Marc Augsburger
- University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland.
| | | | - Stephan C Bischoff
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Michael P Casaer
- KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium.
| | - Kursat Gundogan
- Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey.
| | | | - Angélique M E de Man
- Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands.
| | - Giovanna Muscogiuri
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università di Napoli (Federico II), Naples, Italy; United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy.
| | - Magdalena Pietka
- Pharmacy Department, Stanley Dudrick's Memorial Hospital, Skawina, Poland.
| | - Loris Pironi
- Department of Medical and Surgical Sciences, University of Bologna, Italy; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
| | - Serge Rezzi
- Swiss Nutrition and Health Foundation, Epalinges, Switzerland.
| | - Anna Schweinlin
- Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany.
| | - Cristina Cuerda
- Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
| |
Collapse
|
49
|
Akinajo OR, Olorunfemi G, Oshun PO, Ogunjimi MA, Oluwole AA. Serum Vitamin D Deficiency and Male Infertility: A Relationship? Cureus 2024; 16:e56070. [PMID: 38618377 PMCID: PMC11009830 DOI: 10.7759/cureus.56070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
Background Male infertility is one of the major reproductive health concerns, causing a lot of distress for couples globally. Others have looked into its connection to vitamin D deficiency, but their findings are conflicting. Aim This study aimed to determine the relationship between male infertility and vitamin D deficiency among Nigerians. Method This analytical cross-sectional study was conducted among 132 men. A purposive sampling technique was employed to recruit 66 participants in the study (men with infertility) and control groups (men with proven fertility). Descriptive statistics were conducted, while the association between vitamin D level and sperm parameters was assessed using bivariate and regression modeling. A two-tailed test of the hypothesis was assumed, and the level of statistical significance was set at a P-value < 0.05. Results None of the participants had a serum vitamin D deficiency. However, the overall serum vitamin D insufficiency rate was 15%. The median vitamin D level for the total study population (both fertile and infertile) was 37.52 ng/ml (IQR: 32.1 - 51.69). This study demonstrated no association between serum vitamin D levels and male infertility, as well as no association between serum vitamin D levels and the quality of semen parameters. Conclusion There was no significant association between vitamin D levels, male infertility, and seminal fluid parameters. However, larger multi-center studies are recommended to provide further insights into this conclusion.
Collapse
Affiliation(s)
- Opeyemi R Akinajo
- Department of Obstetrics and Gynecology, Lagos University Teaching Hospital, Lagos, NGA
| | - Gbenga Olorunfemi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Johannesburg, ZAF
| | - Philip O Oshun
- Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, NGA
| | - Moses A Ogunjimi
- Department of Surgery, Division of Urology, Lagos University Teaching Hospital, Lagos, NGA
| | - Ayodeji A Oluwole
- Department of Obstetrics and Gynecology, College of Medicine, University of Lagos, Lagos, NGA
| |
Collapse
|
50
|
Weffort VRS, Lamounier JA. Hidden hunger - a narrative review. J Pediatr (Rio J) 2024; 100 Suppl 1:S10-S17. [PMID: 37918810 PMCID: PMC10960185 DOI: 10.1016/j.jped.2023.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE Malnutrition is characterized by situations of undernutrition and obesity resulting from the lack of micronutrients with the greatest impact on children. The objective of this review was to highlight inadequate food consumption, food security, and nutritional inadequacy leading to hidden hunger and the prevention and treatment of the main micronutrient deficiencies in Brazil. DATA SOURCE Literature review carried out through a bibliographic survey in PubMed (National Library of Medicine, United States), Lilacs (Latin American and Caribbean Literature in Health Sciences), and SciELO (Scientific Electronic Library Online) databases. The search used the terms Occult hunger, (hidden hunger), and Child, in articles published between 2013 and 2023 in Portuguese, English and Spanish. The search was performed on 06/25/2023. DATA SYNTHESIS The lack of micronutrients can occur insidiously and without clinical manifestations, being called hidden hunger. The prevention of nutritional deficiencies is part of the recommended actions in childcare, with healthy eating. Studies were cited related to macro and micronutrient intake deficiencies, both national and international, and strategies to improve micronutrient intake, including routine supplementation of iron, and vitamins D and A. The diagnosis, prevention, and treatment of the main deficiencies in Brazil (iron, vitamin A, vitamin D, zinc), currently adopted, concluded the topic. CONCLUSION Zero hunger and zero obesity must be part of the same policy, together with a nutritional education program.
Collapse
|