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Bellone S, Siegel EE, Santin AD. Increased serum 1, 25-dihydroxyvitamin D levels in gynecologic cancer patients with Post-Acute-Covid-Sequela (PASC)/Long COVID. Gynecol Oncol Rep 2023; 50:101301. [PMID: 38029227 PMCID: PMC10654147 DOI: 10.1016/j.gore.2023.101301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Post-acute sequelae of COVID-19 (PASC), also known as Long-Covid (LC), may affect 10-30 % of COVID-infected patients, and is characterized by a variety of debilitating symptoms lasting over 3 months after the acute infection, including but not limited to dyspnea, fatigue, and musculoskeletal, cognitive, and/or mental health impairments. Vitamin D is an essential nutrient primarily recognized for its role in regulating calcium and bone health but also endowed with potent anti-inflammatory activity affecting a variety of immune cells. We retrospectively evaluated the plasmatic levels of both 1,25-dihydroxyvitamin-D (1,25 OH), and 25-hydroxyvitamin-D (25 OH), the active and storage forms of vitamin-D3, respectively, in the serum of gynecologic cancer patients affected by PASC/LC vs control cancer patients. We found elevated 1,25-dihydroxyvitamin-D levels in 5 out of 5 of the PASC/LC patients (mean ± SD = 97.2 ± 26.9 pg/mL) versus 0 out of 10 of randomly selected cancer control patients (44.9 ± 17.2 pg/mL, p = 0.0005). In contrast, no significant difference was noted in the levels of 25-dihydroxyvitamin-D in PASC/LC (mean ± SD = 48.2 ± 15.8 ng/mL) versus controls (43.0 ± 11.6 ng/mL, p = 0.48). Importantly, abnormal levels of vitamin D were found to persist for at least 2 years in patients with long covid symptoms. The active form (1,25OH) but not the storage form (25 OH) of vitamin-D is significantly elevated in PASC/LC cancer patients. Abnormally and persistently elevated 1,25OH levels, similarly to sarcoidosis patients, may represent the results of extrarenal conversion of vitamin D by activated macrophages, and a novel biomarker of persistent inflammation in gynecologic cancer patients with PASC/LC.
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Affiliation(s)
- Stefania Bellone
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
| | - Eric E. Siegel
- Department of Biostatistics, University of Arkansas for Medical Science, Little Rock, AR 72205, USA
| | - Alessandro D. Santin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT 06520, USA
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Das L, Holick MF, Sachdeva N, Bhadada SK, Singhmar S, Thakur N, Dutta P, Marwaha RK. Efficacy, safety, and dose-response effects of calcifediol supplementation on 25-hydroxyvitamin D, parathyroid hormone, and 1, 25-dihydroxyvitamin D levels in healthy adults: An open-label, interventional pilot study. Indian J Pharmacol 2023; 55:286-292. [PMID: 37929406 PMCID: PMC10751521 DOI: 10.4103/ijp.ijp_873_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is highly prevalent across the globe. Cholecalciferol (Vitamin D3) fails to attain sufficient serum concentrations of 25-hydroxyvitamin D (25(OH)D) in a significant proportion of supplemented individuals. Calcifediol (25-hydroxyvitamin D3) is less studied in healthy adults and its effects on 25(OH)D, parathyroid hormone (PTH), and 1,25-dihydroxyvitamin D (1,25(OH)2D) at higher doses are not well known. MATERIALS AND METHODS The study was an open-label, interventional trial recruiting consecutive participants with VDD who were allocated to receive either 2 capsules (50 μg-group) or 1 capsule (25 μg-group) daily doses of calcifediol. Baseline assessment included clinicodemographic parameters, dietary calcium, calcemic (calcium, inorganic phosphate, albumin, alkaline phosphatase, urine spot calcium/creatinine), and hormonal parameters (25(OH)D, PTH, and 1,25(OH)2D). Participants were followed up at 4 and 8 weeks with repeat assessments of calcemic and hormonal parameters. RESULTS There were 64 participants, 35 (50 μg-group) and 29 (25 μg-group), without any significant difference in any of the baseline parameters. 97.1% participants in the 50 μg-group (at 4 and 8 weeks) and 93.1% (at 4 weeks) and 96.5% (at 8 weeks) in the 25 μg-group attained 25(OH)D sufficiency (≥30 ng/ml) with calcifediol. The mean serum 25(OH)D was 84.0 ± 27.7 ng/ml in the 50 μg-group and 58.0 ± 23.6 ng/ml in the 25 μg-group group at 4 weeks, which later rose to 94.3 ± 21.8 ng/ml and 76.0 ± 16.4 ng/ml, respectively, at 8 weeks. PTH levels decreased in both groups at both time points. 1,25(OH)2D rose significantly in both groups at 4 and 8 weeks but was not significantly different between both groups. There was no case of incident hypercalcemia or symptomatic nephrolithiasis. CONCLUSION Calcifediol is a safe and efficacious alternative for oral Vitamin D supplementation in young adults. Increment in 25(OH)D levels is rapid and dose-dependent.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Michael F. Holick
- Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shallu Singhmar
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Neetika Thakur
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Raman Kumar Marwaha
- Endocrinology, Society of Endocrine Health Care for Elderly, Adolescents and Children, New Delhi, India
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3
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Zhou J, Li R, Bao T, Jiang W, Huang Y. Association between serum 25-hydroxyvitamin d and myeloperoxidase: A cross-sectional study of a general population in China. Front Nutr 2022; 9:948691. [PMID: 35983482 PMCID: PMC9379339 DOI: 10.3389/fnut.2022.948691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background Several studies have found a strong association between cardiovascular diseases and myeloperoxidase (MPO) as a marker of oxidative stress. Although the anti-inflammatory effects of vitamin D in adults have been validated, evidence about the relationship between MPO and 25(OH)D is lacking. This study aimed to investigate the relationship between MPO and 25(OH)D in the general Chinese population. Methods From November 2018 to August 2019, a total of 6414 subjects were enrolled in a tertiary referral hospital in China, which included 3,122 women and 3,292 men. The dependent and independent variables were MPO and 25(OH)D, respectively. The confounders included age, sex, body mass index, waist-hip ratio, smoking status, alcohol drinking status, calcium, and parathyroid hormone concentration. Results In the fully adjusted model, we found that MPO decreased by 0.12 (95% CI −0.16, −0.08), ng/mL for each unit (1 nmol/L) increase in 25(OH)D. When 25(OH) D was divided into quartiles, compared with Q1 (< 41.4 nmol/L), the adjusted beta coefficients (β) of MPO in Q2–Q4 were −2.29 (95% CI, −4.31 to −0.27), −4.76 (95% CI, −6.83 to −2.69), and −6.07 (95% CI, −8.23 to −3.92), respectively (P for the trend < 0.0001). When 25(OH) D was divided according to clinical severity, compared with the severely deficient (< 30 nmol/L) s≥ 30, < 50 nmol/L) and sufficient groups (≥ 50 nmol/L) were −2.59 (95% CI, −5.87 to 0.69) and −5.87 (95% CI, −9.17 to −2.57), respectively (P for the trend < 0.0001). Conclusion After adjusting for age, sex, BMI, waist-hip ratio, smoking status, alcohol status, calcium, and PTH, circulating 25(OH)D was negatively associated with MPO.
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Affiliation(s)
- Junteng Zhou
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China.,Laboratory of Cardiovascular Diseases, Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ruicen Li
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Bao
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Jiang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
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Galassi A, Fasulo EM, Ciceri P, Casazza R, Bonelli F, Zierold C, Calleri M, Blocki FA, Palmieri MA, Mastronardo C, Cozzolino MG. 1,25-dihydroxyvitamin D as Predictor of Renal Worsening Function in Chronic Kidney Disease. Results From the PASCaL-1,25D Study. Front Med (Lausanne) 2022; 9:840801. [PMID: 35308556 PMCID: PMC8924653 DOI: 10.3389/fmed.2022.840801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/07/2022] [Indexed: 01/01/2023] Open
Abstract
Background Heterogeneous progression of chronic kidney disease (CKD) toward dialysis advocates improving in renal care management. Diagnosis and staging of CKD relies on estimated glomerular filtration rate (eGFR) and albuminuria. Tubular biomarkers emerged as new predictors of worsening renal function (WRF), due to partial inaccuracy of eGFR and existing WRF in non-proteinuric patients. Active vitamin D is synthesized in renal tubules and participates to mineral adaptation in CKD. Circulating 1,25-dihydroxyvitamin D [1,25(OH)2D] was poorly investigated as a biomarker of endocrine tubular function and predictor of WRF. Objective Investigate capability of 1,25(OH)2D to predict parathormone (PTH) increase and WRF in CKD stage 3-4. Methods PASCaL-1,25D was an observational, prospective, monocentric study. Primary outcomes were absolute and 20% increase in PTH, and WRF defined as 20% reduction in eGFR or dialysis initiation at 6 months. Results Seventy-one patients completed follow up. Absolute increase in PTH (1-84) was independently predicted by lower 1,25(OH)2D levels (p = 0.0134). No association was detected between 1,25(OH)2D and iPTH increase. Higher 1,25(OH)2D was associated with reduced risk of WRF at univariate analysis [OR 0.89 (95% CI 0.86-0.93), p = 0.006]. The 1,25(OH)2D/PTH (1-84) ratio was associated with non-significant 84% risk reduction for WRF [OR 0.16 (95% CI 0.06-0.41), p = 0.05]. Low 1,25(OH)2D reached 100% sensitivity in predicting WRF in CKD stage 3 (AUC 9.909, p < 0.0001) and non-elderly patients (AUC 0.883, p < 0.0001). Machine learning models retained 1,25(OH)2D/PTH (1-84) as relevant predictor of WRF together with eGFR and albuminuria. Age influenced interaction between renal and mineral biomarkers. Conclusion 1,25(OH)2D deserves attention as biomarker of tubular health, and sensible predictor of WRF on the short run among non-elderly patients affected by stage 3 CKD. The 1,25(OH)2D/PTH (1-84) ratio may represent a composite biomarker of tubular reserve/endocrine response to the transition from adaptive to maladaptive equilibrium in CKD-MBD.
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Affiliation(s)
- Andrea Galassi
- Renal Division, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy
| | - Eliana Maria Fasulo
- Renal Division, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy
| | - Paola Ciceri
- Renal Division, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy
| | - Roberta Casazza
- Renal Division, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy
| | | | | | | | | | | | | | - Mario G Cozzolino
- Renal Division, Azienda Socio Sanitaria Territoriale (ASST) Santi Paolo e Carlo, Department of Health Science, University of Milan, Milan, Italy
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Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. In this study, serum 25-hydroxyvitamin D levels were compared between women with and without PCOS and with regard to anthropometric indices and lipid and glucose biomarkers. Thirty-one women with PCOS and 75 controls answered a questionnaire on vitamin D, in addition to general health and lifestyle. The patients with PCOS had lower vitamin D levels (p < 0.05), a significantly higher rate of obesity (p < 0.05), and significantly higher serum triglyceride levels than did controls. The number of patients with PCOS consumed milk and dairy products (p < 0.05) and exposed to sun (p < 0.006) were lower compared to controls. Triglyceride levels were significantly correlated with body mass index (BMI); vitamin D level was not significantly correlated with anthropometrical or biochemical variables. These results affirm that vitamin D levels are lower in women with PCOS; however, despite the significantly higher proportion of obesity among patients with PCOS, hypovitaminosis was not associated with BMI. The relationship between body composition and vitamin D in PCOS and the effect of vitamin D correction on metabolic and hormonal parameters associated with PCOS must be assessed in future trials.
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Affiliation(s)
- Iman Abdullah Bindayel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Albahlol IA, Almaeen AH, Alduraywish AA, Dar UF, El-Metwally TH. Vitamin D Status and Pregnancy Complications: Serum 1,25-di-hydroxyl-Vitamin D and its Ratio to 25-hydroxy-Vitamin D are Superior Biomarkers than 25-hydroxy-Vitamin D. Int J Med Sci 2020; 17:3039-3048. [PMID: 33173424 PMCID: PMC7646113 DOI: 10.7150/ijms.47807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/14/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D (VitD) deficiency during pregnancy has been associated with adverse neonatal outcomes and increased risk of late pregnancy complications. We planned to correlate serum VitD biomarkers; 25-hydroxyvitamin D (25-OH-VitD) and 1,25-dihydroxyvitamin D (1,25-diOH-VitD) levels; and their ratio with the frequency of feto-maternal pregnancy complications. A prospective cross-sectional case-control study was conducted at Aljouf Maternity and Children Hospital, Sakaka, Saudi Arabia, during the period of September 1, 2017 to September 30, 2019. 322 pregnant women were stratified into 2 groups: controls (110 cases) and complicated group (212 cases). The later comprised severe preeclamptic toxemia associated with intrauterine growth restriction (58 cases), gestational diabetes mellitus (GDM; 82 cases), abortion (26 cases), undisturbed ectopic pregnancy (16 cases), premature rupture of membranes (PROM; 14 cases), and, inevitable preterm labour (16 cases). After clinical assessment, peripheral blood samples were collected. Serum biomarkers were measured using specific immunoassays. The direct 1,25-diOH-VitD/25-OH-VitD ratio was calculated. Serum 25-OH-VitD indicated widely spreading VitD deficiency among participants with significantly higher levels in controls vs. GDM subgroup only. 1,25-diOH-VitD levels and the ratio were markedly reduced in the six complicated subgroups vs. controls, with non-significant differences amongst the complicated subgroups. ROC analysis showed very high sensitivity and specificity, to differentiate patients from controls, only for 1,25-diOH-VitD (AUC = 0.965; 0.947 - 0.983, p <0.001) followed by the ratio but not 25-OH-VitD. In conclusions, 25-OH-VitD did not show significant changes except for GDM. 1,25-diOH-VitD levels and the ratio showed strong associations with pregnancy complications. Serum 1,25-di-OH-VitD and its ratio to 25-OH-VitD are more reliable and physiologically relevant biomarkers for VitD status in pregnancy.
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Affiliation(s)
- Ibrahim A Albahlol
- Department of Obstetrics and Gynecology, College of Medicine, Jouf University, Sakaka, Saudi Arabia. .,Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt
| | - Abdulrahman H Almaeen
- Department of Pathology, College of Medicine, Jouf University, Sakaka, Saudi Arabia.
| | | | - Umar F Dar
- Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia.
| | - Tarek H El-Metwally
- Department of Pathology, Biochemistry Division, College of Medicine, Jouf University, Sakaka, Saudi Arabia. .,Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
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Coche S, Cornet G, Morelle J, Labriola L, Kanaan N, Demoulin N. Hypercalcemia associated with Pneumocystis jirovecii pneumonia in renal transplant recipients: case report and literature review. Acta Clin Belg 2019; 76:75-78. [PMID: 31470765 DOI: 10.1080/17843286.2019.1655233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Pneumocystis jirovecii associated pneumonia is a potentially life-threatening opportunistic infection, occurring most frequently in the first year after renal transplantation, and may be associated with hypercalcemia. Clinical presentation:We report the case of a renal transplant recipient presenting with Pneumocystis jirovecii associated pneumonia and hypercalcemia due to ectopic production of 1,25-dihydroxyvitamin D, 6 years after renal transplantation. Calcemia and 1-25 hydroxyvitamin D levels normalized after our patient was treated by trimethoprim-sulfamethoxazole. Discussion: We review similar cases to delineate the clinical and biological profile of patients with Pneumocystis jirovecii pneumonia associated hypercalcemia. Conclusion:Physicians should evoke this diagnosis in renal transplant recipients presenting with pulmonary infection associated with hypercalcemia.
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Affiliation(s)
- Sophie Coche
- Division of Nephrology, Cliniques universitaires Saint-Luc , Brussels, Belgium
| | - Georges Cornet
- Division of Nephrology, Centre Hospitalier Peltzer-La Tourelle , Verviers, Belgium
| | - Johann Morelle
- Division of Nephrology, Cliniques universitaires Saint-Luc , Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels, Belgium
| | - Laura Labriola
- Division of Nephrology, Cliniques universitaires Saint-Luc , Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels, Belgium
| | - Nada Kanaan
- Division of Nephrology, Cliniques universitaires Saint-Luc , Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels, Belgium
| | - Nathalie Demoulin
- Division of Nephrology, Cliniques universitaires Saint-Luc , Brussels, Belgium.,Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain , Brussels, Belgium
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Xu J, Bartz TM, Chittoor G, Eiriksdottir G, Manichaikul AW, Sun F, Terzikhan N, Zhou X, Booth SL, Brusselle GG, de Boer IH, Fornage M, Frazier-Wood AC, Graff M, Gudnason V, Harris TB, Hofman A, Hou R, Houston DK, Jacobs Jr DR, Kritchevsky SB, Latourelle J, Lemaitre RN, Lutsey PL, Connor GO, Oelsner EC, Pankow JS, Psaty BM, Rohde RR, Rich SS, Rotter JI, Smith LJ, Stricker BH, Voruganti VS, Wang TJ, Zillikens MC, Barr RG, Dupuis J, Gharib SA, Lahousse L, London SJ, North KE, Smith AV, Steffen LM, Hancock DB, Cassano PA. Meta-analysis across Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium provides evidence for an association of serum vitamin D with pulmonary function. Br J Nutr 2018; 120:1159-1170. [PMID: 30205856 PMCID: PMC6263170 DOI: 10.1017/s0007114518002180] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The role that vitamin D plays in pulmonary function remains uncertain. Epidemiological studies reported mixed findings for serum 25-hydroxyvitamin D (25(OH)D)-pulmonary function association. We conducted the largest cross-sectional meta-analysis of the 25(OH)D-pulmonary function association to date, based on nine European ancestry (EA) cohorts (n 22 838) and five African ancestry (AA) cohorts (n 4290) in the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium. Data were analysed using linear models by cohort and ancestry. Effect modification by smoking status (current/former/never) was tested. Results were combined using fixed-effects meta-analysis. Mean serum 25(OH)D was 68 (sd 29) nmol/l for EA and 49 (sd 21) nmol/l for AA. For each 1 nmol/l higher 25(OH)D, forced expiratory volume in the 1st second (FEV1) was higher by 1·1 ml in EA (95 % CI 0·9, 1·3; P<0·0001) and 1·8 ml (95 % CI 1·1, 2·5; P<0·0001) in AA (P race difference=0·06), and forced vital capacity (FVC) was higher by 1·3 ml in EA (95 % CI 1·0, 1·6; P<0·0001) and 1·5 ml (95 % CI 0·8, 2·3; P=0·0001) in AA (P race difference=0·56). Among EA, the 25(OH)D-FVC association was stronger in smokers: per 1 nmol/l higher 25(OH)D, FVC was higher by 1·7 ml (95 % CI 1·1, 2·3) for current smokers and 1·7 ml (95 % CI 1·2, 2·1) for former smokers, compared with 0·8 ml (95 % CI 0·4, 1·2) for never smokers. In summary, the 25(OH)D associations with FEV1 and FVC were positive in both ancestries. In EA, a stronger association was observed for smokers compared with never smokers, which supports the importance of vitamin D in vulnerable populations.
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Affiliation(s)
- Jiayi Xu
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States
| | - Traci M. Bartz
- Department of Biostatistics, University of Washington, Seattle, Washington, United States
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States
| | - Geetha Chittoor
- Department of Biomedical and Translational Informatics, Geisinger, Danville, Pennsylvania, United States
- Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | | | - Ani W. Manichaikul
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Fangui Sun
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States
| | - Natalie Terzikhan
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Xia Zhou
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Sarah L. Booth
- Jean Mayer-U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts, United States
| | - Guy G. Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Respiratory Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Ian H. de Boer
- Department of Medicine, University of Washington, Seattle, Washington, United States
| | - Myriam Fornage
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, Texas, United States
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, United States
| | - Alexis C. Frazier-Wood
- Children’s Nutrition Research Center, Baylor College of Medicine, Houston, Texas, United States
| | - Mariaelisa Graff
- Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Vilmundur Gudnason
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Tamara B. Harris
- Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, United States
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging, Leiden, the Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Ruixue Hou
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, United States
| | - Denise K. Houston
- Sticht Center on Aging, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United State
| | - David R. Jacobs Jr
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Stephen B. Kritchevsky
- Sticht Center on Aging, Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, United State
| | - Jeanne Latourelle
- The Pulmonary Center, Department of Medicine, Boston University, Boston, Massachusetts, United State
- Department of Neurology, Boston University, Boston, Massachusetts, United States
| | - Rozenn N. Lemaitre
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States
- Department of Medicine, University of Washington, Seattle, Washington, United States
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - George O. Connor
- The Pulmonary Center, Department of Medicine, Boston University, Boston, Massachusetts, United State
| | | | - James S. Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Bruce M. Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States
- Department of Medicine, University of Washington, Seattle, Washington, United States
- Department of Epidemiology, University of Washington, Seattle, Washington, United States
- Department of Health Services, University of Washington, Seattle, Washington, United States
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington, United States
| | - Rebecca R. Rohde
- Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia, United States
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Department of Pediatrics at Harbor-UCLA Medical Center, Torrance, California, United States
| | - Lewis J. Smith
- Division of Pulmonary and Critical Care, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
| | - Bruno H. Stricker
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging, Leiden, the Netherlands
| | - V. Saroja Voruganti
- Department of Nutrition and Nutrition Research Institute, University of North Carolina at Chapel Hill, Kannapolis, North Carolina, United States
| | - Thomas J. Wang
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University, Nashville, Tennessee, United States
| | - M. Carola Zillikens
- Netherlands Genomics Initiative (NGI)-sponsored Netherlands Consortium for Healthy Aging, Leiden, the Netherlands
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - R. Graham Barr
- Department of Medicine, Columbia University, New York, New York, United States
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States
| | - Sina A. Gharib
- Department of Medicine, University of Washington, Seattle, Washington, United States
- Center for Lung Biology, University of Washington, Seattle, Washington, United States
| | - Lies Lahousse
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
- Department of Bioanalysis, Ghent University, Ghent, Belgium
| | - Stephanie J. London
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, United States
| | - Kari E. North
- Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Albert V. Smith
- Icelandic Heart Association, Kopavogur, Iceland
- University of Iceland, Reykjavik, Iceland
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, United States
| | - Dana B. Hancock
- Behavioral and Urban Health Program, Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, North Carolina, United States
| | - Patricia A. Cassano
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, United States
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9
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Abstract
Approximately 15% of patients with diabetes mellitus (DM) are prone to developing diabetic foot ulcers (DFU) in their lifetime. The term vitamin D status or 25-hydroxyvitamin D (25(OH)D) levels is used interchangeably to represent the status of vitamin D in individuals throughout this article. Evidence suggests a relationship between 25(OH)D levels and DFU. However, very minimal data are available on the association between DFU and vitamin D deficiency. After a careful review of the literature, it was inferred that vitamin D could be associated with DFU and diabetic foot infections. Available evidence on vitamin D and DFU suggests a negative correlation between 25(OH)D levels and the presence of DFU. Evidence also supports a negative relationship between 25(OH)D levels and diabetic foot infections. Further large-scale randomized controlled studies need to be done to confirm the relationship between 25(OH)D levels and DFU including the use of vitamin D in the management of DFU and diabetic foot infections.
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Affiliation(s)
- Antony Macido
- Catherine McAuley School of Nursing, Maryville University, Missouri, USA
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10
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Smith TJ, Tripkovic L, Lanham-New SA, Hart KH. Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy. Proc Nutr Soc 2018; 77:292-301. [PMID: 29198201 DOI: 10.1017/S0029665117004104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Vitamin D is a unique nutrient. First, it acts as a pro-hormone and secondly, the requirement for vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This complicates the determination of dietary requirements for vitamin D, which along with the definition of optimal vitamin D status, have been highly controversial and much debated over recent years. Adolescents are a population group at high risk of low vitamin D status, which is concerning given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations are important from a public health perspective in helping to avoid deficiency and optimise vitamin D status for health. However limited experimental data from winter-based dose-response randomised trials in adolescents has hindered the development of evidence-based dietary requirements for vitamin D in this population group. This review will highlight how specifically designed randomised trials and the approach adopted for estimating such requirements can lead to improved recommendations. Such data indicate that vitamin D intakes of between 10 and about 30 µg/d may be required to avoid deficiency and ensure adequacy in adolescents, considerably greater than the current recommendations of 10-15 µg/d. Finally this review will consider the implications of this on public health policy, in terms of future refinements of vitamin D requirement recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency.
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11
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Millward DJ. Nutrition, infection and stunting: the roles of deficiencies of individual nutrients and foods, and of inflammation, as determinants of reduced linear growth of children. Nutr Res Rev 2017; 30:50-72. [PMID: 28112064 DOI: 10.1017/S0954422416000238] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The regulation of linear growth by nutritional and inflammatory influences is examined in terms of growth-plate endochondral ossification, in order to better understand stunted growth in children. Linear growth is controlled by complex genetic, physiological, and nutrient-sensitive endocrine/paracrine/autocrine mediated molecular signalling mechanisms, possibly including sleep adequacy through its influence on growth hormone secretion. Inflammation, which accompanies most infections and environmental enteric dysfunction, inhibits endochondral ossification through the action of mediators including proinflammatory cytokines, the activin A-follistatin system, glucocorticoids and fibroblast growth factor 21 (FGF21). In animal models linear growth is particularly sensitive to dietary protein as well as Zn intake, which act through insulin, insulin-like growth factor-1 (IGF-1) and its binding proteins, triiodothyronine, amino acids and Zn2+ to stimulate growth-plate protein and proteoglycan synthesis and cell cycle progression, actions which are blocked by corticosteroids and inflammatory cytokines. Observational human studies indicate stunting to be associated with nutritionally poor, mainly plant-based diets. Intervention studies provide some support for deficiencies of energy, protein, Zn and iodine and for multiple micronutrient deficiencies, at least during pregnancy. Of the animal-source foods, only milk has been specifically and repeatedly shown to exert an important influence on linear growth in both undernourished and well-nourished children. However, inflammation, caused by infections, environmental enteric dysfunction, which may be widespread in the absence of clean water, adequate sanitation and hygiene (WASH), and endogenous inflammation associated with excess adiposity, in each case contributes to stunting, and may explain why nutritional interventions are often unsuccessful. Current interventions to reduce stunting are targeting WASH as well as nutrition.
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12
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Wetmore JB, Kimber C, Mahnken JD, Stubbs JR. Cholecalciferol v. ergocalciferol for 25-hydroxyvitamin D (25(OH)D) repletion in chronic kidney disease: a randomised clinical trial. Br J Nutr 2016; 116:2074-81. [PMID: 28065190 DOI: 10.1017/S000711451600427X] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Patients with chronic kidney disease (CKD) demonstrate complex mineral metabolism derangements and a high prevalence of vitamin D deficiency. However, the optimal method of 25-hydroxyvitamin D (25(OH)D) repletion is unknown, and trials analysing the comparative efficacy of cholecalciferol and ergocalciferol in this population are lacking. We conducted a randomised clinical trial of cholecalciferol 1250μg (50 000 IU) weekly v. ergocalciferol 1250μg (50 000 IU) weekly for 12 weeks in forty-four non-dialysis-dependent patients with stage 3-5 CKD. The primary outcome was change in total 25(OH)D from baseline to week 12 (immediately after therapy). Secondary analyses included the change in 1,25-dihydroxyvitamin D (1,25(OH)2D), parathyroid hormone (PTH), D2 and D3 sub-fractions of 25(OH)D and 1,25(OH)2D and total 25(OH)D from baseline to week 18 (6 weeks after therapy). Cholecalciferol therapy yielded a greater change in total 25(OH)D (45·0 (sd 16·5) ng/ml) v. ergocalciferol (30·7 (sd 15·3) ng/ml) from baseline to week 12 (P<0·01); this observation partially resulted from a substantial reduction in the 25(OH)D3 sub-fraction with ergocalciferol. However, following cessation of therapy, no statistical difference was observed for total 25(OH)D change from baseline to week 18 between cholecalciferol and ergocalciferol groups (22·4 (sd 12·7) v. 17·6 (sd 8·9) ng/ml, respectively; P=0·17). We observed no significant difference between these therapies with regard to changes in serum PTH or 1,25(OH)2D. Therapy with cholecalciferol, compared with ergocalciferol, is more effective at raising serum 25(OH)D in non-dialysis-dependent CKD patients while active therapy is ongoing. However, levels of 25(OH)D declined substantially in both arms following cessation of therapy, suggesting the need for maintenance therapy to sustain levels.
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13
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Abstract
Vitamin D enters the body through multiple routes and in a variety of chemical forms. Utilization varies with input, demand, and genetics. Vitamin D and its metabolites are carried in the blood on a Gc protein that has three principal alleles with differing binding affinities and ethnic prevalences. Three major metabolites are produced, which act via two routes, endocrine and autocrine/paracrine, and in two compartments, extracellular and intracellular. Metabolic consumption is influenced by physiological controls, noxious stimuli, and tissue demand. When administered as a supplement, varying dosing schedules produce major differences in serum metabolite profiles. To understand vitamin D's role in human physiology, it is necessary both to identify the foregoing entities, mechanisms, and pathways and, specifically, to quantify them. This review was performed to delineate the principal entities and transitions involved in the vitamin D economy, summarize the status of present knowledge of the applicable rates and masses, draw inferences about functions that are implicit in these quantifications, and point out implications for the determination of adequacy.
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Affiliation(s)
- Robert P Heaney
- R.P. Heaney is with Creighton University, Omaha, Nebraska, USA. L.A.G. Armas is with the Department of Medicine, Creighton University, Omaha, Nebraska, USA
| | - Laura A G Armas
- R.P. Heaney is with Creighton University, Omaha, Nebraska, USA. L.A.G. Armas is with the Department of Medicine, Creighton University, Omaha, Nebraska, USA
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14
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Deschasaux M, Souberbielle JC, Latino-Martel P, Sutton A, Charnaux N, Druesne-Pecollo N, Galan P, Hercberg S, Le Clerc S, Kesse-Guyot E, Ezzedine K, Touvier M. A prospective study of plasma 25-hydroxyvitamin D concentration and prostate cancer risk. Br J Nutr 2016; 115:305-14. [PMID: 26568368 DOI: 10.1017/S0007114515004353] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Mechanistic hypotheses suggest that vitamin D and the closely related parathyroid hormone (PTH) may be involved in prostate carcinogenesis. However, epidemiological evidence is lacking for PTH and inconsistent for vitamin D. Our objectives were to prospectively investigate the association between vitamin D status, vitamin D-related gene polymorphisms, PTH and prostate cancer risk. A total of 129 cases diagnosed within the Supplémentation en Vitamines et Minéraux Antioxydants cohort were included in a nested case-control study and matched to 167 controls (13 years of follow-up). 25-Hydroxyvitamin D (25(OH)D) and PTH concentrations were assessed from baseline plasma samples. Conditional logistic regression models were computed. Higher 25(OH)D concentration was associated with decreased risk of prostate cancer (ORQ4 v. Q1 0·30; 95 % CI 0·12, 0·77; P trend=0·007). PTH concentration was not associated with prostate cancer risk (P trend=0·4) neither did the studied vitamin D-related gene polymorphisms. In this prospective study, prostate cancer risk was inversely associated with 25(OH)D concentration but not with PTH concentration. These results bring a new contribution to the understanding of the relationship between vitamin D and prostate cancer, which deserves further investigation.
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15
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Abstract
In recent years, new functional roles of vitamin D beyond its traditional role in calcium homoeostasis and bone metabolism have emerged linking the fat-soluble vitamin to various non-communicable diseases. Vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) < 25-30 nmol/l) and sub-optimal status (25(OH)D < 50-100 nmol/l) are increasingly associated with unfavourable metabolic phenotypes, including insulin resistance, type 2 diabetes and CVD; conditions also commonly linked with overweight and obesity. Early studies reported poor vitamin D status in the morbidly obese. More recently, it has been observed that a graded relationship between vitamin D status and BMI, or specifically adiposity, exists in the general population. A number of hypotheses have been proposed to explain the potential mechanisms whereby alterations in the vitamin D endocrine system occur in the obese state. Plausible explanations include sequestration in adipose tissue, volumetric dilution or negative feedback mechanisms from increased circulating 1,25-dihydroxyvitamin D3. Others hypothesise that heavier individuals may partake in less outdoor activity, may also cover-up and wear more clothing than leaner individuals, thus decreasing sun exposure and limiting endogenous production of cholecalciferol in the skin. Moreover, in some but not all studies, BMI and adiposity have been negatively associated with the change in vitamin D status following vitamin D supplementation. It therefore remains unclear if body size and/or adiposity should be taken into account when determining the dietary requirements for vitamin D. This review will evaluate the current evidence linking vitamin D status and supplementation to overweight and obesity, and discuss the implications for setting dietary requirements.
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16
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Zhao S, Duffield SJ, Moots RJ, Goodson NJ. Systematic review of association between vitamin D levels and susceptibility and disease activity of ankylosing spondylitis. Rheumatology (Oxford) 2014; 53:1595-603. [PMID: 24706990 DOI: 10.1093/rheumatology/keu042] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Vitamin D appears to have significant effects on both innate and acquired immunity and deficiency may be associated with both susceptibility and disease severity in some autoimmune conditions. There has been little focus on the potential immunomodulatory role of vitamin D in AS. This study systematically reviews the evidence for an association between vitamin D deficiency and disease susceptibility and severity in AS. METHODS A systematic review was conducted using Medline, EMBASE, Web of Science and conference abstracts of the European League Against Rheumatism (2002-13), British Society for Rheumatology (1993-2013) and ACR (2006-13). RESULTS Fifteen original articles and five conference abstracts met the criteria for inclusion. All were cross-sectional in design. Seven of 11 studies identified lower concentrations of 25-hydroxyvitamin D (25OHD) in AS patients compared with healthy controls. A significant inverse correlation between 25OHD and disease activity was observed in 5 of 11 studies. The majority of studies that failed to demonstrate significant findings used inappropriate statistical methods. CONCLUSION Cross-sectional studies using appropriate statistical analyses have highlighted that AS is associated with lower vitamin D concentrations. Within groups of AS patients there is some evidence that low vitamin D concentrations are associated with higher disease activity. However, there are insufficient published data to support an immunomodulatory role for vitamin D in AS. Further study with a longitudinal design is required to understand whether optimizing vitamin D in AS has potential as a disease-modifying intervention.
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Affiliation(s)
- Sizheng Zhao
- Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK
| | - Stephen J Duffield
- Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK
| | - Robert J Moots
- Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK
| | - Nicola J Goodson
- Department of Rheumatology, Aintree University Hospital and School of Medical Education, University of Liverpool, Liverpool, UK.
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17
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Sulistyoningrum DC, Gasevic D, Green TJ, Lear SA, Devlin AM. Adiposity and the relationship between vitamin D and blood pressure. Metabolism 2013; 62:1795-802. [PMID: 23987237 DOI: 10.1016/j.metabol.2013.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 07/06/2013] [Accepted: 07/17/2013] [Indexed: 01/28/2023]
Abstract
OBJECTIVE Circulating vitamin D (25OHD) concentrations are negatively associated with blood pressure (BP) but little is known about the mechanisms for this relationship. Adiposity is positively associated with BP and inversely with circulating 25OHD concentrations but no studies have assessed the relationship between plasma 25OHD and adiposity on BP. The goal of this study is to investigate if the association between plasma 25OHD and BP is mediated by adiposity. MATERIALS/METHODS The relationship between plasma 25OHD, systolic and diastolic BP, and adiposity [BMI, waist circumference, visceral adipose tissue (VAT)] was assessed in a multi-ethnic cross-sectional study of Aboriginal (n=151), Chinese (n=190), European (n=170), and South Asian (n=176) participants by linear regression models. RESULTS Plasma 25OHD concentrations were negatively associated with systolic (standardized B=-0.191, P<0.001) and diastolic BP (standardized B=-0.196, P<0.001) in models adjusted for age, sex, ethnicity, family history of CVD, smoking status, alcohol consumption, and physical activity. The negative relationship between plasma 25OHD concentrations and systolic and diastolic BP was attenuated after the addition of BMI, waist circumference, and VAT to the models, but the relationship remained significant. Plasma 25OHD concentrations accounted for 0.7% and 0.8% of the variance in systolic and diastolic BP, respectively. CONCLUSION These findings suggest that the relationship between vitamin D and BP is independent of adiposity. Further studies are required to determine the mechanisms by which vitamin D affects BP.
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Affiliation(s)
- Dian C Sulistyoningrum
- Department of Pathology and Laboratory Medicine, University of British Columbia, Child and Family Research Institute, Vancouver, Canada
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