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O'Sullivan M, Moran C, Griffin TP, Doheny H, McCartney DM, O'Shea PM. Impact of the COVID-19 lockdown on the vitamin D status of people in the West of Ireland. Ir J Med Sci 2024; 193:1061-1071. [PMID: 37864675 DOI: 10.1007/s11845-023-03543-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: 04/09/2023] [Accepted: 09/29/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE Identify the impact of COVID-19 lockdown restrictions on the vitamin D status of individuals in the west of Ireland. DESIGN Cross-sectional study. SETTING Adults who had wintertime serum 25(OH)D analysis completed in Galway University Hospital. PARTICIPANTS A total of 16,725 participants (2015-2020 (n = 13,449) and 2020-2021 (n = 3276)). Baseline demographics; sex, age, origin of the sample and the date of sample collection. RESULTS Median serum vitamin D and serum vitamin D3 concentrations were higher in the 5-month period from October-February 2020-2021 (61 nmol/L (± 36-85 nmol/L) and 60 nmol/L (± 34-85 nmol/L)) respectively, than for the corresponding 5-month period (October-February) in 2015-2020 (53 nmol/L (± 32-78 nmol/L) and 51 nmol/L (± 30-77 nmol/L)) respectively. These changes coincided with a decline in the prevalence of deficiency. In the 5-month period October-February 2020-2021, 19.2% of the population were vitamin D deficient (< 30 nmol/L) compared to 22.5% in the corresponding 5-month period in 2015-2020, and 38.1% were vitamin D deficient (< 50 nmol/L) in the 5-month period October-February 2020-2021 compared to 46.6% in the corresponding 5-month period in 2015-2020. Males were more likely to be deficient at both thresholds (p < 0.001). For the total cohort, at the < 30 nmol/L threshold, inpatients (25.5%) and nursing home residents (34.1%) had higher prevalence of deficiency. CONCLUSIONS Vitamin D levels were higher in the 5-month period of October-February 2020-2021, and this precipitated a decline in deficiency at both thresholds, indicating that lockdown coincided with enhanced vitamin D status. We postulate that it may be attributable to changes in diet and/or supplementation, or increased sun exposure, but further confirmatory studies are required.
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Affiliation(s)
- Maria O'Sullivan
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland.
| | - Caoimhe Moran
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland
| | - Tomás P Griffin
- Centre for Endocrinology, Diabetes Mellitus and Metabolism, Saolta University Health Care Group (SUHCG), Galway University Hospitals, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Helen Doheny
- Department of Clinical Biochemistry, Saolta University Health Care Group (SUHCG), Galway University Hospital, Galway, Ireland
| | - Daniel Ma McCartney
- School of Biological, Health and Sports Sciences, Technological University Dublin - City Campus, Central Quad, Dublin 7, Grangegorman, D07 XT95, Ireland
| | - Paula M O'Shea
- School of Medicine, University of Galway, Galway, Ireland
- Department of Clinical Biochemistry, Saolta University Health Care Group (SUHCG), Galway University Hospital, Galway, Ireland
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McCourt AF, Mulrooney SL, O’Neill GJ, O’Riordan ED, O’Sullivan AM. Serum 25-hydroxyvitamin D response to vitamin D supplementation using different lipid delivery systems in middle-aged and older adults: a randomised controlled trial. Br J Nutr 2023; 130:1548-1557. [PMID: 36912075 PMCID: PMC10551469 DOI: 10.1017/s0007114523000636] [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: 07/27/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Food fortification improves vitamin D intakes but is not yet mandated in many countries. Combining vitamin D with different dietary lipids altered vitamin D absorption in in vitro and postprandial studies. This randomised, placebo-controlled trial examined the effect of the lipid composition of a vitamin D-fortified dairy drink on change in 25-hydroxyvitamin D (25(OH)D) concentrations. Sixty-three healthy adults aged 50+ years were randomised to one of the following for 4 weeks: vitamin D-fortified olive oil dairy drink, vitamin D-fortified coconut oil dairy drink, vitamin D supplement or placebo control dairy drink. All vitamin D groups received 20 µg of vitamin D3 daily. Serum was collected at baseline and post-intervention to measure 25(OH)D concentrations and biomarkers of metabolic health. Repeated-measures general linear model ANCOVA (RM GLM ANCOVA) compared changes over time. There was a significant time × treatment interaction effect on 25(OH)D concentrations for those classified as vitamin D-insufficient (P < 0·001) and -sufficient at baseline (P = 0·004). 25(OH)D concentrations increased significantly for all insufficient participants receiving vitamin D3 in any form. However, for vitamin D-sufficient participants at baseline, 25(OH)D concentrations only increased significantly with the coconut oil dairy drink and supplement. There was no effect of vitamin D on biomarkers of metabolic health. Vitamin D fortification of lipid-containing foods may be used in lieu of supplementation when supplement adherence is low or for individuals with dysphagia. These results are important given the recent recommendation to increase vitamin D intakes to 15-20 µg for older adults in Ireland.
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Affiliation(s)
- Aislinn F. McCourt
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Steven L. Mulrooney
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Graham J. O’Neill
- TUD School of Food Science and Environmental Health, Technological University Dublin (TUD), Dublin, Republic of Ireland
| | - E. Dolores O’Riordan
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
| | - Aifric M. O’Sullivan
- UCD Institute of Food and Health, University College Dublin (UCD), Dublin, Republic of Ireland
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3
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Scully H, Laird EJ, Healy M, Crowley V, Walsh JB, McCarroll K. Vitamin D: determinants of status, indications for testing and knowledge in a convenience sample of Irish adults. Br J Nutr 2023; 130:1144-1154. [PMID: 37675548 DOI: 10.1017/s0007114523000168] [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: 02/11/2023]
Abstract
Vitamin D deficiency is common in Irish adults, though there is limited research on its determinants, knowledge of vitamin D or indications for testing. We aimed to explore the determinants of vitamin D status in adults and examine knowledge and reasons for testing. The study population comprised adults who had serum 25-hydroxyvitamin D tested by general practitioners request at a Dublin Hospital in 2020. Questionnaires detailing dietary intake, sun exposure, ethnicity, biophysical factors and vitamin D knowledge were sent to a sample stratified by age, sex and vitamin D status. In total, there were 383 participants, mean age 56·0 (sd 16·6) years. Wintertime deficiency disproportionally affected non-white v. white (60 % v. 24 %, P < 0·001). The greatest predictors of deficiency were low vitamin D intake (< 10 μg/d) (P < 0·001) and non-white ethnicity (P = 0·006), followed by sun avoidance (P = 0·022). It was also more prevalent in those with lower body exposure when outdoors. The majority (86 %) identified vitamin D as important for bone health. However, 40 % were tested for non-clinical indications and half were not aware of the recommended daily allowance (RDA). Low vitamin D intake was the most important determinant of deficiency, but ethnicity and sun exposure habits were also significant predictors. The majority had no clear indication for testing and were not aware of the RDA. Public health policies to improve knowledge and vitamin D intake, especially for those of non-white ethnicity and with reduced sun exposure, should be considered.
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Affiliation(s)
- Helena Scully
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Eamon J Laird
- Department of Sport and Exercise, University of Limerick, Limerick, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Vivion Crowley
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
| | - James Bernard Walsh
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Kevin McCarroll
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
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Tang L, Zeng H, Yang B, Dong C, Li M, Zhang X, Pan J. Vitamin D is inversely associated with Monocyte to HDL-C ratio among medical staff in Chengdu, China. BMC Endocr Disord 2023; 23:149. [PMID: 37438744 DOI: 10.1186/s12902-023-01406-2] [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: 02/08/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
PURPOSE The primary objective of this study was to explore the association of vitamin D with the monocyte to HDL-C ratio (MHR) among medical staff in Chengdu, China. MATERIALS AND METHODS This cross-sectional study involved 538 medical staff, including 393 females and 145 males, and included data on gender, age, body mass index, and laboratory parameters (including complete blood count, vitamin D levels, lipid, etc.). According to serum 25 (OH)D < 20 ng/ml as vitamin D deficiency, subjects were divided into two groups based on serum 25 (OH)D levels: a vitamin D deficiency group with serum 25 (OH)D < 20 ng/ml and a vitamin D sufficiency group with serum 25 (OH)D ≥ 20 ng/ml. When considering vitamin D as a categorical variable, a multivariable logistic regression analysis was conducted to assess the risk factors associated with vitamin D deficiency. On the other hand, when examining the factors influencing vitamin D levels as a continuous variable, a multiple linear regression model was utilized. RESULTS The prevalence of vitamin D deficiency was 86.25% among all the participants. Males exhibited a higher risk of vitamin D deficiency compared to females (β=0.383, P = 0.026). Vitamin D deficiency risk decreased with age (β = 0.910, P < 0.001). Additionally, elevated values of MHR were associated with an increased risk of vitamin D deficiency (β = 1.530, P = 0.019). When treating vitamin D as a continuous variable, the results of multiple linear regression revealed that age (β = 0.342, P < 0.001), and TG (β=-1.327, P = 0.010) were independent influencing factors for vitamin D levels, indicating that vitamin D levels increase with age. A reverse association between MHR and vitamin D levels demonstrated a marginal trend toward significance (β=-0.581, P = 0.052). CONCLUSIONS Vitamin D is inversely associated with MHR among young medical staff in Chengdu, China.
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Affiliation(s)
- Lei Tang
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Honglian Zeng
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Bo Yang
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Chaohui Dong
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Mao Li
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Xiaoli Zhang
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China
| | - Jia Pan
- Department of Health Management Center, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.
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Laird E, O'Halloran AM, Molloy AM, Healy M, Bourke N, Kenny RA. Vitamin D status & associations with inflammation in older adults. PLoS One 2023; 18:e0287169. [PMID: 37379302 DOI: 10.1371/journal.pone.0287169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
Research studies have observed associations of vitamin D with inflammation but data in representative older adult studies is lacking. We aimed to investigate the association of C-reactive protein (CRP) with vitamin D status in a representative sample of the older Irish population. The concentrations of 25-hydroxyvitamin D (25(OH)D) and CRP was measured in 5,381 community dwelling Irish adults aged ≥50 years from the Irish Longitudinal Study on Ageing (TILDA). Demographic, health and lifestyle variables were assessed by questionnaire and categorical proportions of CRP were generated by vitamin D status and age. Multi-nominal logistic regression was used to investigate the association of 25(OH)D and CRP status. The prevalence (mean; 95% confidence interval (95% CI)) of normal CRP status (0-5 mg/dL) was 83.9% (82.6-85.0%), elevated status (5-10 mg/dL) 11.0% (9.9-12.0%) and high status (>10 mg/dL) was 5.1% (4.5-5.8%). Mean (95% CI) CRP concentrations were lower in those with normal vs. deficient 25(OH)D status (2.02 mg/dL (1.95-2.08) vs. 2.60 mg/dL (2.41-2.82); p<0.0001). In a logistic regression analysis, those with insufficient or sufficient 25(OH)D status were less likely to have a high CRP status compared to those with deficient 25(OH)D status (insufficient: coefficient (CE) -0.732, 95% CI -1.12-0.33, p<0.0001; sufficient: CE -0.599, 95% CI -0.95-0.24, p = 0.001). In conclusion older adults with deficient vitamin D status had higher levels of inflammation as measured by CRP. Given that inflammation is an important pathological driver of chronic diseases of ageing, and that emerging evidence suggests that vitamin D therapy can reduce inflammation in some disease settings, optimising vitamin D status could represent an effective low risk/low-cost pathway to modulate inflammation in community dwelling older adults.
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Affiliation(s)
- Eamon Laird
- School of Physical Education and Sports Science, University of Limerick, Limerick, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nollaig Bourke
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- The TILDA Study, School of Medicine, Trinity College Dublin, Dublin, Ireland
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McCourt AF, O’Sullivan AM. Influence of Vitamin D Status and Supplementation on Metabolomic Profiles of Older Adults. Metabolites 2023; 13:metabo13020166. [PMID: 36837785 PMCID: PMC9961282 DOI: 10.3390/metabo13020166] [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: 10/24/2022] [Revised: 01/06/2023] [Accepted: 01/12/2023] [Indexed: 01/26/2023] Open
Abstract
Metabolomics can identify metabolite patterns associated with different nutrition phenotypes and determine changes in metabolism in response to nutrition interventions. Vitamin D insufficiency is associated with increased metabolic disease risk; however, the role of vitamin D in metabolic health is not fully understood. This randomised, placebo-controlled trial (RCT) examined the influence of vitamin D status and the effect of vitamin D supplementation on metabolomic profiles in older adults. Healthy adults aged 50+ were randomly assigned to consume 20 µg vitamin D3 or a placebo daily for 4 weeks. Serum samples were collected at baseline and post-intervention for 25(OH)D and metabolomics analysis via liquid chromatography tandem mass spectrometry (LC-MS/MS). Pearson's correlation examined relationships between 25(OH)D and metabolite concentrations. GLM ANCOVA compared metabolite concentrations between vitamin D-insufficient (<50 nmol/L) and -sufficient (>50 nmol/L) participants. The repeated-measures general linear model of covariance (RM GLM ANCOVA) examined changes in metabolites over time. Out of 132 metabolites, 2 short chain fatty acid concentrations were higher in the insufficient participants compared to sufficient participants, and 11 glycerophospholipid concentrations were lower in insufficient participants compared to sufficient participants at baseline. Three acylcarnitine concentrations decreased with vitamin D supplementation in vitamin D-insufficient participants. Our findings suggest that vitamin D status influences lipid metabolism in healthy older adults and supports the use of metabolomics in vitamin D research.
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McKenna MJ, Lyons OC, Flynn MA, Crowley RK, Twomey PJ, Kilbane MT. COVID-19 pandemic and vitamin D: rising trends in status and in daily amounts of vitamin D provided by supplements. BMJ Open 2022; 12:e059477. [PMID: 35926985 PMCID: PMC9358618 DOI: 10.1136/bmjopen-2021-059477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Since the onset of the COVID-19 pandemic in 2020, there have been plausible suggestions about the need to augment vitamin D intake by supplementation in order to prevent SARS-CoV2 infection and reduce mortality. Some groups have advocated supplementation for all adults, but governmental agencies have advocated targeted supplementation. We sought to explore the effect of the COVID-19 pandemic on both vitamin D status and on the dose of new-to-market vitamin D supplements. SETTING University hospital, Dublin, Ireland. PARTICIPANTS Laboratory-based samples of circulating 25-hydroxyvitamin D (25OHD) (n=100 505). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes: comparing yearly average 25OHD prior to the pandemic (April 2019 to March 2020) with during the pandemic (April 2020 to March 2021) and comparing the dose of new-to-market vitamin D supplements between 2017 and 2021 (n=2689). SECONDARY OUTCOME comparing prevalence of vitamin D deficiency and vitamin D excess during the two time periods. RESULTS The average yearly serum 25OHD measurement increased by 2.8 nmol/L (61.4, 95% CI 61.5 to 61.7 vs 58.6, 95% CI 58.4 to 58.9, p<0.001), which was almost threefold higher than two similar trend analyses that we conducted between 1993 and 2016. There was a lower prevalence of low 25OHD and a higher prevalence of high 25OHD. The dose of new-to-market vitamin D supplements was higher in the years 2020-2021 compared with the years 2017-2019 (p<0.001). CONCLUSIONS We showed significant increases in serum 25OHD and in the dose of new-to-market vitamin D supplements. The frequency of low vitamin D status reduced indicating benefit, but the frequency of vitamin D excess increased indicating risk of harm. Rather than a blanket recommendation about vitamin D supplementation for all adults, we recommend a targeted approach of supplementation within current governmental guidelines to at-risk groups and cautioning consumers about adverse effects of high dose supplements on the market.
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Affiliation(s)
- Malachi J McKenna
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Oonagh C Lyons
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Mary At Flynn
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Rachel K Crowley
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Patrick J Twomey
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Mark T Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
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Low socioeconomic status predicts vitamin D status in a cross-section of Irish children. J Nutr Sci 2022; 11:e61. [PMID: 35912305 PMCID: PMC9334117 DOI: 10.1017/jns.2022.57] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 06/30/2022] [Indexed: 11/06/2022] Open
Abstract
Vitamin D is essential for bone and muscle health with adequate status in childhood crucial for normal skeletal development. We aimed to investigate vitamin D status in a convenience sample (n = 1226) of Irish children (aged 1-17 years) who had serum 25-hydroxyvitamin D (25(OH)D) tested by request of their GP at a Dublin Hospital between 2014 and 2020. We examined predictors including age, sex, season and socioeconomic status (SES). Vitamin D deficiency (<30 nmol/l) was prevalent affecting 23 % and was more common in disadvantaged areas (34 %) and in those aged >12 v. ≤12 years (24 % v. 16 %, P = 0⋅033). The greatest predictor was SES (disadvantaged v. affluent, OR 2⋅18, CI 1⋅34, 3⋅53, P = 0⋅002), followed by female sex (OR 1⋅57, CI 1⋅15, 2⋅14, P = 0⋅005) and winter season (October to February, OR 1⋅40, CI 1⋅07, 1⋅84, P = 0⋅015). A quarter of our sample of children were deficient, rising to one-third in those in disadvantaged areas. Females and those aged over 12 years had a higher prevalence of deficiency. Public health strategies to improve vitamin D status in Irish children, including systematic food fortification may need to be considered to address this issue.
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Walsh JB, McCartney DM, Laird É, McCarroll K, Byrne DG, Healy M, O’Shea PM, Kenny RA, Faul JL. Title: Understanding a Low Vitamin D State in the Context of COVID-19. Front Pharmacol 2022; 13:835480. [PMID: 35308241 PMCID: PMC8931482 DOI: 10.3389/fphar.2022.835480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19. Applying the Bradford-Hill criteria, however, the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 (respiratory failure, requirement for ventilation and mortality). A biologically plausible rationale exists for these findings, given vitamin D's role in immune regulation. The thresholds which define low, deficient, and replete vitamin D states vary according to the disease studied, underscoring the complexities for determining the goals for supplementation. All are currently unknown in the setting of COVID-19. The design of vitamin D randomised controlled trials is notoriously problematic and these trials commonly fail for a number of behavioural and methodological reasons. In Ireland, as in most other countries, low vitamin D status is common in older adults, adults in institutions, and with obesity, dark skin, low UVB exposure, diabetes and low socio-economic status. Physiological vitamin D levels for optimal immune function are considerably higher than those that can be achieved from food and sunlight exposure alone in Ireland. A window exists in which a significant number of adults could benefit from vitamin D supplementation, not least because of recent data demonstrating an association between vitamin D status and COVID-19. During the COVID pandemic, we believe that supplementation with 20-25ug (800-1000 IU)/day or more may be required for adults with apparently normal immune systems to improve immunity against SARS-CoV-2. We expect that higher monitored doses of 37.5-50 ug (1,500-2,000)/day may be needed for vulnerable groups (e.g., those with obesity, darker skin, diabetes mellitus and older adults). Such doses are within the safe daily intakes cited by international advisory agencies.
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Affiliation(s)
- James Bernard Walsh
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Daniel M. McCartney
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin, Dublin, Ireland
| | - Éamon Laird
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Kevin McCarroll
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Declan G. Byrne
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Medicine Directorate, St. James’s Hospital, Dublin, Ireland
| | - Martin Healy
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Department of Clinical Biochemistry, St James’s Hospital, Dublin, Ireland
| | - Paula M. O’Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - Rose Anne Kenny
- Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - John L. Faul
- James Connolly Memorial Asthma Research Centre, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin, Ireland
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10
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The association between area-level demographic and socioeconomic parameters and vitamin D status in Ireland. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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11
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McCartney DM, O'Shea PM, Faul JL, Healy MJ, Byrne G, Griffin TP, Walsh JB, Byrne DG, Kenny RA. Vitamin D and SARS-CoV-2 infection-evolution of evidence supporting clinical practice and policy development : A position statement from the Covit-D Consortium. Ir J Med Sci 2021; 190:1253-1265. [PMID: 33219912 PMCID: PMC7679797 DOI: 10.1007/s11845-020-02427-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 10/29/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Daniel M McCartney
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland.
| | - Paula M O'Shea
- Department of Clinical Biochemistry, Galway University Hospitals, Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway, Ireland
| | - John L Faul
- James Connolly Memorial Asthma Research Centre, Royal College of Surgeons in Ireland, Connolly Hospital Blanchardstown, Dublin 15, Ireland
| | - Martin J Healy
- Biochemistry Department, St. James's Hospital, Dublin 8, Ireland
| | - Greg Byrne
- School of Biological and Health Sciences, College of Sciences & Health, Technological University Dublin - City Campus, Dublin 8, Ireland
| | - Tomás P Griffin
- Regenerative Medicine Institute at CÚRAM SFI Research Centre, School of Medicine, National University of Ireland Galway, Galway, Ireland
- Centre for Endocrinology, Diabetes and Metabolism, Galway University Hospitals, Galway, Ireland
| | - James Bernard Walsh
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Declan G Byrne
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Medicine Directorate, St. James's Hospital, Dublin 8, Ireland
| | - Rose Anne Kenny
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland
- Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
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12
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Scully H, Laird E, Healy M, Crowley V, Walsh JB, McCarroll K. Vitamin D retesting by general practitioners: a factor and cost analysis. Clin Chem Lab Med 2021; 59:1790-1799. [PMID: 34271597 DOI: 10.1515/cclm-2021-0607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/01/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Vitamin D testing by Primary Care doctors is increasing, placing greater workloads on healthcare systems. There is little data though on vitamin D retesting in Ireland. This study aims to investigate the factors associated with vitamin D retesting by Irish General Practitioners (GPs) and examine the resulting costs. METHODS This is a retrospective analysis over 5 years (2014-2018) of GP requested 25-hydroxyvitamin D (25(OH)D) results in 36,458 patients at a major city hospital in Dublin, Ireland. Those with one test were compared with individuals who were retested and samples categorised to determine changes in status between tests. RESULTS Nearly one in four patients (n=8,305) were retested. Positive predictors of retesting were female (p<0.001), age (60-69 years, p<0.001), location (Co. Kildare, p<0.001) and initial deficiency (<30 nmol/L, p<0.001) or insufficiency (30-49.9 nmol/L, p<0.001). Vitamin D status improved on retesting, with deficiency halving on first retest (9 vs. 18%, p<0.001) and dropping to 6% on further retests. About 12.2% of retests were done within 3 months and 29% had ≥2 retests within 1 year. 57% of retests were in those initially vitamin D replete (>50 nmol/L). The annual cost of inappropriate testing was €61,976. CONCLUSIONS One in four patients were retested and this varied by age, gender and patient location. Over 10% of retests were inappropriately early (<3 months), a third too frequent and over half were in replete individuals incurring significant costs. Clear guidance for GPs on minimum retesting intervals is needed, as well as laboratory ordering systems to limit requests using pre-defined criteria.
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Affiliation(s)
- Helena Scully
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Eamon Laird
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - Vivion Crowley
- Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - James Bernard Walsh
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
| | - Kevin McCarroll
- Mercers Institute for Research on Ageing, St James's Hospital, Dublin, Ireland
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Vitamin D in childhood-high rates of deficiency in a cohort of Irish children. Proc Nutr Soc 2021. [DOI: 10.1017/s0029665121002342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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