1
|
Tao X, Yang W, Zhang Q, Wang Y, Gao F, Wang Y, Zhang T, Liu H, Chen J. Effects of intermittent overload doses of oral vitamin D3 on serum 25(OH)D concentrations and the incidence rates of fractures, falls, and mortality in elderly individuals: A systematic review and meta-analysis. BIOMOLECULES & BIOMEDICINE 2024; 24:1068-1076. [PMID: 38615341 PMCID: PMC11379009 DOI: 10.17305/bb.2024.10449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
Vitamin D is commonly used to prevent and treat osteoporosis, with studies indicating its potential to reduce fractures, falls, and mortality. However, meta-analyses present inconsistent findings regarding its efficacy, particularly reflecting significant variability in data and outcomes related to various dosing regimens. In this meta-analysis, we assessed the impact of high-dose intermittent oral administration of vitamin D3 on serum 25(OH)D levels, fractures, falls, and mortality among elderly individuals. We included 14 randomized controlled trials (RCTs) and employed Review Manager 5.4 for statistical analysis. Our findings indicate that intermittent monthly administration of vitamin D3 (over 800 IU per day) significantly raised serum 25(OH)D levels at all timepoints after six months, maintaining levels above 75 nmol/L throughout the year. This regimen showed no increase in all-cause mortality, with a risk ratio (95% CI) of 0.95 (0.87-1.04). Likewise, it did not significantly reduce the risks of falls and fractures, with risk ratios of 1.02 (0.98-1.05) and 0.95 (0.87-1.04) respectively. Although one-year intermittent administration significantly increased the concentration of 25(OH)D in serum, further research is needed to determine if this method would increase the incidence of falls. Therefore, it is not recommended at this stage due to the lack of demonstrated safety in additional relevant RCTs. This study had been registered at PROSPERO (CRD42022363229).
Collapse
Affiliation(s)
- Xiaoyang Tao
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Wupeng Yang
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Qinxin Zhang
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Yongjiang Wang
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Feng Gao
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | | | - Tingxin Zhang
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Hao Liu
- Orthopedics Department, Ordos Central Hospital, Ordos, China
| | - Jindong Chen
- Ordos School of Clinical Medicine, Inner Mongolia Medical University, Ordos, China
| |
Collapse
|
2
|
Chen WY, Cheng YC, Chiu CC, Liu HC, Huang MC, Tu YK, Kuo PH. Effects of Vitamin D Supplementation on Cognitive Outcomes: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2024; 34:568-580. [PMID: 37418225 DOI: 10.1007/s11065-023-09598-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: 08/02/2022] [Accepted: 05/11/2023] [Indexed: 07/08/2023]
Abstract
Clinical studies examining the effects of vitamin D on cognition have reported inconsistent results. To date, no comprehensive study has examined this effect on the basis of sample characteristics or intervention model-related factors. This systematic review and meta-analysis of randomized controlled trials investigated the effects of vitamin D supplementation on global cognitive function and specific cognitive domains. This review was preregistered in the PROSPERO database (CRD42021249908) and comprised 24 trials enrolling 7557 participants (mean age: 65.21 years; 78.54% women). The meta-analysis revealed that vitamin D significantly influenced global cognition (Hedges' g = 0.128, p = .008) but not specific cognitive domains. A subgroup analysis indicated that the effect size of vitamin D was stronger for vulnerable populations (Hedges' g = 0.414) and those with baseline vitamin D deficiency (Hedges' g = 0.480). On the basis of subgroup analyses in studies without biological flaws (Hedges' g = 0.549), we suggest that an intervention model should correct baseline vitamin D deficiency. Our results indicate that vitamin D supplementation has a small but significant positive effect on cognition in adults.
Collapse
Affiliation(s)
- Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsing-Cheng Liu
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yu-Kang Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan.
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
- College of Public Health, Health Behaviors and Community Sciences, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
3
|
Ruggiero C, Baroni M, Xenos D, Parretti L, Macchione IG, Bubba V, Laudisio A, Pedone C, Ferracci M, Magierski R, Boccardi V, Antonelli-Incalzi R, Mecocci P. Dementia, osteoporosis and fragility fractures: Intricate epidemiological relationships, plausible biological connections, and twisted clinical practices. Ageing Res Rev 2024; 93:102130. [PMID: 38030092 DOI: 10.1016/j.arr.2023.102130] [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: 09/20/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
Dementia, osteoporosis, and fragility fractures are chronic diseases, often co-existing in older adults. These conditions pose severe morbidity, long-term disability, and mortality, with relevant socioeconomic implications. While in the research arena, the discussion remains on whether dementia is the cause or the consequence of fragility fractures, healthcare professionals need a better understanding of the interplay between such conditions from epidemiological and physiological standpoints. With this review, we summarized the available literature surrounding the relationship between cognitive impairment, dementia, and both low bone mineral density (BMD) and fragility fractures. Given the strength of the bi-directional associations and their impact on the quality of life, we shed light on the biological connections between brain and bone systems, presenting the main mediators, including gut microbioma, and pathological pathways leading to the dysregulation of bone and brain metabolism. Ultimately, we synthesized the evidence about the impact of available pharmacological treatments for the prevention of fragility fractures on cognitive functions and individuals' outcomes when dementia coexists. Vice versa, the effects of symptomatic treatments for dementia on the risk of falls and fragility fractures are explored. Combining evidence alongside clinical practice, we discuss challenges and opportunities related to the management of older adults affected by cognitive impairment or dementia and at high risk for fragility fracture prevention, which leads to not only an improvement in patient health-related outcomes and survival but also a reduction in healthcare cost and socio-economic burden.
Collapse
Affiliation(s)
- C Ruggiero
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy.
| | - M Baroni
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - D Xenos
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - L Parretti
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - I G Macchione
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - V Bubba
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - A Laudisio
- Department of Medicine, Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy
| | - C Pedone
- Department of Medicine, Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy
| | - M Ferracci
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - R Magierski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - V Boccardi
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| | - R Antonelli-Incalzi
- Department of Medicine, Unit of Geriatrics, Campus Bio-Medico di Roma University, Rome, Italy
| | - P Mecocci
- Department of Medicine, Section of Gerontology and Geriatrics, University of Perugia, Italy
| |
Collapse
|
4
|
Manjari SKV, Abraham SM, Poornima R, Chaturvedi RK, Maity S, Komal P. Unprecedented effect of vitamin D3 on T-cell receptor beta subunit and alpha7 nicotinic acetylcholine receptor expression in a 3-nitropropionic acid induced mouse model of Huntington's disease. IBRO Neurosci Rep 2023; 15:116-125. [PMID: 38204575 PMCID: PMC10776327 DOI: 10.1016/j.ibneur.2023.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 05/27/2023] [Accepted: 07/12/2023] [Indexed: 01/12/2024] Open
Abstract
Introduction 3-NP induction in rodent models has been shown to induce selective neurodegeneration in the striatum followed by the cortex (Brouillet, 2014). However, it remains unclear whether, under such a neurotoxic condition, characterized by neuroinflammation and oxidative stress, the gene expression of the immune resident protein, T-cell receptor beta subunit (TCR-β), α7 nicotinic acetylcholine receptor (α7 nAChRs), the nuclear factor kappa B (NF-κB), inflammatory cytokines (TNF-α and IL-6), and antioxidants (Cat and GpX4) get modulated on Vitamin D3 (VD) supplementation in the central nervous system. Methods In the present study, real-time polymerase chain reaction (RT-PCR) was performed to study the expression of respective genes. Male C57BL/6 mice (8-12 weeks) were divided into four groups namely, Group I: Control (saline); Group II: 3-NP induction via i.p (HD); Group III: Vitamin D3 (VD) and Group IV: (HD + VD) (Manjari et al., 2022). Results On administration of 500IU/kg/day of VD, HD mice showed a significant reduction in the gene expression of the immune receptor, TCR-β subunit, nuclear factor kappa B (NF-κB), inflammatory cytokines, and key antioxidants, followed by a decrease in the acetylcholinesterase activity. Conclusion A novel neuroprotective effect of VD in HD is demonstrated by combating the immune receptor, TCR-β gene expression, antioxidant markers, and inflammatory cytokines. In addition, HD mice on VD administration for 0-15 days showed an enhancement in cholinergic signaling with restoration in α7 nAChRs mRNA and protein expression in the striatum and cortex.
Collapse
Affiliation(s)
- SKV Manjari
- Department of Biological Sciences, Birla Institute of Technology and Sciences (BITS)-Pilani (Hyderabad Campus), Shameerpet-Mandal, Hyderabad, Telangana 500078, India
| | - Sharon Mariam Abraham
- Department of Biological Sciences, Birla Institute of Technology and Sciences (BITS)-Pilani (Hyderabad Campus), Shameerpet-Mandal, Hyderabad, Telangana 500078, India
| | - R. Poornima
- Department of Biological Sciences, Birla Institute of Technology and Sciences (BITS)-Pilani (Hyderabad Campus), Shameerpet-Mandal, Hyderabad, Telangana 500078, India
| | - Rajneesh Kumar Chaturvedi
- Department of Toxicology and health assessment, CSIR-Indian Institute of Toxicology Research, Vishvigyan Bhavan, 31, Mahatma Gandhi Marg P.O. Box No. 80, Lucknow 226 001 Uttar Pradesh, India
| | - Shuvadeep Maity
- Department of Biological Sciences, Birla Institute of Technology and Sciences (BITS)-Pilani (Hyderabad Campus), Shameerpet-Mandal, Hyderabad, Telangana 500078, India
| | - Pragya Komal
- Department of Biological Sciences, Birla Institute of Technology and Sciences (BITS)-Pilani (Hyderabad Campus), Shameerpet-Mandal, Hyderabad, Telangana 500078, India
| |
Collapse
|
5
|
Xie Y, Bai C, Feng Q, Gu D. Serum Vitamin D 3 Concentration, Sleep, and Cognitive Impairment among Older Adults in China. Nutrients 2023; 15:4192. [PMID: 37836477 PMCID: PMC10574235 DOI: 10.3390/nu15194192] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Cognitive decline in older adults has become one of the critical challenges to global health. This study aims to examine both cross-sectional and longitudinal associations of levels of serum 25-hydroxyvitamin D3 (25(OH)D3) (briefed as VD3) concentration and sleep quality/duration, especially their interactions, with risk of cognitive impairment among older adults in China. METHODS We utilized a special subsample of adults aged 65-105 years (individuals = 3412, observations = 4816) from eight provinces in China derived from the 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey. Cognitive impairment was measured by the Mini-Mental State Examination scale. Sleep quality was classified as good versus fair/poor, and sleep duration was classified into short (<7 h), normal (≥7 but <9 h), and long (≥9 h). The VD3 concentration was divided into three levels: deficiency (VD3 < 25 nmol/L), insufficiency (25 nmol/L ≤ VD3 < 50 nmol/L), and sufficiency (VD3 ≥ 50 nmol/L). A wide set of covariates that include demographics, socioeconomic status, family support, health practice, and health conditions was adjusted for robust findings. Multilevel random intercept logit regression models were used to examine the cross-sectional associations between VD3, sleep, and cognitive impairment, whereas logit regression models were applied to investigate the longitudinal associations. RESULTS In the cross-sectional analyses, when all covariates were adjusted, VD3 sufficiency was significantly associated with a 33% lower risk of cognitive impairment compared with VD3 deficiency; good sleep quality was associated with 34% lower odds of cognitive impairment compared with fair/poor sleep quality; sleep hours were not associated with cognitive impairment, although a long sleep duration (≥9 h) was associated with 30% higher odds of being cognitively impaired when baseline health was not controlled. Interaction analyses reveal that VD3 sufficiency could help to additionally reduce the risk of cognitive impairment for good sleep quality and normal sleep hours. In the longitudinal analyses, the association of VD3 sufficiency remains significant, whereas sleep quality and sleep duration were not significant associates. CONCLUSIONS Good sleep quality, normal sleep hours, and VD3 sufficiency are positively associated with good cognitive function. VD3 sufficiency could enhance the associations between sleep and cognitive impairment.
Collapse
Affiliation(s)
- Yuning Xie
- School of Labor and Human Resources, Renmin University of China, Beijing 100872, China; (Y.X.); (C.B.)
| | - Chen Bai
- School of Labor and Human Resources, Renmin University of China, Beijing 100872, China; (Y.X.); (C.B.)
| | - Qiushi Feng
- Centre for Family and Population Research, Department of Sociology and Anthropology, National University of Singapore, Singapore 119077, Singapore
| | - Danan Gu
- Independent Researcher, Nanjing 210042, China
| |
Collapse
|
6
|
Lee KJ, Kim H, Lee SJ, Duperron MG, Debette S, Bae HJ, Sung J. Causal Effect of the 25-Hydroxyvitamin D Concentration on Cerebral Small Vessel Disease: A Mendelian Randomization Study. Stroke 2023; 54:2338-2346. [PMID: 37465996 PMCID: PMC10453327 DOI: 10.1161/strokeaha.123.042980] [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: 02/19/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Previous observational studies reported that a lower serum 25-hydroxyvitamin D [25(OH)D] concentration is associated with a higher burden of cerebral small vessel disease (cSVD). The causality of this association is uncertain, but it would be clinically important, given that 25(OH)D can be a target for intervention. We tried to examine the causal effect of 25(OH)D concentration on cSVD-related phenotypes using a Mendelian randomization approach. METHODS Genetic instruments for each serum 25(OH)D concentration and cSVD-related phenotypes (lacunar stroke, white matter hyperintensity, cerebral microbleeds, and perivascular spaces) were derived from large-scale genome-wide association studies. We performed 2-sample Mendelian randomization analyses with multiple post hoc sensitivity analyses. A bidirectional Mendelian randomization approach was also used to explore the possibility of reverse causation. RESULTS We failed to find any significant causal effect of 25(OH)D concentration on cSVD-related phenotypes (odds ratio [95% CI], 1.00 [0.87-1.16], 1.01 [0.96-1.07], 1.06 [0.85-1.33], 1.00 [0.97-1.03], 1.02 [0.99-1.04], 1.01 [0.99-1.04] for lacunar stroke, white matter hyperintensity, cerebral microbleeds, and white matter, basal ganglia, hippocampal perivascular spaces, respectively). These results were reproduced in the sensitivity analyses accounting for genetic pleiotropy. Conversely, when we examined the effects of cSVD phenotypes on 25(OH)D concentration, cerebral microbleeds were negatively associated with 25(OH)D concentration (0.94 [0.92-0.96]). CONCLUSIONS Given the adequate statistical power (>0.8) of the analyses, our findings suggest that the previously reported association between 25(OH)D concentration and cSVD phenotypes might not be causal and partly attributed to reverse causation.
Collapse
Affiliation(s)
- Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Seoul, Republic of Korea (K.-J.L.)
| | - Hakyung Kim
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health (H.K., S.J.L., J.S.), Seoul National University, Republic of Korea
| | - Soo Ji Lee
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health (H.K., S.J.L., J.S.), Seoul National University, Republic of Korea
- Health and Environment Institute (S.J.L., J.S.), Seoul National University, Republic of Korea
| | | | - Stéphanie Debette
- Bordeaux Population Health Research Center, University of Bordeaux, France (M.-G.D., S.D.)
| | - Hee-Joon Bae
- Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea (H.-J.B.)
| | - Joohon Sung
- Genome and Health Big Data Laboratory, Department of Public Health, Graduate School of Public Health (H.K., S.J.L., J.S.), Seoul National University, Republic of Korea
- Health and Environment Institute (S.J.L., J.S.), Seoul National University, Republic of Korea
| |
Collapse
|
7
|
Hersant H, He S, Maliha P, Grossberg G. Over the Counter Supplements for Memory: A Review of Available Evidence. CNS Drugs 2023; 37:797-817. [PMID: 37603263 DOI: 10.1007/s40263-023-01031-6] [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] [Accepted: 07/24/2023] [Indexed: 08/22/2023]
Abstract
In 2021, the Global Brain Health Supplement Industry Market size was valued at US$7.6 billion. It is predicted to increase to US$15.59 billion by 2030. Memory and its enhancement are a segment of the market that comprised the highest global revenue share in 2021. In the USA alone, dietary supplement sales reached US$18 billion in 2018. The US Food and Drug Administration (FDA) does not have the authority to approve dietary supplements' safety, effectiveness, or labeling before products go on the market. The FDA often does not even review supplements before they go to market. Supplement manufacturers are thus responsible for ensuring their products are safe and that their claims are truthful. An extensive review of current supplements on the market was performed by surveying memory products for sale at local and national pharmacies and grocery stores. A list of 103 supplements was compiled and the ingredients in these memory supplements were reviewed. The 18 most common ingredients in these supplements were identified. Each of the supplements included at least one of the 18 most common ingredients. Scientific data relative to these ingredients and their effect on memory was searched using PubMed and Cochrane library databases. Currently, there is no compelling evidence for use of apoaequorin, coenzyme Q10, coffee extracts, L-theanine, omega-3 fatty acids, vitamin B6, vitamin B9, or vitamin B12 supplementation for memory. On the other hand, there is some current evidence for memory benefit from supplementation with ashwagandha, choline, curcumin, ginger, Lion's Mane, polyphenols, phosphatidylserine, and turmeric. There are current studies with mixed results regarding the benefit of carnitine, gingko biloba, Huperzine A, vitamin D, and vitamin E supplementation for memory. Dietary supplements geared toward improving cognition are a billion-dollar industry that continues to grow despite lacking a solid scientific foundation for their marketing claims. More rigorous studies are needed relative to the long-term use of these supplements in homogenous populations with standardized measurements of cognition. Health care providers need to be aware of any and all supplements their older adult patients may be consuming and be educated about their side effects and interactions with prescription medications. Lastly, the FDA needs to take an active position relative to monitoring marketed supplements regarding safety, purity and claims of efficacy.
Collapse
Affiliation(s)
- Haley Hersant
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA.
| | - Sean He
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
| | - Peter Maliha
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
| | - George Grossberg
- Department of Psychiatry & Behavioral Neuroscience, Saint Louis University School of Medicine, 1438 South Grand Boulevard, Saint Louis, MO, 63104, USA
| |
Collapse
|
8
|
Kamal K, Tewari J, Bharti V, Sharma D, Atam I, Atam V, Rana A, Roy S. Serum Vitamin D Level as a Risk Factor and Prognostic Marker for Acute Ischemic Stroke: A Case-Control Study at a Tertiary Care Centre in Northern India. Cureus 2023; 15:e46117. [PMID: 37900424 PMCID: PMC10612136 DOI: 10.7759/cureus.46117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Stroke is a predominant cause of death worldwide. Major risk factors for stroke in any age group are diabetes, hypertension, heart disease, smoking, and long-term alcohol abuse. It is of utmost importance to identify the risk factors for stroke to prevent recurrence. Vitamin D deficiency is identified as a risk factor for stroke. Therefore, we attempted to look for a correlation between vitamin D levels and acute ischemic stroke. Methods This observational case-control study was conducted with 150 patients (75 cases and 75 controls). On the day of admission, the National Institutes of Health Stroke Scale (NIHSS) score was calculated, and vitamin D levels were measured for each patient. The functional outcome was determined by the modified Rankin scale (mRS). Results The most common risk factors identified in this study were hypertension (61.3%), diabetes mellitus (41.3%), and smoking (37.3%). Out of 75 patients enrolled in the study, 49.4% had significant vitamin D deficiency, and 30.6% had insufficient vitamin D levels. Our study showed a significant correlation between vitamin D sufficiency in the body and the incidence of stroke (x2=3.888 and p=0.048). A significant correlation (p=0.03) was found between the NIHSS score and vitamin D levels in patients with acute ischemic stroke. Conclusion In this observational case-control study, we concluded that the increasing severity of vitamin D deficiency was associated with more deaths and poor outcomes.
Collapse
Affiliation(s)
- Kislaya Kamal
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Jay Tewari
- Medicine, King George's Medical University, Lucknow, IND
| | - Vipin Bharti
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Deepak Sharma
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Isha Atam
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Virendra Atam
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Anadika Rana
- Internal Medicine, King George's Medical University, Lucknow, IND
| | - Shubhajeet Roy
- Medicine, King George's Medical University, Lucknow, IND
| |
Collapse
|
9
|
Mirarchi A, Albi E, Beccari T, Arcuri C. Microglia and Brain Disorders: The Role of Vitamin D and Its Receptor. Int J Mol Sci 2023; 24:11892. [PMID: 37569267 PMCID: PMC10419106 DOI: 10.3390/ijms241511892] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Accounting for 5-20% of the total glial cells present in the adult brain, microglia are involved in several functions: maintenance of the neural environment, response to injury and repair, immunesurveillance, cytokine secretion, regulation of phagocytosis, synaptic pruning, and sculpting postnatal neural circuits. Microglia contribute to some neurodevelopmental disorders, such as Nasu-Hakola disease (NHD), Tourette syndrome (TS), autism spectrum disorder (ASD), and schizophrenia. Moreover, microglial involvement in neurodegenerative diseases, such as Alzheimer's (AD) and Parkinson's (PD) diseases, has also been well established. During the last two decades, epidemiological and research studies have demonstrated the involvement of vitamin D3 (VD3) in the brain's pathophysiology. VD3 is a fat-soluble metabolite that is required for the proper regulation of many of the body's systems, as well as for normal human growth and development, and shows neurotrophic and neuroprotective actions and influences on neurotransmission and synaptic plasticity, playing a role in various neurological diseases. In order to better understand the exact mechanisms behind the diverse actions of VD3 in the brain, a large number of studies have been performed on isolated cells or tissues of the central nervous system (CNS). Here, we discuss the involvement of VD3 and microglia on neurodegeneration- and aging-related diseases.
Collapse
Affiliation(s)
- Alessandra Mirarchi
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy;
| | - Elisabetta Albi
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy; (E.A.); (T.B.)
| | - Tommaso Beccari
- Department of Pharmaceutical Sciences, University of Perugia, 06123 Perugia, Italy; (E.A.); (T.B.)
| | - Cataldo Arcuri
- Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy;
| |
Collapse
|
10
|
Cheng M, Song Z, Guo Y, Luo X, Li X, Wu X, Gong Y. 1α,25-Dihydroxyvitamin D 3 Improves Follicular Development and Steroid Hormone Biosynthesis by Regulating Vitamin D Receptor in the Layers Model. Curr Issues Mol Biol 2023; 45:4017-4034. [PMID: 37232725 DOI: 10.3390/cimb45050256] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 05/27/2023] Open
Abstract
1α,25-Dihydroxyvitamin D3 (VitD3) is the active form of vitamin D, and it regulates gene expression and protein synthesis in mammalian follicle development. However, the function of VitD3 in the follicular development of layers remains unclear. This study investigated, through in vivo and in vitro experiments, the effects of VitD3 on follicle development and steroid hormone biosynthesis in young layers. In vivo, ninety 18-week-old Hy-Line Brown laying hens were randomly divided into three groups for different treatments of VitD3 (0, 10, and 100 μg/kg). VitD3 supplementation promoted follicle development, increasing the number of small yellow follicles (SYFs) and large yellow follicles (LYFs) and the thickness of the granulosa layer (GL) of SYFs. Transcriptome analysis revealed that VitD3 supplementation altered gene expression in the ovarian steroidogenesis, cholesterol metabolism, and glycerolipid metabolism signaling pathways. Steroid hormone-targeted metabolomics profiling identified 20 steroid hormones altered by VitD3 treatment, with 5 being significantly different among the groups. In vitro, it was found that VitD3 increased cell proliferation, promoted cell-cycle progression, regulated the expression of cell-cycle-related genes, and inhibited the apoptosis of granulosa cells from pre-hierarchical follicles (phGCs) and theca cells from prehierarchical follicles (phTCs). In addition, the steroid hormone biosynthesis-related genes, estradiol (E2) and progesterone (P4) concentrations, and vitamin D receptor (VDR) expression level was significantly altered by VitD3. Our findings identified that VitD3 altered the gene expression related to steroid metabolism and the production of testosterone, estradiol, and progesterone in the pre-hierarchical follicles (PHFs), resulting in positive effects on poultry follicular development.
Collapse
Affiliation(s)
- Manman Cheng
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Zhenquan Song
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Yan Guo
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Xuliang Luo
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Xuelian Li
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Xiaohui Wu
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Yanzhang Gong
- Key Laboratory of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| |
Collapse
|
11
|
Choudhary A, Kumar A, Sharma R, Khurana L, Jain S, Sharma S, Kumar D, Sharma S. Optimal vitamin D level ameliorates neurological outcome and quality of life after traumatic brain injury: a clinical perspective. Int J Neurosci 2023; 133:417-425. [PMID: 33930999 DOI: 10.1080/00207454.2021.1924706] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Deficiency of vitamin D along with traumatic brain injury (TBI) augments the risk of injury severity. This possibly affects the therapeutic regimen prescribed for TBI which may pessimistically affects its outcome. METHODS Studies literature search was conducted in Google Scholar and PubMed. The inclusions were studies performed clinically on both male and female. All included studies' references were also reviewed to find any additional relevance related to this review. Studies published in English were considered for this review. This review focuses upon the incidence of vitamin D deficiency in TBI and how it affects the Quality of life of the sufferer. RESULTS A total of 176 studies were reviewed and 58 were thoroughly focussed for review as they met inclusion criteria. These studies demonstrate that levels of vitamin D influence the recovery outcome after TBI. Vitamin D deficiency has been found to cause more deterioration in severe TBI than in patients with mild TBI. CONCLUSION Paucity of vitamin D significantly affects the outcome after brain injury. This clearly validates the necessity for screening of vitamin D levels in neurological deficit in order to reduce the risk of morbidity in terms of neurocognitive disorder.
Collapse
Affiliation(s)
- Ajay Choudhary
- Department of Neurosurgery, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Ashok Kumar
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Rajesh Sharma
- Department of Neurosurgery, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Lipika Khurana
- Institute of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, New Delhi, India
| | - Smita Jain
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Shallu Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| | - Deepak Kumar
- Department of Physical Medicine and Rehabilitation, PGIMER, Dr. R.M.L. Hospital, New Delhi, India
| | - Swapnil Sharma
- Department of Pharmacy, Banasthali Vidyapith, Banasthali, Rajasthan, India
| |
Collapse
|
12
|
Jain S, Grover S, Narang S, Gupta R, Garg S, Sharma D. Evaluation of cognitive function, serum 25-hydroxyvitamin D, and Vitamin D binding protein levels in chronic obstructive pulmonary disease: A case–control study. INTERNATIONAL JOURNAL OF NONCOMMUNICABLE DISEASES 2023. [DOI: 10.4103/jncd.jncd_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
|
13
|
Karaoglan M, Voegeli D. Is vitamin D supplementation of potential benefit for community-living people with Alzheimer's disease? BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S12-S19. [PMID: 36416632 DOI: 10.12968/bjon.2022.31.21.s12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Vitamin D is associated not only with effects on calcium and bone metabolisms but also with many chronic diseases. Low vitamin D levels in patients with Alzheimer's disease have been widely reported in the literature. AIM The purpose of this study was to critically review the potential benefit of vitamin D supplementation in individuals with Alzheimer's disease living in the community. METHODS A systematic literature search was conducted in PubMed, CINAHL, EMBASE and the Cochrane Library for papers published 2011-2018. RESULTS Seven papers were selected, consisting of one clinical trial, five cohort studies and one systematic review. Studies showed an association only between vitamin D deficiency and lower attention in older people. None of the reviewed studies provided evidence of a positive impact of vitamin D supplementation on cognitive function in older people with Alzheimer's disease. CONCLUSION There was no evidence that vitamin D supplementation has a direct benefit for Alzheimer's disease. The review synthesised the existing body of knowledge and concluded that optimum levels of vitamin D (neither too low nor too high) do appear to have positive effects on patient outcomes and quality of life. It is still unclear why vitamin D intake is inadequate as people age. Further research is needed to clarify vitamin-D-related aspects of Alzheimer's disease.
Collapse
Affiliation(s)
- Mehmet Karaoglan
- Time of writing was a Student - MSc Advanced Clinical Practice, Faculty of Health Sciences, University of Southampton
| | - David Voegeli
- Professor of Nursing, Faculty of Health Sciences, University of Southampton
| |
Collapse
|
14
|
Pelgrim CE, van Ark I, van Berkum RE, Schuitemaker-Borneman AM, Flier I, Leusink-Muis T, Janbazacyabar H, Diks MAP, Gosker HR, Kelders MCJM, Langen RCJ, Schols AMWJ, Hageman RJJ, Braber S, Garssen J, Folkerts G, van Helvoort A, Kraneveld AD. Effects of a nutritional intervention on impaired behavior and cognitive function in an emphysematous murine model of COPD with endotoxin-induced lung inflammation. Front Nutr 2022; 9:1010989. [PMID: 36466426 PMCID: PMC9714332 DOI: 10.3389/fnut.2022.1010989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/02/2022] [Indexed: 08/29/2023] Open
Abstract
One cluster of the extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) is related to the brain, which includes anxiety, depression and cognitive impairment. Brain-related comorbidities are related to worsening of symptoms and increased mortality in COPD patients. In this study, a murine model of COPD was used to examine the effects of emphysema and repetitive pulmonary inflammatory events on systemic inflammatory outcomes and brain function. In addition, the effect of a dietary intervention on brain-related parameters was assessed. Adult male C57Bl/6J mice were exposed to elastase or vehicle intratracheally (i.t.) once a week on three consecutive weeks. Two weeks after the final administration, mice were i.t. exposed to lipopolysaccharide (LPS) or vehicle for three times with a 10 day interval. A dietary intervention enriched with omega-3 PUFAs, prebiotic fibers, tryptophan and vitamin D was administered from the first LPS exposure onward. Behavior and cognitive function, the degree of emphysema and both pulmonary and systemic inflammation as well as blood-brain barrier (BBB) integrity and neuroinflammation in the brain were assessed. A lower score in the cognitive test was observed in elastase-exposed mice. Mice exposed to elastase plus LPS showed less locomotion in the behavior test. The enriched diet seemed to reduce anxiety-like behavior over time and cognitive impairments associated with the presented COPD model, without affecting locomotion. In addition, the enriched diet restored the disbalance in splenic T-helper 1 (Th1) and Th2 cells. There was a trend toward recovering elastase plus LPS-induced decreased expression of occludin in brain microvessels, a measure of BBB integrity, as well as improving expression levels of kynurenine pathway markers in the brain by the enriched diet. The findings of this study demonstrate brain-associated comorbidities - including cognitive and behavioral impairments - in this murine model for COPD. Although no changes in lung parameters were observed, exposure to the specific enriched diet in this model appeared to improve systemic immune disbalance, BBB integrity and derailed kynurenine pathway which may lead to reduction of anxiety-like behavior and improved cognition.
Collapse
Affiliation(s)
- Charlotte E. Pelgrim
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Ingrid van Ark
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Ronja E. van Berkum
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Anne M. Schuitemaker-Borneman
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Inge Flier
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Thea Leusink-Muis
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Hamed Janbazacyabar
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Mara A. P. Diks
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Harry R. Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Marco C. J. M. Kelders
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Ramon C. J. Langen
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Annemie M. W. J. Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
| | | | - Saskia Braber
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Johan Garssen
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
- Danone Nutricia Research, Utrecht, Netherlands
| | - Gert Folkerts
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Ardy van Helvoort
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, Netherlands
- Danone Nutricia Research, Utrecht, Netherlands
| | - Aletta D. Kraneveld
- Division of Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
15
|
Muneeb M, Mansou SM, Saleh S, Mohammed RA. Vitamin D and rosuvastatin alleviate type-II diabetes-induced cognitive dysfunction by modulating neuroinflammation and canonical/noncanonical Wnt/β-catenin signaling. PLoS One 2022; 17:e0277457. [PMID: 36374861 PMCID: PMC9662739 DOI: 10.1371/journal.pone.0277457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 10/27/2022] [Indexed: 11/16/2022] Open
Abstract
Background Type-II diabetes mellitus (T2DM) is a major risk factor for cognitive impairment. Protecting the brain environment against inflammation, and neurodegeneration, as well as preservation of the BBB veracity through modulating the crosstalk between insulin/AKT/GSK-3β and Wnt/β-catenin signaling, might introduce novel therapeutic targets. Purpose This study aimed at exploring the possible neuroprotective potential of vitamin D3 (VitD) and/or rosuvastatin (RSV) in T2DM-induced cognitive deficits. Methods T2DM was induced by a high-fat sucrose diet and a single streptozotocin (STZ) dose. Diabetic rats were allocated into a diabetic control and three groups treated with RSV (15 mg/kg/day, PO), VitD (500 IU/kg/day, PO), or their combination. Results Administration of VitD and/or RSV mitigated T2DM-induced metabolic abnormalities and restored the balance between the anti-inflammatory, IL 27 and the proinflammatory, IL 23 levels in the hippocampus. In addition, they markedly activated both the canonical and noncanonical Wnt/β-catenin cassettes with stimulation of their downstream molecular targets. VitD and/or RSV upregulated insulin and α7 nicotinic acetylcholine (α7nACh) receptors gene expression, as well as blood-brain barrier integrity markers including Annexin A1, claudin 3, and VE-cadherin. Also, they obliterated hippocampal ApoE-4 content, Tau hyperphosphorylation, and Aβ deposition. These biochemical changes were reflected as improved behavioral performance in Morris water maze and novel object recognition tests and restored hippocampal histological profile. Conclusion The current findings have accentuated the neuroprotective potential of VitD and RSV and provide new incentives to expand their use in T2DM-induced cognitive and memory decline. This study also suggests a superior benefit of combining both treatments over either drug alone.
Collapse
Affiliation(s)
- Muhammad Muneeb
- Department of Pharmacology, Toxicology, and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
| | - Suzan M. Mansou
- Department of Pharmacology, Toxicology, and Biochemistry, Faculty of Pharmacy, Future University in Egypt, Cairo, Egypt
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- * E-mail: ,
| | - Samira Saleh
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Reham A. Mohammed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| |
Collapse
|
16
|
Muacevic A, Adler JR, Ramaraju R, Vats A, Nair AR, Bandhu AK, Koirala D, Pallapothu MR, Quintana Mariñez MG, Khan S. The Efficacy of Vitamin D Supplementation in Patients With Alzheimer's Disease in Preventing Cognitive Decline: A Systematic Review. Cureus 2022; 14:e31710. [PMID: 36569670 PMCID: PMC9771092 DOI: 10.7759/cureus.31710] [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: 08/17/2022] [Accepted: 11/20/2022] [Indexed: 11/22/2022] Open
Abstract
To evaluate the role of vitamin D supplementation in preventing cognitive decline in patients with Alzheimer's disease (AD), five databases such as PubMed, PubMed Central (PMC), Medical Literature Analysis and Retrieval System Online (MEDLINE), ScienceDirect, and Google Scholar were searched for articles relevant to the research question with filters such as English and human studies from 2011 to 2022. Two investigators extracted the data and assessed the quality of the study using the predefined criteria. We identified 24 relevant articles after the critical screening. There were five randomized controlled trials (RCTs), two observational studies, two systematic reviews and meta-analyses, one pilot study, and 14 review articles. Most RCTs showed no significant improvement in vitamin D supplementation except for one study, which reported significant improvement in cognition on taking vitamin D in Alzheimer's disease but was not taken much into consideration as it had a small sample size (n=210) and was for a shorter duration. Another study evidenced significant improvement in Mini-Mental State Examination (MMSE) score when memantine and vitamin D were taken together compared to when memantine and vitamin D were taken independently. Studies have shown that vitamin D deficiency is associated with an increased risk of developing cognitive impairment. But there is no sufficient evidence indicating vitamin D supplementation can improve cognitive function in Alzheimer's disease.
Collapse
|
17
|
Rihal V, Khan H, Kaur A, Singh TG, Abdel-Daim MM. Therapeutic and mechanistic intervention of vitamin D in neuropsychiatric disorders. Psychiatry Res 2022; 317:114782. [PMID: 36049434 DOI: 10.1016/j.psychres.2022.114782] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/19/2022]
Abstract
Vitamin D deficiency is believed to affect between 35 and 55% of the world's population, making it a hidden pandemic. In addition to its role in bone and calcium homeostasis, vitamin D has also been linked in preclinical and clinical research to brain function. These outcomes have also been used for a variety of neuropsychiatric and neurodevelopmental problems. Nevertheless, these individuals are more prone to develop signs of cognitive decline. This review will emphasize the association between vitamin D and neuropsychiatric illnesses such as autism, schizophrenia, depression, and Attention Deficit Hyperactivity Disorder (ADHD). While numerous research show vitamin D's essential role in cognitive function in neuropsychiatric illnesses, it is too early to propose its effect on cognitive symptoms with certainty. It is necessary to conduct additional research into the associations between vitamin D deficiency and cognitive abnormalities, particularly those found in autism, schizophrenia, depression, and ADHD, to develop initiatives that address the pressing need for novel and effective preventative therapeutic strategies.
Collapse
Affiliation(s)
- Vivek Rihal
- Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India
| | - Heena Khan
- Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India
| | - Amarjot Kaur
- Chitkara College of Pharmacy, Chitkara University, Punjab 140401, India
| | | | - Mohamed M Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, P.O. Box 6231 Jeddah 21442, Saudi Arabia; Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia 41522, Egypt
| |
Collapse
|
18
|
Correlation between Cord Blood Vitamin D Levels and Problem-Solving Neurodevelopment in Early Childhood: A Cohort Study in Rural Indonesia. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9101581. [PMID: 36291517 PMCID: PMC9600364 DOI: 10.3390/children9101581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
Abstract
Vitamin D influence on brain development and subsequent postnatal neurodevelopment remains controversial. We explored the correlation between cord blood vitamin D levels and longitudinal neurodevelopment in early childhood. A cohort study was conducted on term infants with no congenital abnormalities, born from pregnant women from a cohort study. Cord blood samples were collected to measure vitamin D. Neurodevelopment was examined three times in infants aged 6, 12 and 24 months using the Ages and Stages Questionnaire-3, which comprises 30 questions of five developmental domains: gross motor, fine motor, communication, problem-solving and social–personal. Statistical analysis was conducted with Spearman’s rank correlation and multiple linear regression. Of the 141 babies born from previous cohort studies, only 116 participants were included. The mean level of cord blood vitamin D was 16.2 ng/mL. The percentage participants with vitamin D deficiency and insufficiency were 12.9 and 65.5, respectively. Cord blood vitamin D and the problem-solving domain for infant aged 12 and 24 months were correlated (r = 0.217 and 0.414, respectively). Multiple linear regression showed a decreased problem-solving domain score of 0.641 associated with decreased vitamin D levels. In conclusion, cord blood vitamin D levels correlated with infant neurodevelopmental status.
Collapse
|
19
|
Kotb Elmala M, Suliman HA, Al-Shokary AH, Ibrahim AO, Kamal NM, Elshorbagy HH, Nasef KA, El Din Fathallah MG. The Impact of Vitamin D 3 Supplementation to Topiramate Therapy on Pediatric Migraine Prophylaxis. J Child Neurol 2022; 37:833-839. [PMID: 35733373 DOI: 10.1177/08830738221092882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background:There is still a need for more studies to evaluate the role of vitamin D3 in pediatric migraine prophylaxis. Objectives: We aimed to evaluate the effects and safety of vitamin D3 supplementation to topiramate on pediatric migraine. Methods: A double-blinded prospective clinical trial was conducted on 5- to 14-year-old children with migraine. They were randomly assigned in a 1:1 ratio into 2 groups, one with vitamin D3 supplementation (the supplementation group) and the other without vitamin D supplementation (the placebo group). The supplementation group received topiramate plus one 5000-IU dose of vitamin D3 daily for 4 months. The placebo group received topiramate with a placebo capsule without any effective substances. The primary outcomes were a monthly frequency of headache attacks, a good response to intervention, and reduction in migraine severity, duration, and disability before and after treatment. Fifty-six children completed the trial. Vitamin D3 supplementation to topiramate was more effective than the placebo group in the reduction of monthly frequency (6231.31 vs 9792.24 times, P = .01) and disability score for migraines (17 566.43 vs 25 187.65, P = .04). A good response was observed in 76.13% of patients in the vitamin D3 supplementation group and 53.5% of patients in the placebo group, and vitamin D3 supplementation was significantly more effective than placebo (P = .01). Side effects were observed in 13.3% and 20% of the intervention group and placebo groups, respectively, P = .5. Conclusion: Vitamin D3 supplementation in pediatric migraine prophylaxis could be a well-tolerated, safe, and effective strategy.
Collapse
Affiliation(s)
| | | | | | | | | | - Hatem Hamed Elshorbagy
- Pediatric Department, 68872Menoufia University, Shebeen Elkom, Egypt.,Pediatric Department, Alhada and Taif Armed Forces Hospitals, Taif, Saudi Arabia
| | | | | |
Collapse
|
20
|
Kumar PNS, Menon V, Andrade C. A randomized, double-blind, placebo-controlled, 12-week trial of vitamin D augmentation in major depressive disorder associated with vitamin D deficiency. J Affect Disord 2022; 314:143-149. [PMID: 35843459 DOI: 10.1016/j.jad.2022.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 07/04/2022] [Accepted: 07/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Randomized controlled trials (RCTs) of vitamin D (VitD) supplementation for depression have yielded inconsistent results. We conducted the first RCT of VitD supplementation with multipoint serum 25(OH)D assessments in major depressive disorder (MDD) patients with concurrent severe VitD deficiency. METHODS We randomized antidepressant-free depressed adults with mean baseline 25(OH)D of 11.5 ng/ml to VitD (60,000 IU every 5 days; n = 31) or placebo (n = 28) for 12 weeks. All patients also received escitalopram (10-20 mg/day). Patients were rated at baseline and at the end of weeks 4, 8, and 12. Serum 25(OH)D was estimated at baseline, week 8, and week 12. RESULTS In an intent-to-treat analysis, mean Hamilton Depression Scale scores dropped from 25.7 to 5.7 and from 25.8 to 5.0 in VitD and placebo groups, respectively (primary outcome; P = 0.92). VitD and placebo groups did not differ on other objective and subjective ratings of depression, or on global ratings. Similar findings characterized completer analyses. No significant correlations were observed between 25(OH)D levels and depression ratings across the course of the study. Importantly, endpoint escitalopram doses were 4 mg/day higher in placebo than in VitD patients, and 4 mg/day higher in VitD deficient than in VitD sufficient patients. LIMITATIONS A ceiling effect with escitalopram may have prevented the discovery of benefits with VitD supplementation. CONCLUSIONS VitD supplementation does not improve antidepressant outcomes with flexibly dosed escitalopram. VitD deficient depressed patients may require higher antidepressant doses to experience benefits similar to those whose deficiency is corrected by VitD supplementation.
Collapse
Affiliation(s)
- P N Suresh Kumar
- IQRAA International Hospital and Research Center, P.O. Malaparamba, Kozhikode, Kerala, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
| | - Chittaranjan Andrade
- Department of Clinical Psychopharmacology and Neurotoxicology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| |
Collapse
|
21
|
Vitamin D levels and menopause-related symptoms in postmenopausal women. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2022. [DOI: 10.1186/s43043-022-00120-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Menopause is an important period in women’s life. It is characterized by many symptoms that affect women’s quality of life. This study aimed to the evaluation of the relation between vitamin D levels and menopause-related symptoms.
Results
Vitamin D insufficiency was noted in 52.4% of the studied population. There was no statistically significant difference in any of the menopausal rating scale dimensions, psychological symptoms (p = 0.16), somato-vegetative symptoms (p = 0.45), or urogenital symptoms (p = 0.59), between vitamin D sufficient and insufficient groups. The severity of the menopausal symptoms was affected by the presence of medical illness (p < 0.001).
Conclusion
Vitamin D deficiency is an alarming issue among postmenopausal women. It was not associated with menopause-related symptoms.
Collapse
|
22
|
Association between lower serum vitamin D (25-hydroxy-cholecalciferol) concentrations and cognitive impairment in older adults: data from a populational-based cohort study in a middle-income country. Public Health Nutr 2022; 25:2507-2516. [PMID: 34689855 PMCID: PMC9991716 DOI: 10.1017/s1368980021004407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To investigate the association between serum vitamin D (25-hydroxy-cholecalciferol) (25(OH)D) concentrations and cognitive impairment in older adults living in Southern Brazil. DESIGN Cross-sectional analysis using data from the second follow-up wave of the populational-based EpiFloripa Aging Cohort Study was collected in 2013-2014. SETTING Cognitive impairment was evaluated using the Mini-Mental State Examination (MMSE). Blood samples were collected to measure serum vitamin D concentrations using a chemiluminescent microparticle immunoassay. Vitamin D concentrations were distributed in quartiles (Q1: 4·0-20·7 ng/ml; Q2: 20·8-26·6 ng/ml; Q3: 26·7-32·0 ng/ml and Q4: 32·1-60·1 ng/ml), and its association with cognitive impairment was tested by crude and adjusted logistic regression (sociodemographic, behavioural and health aspects) using Q4 as a reference group. PARTICIPANTS 200 men and 371 women aged 60 years or older participated in this study. RESULTS The prevalence of probable cognitive impairment was 21·7 %. Those without cognitive impairment had a higher mean of vitamin D serum concentrations (26·8 v. 24·6, P = 0·014). In the crude analysis, only individuals in Q2 of vitamin D presented an increased risk for probable cognitive impairment compared with Q4 (highest quartile) (OR 2·65, 95 % CI 1·46, 4·81), remaining significant in the adjusted analysis (OR 6·04, 95 % CI 2·78, 13·13). While Q1 (lowest quartile) was not associated in the crude analysis, but when adjusted, an increased risk of cognitive impairment was observed. CONCLUSION The lowest quartile of vitamin D was directly associated with probable cognitive impairment in older adults in Southern Brazil. More studies are needed to investigate whether maintaining adequate serum levels may represent a significant factor in preventing age-related neurological disorders as well as to verify the need for new cutoff points for this age group.
Collapse
|
23
|
The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients 2022; 14:nu14132761. [PMID: 35807941 PMCID: PMC9268813 DOI: 10.3390/nu14132761] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 01/27/2023] Open
Abstract
Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention.
Collapse
|
24
|
R. R, Uthaiah CA, C. M. R, Madhunapantula SV, Salimath PV, K. P, M. SK, M. R. K. Comparative assessment of cognitive impairment and oxidative stress markers among vitamin D insufficient elderly patients with and without type 2 diabetes mellitus (T2DM). PLoS One 2022; 17:e0269394. [PMID: 35709193 PMCID: PMC9202850 DOI: 10.1371/journal.pone.0269394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disorders of mental health are known to affect cognitive functions, hence called as cognitive disorders. Impaired glucose metabolism, insulin resistance, vitamin-D deficiency and oxidative stress are some of the key early events reported to be involved in the pathogenesis of most common cognitive disorders, which include Alzheimer's disease. Type-2 diabetes mellitus (T2DM) is one of the known contributing factors of cognitive impairment and dementia. METHODS A cross sectional study was carried out in 145 subjects, who were assessed for cognitive function by modified mini mental status examination (3MS). In addition, measurement of fasting blood sugar (FBS), fasting insulin, HbA1c, lipid profile, vitamin D and oxidative markers was performed. Participants were divided into different groups based on (a) vitamin D insufficiency and sufficiency; (b) diabetic and non-diabetic with and without cognitive impairment. RESULTS The study included a total of 145 subjects; 51 males and 94 females and the mean age was 68.24±9.70 years. Among diabetics with vitamin D insufficiency, 35 subjects (71.43%) had cognitive impairment, but, among non-diabetics with vitamin D insufficiency, 27 subjects (62.79%) had cognitive impairment. Chi square test showed no significant association between diabetes, vitamin D insufficiency and cognitive impairment. Glutathione peroxidase (GPx) and superoxide dismutase (SOD) levels were non-significantly lower in cognition-impaired subjects, when compared to cognition normal subjects in diabetics with vitamin D insufficiency. CONCLUSION Our study showed that cognitive impairment is more predominant in individuals with diabetes. However, our study did not find any significant relationship between T2DM, vitamin D deficiency, cognitive impairment, and oxidative stress. A significant association was found only with GPx and 3MSE score in vitamin D insufficient non-diabetics.
Collapse
Affiliation(s)
- Rajalakshmi R.
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Chinnappa A. Uthaiah
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Ramya C. M.
- Department of Physiology, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - SubbaRao V. Madhunapantula
- Center of Excellence in Molecular Biology and Regenerative Medicine (CEMR) Laboratory (A DST-FIST Supported Center), Department of Biochemistry (A DST-FIST Supported Department), JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Paramahans V. Salimath
- JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Praveen K.
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Srinath K. M.
- Department of Medicine, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Kishor M. R.
- Department of Psychiatry, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| |
Collapse
|
25
|
Leirós M, Amenedo E, Rodríguez M, Pazo-Álvarez P, Franco L, Leis R, Martínez-Olmos MÁ, Arce C. Cognitive Status and Nutritional Markers in a Sample of Institutionalized Elderly People. Front Aging Neurosci 2022; 14:880405. [PMID: 35686024 PMCID: PMC9171327 DOI: 10.3389/fnagi.2022.880405] [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: 02/21/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Since many of the risk factors for cognitive decline can be modified by diet, the study of nutrition and its relationships with cognitive status in aging has increased considerably in recent years. However, there are hardly any studies that have assessed cognitive status using a comprehensive set of neuropsychological tests along with measures of functional capacity and mood and that have related it to nutritional status measured from several nutritional parameters that have shown its relationships with cognitive function. Objective To test the differences in depressive symptomatology and in several measures of nutritional status between three groups classified according to their cognitive status (CS hereafter). Method One hundred thirteen participants from nursing homes in Galicia, Spain, underwent a comprehensive neuropsychological examination, including a general screening test (MMSE) and tests for different cognitive domains along with measures of activities of daily living (ADL) and assessment of depressive symptomatology (GDS-SF). According to established clinical criteria, participants were divided into three CS groups, Cognitively Intact (CI), Mild Cognitive Impairment (MCI), and All-Cause Dementia (ACD). Nutritional status was also examined using blood-derived measures, body mass index (BMI) and a nutritional screening test (MNA-SF). Differences between CS groups in all nutritional variables were studied by one-way ANOVAs with post-hoc Bonferroni correction or Kruskal-Wallis with Games-Howell post-hoc correction when appropriate. Multinomial logistic regression was also applied to test the association between nutritional variables and CS. Results Differences between CS groups were statistically significant for depressive symptomatology, vitamin A and D, albumin, selenium (Se), uric acid (UA), and BMI. The results of multinomial logistic regression found positive associations between groups with better CS and higher concentrations of vitamins A and D, transthyretin (TTR), albumin, Se, and UA, while negative associations were found for BMI. Conclusion Higher serum levels of vitamin A, vitamin D, TTR, albumin, Se, and UA could act as protective factors against cognitive decline, whereas higher BMI could act as a risk factor.
Collapse
Affiliation(s)
- María Leirós
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Elena Amenedo
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Marina Rodríguez
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Paula Pazo-Álvarez
- Research Group in Cognitive and Affective Neuroscience (NECEA), Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruña, Spain
| | - Luis Franco
- Economic Analysis and Modeling Group, Instituto de Estudios y Desarrollo de Galicia (IDEGA), Santiago de Compostela, Spain
| | - Rosaura Leis
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Hospital Clínico Universitario de Santiago, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.,Unit of Investigation in Nutrition, Growth and Human Development of Galicia, Department of Forensic Sciences, Pathological Anatomy, Gynecology and Obstetrics, and Pediatrics, University of Santiago de Compostela, Santiago de Compostela, Spain.,CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Miguel-Ángel Martínez-Olmos
- CIBEROBN (Physiopathology of Obesity and Nutrition), Institute of Health Carlos III (ISCIII), Madrid, Spain.,Section of Endocrinology-Nutrition Area, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Constantino Arce
- Department of Social, Basic and Methodology Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | |
Collapse
|
26
|
Eymundsdottir H, Sigurdardottir S, Ramel A, Jonsson PV, Gudnason V, Launer L, Chang M. Social network and the risk for developing mild cognitive impairment and dementia among older adults. Aging Clin Exp Res 2022; 34:2155-2163. [PMID: 35687312 DOI: 10.1007/s40520-022-02150-8] [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: 01/13/2022] [Accepted: 05/02/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND This study aimed to investigate the longitudinal associations between social network (SN) and the risk of lower cognitive function, mild cognitive impairment (MCI), and dementia among cognitively normal individuals 65 years and older. METHODS Data from the Age, Gene/Environment Susceptibility (AGES) Reykjavik Study on 2816 participants (aged 65 to 96 years) were used to examine the associations using multiple logistic and linear regression models. SN included questions on frequency of contact with family and friends as well as information on marital status, resulting in a score ranging from 0 (poor social network) to 3 (good social network). Cognitive function outcomes included the speed of processing (SP), executive function (EF) and memory function (MF). MCI and dementia were diagnosed using a detailed assessment according to international guidelines. RESULTS At baseline 0.5, 7.0, 41.7 and 50.8% reported a score of 0, 1, 2 and 3, respectively. During a mean follow-up time of 5.2 years, 7.1% (n = 188) of cognitively intact participants developed MCI and 3.0% (n = 79) developed dementia. Longitudinal analyses demonstrated that participants who had low SN were significantly more likely to have declines in MF (β = - 0.533, P = 0.014) compared to high SN. Social networks were not independently associated with the decline of SP and EF during follow-up. According to fully adjusted models using logistic regression, SN was significantly associated with incidence risk of MCI (OR = 2.030, P = 0.014 and OR = 1.847 P = 0.001). These associations were largely independent of other lifestyle factors, depression and genetic disposition. CONCLUSIONS Community-dwelling older adults who have poor social networks have a higher risk of declining memory function as well as a higher risk of mild cognitive impairment than older adults who have a higher social network. This study included numbers of relevant covariates in the study analysis, thereby significantly contributing to the literature on cognitive aging.
Collapse
Affiliation(s)
- Hrafnhildur Eymundsdottir
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavik, Iceland. .,Faculty of Social Science, University of Iceland, Reykjavik, Iceland.
| | | | - Alfons Ramel
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavik, Iceland.,Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Pálmi V Jonsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Geriatrics, The National University Hospital of Iceland, Reykjavik, Iceland
| | - Vilmundur Gudnason
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Icelandic Heart Association, Kopavogur, Iceland
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Milan Chang
- The Icelandic Gerontological Research Center, The National University Hospital of Iceland, Tungata 26, 101, Reykjavik, Iceland
| |
Collapse
|
27
|
Shulpekova Y, Zharkova M, Tkachenko P, Tikhonov I, Stepanov A, Synitsyna A, Izotov A, Butkova T, Shulpekova N, Lapina N, Nechaev V, Kardasheva S, Okhlobystin A, Ivashkin V. The Role of Bile Acids in the Human Body and in the Development of Diseases. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27113401. [PMID: 35684337 PMCID: PMC9182388 DOI: 10.3390/molecules27113401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/13/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022]
Abstract
Bile acids are specific and quantitatively important organic components of bile, which are synthesized by hepatocytes from cholesterol and are involved in the osmotic process that ensures the outflow of bile. Bile acids include many varieties of amphipathic acid steroids. These are molecules that play a major role in the digestion of fats and the intestinal absorption of hydrophobic compounds and are also involved in the regulation of many functions of the liver, cholangiocytes, and extrahepatic tissues, acting essentially as hormones. The biological effects are realized through variable membrane or nuclear receptors. Hepatic synthesis, intestinal modifications, intestinal peristalsis and permeability, and receptor activity can affect the quantitative and qualitative bile acids composition significantly leading to extrahepatic pathologies. The complexity of bile acids receptors and the effects of cross-activations makes interpretation of the results of the studies rather difficult. In spite, this is a very perspective direction for pharmacology.
Collapse
Affiliation(s)
- Yulia Shulpekova
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Maria Zharkova
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Pyotr Tkachenko
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Igor Tikhonov
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Alexander Stepanov
- Biobanking Group, Branch of Institute of Biomedical Chemistry “Scientific and Education Center”, 119435 Moscow, Russia; (A.S.); (A.I.); (T.B.)
| | - Alexandra Synitsyna
- Biobanking Group, Branch of Institute of Biomedical Chemistry “Scientific and Education Center”, 119435 Moscow, Russia; (A.S.); (A.I.); (T.B.)
- Correspondence: ; Tel.: +7-499-764-98-78
| | - Alexander Izotov
- Biobanking Group, Branch of Institute of Biomedical Chemistry “Scientific and Education Center”, 119435 Moscow, Russia; (A.S.); (A.I.); (T.B.)
| | - Tatyana Butkova
- Biobanking Group, Branch of Institute of Biomedical Chemistry “Scientific and Education Center”, 119435 Moscow, Russia; (A.S.); (A.I.); (T.B.)
| | | | - Natalia Lapina
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Vladimir Nechaev
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Svetlana Kardasheva
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Alexey Okhlobystin
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| | - Vladimir Ivashkin
- Sechenov First Moscow State Medical University (Sechenov University), 119435 Moscow, Russia; (Y.S.); (M.Z.); (P.T.); (I.T.); (N.L.); (V.N.); (S.K.); (A.O.); (V.I.)
| |
Collapse
|
28
|
Beijers RJ, van Iersel LEJ, Schuurman LT, Hageman RJJ, Simons SO, van Helvoort A, Gosker HR, Schols AM. Effect of targeted nutrient supplementation on physical activity and health-related quality of life in COPD: study protocol for the randomised controlled NUTRECOVER trial. BMJ Open 2022; 12:e059252. [PMID: 35296491 PMCID: PMC8928317 DOI: 10.1136/bmjopen-2021-059252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Physical and mental health are often affected in chronic obstructive pulmonary disease (COPD) adversely affecting disease course and quality of life. Abnormalities in whole body and cellular energy metabolism, dietary and plasma nutrient status and intestinal permeability have been well established in these patients as systemic determinants of functional decline and underexplored treatable traits. The aim of this study is to investigate the efficacy of 1 year targeted nutrient supplementation on physical activity level and health-related quality of life in patients with COPD. METHODS AND ANALYSIS This study is a single-centre randomised, placebo-controlled, double-blind trial in 166 patients with COPD recruited from multiple hospitals in the Netherlands. The intervention group will receive a multinutrient supplement, including vitamin D, tryptophan, long-chain polyunsaturated fatty acids and prebiotic dietary fibres as main components (94 kCal per daily dose). The control group will receive an isocaloric isonitrogenous placebo. Both groups will ingest one portion per day for at least 12 months and will additionally receive counselling on healthy lifestyle and medical adherence over the course of the study. Coprimary outcomes are physical activity assessed by triaxial accelerometry and health-related quality of life measured by the EuroQol-5 dimensions questionnaire. Secondary outcomes are cognitive function, psychological well-being, physical performance, patient-reported outcomes and the metabolic profile assessed by body composition, systemic inflammation, plasma nutrient levels, intestinal integrity and microbiome composition. Outcomes will be measured at baseline and after 12 months of supplementation. In case patients are hospitalised for a COPD exacerbation, a subset outcome panel will be measured during a 4-week recovery period after hospitalisation. ETHICS AND DISSEMINATION This study was approved by the local Ethics Committee of Maastricht University. Subjects will be included after written informed consent is provided. Study outcomes will be disseminated through presentations at (inter)national conferences and through peer-reviewed journals. TRIAL REGISTRATION NCT03807310.
Collapse
Affiliation(s)
- Rosanne Jhcg Beijers
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Lieke E J van Iersel
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Lisanne T Schuurman
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | | | - Sami O Simons
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Ardy van Helvoort
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
- Danone Nutricia Research, Utrecht, the Netherlands
| | - Harry R Gosker
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Annemie Mwj Schols
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, the Netherlands
| |
Collapse
|
29
|
The effects of vitamin D on learning and memory of hypothyroid juvenile rats and brain tissue acetylcholinesterase activity and oxidative stress indicators. Naunyn Schmiedebergs Arch Pharmacol 2022; 395:337-351. [PMID: 34982186 DOI: 10.1007/s00210-021-02195-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 12/15/2021] [Indexed: 01/28/2023]
Abstract
Apart from a role as a key regulator of calcium/phosphate homeostasis, vitamin D (Vit D) is suggested to be a potential player in nervous system growth and function. This study aimed to assess the impacts of Vit D administration on memory impairment, oxidative damage, and acetylcholinesterase (AchE) overactivity in hypothyroid juvenile rats. The animals were randomly grouped as (1) Control; (2) Hypothyroid; (3) Hypothyroid-Vit D100, and (4) Hypothyroid-Vit D 500. Propylthiouracil (PTU) was added to their drinking water (0.05%) for 6 weeks, and Vit D (100 or 500 IU/kg) treatment was performed daily by gavage. Morris water maze (MWM) and passive avoidance (PA) tests were performed. The brains were removed under deep anesthesia, then the hippocampal and cortical tissues were separated to assess biochemical parameters. Hypothyroidism was significantly associated with learning and memory impairment in MWM and PA tests. Hypothyroidism was also accompanied by an elevation in AChE activity and malondialdehyde (MDA) content and a reduced level of thiol content and superoxide dismutase (SOD) activity in the brain. Treatment with Vit D recovered hypothyroidism-induced cognitive impairment and improved memory performance in MWM and PA tasks. On the other hand, Vit D alleviated AChE activity and MDA level, whereas increased SOD activity and thiol content in the hippocampal and cortical tissues. In conclusion, these outcomes suggest an association between the oral administrations of Vit D and learning and memory improvement of hypothyroid rats, which was accompanied by decreasing AChE activity and brain tissue oxidative damage.
Collapse
|
30
|
Eid MA, Ibrahim MM, Radwan NL, Aly SM. Effects of vitamin D supplementation and aerobic exercises on balance and physical performance in children with Down syndrome. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2020.0162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Children with Down syndrome are prone to vitamin D deficiency. Vitamin D supplements are commonly used to treat and prevent vitamin D deficiencies. There is growing evidence that support the role of vitamin D improving muscles and central nervous system function. The aim of this study was to investigate the interaction effects of vitamin D supplementation combined with aerobic exercises and conventional physical therapy on balance and physical performance in children with Down syndrome. Methods A randomised controlled trial was conducted for 38 children with Down syndrome, with ages ranging from 8 to 12 years. They were divided randomly into two groups. The control group (n=19) received conventional physical therapy and aerobic exercises, while the study group (n=19) received conventional physical therapy, aerobic exercises and vitamin D in the form of an oral daily dose of vitamin D3 400 IU (cholecalciferol). The children in both groups participated in the same physical therapy for 45 minutes, 3 days a week for 12 weeks, and undertook 15 minutes of aerobic exercise after the physical therapy sessions. Balance was evaluated by using the Biodex Stability System and physical performance was evaluated by using the 6-Minute Walk Test. Results All groups showed a significant improvement in the medial-lateral stability index, the anterior-posterior stability index, the overall stability index and the 6-Minute Walk Test after treatment (P<0.05). The study group showed a significant improvement in the measured variables compared with that of the control group (P<0.05). Conclusions Vitamin D supplements, combined with aerobic exercises and conventional physical therapy, could improve balance and physical performance in children with Down syndrome. Therefore, vitamin D and aerobic exercises should be considered as an adjunctive to physical therapy.
Collapse
Affiliation(s)
- Mohamed A Eid
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Marwa M Ibrahim
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Nadia L Radwan
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Sobhy M Aly
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| |
Collapse
|
31
|
Can Nutrients and Dietary Supplements Potentially Improve Cognitive Performance Also in Esports? Healthcare (Basel) 2022; 10:healthcare10020186. [PMID: 35206801 PMCID: PMC8872051 DOI: 10.3390/healthcare10020186] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 12/13/2022] Open
Abstract
Factors influencing brain function and cognitive performance can be critical to athletic performance of esports athletes. This review aims to discuss the potential beneficial effects of micronutrients, i.e., vitamins, minerals and biologically active substances on cognitive functions of e-athletes. Minerals (iodine, zinc, iron, magnesium) and vitamins (B vitamins, vitamins E, D, and C) are significant factors that positively influence cognitive functions. Prevention of deficiencies of the listed ingredients and regular examinations can support cognitive processes. The beneficial effects of caffeine, creatine, and probiotics have been documented so far. There are many plant products, herbal extracts, or phytonutrients that have been shown to affect precognitive activity, but more research is needed. Beetroot juice and nootropics can also be essential nutrients for cognitive performance. For the sake of players’ eyesight, it would be useful to use lutein, which, in addition to improving vision and protecting against eye diseases, can also affect cognitive functions. In supporting the physical and mental abilities of e-athletes the base is a well-balanced diet with adequate hydration. There is a lack of sufficient evidence that has investigated the relationship between dietary effects and improved performance in esports. Therefore, there is a need for randomized controlled trials involving esports players.
Collapse
|
32
|
Zhou W, Deng Y, Zhang C, Dai H, Guan L, Luo X, He W, Tian J, Zhao L. Chlorpyrifos residue level and ADHD among children aged 1-6 years in rural China: A cross-sectional study. Front Pediatr 2022; 10:952559. [PMID: 36313880 PMCID: PMC9616114 DOI: 10.3389/fped.2022.952559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/27/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in childhood and is caused by both genetic and environmental factors. As genetic factors are nonmodifiable, environmental factors have attracted increasing attention. OBJECTIVE To investigate the relationships between urinary chlorpyrifos (CPF) levels, blood micronutrient levels, and ADHD prevalence in children living in rural areas of China. METHODS This cross-sectional study collected data on CPF exposure (according to urinary levels), blood micronutrient levels, and ADHD prevalence in children aged 1-6 years in rural China. The CPF levels were determined by mass spectrometry. Blood levels of micronutrients, including zinc, iron, calcium, copper, magnesium, and vitamin D, were measured by professional detection kits. ADHD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. Descriptive statistics and univariate analysis were conducted using SPSS 21.0, and path analysis was conducted using Mplus 8.0. RESULTS Of the 738 children who met the eligibility criteria, 673 children (673/738, 91.2%) were included in the final analysis. Baseline questionnaires and urine samples were collected from all 673 subjects. A total of 672 children provided blood samples for micronutrient testing, and 651 completed the ADHD assessment. Approximately one-fifth of children (144/673, 21.4%) had detectable levels of CPF in their urine, and 6.9% (45/651) were diagnosed with ADHD. Path analysis showed that the total effect of CPF exposure on ADHD risk was 0.166 (P < 0.05), with a direct effect of 0.197 (P < 0.05) and an indirect effect of -0.031 (P < 0.05) via vitamin D. The mediating effect of urinary CPF levels on ADHD risk via vitamin D was 18.67%. CONCLUSION Higher levels of CPF exposure are associated with higher risk of ADHD. Additionally, increasing vitamin D levels may have a beneficial effect on the relationship between CPF exposure and ADHD risk. Our findings highlight the importance of modifying environmental factors to reduce ADHD risk and provide insight into future ADHD interventions.
Collapse
Affiliation(s)
- Wenjuan Zhou
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yuanying Deng
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chen Zhang
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Hongmei Dai
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Lan Guan
- School of Public Health, Central South University, Changsha, China
| | - Xiangwen Luo
- Hunan Academy of Agricultural Sciences, Changsha, China
| | - Wei He
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing Tian
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingling Zhao
- Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
33
|
WANG G, ZHANG J, ZHANG K, ZHAO Q, ZHOU F, XU J, XUE W, ZHANG C, FU C. Possible action mechanisms of vitamin D supplementation in combating obesity and obesity-related issues of bone health: a mini review. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.114621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Guiqing WANG
- the Sixth Hospital affiliated to Guangzhou Medical University, China
| | - Jie ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Kailong ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Qingqing ZHAO
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Fang ZHOU
- National University of Singapore (Suzhou) Research Institude, China
| | - Jie XU
- National University of Singapore (Suzhou) Research Institude, China
| | - Wenshuang XUE
- National University of Singapore (Suzhou) Research Institude, China
| | - Chunye ZHANG
- Beijing Zhongwei Research Center of Biological and Translational Medicine, China
| | - Caili FU
- National University of Singapore (Suzhou) Research Institude, China
| |
Collapse
|
34
|
Bahrami A, Rezaeitalab F, Farahmand SK, Mazloum Khorasani Z, Arabi SM, Bahrami-Taghanaki H, Ferns GA, Ghayour-Mobarhan M. High-dose Vitamin D Supplementation and Improvement in Cognitive Abilities, Insomnia, and Daytime Sleepiness in Adolescent Girls. Basic Clin Neurosci 2021; 12:339-348. [PMID: 34917293 PMCID: PMC8666927 DOI: 10.32598/bcn.2021.1910.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 07/10/2019] [Accepted: 09/02/2020] [Indexed: 11/20/2022] Open
Abstract
Introduction: Vitamin D may affect the modulation of signaling pathways in the central nervous system. We aimed to evaluate the effect of high-dose vitamin D supplementation on neuropsychological functions in female adolescents. Methods: We studied the effects of 9 weeks of vitamin D supplementation (50000 IU vitamin D3 [cholecalciferol]/week) on cognitive abilities and sleep disorders in 940 adolescent girls. Results: Oral vitamin D supplementation improved cognitive abilities, including memory, inhibitory control, selective attention, decision making, planning, sustained attention, and cognitive flexibility in healthy adolescent girls (P<0.001). The prevalence of subjects with insomnia after intervention fell from 15.0% to 11.3%. Similar results were also found for the prevalence of sleepiness (15.6% reduced to 14.7%), or cases with both insomnia and sleepiness (8.0% reduced to 6.1%; P<0.05). Conclusion: High dose of vitamin D can improve cognitive abilities and alleviate insomnia and daytime sleepiness in adolescent girls. Further investigations are required on different population groups (age and gender) to determine the sustainability of these effects. The value of vitamin D therapy in other neurological disorders would also be of research interest.
Collapse
Affiliation(s)
- Afsane Bahrami
- Cellular and Molecular Research Center, School of Medicine, Birjand University of Medical Sciences, Bijand, Iran
| | - Fariborz Rezaeitalab
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Kazem Farahmand
- Department of Traditional Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Mazloum Khorasani
- Endocrine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyed Mostafa Arabi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamidreza Bahrami-Taghanaki
- Chinese and Complementary Medicine Research Center, School of Traditional and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, School of Brighton & Sussex Medical, University of Brighton and the University of Sussex, Falmer, Brighton, Sussex, UK
| | - Majid Ghayour-Mobarhan
- Metabolic Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
35
|
Kang JH, Vyas CM, Okereke OI, Ogata S, Albert M, Lee IM, D'Agostino D, Buring JE, Cook NR, Grodstein F, Manson JE. Effect of vitamin D on cognitive decline: results from two ancillary studies of the VITAL randomized trial. Sci Rep 2021; 11:23253. [PMID: 34853363 PMCID: PMC8636504 DOI: 10.1038/s41598-021-02485-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Low vitamin D levels have been associated with cognitive decline; however, few randomized trials have been conducted. In a trial, we evaluated vitamin D3 supplementation on cognitive decline. We included participants aged 60+ years (mean[SD] = 70.9[5.8] years) free of cardiovascular disease and cancer in two substudies in the VITAL 2 × 2 randomized trial of vitamin D3 (2000 IU/day of cholecalciferol) and fish oil supplements: 3424 had cognitive assessments by phone (eight neuropsychologic tests; 2.8 years follow-up) and 794 had in-person assessments (nine tests; 2.0 years follow-up). The primary, pre-specified outcome was decline over two assessments in global composite score (average z-scores of all tests); substudy-specific results were meta-analyzed. The pooled mean difference in annual rate of decline (MD) for vitamin D3 versus placebo was 0.01 (95% CI - 0.01, 0.02; p = 0.39). We observed no interaction with baseline 25-hydroxyvitamin-D levels (p-interaction = 0.84) and a significant interaction with self-reported race (p-interaction = 0.01). Among Black participants (19%), those assigned vitamin D3 versus placebo had better cognitive maintenance (MD = 0.04, 95% CI 0.01, 0.08, similar to that observed for Black participants 1.2 years apart in age). Thus, vitamin D3 (2000 IU/day cholecalciferol) supplementation was not associated with cognitive decline over 2-3 years among community-dwelling older participants but may provide modest cognitive benefits in older Black adults, although these results need confirmation.Trial registration ClinicalTrials.gov; VITAL (NCT01169259), VITAL-DEP (NCT01696435) and VITAL-Cog (NCT01669915); the date the registration for the parent trial (NCT01169259) was submitted to the registry: 7/26/2010 and the date of first patient enrollment in either of the ancillary studies for cognitive function in a subset of eligible VITAL participants: 9/14/2011.
Collapse
Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA.
| | - Chirag M Vyas
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Michelle Albert
- University of California at San Francisco School of Medicine, San Francisco, CA, USA
| | - I-Min Lee
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Denise D'Agostino
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Julie E Buring
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Nancy R Cook
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| | - Francine Grodstein
- Channing Division of Network Medicine, Brigham and Women's Hospital/Harvard Medical School, 181 Longwood Ave, Boston, MA, 02115, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - JoAnn E Manson
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, 02215, USA
| |
Collapse
|
36
|
Vitamin D Supplement for Prevention of Alzheimer's Disease: A Systematic Review and Meta-Analysis. Am J Ther 2021; 28:e638-e648. [DOI: 10.1097/mjt.0000000000001302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Zeng Y, Yuan C, Wu M, Cheng L, Zhou S, Hu P, Fan K, Tang W, He J. Low vitamin D levels and the long-term functional outcome of stroke up to 5 years. Brain Behav 2021; 11:e2244. [PMID: 34473410 PMCID: PMC8553318 DOI: 10.1002/brb3.2244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 05/13/2021] [Accepted: 05/23/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Previous studies have established that vitamin D was associated with stroke. The purpose of this study was to investigate the relationship between vitamin D and 5-year outcome of patients with stroke including acute ischemic stroke (AIS) and intracranial hemorrhage (ICH) stroke. METHODS Serum 25-hydroxyvitamin D levels were prospectively analyzed in patients admitted to the First Affiliated Hospital of Wenzhou Medical University from 2013 to 2015. Modified Rankin scale (mRS) was used to evaluate their 5-year functional outcome, and univariate and multivariate logistic regressions were applied to evaluate the effects of vitamin D on stroke outcome. RESULTS In total, 668 patients diagnosed with stroke were recruited, and 420 completed the 5-year follow-up. Ninety-five patients experienced poor outcome in the 5 years since stroke onset. Vitamin D levels in patients with poor outcome showed significant differences compared to good outcome patients (p < .001). In multivariable logistic regression analysis, after adjusting the potential confounders, the 5-year functional outcome was significantly associated with vitamin D levels. Stroke patients with vitamin D levels less than 38.4 nmol/L had a higher risk for poor outcome compared with those with vitamin D level over 71.4 nmol/L at 5-year (odds ratio [OR] = 3.66, 95% confidence interval [CI] = 1.42-9.45, p = .007), which was consistent with AIS patients (OR = 6.36, 95% CI = 1.89-21.44, p = .003). CONCLUSION Vitamin D level less than 38.4 nmol/L at admission is a potential risk biomarker for poor functional outcome at 5-year prognosis in AIS patients, which might provide new ideas for the prognostic assessment of stroke.
Collapse
Affiliation(s)
- Ya‐Ying Zeng
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
- First School of Clinical MedicineWenzhou Medical UniversityWenzhouChina
| | - Cheng‐Xiang Yuan
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Meng‐Xuan Wu
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Lin Cheng
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
- First School of Clinical MedicineWenzhou Medical UniversityWenzhouChina
| | - Sheng‐Nan Zhou
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Ping‐lang Hu
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Kai‐Li Fan
- School of Mental HealthWenzhou Medical UniversityWenzhouChina
| | - Wen‐Jie Tang
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
- First School of Clinical MedicineWenzhou Medical UniversityWenzhouChina
| | - Jin‐Cai He
- Department of NeurologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| |
Collapse
|
38
|
Lewis JE, Poles J, Shaw DP, Karhu E, Khan SA, Lyons AE, Sacco SB, McDaniel HR. The effects of twenty-one nutrients and phytonutrients on cognitive function: A narrative review. J Clin Transl Res 2021; 7:575-620. [PMID: 34541370 PMCID: PMC8445631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND AND AIM Brain health is becoming more important to the average person as the number of people with cognitive impairments, such as Alzheimer's disease (AD), is rising significantly. The current Food and Drug Administration-approved pharmacotherapeutics for dementia neither cure nor halt cognitive decline; they just delay the worsening cognitive impairment. This narrative review summarizes the effects of nutrients and phytonutrients on cognitive function. METHODS A comprehensive literature search of PubMed was performed to find clinical trials in humans that assessed the effects of nutrients and phytonutrients on cognitive function published in English between 2000 and 2021. Six independent reviewers evaluated the articles for inclusion in this review. RESULTS Ninety-six articles were summarized in this narrative review. In total 21 categories of nutrients and phytonutrients were included, i.e., α-lipoic acid, Bacopa monnieri, B vitamins, cholinergic precursors, vitamin D, vitamin E, Ginkgo biloba, ginseng, lion's mane mushroom, N-acetyl cysteine, omega-3 fatty acids, aloe polysaccharides, Rhodiola rosea, rosemary, saffron, tart cherries, turmeric, wild yam, Withania somnifera, xanthines, and zinc. Particular noteworthy effects on cognition included memory, recollection, attention, intelligence, vocabulary, recognition, response inhibition, arousal, performance enhancement, planning, creative thinking, reaction time, vigilance, task switching, orientation to time, place, and person, reading, writing, comprehension, accuracy, learning, information processing speed, executive function, mental flexibility, daily functioning, decrease in mental fatigue, and freedom from distractibility. Some nutrients and phytonutrients also improved mood and contentedness and reduced anxiety and the need for caregiving. These effects are not completely consistent or ubiquitous across all patient populations or health statuses. Adverse effects were minimal or nonexistent. CONCLUSION Due to the growing population of people with cognitive impairment and the lack of effective pharmacotherapeutics, it is prudent for those afflicted or their caregivers to find alternative treatments. Our narrative review shows that many of these nutrients and phytonutrients may be promising for treating some aspects of cognitive impairment, especially for people afflicted with AD. RELEVANCE FOR PATIENTS As demonstrated in a number of clinical trials, healthy adults and patients with various health challenges (e.g., AD, mild cognitive impairment, multiple sclerosis, and Parkinson's disease) exhibiting a wide range of severity in cognitive defects would be best served to consider multiple nutrients and phytonutrients to improve aspects of their cognitive function.
Collapse
Affiliation(s)
- John E. Lewis
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jillian Poles
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Delaney P. Shaw
- Institute of Human Nutrition, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Elisa Karhu
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sher Ali Khan
- Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Annabel E. Lyons
- School of Nursing and Health Studies, University of Miami, Coral Gables, FL, USA
| | | | | |
Collapse
|
39
|
Bakhtiari-Dovvombaygi H, Izadi S, Zare M, Asgari Hassanlouei E, Dinpanah H, Ahmadi-Soleimani SM, Beheshti F. Vitamin D3 administration prevents memory deficit and alteration of biochemical parameters induced by unpredictable chronic mild stress in rats. Sci Rep 2021; 11:16271. [PMID: 34381124 PMCID: PMC8357828 DOI: 10.1038/s41598-021-95850-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/26/2021] [Indexed: 12/18/2022] Open
Abstract
The present study aimed to investigate the effects of vitamin D3 (Vit D) administration on memory function, hippocampal level of amyloid-beta (Aβ), brain-derived neurotrophic factor (BDNF) and oxidative stress status in a rat model of unpredictable chronic mild stress (UCMS). Vit D was intraperitoneally administered at doses of 100, 1000, and 10,000 IU/kg. Animals were subjected to UCMS for a total period of 4 weeks. Memory function was assessed using morris water maze (MWM) and passive avoidance (PA) tests. Biochemical markers were measured to reveal the status of oxidative stress and antioxidant defense system. In addition, the levels of Aβ and BDNF were measured in hippocampal region. In the UCMS group, latency to find the platform was greater and the time spent in target quadrant (MWM test) as well as the latency to enter the dark compartment (PA test), were less than the vehicle group. Hippocampal malondialdehyde (MDA) and Aβ concentrations in the UCMS group were higher than the vehicle group. Hippocampal level of thiol and BDNF plus the activities of catalase and superoxide dismutase (SOD) were reduced in UCMS group compared to the control subjects (i.e. vehicle group). Interestingly, Vit D treatment supplementation reversed the mentioned effects of UCMS. Our findings indicated that Vit D administration improves UCMS-induced impairment of learning and memory through prevention of adverse effects on Aβ, BDNF and oxidative stress parameters.
Collapse
Affiliation(s)
- Hossein Bakhtiari-Dovvombaygi
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Departments of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Saeed Izadi
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Departments of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mostafa Zare
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.,Departments of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | | | - Hossein Dinpanah
- Department of Emergency Medicine, 9 Dey Educational Hospital, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - S Mohammad Ahmadi-Soleimani
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. .,Departments of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Farimah Beheshti
- Neuroscience Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran. .,Departments of Physiology, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| |
Collapse
|
40
|
Dorman G, Flores I, Gutiérrez C, Castaño RF, Aldecoa M, Kim L. Medicinal herbs and nutritional supplements for dementia therapy: potential therapeutic targets and clinical evidence. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 21:26-51. [PMID: 34370647 DOI: 10.2174/1871527320666210809121230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 02/20/2021] [Accepted: 03/28/2021] [Indexed: 11/22/2022]
Abstract
Spices and herbs have been used for medicinal purposes for centuries. Also, in the last decades, the use of different nutritional supplements has been implemented to treat all kinds of diseases, including those that present an alteration in cognitive functioning. Dementia is a clinical syndrome in which a person's mental and cognitive capacities gradually decline. As the disease progresses, the person's autonomy diminishes. As there is not an effective treatment to prevent progressive deterioration in many of these pathologies, nutritional interventions have been, and still are, one of the most widely explored therapeutic possibilities. In this review, we have discussed a great number of potentially interesting plants, nutritional derivatives and probiotics for the treatment of dementia around the world. Their action mechanisms generally involve neuroprotective effects via anti-inflammatory, antioxidant, anti-apoptotic, b-amyloid and tau anti-aggregate actions; brain blood flow improvement, and effects on synaptic cholinergic and dopaminergic neurotransmission, which may optimize cognitive performance in patients with cognitive impairment. As for their efficacy in patients with cognitive impairment and/or dementias, evidence is still scarce and/or their outcomes are controversial. We consider that many of these substances have promising therapeutic properties. Therefore, the scientific community has to continue with a more complete research focused on both identifying possible action mechanisms and carrying out clinical trials, preferably randomized double-blind ones, with a greater number of patients, a long-term follow-up, dose standardization and the use of current diagnosis criteria.
Collapse
Affiliation(s)
- Guido Dorman
- Division of Neurology, Ramos Mejia Hospital. Argentina
| | - Ignacio Flores
- Neuroscience Institute, Favaloro Foundation Hospital. Argentina
| | | | | | - Mayra Aldecoa
- Division of Neurology, Ramos Mejia Hospital. Argentina
| | - Leandro Kim
- Division of Neurology, Ramos Mejia Hospital. Argentina
| |
Collapse
|
41
|
Juwita F, Gumilang L, Risan NA, Dhamayanti M. The Association of Vitamin D and Neurodevelopmental Status Among 2 Years Old Infants. Glob Pediatr Health 2021; 8:2333794X211034075. [PMID: 34350310 PMCID: PMC8295950 DOI: 10.1177/2333794x211034075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 01/05/2023] Open
Abstract
The previous studies about association of vitamin D and neurodevelopmental status in the first 1000 days of life showed inconsistent results. This study aimed to investigate correlation between vitamin D deficiency and neurodevelopmental in 2 years old infants. A cross-sectional study was conducted in Sukabumi and Waled, West Java involving 2 years old infants born from the mothers participated in previous cohort. Total 109 infants met the criteria. Vitamin D was measured and neurodevelopmental status was assessed using ASQ-3 in each subject. Statistical analysis using Spearman's Rank correlation and multiple regression model. 50.4% infants had vitamin D deficiency (<50 nmol/L). Neurodevelopmental status showed appropriate for age. No significant association between vitamin D level and neurodevelopmental in 2 years old infants. However, there was an association between some developmental domains and vitamin D level at birth. No correlation between vitamin D and neurodevelopmental in 2 years old infants.
Collapse
Affiliation(s)
- Feby Juwita
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Lani Gumilang
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Nelly Amalia Risan
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Meita Dhamayanti
- Department of Child Health, Hasan Sadikin General Hospital, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia
| |
Collapse
|
42
|
Yang G, Li C, Wang W, Wang C, Dong A, Wang F, Zhang H. Risk factors for cognitive impairment in patients with first-time ischemic stroke. Am J Transl Res 2021; 13:1884-1889. [PMID: 33841715 PMCID: PMC8014415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/24/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To determine the risk factors for cognitive impairment (CI) in patients with first-time ischemic stroke. METHODS The clinical data of 180 patients with ischemic stroke who were admitted to our hospital from January 2018 to December 2019 was retrospectively analyzed. Patients with MMSE score ≤24 were included into the CI group and the rest of the patients were placed into the normal group. Multivariate logistic regression was applied to describe risk factors for CI in patients with first-time ischemic stroke. RESULTS Among the patients with first-time ischemic stroke, 96 cases (53%) developed CI, 84 cases (47%) were normal. In different subtypes of TOAST classifications, patients with large-artery atherosclerosis had the highest CI incidence (66.96%). For different infarction sites, the highest CI incidence occurred in the frontal lobe (82.35%), and the lowest was from cerebellar infarction (37.50%). The difference of CI incidences in the frontal lobe, parietal lobe, temporal lobe and occipital lobe was significant between the two groups (P<0.05). Logistic regression analysis indicated that independent risk factors for CI in patients with first ischemic stroke include age ≥60 years old, diabetes history, CRP >6.53 mg/L, Hcy >13.84 μmol/L, NIHSS score >4.37, VD <45.16 nmol/L, and the difference was statistically significant (P<0.05). CONCLUSION The study showed a high CI incidence in patients with preexisting ischemic stroke. Age ≥60 years old, history of diabetes mellitus, CRP >6.53 mg/L, Hcy >13.84 μmol/L, NIHSS score >4.37 score, VD <45.16 nmol/L are independent risk factors for CI in patients with first-time ischemic stroke.
Collapse
Affiliation(s)
- Guotao Yang
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Conghui Li
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Wenhui Wang
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Chunyu Wang
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Aiqin Dong
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Fang Wang
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| | - Hailiu Zhang
- Department of The Third Neurology, Cangzhou Central Hospital Cangzhou 061000, Hebei, China
| |
Collapse
|
43
|
Beydoun MA, Ng AE, Fanelli-Kuczmarski MT, Hossain S, Beydoun HA, Evans MK, Zonderman AB. Vitamin D status and its longitudinal association with changes in patterns of sleep among middle-aged urban adults. J Affect Disord 2021; 282:858-868. [PMID: 33601729 PMCID: PMC10103179 DOI: 10.1016/j.jad.2020.12.145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 10/28/2020] [Accepted: 12/23/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We examined relationships of vitamin D status with over time changes in patterns of sleep in a longitudinal study of Whites and African-American urban middle-aged adults, while further testing effect modification by age group, sex and race and the potential roles of dietary and supplemental vitamin D. METHODS Data on 1,760 middle-aged participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS study: Age range at v2: 33-71y, mean±SD:53.0±8.8, % women: 58.4%, % African-American:60.3%) were used, with complete baseline 25-hydroxyvitamin D [25(OH)D] serum concentration data, initial selected covariates and mediators, and initial and/or follow-up data on five sub-scales (sleep duration, daytime dysfunction, sleep disturbance, sleep latency and sleep quality) of the Pittsburgh Sleep Quality Index. Mean±SD time between initial and follow-up visits: 4.1±1.5 years. Time-interval multiple mixed-effects linear regression models were used. RESULTS Upon multiple testing adjustment, among Whites, initial 25(OH)D was associated with better sleep duration [25(OH)D × TIME γ±SE: -0.027±0.011, P=0.017] and sleep quality [25(OH)D × TIME γ±SE: -0.026±0.010, P=0.008] over time, with heterogeneity by race found for both relationships (P<0.05 for 25(OH)D × TIME × Race in the un-stratified model). These relationships remained unaltered after further adjustment for dietary and supplemental vitamin D, indicating that this association may be largely explained by sunlight exposure. LIMITATIONS Limitations included small sample size, selection bias, residual confounding and lack of objective sleep measures. Conclusions Vitamin D status, possibly through mechanisms involving sunlight exposure, was linked to a potential improvement in sleep duration and quality among White urban adults.
Collapse
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD.
| | - Amanda E Ng
- Department of Epidemiology & Biostatistics, University of Maryland, College Park
| | | | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD
| |
Collapse
|
44
|
Rajeev A, Ali M, Tuinebreijer W, Zourob E, Anto J. Preexisting dementia is associated with higher mortality rate in patients with femoral neck fracture. Aging Med (Milton) 2021; 4:12-18. [PMID: 33738375 PMCID: PMC7954834 DOI: 10.1002/agm2.12142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study aimed to assess the mortality and the influence of age, Abbreviated Mental Test (AMT) scores, and American Society of Anesthesiologists (ASA) grades on patients with dementia and femoral neck fracture (FNF) at 30 days, 4 months, 1 year, and 2 years after undergoing surgery. METHODS Of 1296 patients admitted with FNF, 180 had had prefracture dementia. A retrospective study of these 180 patients was carried out. The patient demographics, including age, sex, presence of diabetes mellitus (DM), lipid profile, AMT score, preoperative comorbidities, ASA grade, and incidence of postoperative delirium, were documented. RESULTS A total of 113 patients (62.8%) died postoperatively. The mortality rate was 17.7% (20 patients) at 30 days, 54.9% (62 patients) at 4 months, 77.9% (88 patients) at 1 year, and 87.6% (99 patients) at 2 years. The mortally rate in dementia with FNF was three times higher than that in FNF without dementia and was independent of age, ASA grades, DM, lipid profile, AMT scores, and development of postoperative delirium. CONCLUSIONS Dementia should be a principal predictive factor in mortality of FNF and should be a key determinant in all frailty scores.
Collapse
Affiliation(s)
- Aysha Rajeev
- Queen Elizabeth HospitalGateshead Health Foundation NHS TrustGatesheadUK
| | - Mohammed Ali
- Health Education North EastNewcastle Upon TyneUK
| | - Wim Tuinebreijer
- Department of SurgeryUniversity Medical CentreRotterdamThe Netherlands
| | - Emadeldeen Zourob
- Queen Elizabeth HospitalGateshead Health Foundation NHS TrustGatesheadUK
| | - Joseph Anto
- Queen Elizabeth HospitalGateshead Health Foundation NHS TrustGatesheadUK
| |
Collapse
|
45
|
Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System. Int J Mol Sci 2021; 22:ijms22042128. [PMID: 33669918 PMCID: PMC7924658 DOI: 10.3390/ijms22042128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D, a fat-soluble prohormone, is endogenously synthesized in response to sunlight or taken from dietary supplements. Since vitamin D receptors are present in most tissues and cells in the body, the mounting understanding of the role of vitamin D in humans indicates that it does not only play an important role in the musculoskeletal system, but has beneficial effects elsewhere as well. This review summarizes the metabolism of vitamin D, the research regarding the possible risk factors leading to vitamin D deficiency, and the relationships between vitamin D deficiency and numerous illnesses, including rickets, osteoporosis and osteomalacia, muscle weakness and falls, autoimmune disorders, infectious diseases, cardiovascular diseases (CVDs), cancers, and neurological disorders. The system-wide effects of vitamin D and the mechanisms of the diseases are also discussed. Although accumulating evidence supports associations of vitamin D deficiency with physical and mental disorders and beneficial effects of vitamin D with health maintenance and disease prevention, there continue to be controversies over the beneficial effects of vitamin D. Thus, more well-designed and statistically powered trials are required to enable the assessment of vitamin D’s role in optimizing health and preventing disease.
Collapse
|
46
|
Low Serum 25-Hydroxy Vitamin D (25-OHD) and Hepatic Encephalopathy in HCV-Related Liver Cirrhosis. Int J Hepatol 2021; 2021:6669527. [PMID: 33628512 PMCID: PMC7896845 DOI: 10.1155/2021/6669527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with liver cirrhosis experience a large variety of metabolic disorders associated with more hepatic decompensation. Hepatic encephalopathy (HE) is a significant complication in liver cirrhosis patients, presenting a wide spectrum of neuropsychological symptoms. A deficiency of 25-hydroxy vitamin D (25-OHD) in the general population is associated with a loss of cognitive function, dementia, and Alzheimer's disease. Aim of the Study. Our study aims to check the relationship between low serum 25-OHD and HE in patients with HCV-related liver cirrhosis and assess its link with patient mortality. Patients and Methods. This study was observationally carried out on 100 patients with HCV-related liver cirrhosis. The patients were divided into 2 groups: Group A-included 50 HCV-related cirrhotic patients with HE, and Group B-included 50 HCV-related cirrhotic patients without HE. Assessment of disease severity using the end-stage liver disease (MELD) model and Child Turcotte Pugh (CTP) scores were done, and 25-OHD levels were measured. Comparison of vitamin D levels in different etiologies and different CTP categories was made using one-way ANOVA. Pearson's correlation between the level of vitamin D and other biomarkers was applied. RESULTS There was a statistically significant Vitamin D level difference between the two groups. A lower level of vitamin D was observed in the HE group where the severe deficiency was 16%, while it was 6% in the other group and the moderate deficiency was 24% in HE group as compared to 10% in the other group. The insufficient vitamin D level represented 46% of the non-HE group while none of the HE group falls in this category. Vitamin D level was statistically higher in Grade 1 HE than in Grade 2 which is higher than in Grades 3 to 4. Vitamin D level was also significantly higher in those who improved from HE as compared to those who died. CONCLUSION The lower levels of 25-OHD were associated with the higher incidence of HE in cirrhotic HCV patients. The worsening vitamin D deficiency was associated with increased severity of the liver disease, so vitamin D may be considered a prognostic factor for the severity of liver cirrhosis and high mortality rate in HE patients.
Collapse
|
47
|
Martins LB, Malheiros Silveira AL, Teixeira AL. The link between nutrition and Alzheimer's disease: from prevention to treatment. Neurodegener Dis Manag 2021; 11:155-166. [PMID: 33550870 DOI: 10.2217/nmt-2020-0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. To date, there is no effective pharmacological strategy to slow or stop disease progression. In this context, multiple alternative therapeutic strategies have been investigated for AD. This review addresses the potential role of nutrition interventions in AD prevention and treatment. Nutritional strategies for AD have been based on four pillars: maintaining a healthy weight (i.e., prevention and/or treatment of obesity, especially in midlife and prevention of weight loss in the later stages of AD); correction of nutritional deficiencies; adequate consumption of micronutrients (vitamins and minerals), especially those implicated in the pathways of AD pathophysiology; and microbiota modulation.
Collapse
Affiliation(s)
- Laís Bhering Martins
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA.,Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil
| | - Ana Letícia Malheiros Silveira
- Departamento de Nutrição, Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 30130-100, Brazil.,Departamento de Bioquímica e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Antonio Lúcio Teixeira
- Department of Psychiatry & Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
| |
Collapse
|
48
|
Kaul S, Manikinda J. Role of Vitamin D in Cerebrovascular Disease. Ann Indian Acad Neurol 2021; 24:142-145. [PMID: 34220055 PMCID: PMC8232472 DOI: 10.4103/aian.aian_928_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/09/2020] [Accepted: 11/03/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Vitamin D deficiency is now a well-recognized public health problem affecting almost every second person throughout the world. Recent evidence from many population-based studies has indicated that a poor vitamin D status is a predictor of future strokes. Materials and Methods We reviewed recent studies on 25-hydroxyvitamin D [25(OH)D] and symptomatic ischemic stroke. A graded increase in the risk of symptomatic ischemic stroke with decreasing levels of plasma 25(OH)D has been found in most of the studies. Vitamin D also has a role in the poststroke period where its deficiency may hinder the rehabilitation process. Conclusions After reviewing current literature on the subject, we conclude that there are some data to suggest the role of vitamin D in patients with stroke but it cannot be concluded as a risk factor for stroke. Larger population-based studies are needed to confirm the causative role of vitamin D in stroke.
Collapse
Affiliation(s)
- Subhash Kaul
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Jayasree Manikinda
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| |
Collapse
|
49
|
Panza F, La Montagna M, Lampignano L, Zupo R, Bortone I, Castellana F, Sardone R, Borraccino L, Dibello V, Resta E, Altamura M, Daniele A, Lozupone M. Vitamin D in the development and progression of alzheimer's disease: implications for clinical management. Expert Rev Neurother 2021; 21:287-301. [PMID: 33406925 DOI: 10.1080/14737175.2021.1873768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Although the pathophysiological bases of Alzheimer's disease (AD) remain incompletely understood and disease-modifying therapies are not available, intervention on modifiable risk factors is warranted. Research on nutrition and dietary components is challenging and controversies still persist about the role of micro- and macronutrients and health outcomes in dementia. Importantly, results of preclinical investigations have shown that vitamin D triggers different neural pathways that may be protective against these neurodegenerative mechanisms, including the deposition of amyloid plaques, inflammatory processes, neurofibrillary degeneration, glutamatergic excitotoxicity, excessive intraneuronal calcium influx, and oxidative stress, although its relationship with AD still needs to be fully understood. AREAS COVERED The authors analyzed the recent evidence about the effects of vitamin D insufficiency on AD and the role of supplementation. EXPERT OPINION Both insufficient (25-49.9 ng/ml) and deficient levels (<25 ng/ml) of vitamin D may contribute to an increased susceptibility to AD. However, further well-designed prospective studies are needed for a better understanding of the involvement of low vitamin D concentrations in the AD natural history. Randomized clinical trials will also be necessary to address the issue of causality and determine whether vitamin D supplementation may be effective for the prevention or treatment of AD.
Collapse
Affiliation(s)
- Francesco Panza
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Maddalena La Montagna
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Roberta Zupo
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Ilaria Bortone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Fabio Castellana
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Rodolfo Sardone
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy
| | - Luisa Borraccino
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vittorio Dibello
- Frailty Phenotypes Research Unit, "Salus in Apulia Study", National Institute of Gastroenterology "Saverio De Bellis", Research Hospital, Bari, Italy.,Department of Orofacial Pain & Dysfunction, Academic Centre of Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit Amsterdam, The Netherlands
| | - Emanuela Resta
- Department of Cardiac, Thoracic, and Vascular Science, Institute of Respiratory Disease, University of Bari Aldo Moro, Bari, Italy.,Translational Medicine & Management of Health Systems, University of Foggia, Foggia, Italy
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.,Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| |
Collapse
|
50
|
Meeuwsen KD, Groeneveld KM, Walker LA, Mennenga AM, Tittle RK, White EK. Z-score neurofeedback, heart rate variability biofeedback, and brain coaching for older adults with memory concerns. Restor Neurol Neurosci 2021; 39:9-37. [PMID: 33386829 PMCID: PMC7990441 DOI: 10.3233/rnn-201053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND The three-month, multi-domain Memory Boot Camp program incorporates z-score neurofeedback (NFB), heart rate variability (HRV) biofeedback, and one-on-one coaching to teach memory skills and encourage behavior change in diet, sleep, physical fitness, and stress reduction. OBJECTIVE This prospective trial evaluates the Memory Boot Camp program for adults ages 55 to 85 with symptoms of Mild Cognitive Impairment (MCI) and subjective memory complaints. METHODS Participants were evaluated via the Montreal Cognitive Assessment (MoCA), NeuroTrax Global Cognitive Score, measures of anxiety, depression, sleep, quality of life, quantitative electroencephalography (QEEG), and HRV parameters at four timepoints: baseline, pre-program, post-program, and follow-up. The trial included a three-month waiting period between baseline and pre-program, such that each participant acted as their own control, and follow-up took place six months after completion of the program. RESULTS Participants' MoCA scores and self-reported measures of anxiety, depression, sleep quality, and quality of life improved after treatment, and these changes were maintained at follow-up. Physiological changes in HRV parameters after treatment were not significant, however, breathing rate and QEEG parameters were improved at post-program and maintained at follow-up. Finally, participants' improvement in MoCA score over the treatment period was correlated with their improvement in two brain oscillation parameters targeted by the z-score NFB protocol: relative power of delta and relative power of theta. CONCLUSIONS Trial results suggest that the Memory Boot Camp program is a promising treatment strategy for older adults with symptoms of MCI and subjective memory complaints.
Collapse
|