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Poniedziałek-Czajkowska E, Mierzyński R. Could Vitamin D Be Effective in Prevention of Preeclampsia? Nutrients 2021; 13:nu13113854. [PMID: 34836111 PMCID: PMC8621759 DOI: 10.3390/nu13113854] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/23/2022] Open
Abstract
Prevention of preeclampsia (PE) remains one of the most significant problems in perinatal medicine. Due to the possible unpredictable course of hypertension in pregnancy, primarily PE and the high complication rate for the mother and fetus/newborn, it is urgent to offer pregnant women in high-risk groups effective methods of preventing the PE development or delaying its appearance. In addition, due to the association of PE with an increased risk of developing cardiovascular diseases (CVD) in later life, effective preeclampsia prevention could also be important in reducing their incidence. Ideal PE prophylaxis should target the pathogenetic changes leading to the development of PE and be safe for the mother and fetus, inexpensive and freely available. Currently, the only recognized method of PE prevention recommended by many institutions around the world is the use of a small dose of acetylsalicylic acid in pregnant women with risk factors. Unfortunately, some cases of PE are diagnosed in women without recognized risk factors and in those in whom prophylaxis with acetylsalicylic acid is not adequate. Hence, new drugs which would target pathogenetic elements in the development of preeclampsia are studied. Vitamin D (Vit D) seems to be a promising agent due to its beneficial effect on placental implantation, the immune system, and angiogenic factors. Studies published so far emphasize the relationship of its deficiency with the development of PE, but the data on the benefits of its supplementation to reduce the risk of PE are inconclusive. In the light of current research, the key issue is determining the protective concentration of Vit D in a pregnant woman. The study aims to present the possibility of using Vit D to prevent PE, emphasizing its impact on the pathogenetic elements of preeclampsia development.
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Wong YK, Tse HF. Circulating Biomarkers for Cardiovascular Disease Risk Prediction in Patients With Cardiovascular Disease. Front Cardiovasc Med 2021; 8:713191. [PMID: 34660715 PMCID: PMC8517145 DOI: 10.3389/fcvm.2021.713191] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 09/08/2021] [Indexed: 12/23/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. Risk assessment is crucial for identifying at-risk individuals who require immediate attention as well as to guide the intensity of medical therapy to reduce subsequent risk of CVD. In the past decade, many risk prediction models have been proposed to estimate the risk of developing CVD. However, in patients with a history of CVD, the current models that based on traditional risk factors provide limited power in predicting recurrent cardiovascular events. Several biomarkers from different pathophysiological pathways have been identified to predict cardiovascular events, and the incorporation of biomarkers into risk assessment may contribute to enhance risk stratification in secondary prevention. This review focuses on biomarkers related to cardiovascular and metabolic diseases, including B-type natriuretic peptide, high-sensitivity cardiac troponin I, adiponectin, adipocyte fatty acid-binding protein, heart-type fatty acid-binding protein, lipocalin-2, fibroblast growth factor 19 and 21, retinol-binding protein 4, plasminogen activator inhibitor-1, 25-hydroxyvitamin D, and proprotein convertase subtilisin/kexin type 9, and discusses the potential utility of these biomarkers in cardiovascular risk prediction among patients with CVD. Many of these biomarkers have shown promise in improving risk prediction of CVD. Further research is needed to assess the validity of biomarker and whether the strategy for incorporating biomarker into clinical practice may help to optimize decision-making and therapeutic management.
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Affiliation(s)
- Yuen-Kwun Wong
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Hung-Fat Tse
- Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.,Department of Medicine, Shenzhen Hong Kong University Hospital, Shenzhen, China.,Hong Kong-Guangdong Joint Laboratory on Stem Cell and Regenerative Medicine, The University of Hong Kong, Hong Kong, China.,Shenzhen Institutes of Research and Innovation, The University of Hong Kong, Hong Kong, China
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Cosentino N, Campodonico J, Milazzo V, De Metrio M, Brambilla M, Camera M, Marenzi G. Vitamin D and Cardiovascular Disease: Current Evidence and Future Perspectives. Nutrients 2021; 13:nu13103603. [PMID: 34684604 PMCID: PMC8541123 DOI: 10.3390/nu13103603] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 12/14/2022] Open
Abstract
Vitamin D deficiency is a prevalent condition, occurring in about 30–50% of the population, observed across all ethnicities and among all age groups. Besides the established role of vitamin D in calcium homeostasis, its deficiency is emerging as a new risk factor for cardiovascular disease (CVD). In particular, several epidemiological and clinical studies have reported a close association between low vitamin D levels and major CVDs, such as coronary artery disease, heart failure, and atrial fibrillation. Moreover, in all these clinical settings, vitamin deficiency seems to predispose to increased morbidity, mortality, and recurrent cardiovascular events. Despite this growing evidence, interventional trials with supplementation of vitamin D in patients at risk of or with established CVD are still controversial. In this review, we aimed to summarize the currently available evidence supporting the link between vitamin D deficiency and major CVDs in terms of its prevalence, clinical relevance, prognostic impact, and potential therapeutic implications.
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Affiliation(s)
- Nicola Cosentino
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Jeness Campodonico
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Valentina Milazzo
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
| | - Monica De Metrio
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
| | - Marta Brambilla
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
| | - Marina Camera
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
- Department of Pharmaceutical Sciences, University of Milan, 20133 Milan, Italy
| | - Giancarlo Marenzi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy; (N.C.); (J.C.); (V.M.); (M.D.M.); (M.B.); (M.C.)
- Correspondence: ; Tel.: +39-02-580-021
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54
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Zhernakova NI, Bunova SS, Agarkov NM, Lebedev DT, Aksenov VV. Vitamin D Deficiency as an Independent Predictor of Myocardial Infarction in the Elderly. ARCHIVES OF RAZI INSTITUTE 2021; 76:1069-1076. [PMID: 35096343 PMCID: PMC8791001 DOI: 10.22092/ari.2021.356047.1766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/27/2021] [Indexed: 05/25/2023]
Abstract
Cardiovascular diseases are among the most common causes of disability and death in the world, and the number of patients with this category of diseases is increasing every year. This study aimed to investigate the role of vitamin D and the problems caused by its deficiency on the cardiovascular system. Level of D-(25(OH]D) in blood was studied by enzyme immunoassay in 95 elderly patients with myocardial infarction (MI) (the main group) and 92 elderly patients with no history of MI. The level of lipid metabolism as an indicator was determined using a KoneLab 300 auto-analyzer. Based on the results of this study, it was found that the elderly group without MI had the highest amount of D-(25(OH]D)(24.5±1.2), compared to the elderly group with MI (14.8±1.3). The rates of expressed deficiency, deficiency, and insufficiency in the group of elderly with MI were 53.6±5.1, 23.2±4.4, and 12.6±3.4%, respectively. This experiment has shown that D-(25(OH]D) is involved in lipid metabolism and reduces the accumulation of cholesterol by macrophages. The content of vitamin D in blood plasma was a prognostic predictor of MI, which improved MI in the elderly. Regardless of pathological changes, the deficit level of D-(25(OH]D) should be considered a laboratory predictor of MI in the elderly.
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Affiliation(s)
- N I Zhernakova
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - S S Bunova
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - N M Agarkov
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - D T Lebedev
- FGAOU VO, Belgorod State National Research University, Belgorod, Russia
| | - V V Aksenov
- FGBOU VO, South-West State University, Kursk, Russia
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Chang Villacreses MM, Karnchanasorn R, Panjawatanan P, Ou HY, Chiu KC. Conundrum of vitamin D on glucose and fuel homeostasis. World J Diabetes 2021; 12:1363-1385. [PMID: 34630895 PMCID: PMC8472505 DOI: 10.4239/wjd.v12.i9.1363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/10/2021] [Accepted: 08/05/2021] [Indexed: 02/06/2023] Open
Abstract
As an endocrine hormone, vitamin D plays an important role in bone health and calcium homeostasis. Over the past two decades, the non-calcemic effects of vitamin D were extensively examined. Although the effect of vitamin D on beta cell function were known for some time, the effect of vitamin D on glucose and fuel homeostasis has attracted new interest among researchers. Yet, to date, studies remain inconclusive and controversial, in part, due to a lack of understanding of the threshold effects of vitamin D. In this review, a critical examination of interventional trials of vitamin D in prevention of diabetes is provided. Like use of vitamin D for bone loss, the benefits of vitamin D supplementation in diabetes prevention were observed in vitamin D-deficient subjects with serum 25-hydroxyvitamin D < 50 nmol/L (20 ng/mL). The beneficial effect from vitamin D supplementation was not apparent in subjects with serum 25-hydroxyvitamin D > 75 nmol/L (30 ng/mL). Furthermore, no benefit was noted in subjects that achieved serum 25-hydroxyvitamin D > 100 nmol/L (40 ng/mL). Further studies are required to confirm these observations.
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Affiliation(s)
- Maria Mercedes Chang Villacreses
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, United States
| | - Rudruidee Karnchanasorn
- Division of Endocrinology, Department of Medicine, University of Kansas Medical Center, Kansas City, KS 66160, United States
| | - Panadeekarn Panjawatanan
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Department of Internal Medicine, Bassett Medical Center, Cooperstown, NY 13326, United States
| | - Horng-Yih Ou
- Department of Internal Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 700, Taiwan
| | - Ken C Chiu
- Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, CA 91010, United States
- Division of Endocrinology, Metabolism and Nutrition, Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, United States
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56
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Zandieh N, Rezaei Hemami M, Darvishi A, Hasheminejad SM, Abdollahi Z, Zarei M, Heshmat R. The cost-effectiveness analysis of a nationwide vitamin D supplementation program among Iranian adolescents for adulthood cardiovascular diseases prevention. Public Health 2021; 198:340-347. [PMID: 34509859 DOI: 10.1016/j.puhe.2021.07.019] [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: 03/21/2021] [Revised: 06/18/2021] [Accepted: 07/17/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate a national vitamin D supplementation program's cost-effectiveness among Iranian adolescents to prevent cardiovascular diseases (CVDs) in adulthood. STUDY DESIGN A cost-effectiveness analytical study. METHODS A decision tree model was adopted to evaluate the cost per quality-adjusted life-year (QALY) of monthly intake of nine pearls of 50,000 IU vitamin D for nine months to prevent CVD a one-year horizon compared to no intervention. The analysis was conducted in Iranian adolescents in first or second high school grades of 47 climatically different Iran regions. RESULTS Our analytical analysis estimated the 1090$ cost per QALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the incremental cost-effectiveness ratio (ICER) threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood CVD. It means that vitamin D supplementation costs were substantially less than the costs of CVD treatments compared to the no intervention. CONCLUSIONS Based on these findings, the national program of vitamin D supplementation in adolescents would be cost effective to prevent CVD development in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.
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Affiliation(s)
- Narges Zandieh
- Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohsen Rezaei Hemami
- University of Aberdeen, Aberdeen Centre for Health Data Sciences, Southampton, UK
| | - Ali Darvishi
- Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Zahra Abdollahi
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education
| | - Maryam Zarei
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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57
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Tintut Y, Demer LL. Potential impact of the steroid hormone, vitamin D, on the vasculature. Am Heart J 2021; 239:147-153. [PMID: 34051171 DOI: 10.1016/j.ahj.2021.05.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/20/2021] [Indexed: 02/06/2023]
Abstract
The role of vitamin D in the cardiovascular system is complex because it regulates expression of genes involved in diverse metabolic processes. Although referred to as a vitamin, it is more accurately considered a steroid hormone, because it is produced endogenously in the presence of ultraviolet light. It occurs as a series of sequentially activated forms, here referred to as vitamin D-hormones. A little-known phenomenon, based on pre-clinical data, is that its biodistribution and potential effects on vascular disease likely depend on whether it is derived from diet or sunlight. Diet-derived vitamin D-hormones are carried in the blood, at least in part, in chylomicrons and lipoprotein particles, including low-density lipoprotein. Since low-density lipoprotein is known to accumulate in the artery wall and atherosclerotic plaque, diet-derived vitamin D-hormones may also collect there, and possibly promote the osteochondrogenic mineralization associated with plaque. Also, little known is the fact that the body stores vitamin D-hormones in adipose tissue with a half-life on the order of months, raising doubts about whether the use of the term "daily requirement" is appropriate. Cardiovascular effects of vitamin D-hormones are controversial, and risk appears to increase with both low and high blood levels. Since low serum vitamin D-hormone concentration is reportedly associated with increased cardiovascular and orthopedic risk, oral supplementation is widely used, often together with calcium supplements. However, meta-analyses show that oral vitamin D-hormone supplementation does not protect against cardiovascular events, findings that are also supported by a randomized controlled trial. These considerations suggest that prevalent recommendations for vitamin D-hormone supplementation for the purpose of cardiovascular protection should be carefully reconsidered.
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Affiliation(s)
- Yin Tintut
- Department of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA; Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, CA; Department of Orthopaedic Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA
| | - Linda L Demer
- Department of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA; Department of Physiology, University of California, Los Angeles (UCLA), Los Angeles, CA; Department of Bioengineering, University of California, Los Angeles (UCLA), Los Angeles, CA; VA Greater Los Angeles Healthcare System, Los Angeles, Los Angeles, CA.
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58
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Ismail HM, Algrafi AS, Amoudi O, Ahmed S, Al-Thagfan SS, Shora H, Aljohani M, Almutairi M, Alharbi F, Alhejaili A, Alamri M, Muhawish A, Abdallah A. Vitamin D and Its Metabolites Deficiency in Acute Coronary Syndrome Patients Undergoing Coronary Angiography: A Case-Control Study. Vasc Health Risk Manag 2021; 17:471-480. [PMID: 34408425 PMCID: PMC8364363 DOI: 10.2147/vhrm.s312376] [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: 03/29/2021] [Accepted: 07/15/2021] [Indexed: 12/26/2022] Open
Abstract
Background Vitamin D deficiency is considered an emerging health problem that affects at least one billion patients worldwide. Calcitriol 1,25(OH)2D3 has several systemic effects, including anti-inflammatory, anti-thrombotic and anti-atherosclerotic impacts that explain its cardioprotective effects. The precise association between vitamin D and its metabolites and the value of supplements in acute coronary syndrome (ACS) is still controversial. This study aims to search the association between vitamin D2, D3, and metabolites and ACS in patients undergoing coronary angiography. Materials and Methods This was a case–control study on 73 consecutive adult patients with ACS undergoing coronary angiography compared to 50 controls without coronary artery disease and matched for age and sex from June 2019 till July 2019. Echocardiography and coronary angiography were done for all cases. Plasma vitamin D and its metabolites were measured at admission for all participants along with chemistry profiles. Results Vitamin D and its metabolites were statistically significantly lower in ACS patients than the controls. Multivariate regression analysis revealed that low levels of 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) significantly predicted ACS occurrence; the other significant predictors were high systolic blood pressure (BP), high total cholesterol, and low high-density lipoprotein-cholesterol. Interestingly, vitamin D2 and D3 did not significantly predict ACS (p>0.05). We did not find a statistically significant association between the number of affected coronary vessels and vitamin D metabolites. Moreover, there was no statistically significant correlation between vitamin D and its metabolites and left ventricular ejection fraction measured by echocardiography. Conclusion There was a strong association between vitamin D and all its metabolites with ACS. Significantly, low 25(OH)D and 1,25(OH)2D predicted ACS, but vitamin D2 and D3 did not. Large randomized controlled trials are needed to verify the beneficial values of vitamin D supplementation in ACS patients.
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Affiliation(s)
- Hussein M Ismail
- Department of cardiology, College of Medicine, Suez Canal University, Ismailia, Egypt.,Department of medicine, College of Medicine, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Abeer S Algrafi
- Department of medicine, College of Medicine, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Osama Amoudi
- Madinah Cardiac Center, Adult cardiology, Al-Madinah Al-Munawara, Saudi Arabia
| | - Sameh Ahmed
- Department of Pharmacognosy and Pharmaceutical Chemistry, College of Pharmacy, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Sultan S Al-Thagfan
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Hassan Shora
- Department of molecular biology/biochemistry, Port Said University, Port Said, Egypt
| | - Mohammed Aljohani
- Medical intern, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | | | - Fahad Alharbi
- Medical intern, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | | | - Majed Alamri
- Medical intern, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Abdullah Muhawish
- Medical intern, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
| | - Ayat Abdallah
- Epidemiology and Preventive Medicine Department, National Liver Institute, Shebin El-Kom, Egypt.,Department of Family and Community Medicine, Taibah University, Al-Madinah Al-Munawara, Saudi Arabia
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Molsberry S, Bjornevik K, Hughes KC, Zhang ZJ, Jeanfavre S, Clish C, Healy B, Schwarzschild M, Ascherio A. Plasma Metabolomic Markers of Insulin Resistance and Diabetes and Rate of Incident Parkinson's Disease. JOURNAL OF PARKINSONS DISEASE 2021; 10:1011-1021. [PMID: 32250318 DOI: 10.3233/jpd-191896] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Although there is evidence of shared dysregulated pathways between diabetes and Parkinson's disease, epidemiologic research on an association between the two diseases has produced inconsistent results. OBJECTIVE We aimed to assess whether known metabolomic markers of insulin resistance and diabetes are also associated with Parkinson's disease development. METHODS We conducted a nested case-control study among Nurses' Health Study and Health Professionals Follow-up Study participants who had provided blood samples up to twenty years prior to Parkinson's diagnosis. Cases were matched to risk-set sampled controls by age, sex, fasting status, and time of blood collection. Participants provided covariate information via regularly collected cohort questionnaires. We used conditional logistic regression models to assess whether plasma levels of branched chain amino acids, acylcarnitines, glutamate, or glutamine were associated with incident development of Parkinson's disease. RESULTS A total of 349 case-control pairs were included in this analysis. In the primary analyses, none of the metabolites of interest were associated with Parkinson's disease development. In investigations of the association between each metabolite and Parkinson's disease at different time intervals prior to diagnosis, some metabolites showed marginally significant association but, after correction for multiple testing, only C18 : 2 acylcarnitine was significantly associated with Parkinson's disease among subjects for whom blood was collected less than 60 months prior to case diagnosis. CONCLUSIONS Plasma levels of diabetes-related metabolites did not contribute to predict risk of Parkinson's disease. Further investigation of the relationship between pre-diagnostic levels of diabetes-related metabolites and Parkinson's disease in other populations is needed to confirm these findings.
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Affiliation(s)
- Samantha Molsberry
- Population Health Sciences Program, Harvard University, Cambridge, MA, USA
| | - Kjetil Bjornevik
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Katherine C Hughes
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Zhongli Joel Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sarah Jeanfavre
- Metabolomics Platform, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Clary Clish
- Metabolomics Platform, Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, MA, USA
| | - Brian Healy
- Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Alberto Ascherio
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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60
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Vitamin D, Calcium Supplements, and Implications for Cardiovascular Health: JACC Focus Seminar. J Am Coll Cardiol 2021; 77:437-449. [PMID: 33509400 DOI: 10.1016/j.jacc.2020.09.617] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/10/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Vitamin D and calcium supplements are commonly used, often together, to optimize bone health. Multiple observational studies have linked low serum 25-hydroxyvitamin D concentrations with increased cardiovascular risk. However, subsequent randomized controlled trials (RCTs) failed to demonstrate cardiovascular benefit with vitamin D supplementation. Although vitamin D supplements do not appear to be harmful for cardiovascular health, the lack of benefit in RCTs should discourage their use for this purpose, favoring optimizing vitamin D status through healthy lifestyles such as specific foods and modest sunlight exposure. Furthermore, some (but not all) observational and RCT studies of calcium supplementation have suggested potential for cardiovascular harm. Therefore, calcium supplementation should be used cautiously, striving for recommended intake of calcium predominantly from food sources. In this review, the authors examine the currently available evidence investigating whether vitamin D and calcium supplements are helpful, harmful, or neutral for cardiovascular health.
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61
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Paredes A, Santos-Clemente R, Ricote M. Untangling the Cooperative Role of Nuclear Receptors in Cardiovascular Physiology and Disease. Int J Mol Sci 2021; 22:ijms22157775. [PMID: 34360540 PMCID: PMC8346021 DOI: 10.3390/ijms22157775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
The heart is the first organ to acquire its physiological function during development, enabling it to supply the organism with oxygen and nutrients. Given this early commitment, cardiomyocytes were traditionally considered transcriptionally stable cells fully committed to contractile function. However, growing evidence suggests that the maintenance of cardiac function in health and disease depends on transcriptional and epigenetic regulation. Several studies have revealed that the complex transcriptional alterations underlying cardiovascular disease (CVD) manifestations such as myocardial infarction and hypertrophy is mediated by cardiac retinoid X receptors (RXR) and their partners. RXRs are members of the nuclear receptor (NR) superfamily of ligand-activated transcription factors and drive essential biological processes such as ion handling, mitochondrial biogenesis, and glucose and lipid metabolism. RXRs are thus attractive molecular targets for the development of effective pharmacological strategies for CVD treatment and prevention. In this review, we summarize current knowledge of RXR partnership biology in cardiac homeostasis and disease, providing an up-to-date view of the molecular mechanisms and cellular pathways that sustain cardiomyocyte physiology.
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62
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Acharya P, Dalia T, Ranka S, Sethi P, Oni OA, Safarova MS, Parashara D, Gupta K, Barua RS. The Effects of Vitamin D Supplementation and 25-Hydroxyvitamin D Levels on the Risk of Myocardial Infarction and Mortality. J Endocr Soc 2021; 5:bvab124. [PMID: 34396023 PMCID: PMC8358990 DOI: 10.1210/jendso/bvab124] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Indexed: 12/14/2022] Open
Abstract
Objective The aim of the study was to examine the effects of the vitamin D (Vit-D) treatment and nontreatment on Vit-D–deficient patients without a prior history of myocardial infarction (MI). Materials and Methods This was a retrospective, observational, nested case–control study of patients (N = 20 025) with low 25-hydroxyvitamin D ([25-OH]D) levels (<20 ng/mL) who received care at the Veterans Health Administration from 1999 to 2018. Patients were divided into 3 groups: Group A (untreated, levels ≤20 ng/mL), Group B (treated, levels 21-29 ng/mL), and Group C (treated, levels ≥30 ng/mL). The risk of MI and all-cause mortality were compared utilizing propensity score–weighted Cox proportional hazard models. Results Among the cohort of 20 025 patients, the risk of MI was significantly lower in Group C than in Group B (hazard ratio [HR] 0.65, 95% CI 0.49-0.85, P = .002) and Group A (HR 0.73, 95% CI 0.55-0.96), P = .02). There was no difference in the risk of MI between Group B and Group A (HR 1.14, 95% CI 0.91-1.42, P = 0.24). Compared with Group A, both Group B (HR 0.59, 95% CI 0.54-0.63, P < .001) and Group C (HR 0.61, 95% CI 0.56-0.67, P < .001) had significantly lower all-cause mortality. There was no difference in all-cause mortality between Group B and Group C (HR 0.99, 95% CI 0.89-1.09, P = .78). Conclusions In patients with Vit-D deficiency and no prior history of MI, treatment to the (25-OH)D level of >20 ng/mL and >30 ng/mL was associated with a significantly lower risk of all-cause mortality. The lower risk of MI was observed only in individuals maintaining (25-OH)D levels ≥30 ng/mL.
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Affiliation(s)
- Prakash Acharya
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Tarun Dalia
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Sagar Ranka
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Prince Sethi
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Olurinde A Oni
- Division of Cardiovascular Research, Kansas City VA Medical Center, Kansas City, MO 4128, USA
| | - Maya S Safarova
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Deepak Parashara
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.,Division of Cardiovascular Research, Kansas City VA Medical Center, Kansas City, MO 4128, USA.,Division of Cardiovascular Medicine, Kansas City VA Medical Center, Kansas City, MO 4128, USA
| | - Kamal Gupta
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Rajat S Barua
- Department of Cardiovascular Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA.,Division of Cardiovascular Research, Kansas City VA Medical Center, Kansas City, MO 4128, USA.,Division of Cardiovascular Medicine, Kansas City VA Medical Center, Kansas City, MO 4128, USA
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Abiri B, Vafa M, Azizi-Soleiman F, Safavi M, Kazemi SM, Salehi M, Zaeri F, Sadeghi H. Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial. Biol Trace Elem Res 2021; 199:2590-2601. [PMID: 32975739 DOI: 10.1007/s12011-020-02400-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/16/2020] [Indexed: 11/25/2022]
Abstract
We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron-vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9.
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Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, P.O.BOX: 1449614535, Iran.
| | - Fatemeh Azizi-Soleiman
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Safavi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyyed Morteza Kazemi
- Bone, Joint, and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masood Salehi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farid Zaeri
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Sadeghi
- School of Public Health, Department of Nutrition and Food Science, Texas Woman's University, Denton Campus, Denton, TX, 76204, USA
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AKALTUN MS, ALTINDAĞ Ö, TURAN N, AYDENİZ A, GÜRSOY S, GÜR A. Relationship between metabolic syndrome and vitamin D level in patients with ankylosing spondylitis. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.841343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Gouni-Berthold I, Berthold HK. Vitamin D and Vascular Disease. Curr Vasc Pharmacol 2021; 19:250-268. [PMID: 32183681 DOI: 10.2174/1570161118666200317151955] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 12/20/2022]
Abstract
Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Vitamin D deficiency has been identified as a potential risk factor for a number of diseases unrelated to the classical skeletal pathophysiology, such as cancer and CVD, but the effects of vitamin D supplementation are less clear. Purpose of this narrative review is to discuss the evidence suggesting an association between vitamin D status and CVD as well as the results of supplementation studies. Vitamin D deficiency has been associated with CVD risk factors such as hypertension, dyslipidemia and diabetes mellitus as well as with cardiovascular events such as myocardial infarction, stroke and heart failure. While vitamin D deficiency might contribute to the development of CVD through its association with risk factors, direct effects of vitamin D on the cardiovascular system may also be involved. Vitamin D receptors are expressed in a variety of tissues, including cardiomyocytes, vascular smooth muscle cells and endothelial cells. Moreover, vitamin D has been shown to affect inflammation, cell proliferation and differentiation. While observational studies support an association between low plasma vitamin D levels and increased risk of CVD, Mendelian randomization studies do not support a causal association between the two. At present, high quality randomized trials do not find evidence of significant effects on CVD endpoints and do not support supplementation of vitamin D to decrease CVD events.
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Affiliation(s)
- Ioanna Gouni-Berthold
- Polyclinic for Endocrinology, Diabetes and Preventive Medicine, University of Cologne, Cologne, Germany
| | - Heiner K Berthold
- Department of Internal Medicine and Geriatrics, Bethel Clinic (EvKB), Bielefeld, Germany
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Cianciolo G, Cappuccilli M, Tondolo F, Gasperoni L, Zappulo F, Barbuto S, Iacovella F, Conte D, Capelli I, La Manna G. Vitamin D Effects on Bone Homeostasis and Cardiovascular System in Patients with Chronic Kidney Disease and Renal Transplant Recipients. Nutrients 2021; 13:1453. [PMID: 33922902 PMCID: PMC8145016 DOI: 10.3390/nu13051453] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
Poor vitamin D status is common in patients with impaired renal function and represents one main component of the complex scenario of chronic kidney disease-mineral and bone disorder (CKD-MBD). Therapeutic and dietary efforts to limit the consequences of uremia-associated vitamin D deficiency are a current hot topic for researchers and clinicians in the nephrology area. Evidence indicates that the low levels of vitamin D in patients with CKD stage above 4 (GFR < 15 mL/min) have a multifactorial origin, mainly related to uremic malnutrition, namely impaired gastrointestinal absorption, dietary restrictions (low-protein and low-phosphate diets), and proteinuria. This condition is further worsened by the compromised response of CKD patients to high-dose cholecalciferol supplementation due to the defective activation of renal hydroxylation of vitamin D. Currently, the literature lacks large and interventional studies on the so-called non-calcemic activities of vitamin D and, above all, the modulation of renal and cardiovascular functions and immune response. Here, we review the current state of the art of the benefits of supplementation with native vitamin D in various clinical settings of nephrological interest: CKD, dialysis, and renal transplant, with a special focus on the effects on bone homeostasis and cardiovascular outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Gaetano La Manna
- Nephrology, Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (G.C.); (M.C.); (F.T.); (L.G.); (F.Z.); (S.B.); (F.I.); (D.C.); (I.C.)
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The Relationship of Vitamin D Deficiency with Severity and Outcome of Acute Stroke. ACTA ACUST UNITED AC 2021; 59:351-358. [PMID: 33855844 DOI: 10.2478/rjim-2021-0013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Indexed: 12/14/2022]
Abstract
Background: There are currently conflicting results regarding the link between vitamin D deficiency and increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke.Methods: This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. The levels of 25-hydroxy vitamin D were evaluated by Electrochemiluminescence (ECL) technique. Clinical severity of stroke on admission as well as on discharge time were evaluated using the National Institutes of Health Stroke Scale (NIHSS) or Modified Rankin (mRS) tools.Results: Mean serum level of vitamin D was 25.51 ± 18.87 ng/mL, ranging from 3.0 to 98.6 ng/ml. There was a significant difference between the two groups (with and without vitamin D deficiency) in terms of stroke severity and disability, as reflected by mRS (P=0.003) and NIHSS evaluation (14.24 ± 9.23 versus 9.73 ± 7.36, P=0.003). Also, regarding patients' clinical condition, the mean NIHSS score in those with deficient and normal levels of vitamin D was 14.24 ± 9.23 and 9.73 ± 7.36, respectively with NIHSS score > 5 in 76.1% and 61.5%, respectively (P = 0.003).Conclusion: According to the results of study, vitamin D status can be related to the severity of stroke. However, considering the cross-sectional design of our study, it could not point out the causality between vitamin D deficiency and acute stroke and further studies are warranted. It is not possible to draw any conclusions in terms of causality. Further studies are required in order to assess the relationship between the serum vitamin D levels and stroke severity.
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Wennogle SA, Olver CS, Shropshire SB. Coagulation status, fibrinolysis, and platelet dynamics in dogs with chronic inflammatory enteropathy. J Vet Intern Med 2021; 35:892-901. [PMID: 33665845 PMCID: PMC7995439 DOI: 10.1111/jvim.16092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/12/2021] [Accepted: 02/19/2021] [Indexed: 12/19/2022] Open
Abstract
Background Coagulation status is poorly understood in dogs with chronic inflammatory enteropathy (CIE). Fibrinolytic activity and platelet dynamics have not been evaluated in CIE dogs. Objectives To assess coagulation status and fibrinolysis in normoalbuminemic CIE dogs (CIE‐N) and CIE dogs with protein‐losing enteropathy (CIE‐PLE) compared to healthy controls (HC). To evaluate thromboelastography (TEG) variable differences between groups and for correlations with clinicopathologic data. To report platelet dynamics in CIE dogs. Animals Twenty‐five client‐owned dogs with CIE (n = 16 CIE‐N; n = 9 CIE‐PLE); 14 HC beagle dogs. Methods All dogs had tissue factor + tissue plasminogen activator TEG. Nine of 25 CIE dogs had whole blood impedance platelet aggregometry. The TEG variables and coagulation data were compared between all CIE vs HC dogs, CIE‐N dogs vs HC, and CIE‐PLE dogs vs HC. Clinicopathologic and coagulation data were available for CIE dogs and assessed for correlation to TEG variables. Results Dogs with CIE had higher maximum amplitude (MA; P < .001), longer clot lysis times (CLTs; P < .001), lower % lysis after 30 minutes (LY30; P < .001), and % lysis after 60 minutes (LY60; P < .001) compared to HC, suggesting hypercoagulability and hypofibrinolysis. When separated out, both CIE‐N and CIE‐PLE dogs had higher MA, longer CLT, and lower LY30 and LY60 compared to HC. Serum albumin and 25‐hydroxyvitamin D (25[OH]D) concentrations, and plasma antithrombin and fibrinogen concentrations moderately correlated with MA. Conclusions and Clinical Importance Normoalbuminemic and hypoalbuminemic CIE dogs were considered hypercoagulable based on TEG compared to HC. Some CIE dogs displayed hypofibrinolytic phenotypes on TEG.
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Affiliation(s)
- Sara A Wennogle
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Christine S Olver
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah B Shropshire
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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Jacob J, Mangelschots E, Michez M, Sanak SN, Leys A. Cross-Sectional Study on Vitamin D, Zinc Oxide and Fatty Acid Status in a Population with a Moderate to High Risk of AMD Identified by the STARS ® Questionnaire. Ophthalmol Ther 2021; 10:299-311. [PMID: 33620690 PMCID: PMC8079536 DOI: 10.1007/s40123-021-00335-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 01/23/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction A prospective study was carried out in Belgium to determine the proportion of subjects with a moderate to high risk of developing age-related macular degeneration (AMD), identified using the STARS® (Simplified Théa AMD Risk-Assessment Scale) questionnaire, who were in need of nutritional supplementation, by assessing the vitamin D, zinc oxide and fatty acid profile status. Methods This multicentre cross-sectional pilot study involved 50 Belgian subjects with no or early AMD, aged > 55 years who were at moderate to high risk for AMD. Subjects were assessed using the STARS® questionnaire, visual acuity assessment, an optical coherence tomography scan of the macula and fundus photography. Blood samples were collected, and serum analyses were performed to determine the the omega-6:omega-3 (Ω6:Ω3) ratio and the levels of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), zinc and cupric oxides and vitamin D. Results Abnormal serum levels for at least one of the micronutrients was detected in 94% of the subjects. Lower than optimal vitamin D levels were found in 76% of the participants, and 68% of the subjects demonstrated at least one abnormal fatty acid profile. The Ω6:Ω3 ratio was above the reference range for normal values in 54% of the subjects; DHA and EPA levels were below the reference range in 60 and 46% of the subjects, respectively; and zinc oxide concentration was below the reference range in 50% of the subjects. Only 12% of the subjects exhibited cupric oxide deficiency. Conclusion In this study, the STARS® questionnaire was used for early identification of patients at moderate to high risk of AMD in real life. These patients presented a suboptimal nutritional status. Further research is needed to determine if specific diet modification or micronutrient supplement intake delays the onset or slows down the progression of AMD in these subjects. Trial Registration Trial registration: ClinicalTrials.Gov, identifier: NCT04482465. Supplementary Information The online version of this article (10.1007/s40123-021-00335-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julie Jacob
- Department of Ophthalmology, Universitair Ziekenhuis Leuven (UZ Leuven), Leuven, Belgium.
| | | | - Marine Michez
- Cliniques Universitaires Saint Luc, Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Serdal N Sanak
- Department of Ophthalmology, CHIREC-Hôpital Delta, Brussels, Belgium
| | - Anita Leys
- Department of Ophthalmology, Universitair Ziekenhuis Leuven (UZ Leuven), Leuven, Belgium
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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.
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Low sun exposure habits is associated with a dose-dependent increased risk of hypertension: a report from the large MISS cohort. Photochem Photobiol Sci 2021; 20:285-292. [PMID: 33721253 DOI: 10.1007/s43630-021-00017-x] [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] [Received: 10/07/2020] [Accepted: 01/27/2021] [Indexed: 12/16/2022]
Abstract
In prospective observational cohort studies, increasing sun exposure habits have been associated with reduced risk of cardiovascular mortality. Our aim was to assess possible observational mechanisms for this phenomenon. A written questionnaire was answered by 23,593 women in the year 2000 regarding risk factors for melanoma, including factors of possible interest for hypertension, such as detailed sun exposure habits, hypertension, marital status, education, smoking, alcohol consumption, BMI, exercise, and chronic high stress. Hypertension was measured by the proxy "use of hypertension medication" 2005-2007, and high stress by "need of anti-depressive medication". Sun exposure habits was assessed by the number of `yes' to the following questions; Do you sunbath during summer?, During winter vacation?, Do you travel south to sunbath?, Or do you use sun bed? Women answering 'yes' on one or two questions had moderate and those answering 'yes' on three or four as having greatest sun exposure. The main outcome was the risk of hypertension by sun exposure habits adjusted for confounding. As compared to those women with the greatest sun exposure, women with low and moderate sun exposure were at 41% and 15% higher odds of hypertension (OR 1.41, 95% CI 1.3‒1.6, p < 0.001 and OR 1.15, 95% CI 1.1‒1.2, p < 0.001), respectively. There was a strong age-related increased risk of hypertension. Other risk factors for hypertension were lack of exercise (OR 1.36), a non-fair phenotype (OR 1.08), chronic high stress level (OR 1.8), and lack of university education (OR 1.3). We conclude that in our observational design sun exposure was associated with a dose-dependent reduced risk of hypertension, which might partly explain the fewer deaths of cardiovascular disease with increasing sun exposure.
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Stratford K, Haykal-Coates N, Thompson L, Farraj A, Hazari M. Early-life persistent vitamin D deficiency-induced cardiovascular dysfunction in mice is mediated by transient receptor potential C channels. J Steroid Biochem Mol Biol 2021; 206:105804. [PMID: 33338589 PMCID: PMC9152789 DOI: 10.1016/j.jsbmb.2020.105804] [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: 08/10/2020] [Revised: 12/07/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Studies indicate that chronic vitamin D deficiency (VDD) may predispose to hypertension, yet, there is very little data characterizing its direct cardiac effects. Vitamin D modulates the function of transient receptor potential C cation channels (TRPC), which is a mechanosensitive cation channel that plays a role in cardiac slow-force responses to hemodynamic changes. The purpose of this study was to determine the cardiac effects of VDD and the potential role of TRPC. METHODS Three-week old mice were placed on a VDD or normal diet (ND) for 19 weeks. Mice were then implanted with radiotelemeters for the measurement of heart rate (HR) and heart rate variability (HRV), while a separate group was anesthetized to measure blood pressure (BP) and left ventricular function using an intraventricular probe. Animals were treated with a TRPC antagonist or vehicle after which they were challenged with dobutamine to measure cardiac responses. RESULTS VDD mice had significantly increased BP (72 ± 3 mmHg vs. 62 ± 2 mmHg) and left ventricular pressure (LVP) (84.6 ± 0.8 mmHg vs. 78.2 ± 2.0 mmHg), and decreased cardiac contractility (-3 % vs. + 11 %) and HR response (+8 % vs. + 13 %) to dobutamine when compared to ND. These responses were blocked by the TRPC antagonist. HRV decreased with increasing dobutamine doses in ND but not VDD mice, however, the antagonist had no effect. CONCLUSION VDD increases BP and alters cardiac mechanical function in mice, the latter appears to be mediated by TRPC, in particular TRPC6. Although the cardiac effects might be due to increased BP, it is likely that VDD also affects the function of the heart directly. This is the first study to demonstrate the potentially deleterious effects of VDD on cardiac function and the role of TRPC6 in this response.
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Affiliation(s)
- Kimberly Stratford
- Curriculum in Toxicology and Environmental Medicine, University of North Carolina - Chapel Hill, Chapel Hill, NC, 27599, United States
| | - Najwa Haykal-Coates
- Inhalation Toxicology Facilities Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States
| | - Leslie Thompson
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States
| | - Aimen Farraj
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States
| | - Mehdi Hazari
- Cardiopulmonary and Immunotoxicology Branch, Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711, United States.
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de la Guía-Galipienso F, Martínez-Ferran M, Vallecillo N, Lavie CJ, Sanchis-Gomar F, Pareja-Galeano H. Vitamin D and cardiovascular health. Clin Nutr 2020; 40:2946-2957. [PMID: 33397599 PMCID: PMC7770490 DOI: 10.1016/j.clnu.2020.12.025] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/18/2020] [Accepted: 12/16/2020] [Indexed: 12/22/2022]
Abstract
The principal source of vitamin D in humans is its biosynthesis in the skin through a chemical reaction dependent on sun exposure. In lesser amounts, the vitamin can be obtained from the diet, mostly from fatty fish, fish liver oil and mushrooms. Individuals with vitamin D deficiency, defined as a serum level of 25 hydroxyvitamin D < 20 ng/dl, should be supplemented. Vitamin D deficiency is a prevalent global problem caused mainly by low exposure to sunlight. The main role of 1,25 dihydroxyvitamin D is the maintenance of calcium and phosphorus homeostasis. However, vitamin D receptors are found in most human cells and tissues, indicating many extra-skeletal effects of the vitamin, particularly in the immune and cardiovascular (CV) systems. Vitamin D regulates blood pressure by acting on endothelial cells and smooth muscle cells. Its deficiency has been associated with various CV risk factors and appears to be linked to a higher mortality and incidence of CV disease (CVD). Several mechanisms have been proposed relating vitamin D deficiency to CV risk factors such as renin-angiotensin-aldosterone system activation, abnormal nitric oxide regulation, oxidative stress or altered inflammatory pathways. However, in the latest randomized controlled trials no benefits of vitamin D supplementation for CVD have been confirmed. Although more work is needed to establish the protective role of vitamin D in this setting, according to current evidences vitamin D supplements should not be recommended for CVD prevention.
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Affiliation(s)
- Fernando de la Guía-Galipienso
- Cardiology Service, Hospital Clínica Benidorm, Alicante, Spain; Glorieta Policlinic, Denia, Alicante, Spain; REMA Sports Cardiology Clinic, Denia, Alicante, Spain
| | - María Martínez-Ferran
- Faculty of Sports Sciences and Physiotherapy, Universidad Europea de Madrid, Madrid, Spain
| | - Néstor Vallecillo
- Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Fabian Sanchis-Gomar
- Dept. of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.
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Association of Milk Consumption and Vitamin D Status in the US Population by Ethnicity: NHANES 2001-2010 Analysis. Nutrients 2020; 12:nu12123720. [PMID: 33276516 PMCID: PMC7761481 DOI: 10.3390/nu12123720] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D has been identified as a nutrient of public health concern, and higher intake of natural or fortified food sources of vitamin D, such as milk, are encouraged by the 2015-2020 Dietary Guidelines for Americans. We, therefore, examined the association of milk consumption and vitamin D status in the United States (US) population. Twenty-four-hour dietary recall data and serum 25(OH)D concentrations were obtained from the National Health and Nutrition Examination Survey 2001-2010 and were analyzed by linear and logistic regression after adjusting for anthropometric and demographic variables. Significance was set at p < 0.05. Approximately 57-80% children and 42-60% adults were milk consumers. Milk intake (especially reduced-fat, low fat and no-fat milk) was positively associated (plinear trend < 0.05) with serum vitamin D status and with a 31-42% higher probability of meeting recommended serum vitamin D (>50 nmol/L) levels among all age groups. Serum vitamin D status was also associated with both type and amount of milk intake depending upon the age and ethnicity. In conclusion, the results indicate that milk consumers consistently have higher serum vitamin D levels and higher probability of meeting recommended levels. Therefore, increasing milk intake may be an effective strategy to improve the vitamin D status of the US population.
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75
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Vitamin D gene polymorphisms and risk of acute cardiovascular events. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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76
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Lee LY, Pandey AK, Maron BA, Loscalzo J. Network medicine in Cardiovascular Research. Cardiovasc Res 2020; 117:2186-2202. [PMID: 33165538 DOI: 10.1093/cvr/cvaa321] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/08/2020] [Accepted: 10/30/2020] [Indexed: 12/21/2022] Open
Abstract
The ability to generate multi-omics data coupled with deeply characterizing the clinical phenotype of individual patients promises to improve understanding of complex cardiovascular pathobiology. There remains an important disconnection between the magnitude and granularity of these data and our ability to improve phenotype-genotype correlations for complex cardiovascular diseases. This shortcoming may be due to limitations associated with traditional reductionist analytical methods, which tend to emphasize a single molecular event in the pathogenesis of diseases more aptly characterized by crosstalk between overlapping molecular pathways. Network medicine is a rapidly growing discipline that considers diseases as the consequences of perturbed interactions between multiple interconnected biological components. This powerful integrative approach has enabled a number of important discoveries in complex disease mechanisms. In this review, we introduce the basic concepts of network medicine and highlight specific examples by which this approach has accelerated cardiovascular research. We also review how network medicine is well-positioned to promote rational drug design for patients with cardiovascular diseases, with particular emphasis on advancing precision medicine.
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Affiliation(s)
- Laurel Y Lee
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Arvind K Pandey
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Bradley A Maron
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.,Department of Cardiology, Boston VA Healthcare System, Boston, MA, USA
| | - Joseph Loscalzo
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
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77
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The relationship between plasma vitamin D level and heart valves calcification in acute coronary syndrome and non acute coronary syndrome patients. Cardiovasc Endocrinol Metab 2020; 10:113-119. [PMID: 34113797 DOI: 10.1097/xce.0000000000000235] [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: 06/17/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
Background There is conflicting data regarding the association between low levels of plasma vitamin D and ischemic heart disease. We aimed to investigate the relationship between plasma vitamin D levels and heart valve calcification in hospitalized patients with ischemic heart disease versus non-ischemic heart disease controls. Methods A prospective case-control study comprising two age and gender-matched groups. The study group included consecutive patients hospitalized due to acute coronary syndrome; the control group included consecutive non-ischemic heart disease patients hospitalized for noncardiac causes. Blood samples for 25-hydroxyvitamin D level were drawn. An echocardiogram was performed during the first 3 days of hospitalization and reviewed for presence and degree of valvular calcification. Results Forty patients with acute coronary syndrome and 40 controls (age 58 ± 11 years, 64% male in both groups) were included. Mean plasma 25-hydroxyvitamin D vitamin level in the entire cohort was 24.5 ± 8 ng/ml. Valve calcification rates were similar in acute coronary syndrome versus non-acute coronary syndrome group (28 vs. 21 had valvular calcification; 18 vs. 12 had aortic valve calcification; 21 vs. 14 had mitral valve calcification, respectively; P = NS for all). We found no significant relationship between vitamin D level and valvular calcification, aortic valve calcification, or mitral valve calcification rate or degree in the entire cohort and in each group alone (P = NS for all). There was a negative correlation between 25-hydroxyvitamin D levels and age in the acute coronary syndrome group (r = -0.399, P = 0.012). Conclusions We did not find a significant relationship between plasma vitamin D levels and the rate or degree of calcification of either aortic/mitral/both valves in hospitalized patients with or without ischemic heart disease.
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78
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Sheikh V, Mozaianimonfared A, Gharakhani M, Poorolajal J, Ph D. Effect of vitamin D supplementation versus placebo on essential hypertension in patients with vitamin D deficiency: a double-blind randomized clinical trial. J Clin Hypertens (Greenwich) 2020; 22:1867-1873. [PMID: 32951301 DOI: 10.1111/jch.13926] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/17/2020] [Accepted: 06/11/2020] [Indexed: 11/27/2022]
Abstract
Findings from randomized trials addressing the effect of vitamin D supplementation and blood pressure are inconsistent and have been the subject of recent debate. This study aimed to assess the effect of vitamin D supplementation on primary hypertension. This double-blind randomized clinical trial was conducted on patients aged 26-84 years with essential hypertension from March 2017 to April 2019. Patients with vitamin D insufficiency (serum vitamin D levels 20-30 ng/ml) or vitamin D deficiency (serum vitamin D levels <20 ng/ml) were enrolled in the study. Patients were randomly assigned to receive vitamin D supplementation or placebo. Systolic and diastolic blood pressure was measured before the intervention and one and two months thereafter. Of 208 patients enrolled, 171 patients remained for analysis. The effect of vitamin D supplementation on systolic blood pressure was statistically significant in the first and second months after the intervention (P=0.004 and P=0.024, respectively). The effect of vitamin D supplementation on diastolic blood pressure was statistically significant in the first month after the intervention (P=0.046), but not in the second month (P=0.885). No evidence of drug side effects was reported in the two groups. The results of this trial are suggestive of the potential benefits of vitamin D supplementation on blood pressure end points. Therefore, the use of vitamin D may be recommended as an adjuvant drug in the treatment of essential hypertension in patients with vitamin D deficiency because it is safe and well-tolerated by the patients and can significantly reduce the systolic and diastolic blood pressure. Trial registration: Iranian Registry of Clinical Trials registration number: IRCT201703129014N151.
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Affiliation(s)
- Vida Sheikh
- Department of Internal Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.,Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azadeh Mozaianimonfared
- Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Gharakhani
- Department of Cardiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Ph D
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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79
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Ye Y, Yang H, Wang Y, Zhao H. A comprehensive genetic and epidemiological association analysis of vitamin D with common diseases/traits in the UK Biobank. Genet Epidemiol 2020; 45:24-35. [PMID: 32918767 DOI: 10.1002/gepi.22357] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/20/2020] [Accepted: 08/27/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D has been intensively studied for its association with human health, but the scope of such association and the causal role of vitamin D remain controversial. We aim to comprehensively investigate the links between vitamin D and human health through both epidemiological and Mendelian randomization (MR) analyses. We examined the epidemiological associations between serum 25-hydroxyvitamin D (25(OH)D) concentration and 90 diseases/traits in 326,409 UK Biobank (UKBB) Europeans. The causal relations between 25(OH)D and 106 diseases/traits were investigated by performing MR analysis using genome-wide significant 25(OH)D-associated variants (N = 143) from the largest UKBB GWAS to date. In epidemiological analysis, we found 25(OH)D was associated with 45 diseases/traits across cardiovascular/metabolic diseases, psychiatric/neurological diseases, autoimmune/inflammatory diseases, cancer, musculoskeletal diseases, and quantitative traits. In MR-analysis, we presented evidence suggesting potential causal role of 25(OH)D in increasing height (β = .064, 95% confidence interval [CI] = 0.019-0.11) and preventing the risk of ovarian cancer (odds ratio [OR] = 0.96, 95% CI = 0.93-0.99), multiple sclerosis (OR = 0.96, 95% CI = 0.94-0.98), leg fracture (OR = 0.60, 95% CI = 0.45-0.80) and femur fracture (OR = 0.53, 95% CI = 0.32-0.84). These findings confirmed associations of vitamin D with a broad spectrum of diseases/traits and supported the potential causal role of vitamin D in promoting health.
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Affiliation(s)
- Yixuan Ye
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA
| | - Hongxi Yang
- Department of Health Service and Care Management, School of Public Health, Tianjin Medical University, Tianjin, China.,Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Yaogang Wang
- Department of Health Service and Care Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Hongyu Zhao
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut, USA.,Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
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80
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Giannelou M, Skarlis C, Stamouli A, Antypa E, Moutsopoulos HM, Mavragani CP. Atherosclerosis in SLE: a potential role for serum parathormone levels. Lupus Sci Med 2020; 7:7/1/e000393. [PMID: 32913010 PMCID: PMC7484862 DOI: 10.1136/lupus-2020-000393] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/28/2020] [Accepted: 07/07/2020] [Indexed: 12/17/2022]
Abstract
Objective A link between bone metabolism and cardiovascular (CV) disease has been suggested mainly in the general population. In the current study we explored whether altered bone metabolism influence CV risk in patients with SLE. Methods In 138 consecutive patients with SLE, atherosclerosis was assessed by the presence of plaque and/or arterial wall thickening in carotid/femoral arteries by ultrasound. Bone mineral density (BMD) levels and hip/spinal cord fractures together with classical CV disease and osteoporosis risk factors including serum 25(OH) vitamin D3 and parathormone (PTH) levels were recorded in all patients. Serum osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-Β ligand were quantitated by commercial ELISA. Statistical analysis included both univariate and multivariate models. Results Abnormal PTH serum concentrations (>65 pg/mL)—but not 25(OH) vitamin D3 serum levels—were identified as a risk factor for both plaque formation and arterial wall thickening in patients with SLE (ORs (95% CIs): 8.2 (1.8 to 37.4) and 3.9 (1.3 to 11.8), respectively). This association remained significant following adjustment for vitamin D3 levels and classical CV risk factors. Moreover, an independent association between osteoporosis with plaque formation and arterial wall thickening was detected following adjustment for total steroid dose, premature menopause and disease duration (ORs (95% CIs): 5.3 (1.1 to 26.2) and 3.5 (1.1 to 11.4), respectively). An inverse correlation between femoral neck BMD values and intima–medial thickness scores was also observed (r: −0.42, p=0.008). Conclusions These findings further strengthen the concept of shared pathophysiological mechanisms between atherogenesis and altered bone metabolism in autoimmune populations, revealing heightened PTH levels as a potential marker for atherosclerosis among patients with SLE.
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Affiliation(s)
- Mayra Giannelou
- Department of Rheumatology, Peripheral General Hospital Athens Georgios Gennimatas, Athens, Greece.,Department of Pathophysiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | - Charalampos Skarlis
- Department of Physiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
| | | | - Eleni Antypa
- Department of Radiology, Peripheral General Hospital Athens Georgios Gennimatas, Athens, Greece
| | | | - Clio P Mavragani
- Department of Physiology, National and Kapodistrian University of Athens School of Medicine, Athens, Greece .,Joint Academic Rheumatology Program, National and Kapodistrian University of Athens School of Medicine, Athens, Greece
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81
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Culha MG, Atalay HA, Canat HL, Alkan I, Ozbir S, Can O, Otunctemur A. The relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels. Aging Male 2020; 23:173-178. [PMID: 29616850 DOI: 10.1080/13685538.2018.1459544] [Citation(s) in RCA: 16] [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] [Indexed: 01/13/2023] Open
Abstract
Background: The aim of this study was to evaluate the relationship between mean platelet volume (MPV) and vitamin D levels according to ED severity.Methods: Between October 2015 and September 2017, patients who applied to the andrology outpatient clinic with an ED complaint were retrospectively reviewed. Patients with diabetes, hypertension, hyperlipidemia, malignancy, late-onset hypogonadism and smokers were not included in the study. The International Erectile Function Index-Erectile Function (IIEF-EF) questionnaire was used to assess the levels of erectile function. According to this scoring system, patients were divided into two groups. IIEF score: between 17 and 25 = mild ED (Group 1) and IIEF score between 16 and 0 = moderate-severe ED (Group 2). Blood samples of the patients were taken from antecubital vein and MPV and 25-hydroxyvitamin D [25(OH)D] levels were evaluated.Results: Ninety patients were included in the study (Group 1: n = 41, Group 2: n = 49). The mean age of the patients was 41.07 ± 8.56 and the mean body mass index (BMI) was 27.59 ± 3.91. 25(OH)D levels were found to be statistically lower in Group 2 (18.85 ± 6.09; 13.98 ± 7.10; p = .001). MPV levels were found to be statistically higher in Group 2 (10.05 ± 0.81; 10.78 ± 1.16; p = .001). Correlation between IIEF-EF scores and 25(OH)D levels was positive (p = .03, r = 0.22). There was negative correlation between IIEF-EF scores and MPV and between 25(OH)D levels and MPV levels [p = .003 for IIEF-EF/MPV, p = .04, r = -0.23 for 25(OH)D/MPV].Conclusion: There is a significant positive correlation between ED severity and 25(OH)D levels and there is a significant negative correlation between ED severity and MPV levels.
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Affiliation(s)
- Mehmet Gokhan Culha
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Hasan Anil Atalay
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Halil Lutfi Canat
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Ilter Alkan
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Sait Ozbir
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Osman Can
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
| | - Alper Otunctemur
- Department of Urology, University of Health Sciences, Okmeydani Training & Research Hospital, Istanbul, Turkey
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82
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Abderhalden LA, Meyer S, Dawson-Hughes B, Orav EJ, Meyer U, de Godoi Rezende Costa Molino C, Theiler R, Stähelin HB, Ruschitzka F, Egli A, Forman JP, Willett WC, Bischoff-Ferrari HA. Effect of daily 2000 IU versus 800 IU vitamin D on blood pressure among adults age 60 years and older: a randomized clinical trial. Am J Clin Nutr 2020; 112:527-537. [PMID: 32542307 DOI: 10.1093/ajcn/nqaa145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/18/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Observational studies report higher blood pressure (BP) among individuals with lower 25-hydroxyvitamin D concentration. Whether dosage of vitamin D supplementation has a differential effect on BP control remains unclear. OBJECTIVE The study aimed to determine if daily vitamin D supplementation with 2000 IU is more effective than 800 IU for BP control among older adults. METHODS This randomized, double-blind, ancillary trial of the Zurich Multiple Endpoint Vitamin D Trial in Knee Osteoarthritis enrolled adults aged ≥60 y who underwent elective surgery due to severe knee osteoarthritis. Participants were randomly assigned to receive high dose (2000 IU) or standard dose (800 IU) daily vitamin D3 for 24 mo. Outcomes included daytime and 24-h mean systolic BP. BP variability and serum 25-hydroxyvitamin D concentration were examined in a post hoc and observational analysis. RESULTS Of the 273 participants randomly assigned, 250 participants completed a follow-up 24-h ambulatory BP monitoring (mean age: 70.4 ± 6.4 y; 47.2% men). The difference in daytime mean systolic BP reduction between the 2000 IU (n = 123) and 800 IU (n = 127) groups was not statistically significant (-2.75 mm Hg vs. -3.94 mm Hg; difference: 1.18 mm Hg; 95% CI: -0.68, 3.05; P = 0.21), consistent with 24-h mean systolic BP. However, systolic BP variability was significantly reduced with 2000 IU (average real variability: -0.37 mm Hg) compared to 800 IU vitamin D3 (0.11 mm Hg; difference: -0.48 mm Hg; 95% CI: -0.94, -0.01; P = 0.045). Independent of group allocation, maximal reductions in mean BP were observed at 28.7 ng/mL of achieved serum 25-hydroxyvitamin D concentrations. CONCLUSIONS While daily 2000 IU and 800 IU vitamin D3 reduced mean systolic BP over 2 y to a small and similar extent, 2000 IU reduced mean systolic BP variability significantly more compared with 800 IU. However, without a placebo control group we cannot ascertain whether vitamin D supplementation effectively reduces BP.This trial was registered at www.clinicaltrials.gov as NCT00599807.
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Affiliation(s)
- Lauren A Abderhalden
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Sandra Meyer
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - E John Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Ursina Meyer
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Caroline de Godoi Rezende Costa Molino
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - Robert Theiler
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | | | - Frank Ruschitzka
- Department of Cardiology, University Hospital Zurich, Zurich, Switzerland
| | - Andreas Egli
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
| | - John P Forman
- Department of Nephrology, Brigham and Women's Hospital, Boston, MA, USA
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.,Centre on Aging and Mobility, University Hospital Zurich and Waid City Hospital, Zurich, Switzerland
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83
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Low Vitamin D Levels and Frailty Status in Older Adults: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12082286. [PMID: 32751730 PMCID: PMC7469050 DOI: 10.3390/nu12082286] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 12/16/2022] Open
Abstract
Serum vitamin D deficiency is widespread among older adults and is a potential modifiable risk factor for frailty. Moreover, frailty has been suggested as an intermediate step in the association between low levels of vitamin D and mortality. Hence, we conducted a systematic review of the literature and meta-analysis to test the possible association of low concentrations of serum 25-hydroxyvitamin D (25(OH)D), a marker of vitamin D status, with frailty in later life. We reviewed cross-sectional or longitudinal studies evaluating populations of older adults and identifying frailty by a currently validated scale. Meta-analyses were restricted to cross-sectional data from studies using Fried’s phenotype to identify frailty. Twenty-six studies were considered in the qualitative synthesis, and thirteen studies were included in the meta-analyses. Quantitative analyses showed significant differences in the comparisons of frail (standardized mean difference (SMD)—1.31, 95% confidence interval (CI) (−2.47, −0.15), p = 0.0271) and pre-frail (SMD—0.79, 95% CI (−1.58, −0.003), p = 0.0491) subjects vs. non-frail subjects. Sensitivity analyses reduced heterogeneity, resulting in a smaller but still highly significant between-groups difference. Results obtained indicate that lower 25(OH)D levels are significantly associated with increasing frailty severity. Future challenges include interventional studies testing the possible benefits of vitamin D supplementation in older adults to prevent/palliate frailty and its associated outcomes.
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84
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Allahyari E, Hanachi P, Ariakia F, Kashfi TE, Ferns GA, Bahrami A, Mobarhan MG. The relationship between neuropsychological function and responsiveness to vitamin D supplementation using artificial neural networks. Nutr Health 2020; 26:285-294. [PMID: 32669041 DOI: 10.1177/0260106020937190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Vitamin D has recently attracted interest for its pleiotropic effects. Vitamin D supplements are a potentially important public health intervention, but the response to supplementation varies between individuals. AIM We aimed to assess the association between several neuropsychological parameters and the magnitude of response to vitamin D supplementation using an artificial neural network method. METHODS Neuropsychological function was assessed in 619 participants using standard questionnaires. The study participants received vitamin D capsules containing 50,000 IU vitamin D per week over 9 weeks. To assess the relationship between responsiveness to vitamin D supplements and the impact on these neuropsychological parameters, the best-performing artificial neural network algorithms were selected from a combination of different transfer functions in hidden and output layers and variable numbers of hidden layers (between two and 50). The performance of the artificial neural network algorithm was assessed by receiver operating characteristic analysis and variables of importance were identified. RESULTS The artificial neural network algorithm with sigmoid transfer function in both hidden and output layers could predict responsiveness to vitamin D supplementation effectively. The sensitivity and specificity were between 0.60 and 0.70 and 0.66 and 0.70, respectively. Cognitive abilities (42.5%), basal vitamin D (21.3%), body mass index (9.5%), and daytime sleepiness (8%) are the most widely used variables to predict changes in serum vitamin D levels. CONCLUSIONS Cognitive abilities status and baseline 25-hydroxyvitamin D are important novel modifiers of the enhancement in circulating 25-hydroxyvitamin D after vitamin D supplementation.
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Affiliation(s)
- Elahe Allahyari
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research Center, 125609Birjand University of Medical Sciences, Birjand, Iran
| | - Parichehr Hanachi
- Department of Biology, Biochemistry Unit, 48408Al Zahra University, Tehran, IR Iran
| | - Fatemeh Ariakia
- Department of Biochemistry, School of Medical, Iran University of Medical Sciences, Tehran, Iran
| | - Toktam Emami Kashfi
- Department of Motor Behavior, Faculty of Sport Sciences, 48440Ferdowsi University of Mashhad, Mashhad, Iran
| | - Gordon A Ferns
- 1949Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Afsane Bahrami
- Cellular and Molecular Research Center, 125609Birjand University of Medical Sciences, Birjand, Iran
| | - Majid Ghayour Mobarhan
- Metabolic Syndrome Research Center, 37552Mashhad University of Medical Sciences, Mashhad, Iran
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85
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Birgani FK, Shahi MM, Cheraghian B, Haybar H. Investigating the Relationship the Severity of Coronary Artery Disease with Serum Levels of Vitamin D in Men after Eliminating the Effect of Diet. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401314666181105143051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:Coronary artery disease (CAD) is one of the most common cardiovascular diseases that can lead to mortality, inability, and lower productivity levels.Objective:The aim of this study was to determine the relationship between serum vitamin D level and cardiovascular risk factors and the severity of CAD after determining and eliminating the confounding effects of dietary patterns in male patients undergoing angiography.Methods:This descriptive-analytic study was carried out on 132 men undergoing angiography during 2017 and 2018. To this end, food frequency questionnaire (FFQ) and physical activity questionnaire (PAQ) were completed for the patients. Fasting blood sugar (FBS), triglyceride, total cholesterol, HDL-C, LDL-C and vitamin D levels were also investigated.Results:Serum vitamin D levels significantly decreased with an increase in CAD severity (p=0.001). Also, low serum levels led to the highest severity of CAD (p=0.005). However, there was no significant difference between patients with vitamin D deficiency with different degrees of CAD (p=0.084). Also, the highest percentage of individuals with normal serum levels of vitamin D was observed in the group without any blocked blood arteries (normal) (p=0.023).Conclusion:This study shows an inverse relationship between serum 25(OH) D level and the severity of CAD. Our data show that vitamin D plays an important role in preventing CAD. These findings could help design prospective studies and clinical trials on a wider scale to investigate the effects of vitamin D interventions in preventing the development of CAD.
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Affiliation(s)
- Farshad K. Birgani
- Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid M. Shahi
- Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Epidemiology, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Cardiovascular Research Center and Department of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Barbarawi M, Kheiri B, Zayed Y, Barbarawi O, Dhillon H, Swaid B, Yelangi A, Sundus S, Bachuwa G, Alkotob ML, Manson JE. Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials: A Meta-analysis. JAMA Cardiol 2020; 4:765-776. [PMID: 31215980 DOI: 10.1001/jamacardio.2019.1870] [Citation(s) in RCA: 235] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Observational studies have reported an association between low serum vitamin D levels and elevated risk of cardiovascular disease (CVD) events, but such studies cannot prove causation because of possible unmeasured confounding. Objective We conducted a meta-analysis of randomized clinical trials that tested the association of vitamin D supplementation with reduced CVD events and all-cause mortality. Data Sources Literature search through PubMed, the Cochrane Library, and Embase was completed by 2 reviewers from each database's inception to December 15, 2018. Study Selection Inclusion criteria were randomized clinical trials that reported the effect of long-term (≥1 year) vitamin D supplementation on CVD events and all-cause mortality. Studies that did not include cardiovascular outcomes were excluded. Data Extraction and Synthesis Data were abstracted independently by 2 authors. Random-effects models were used to report the risk ratios (RRs) and 95% CIs. Main Outcomes and Measures Major adverse cardiovascular events was the primary outcome, and rates of myocardial infarction, stroke or cerebrovascular accident, CVD mortality, and all-cause mortality were the secondary end points. Results Twenty-one randomized clinical trials were included (including 83 291 patients, of whom 41 669 received vitamin D and 41 622 received placebos). The mean (SD) age of trial participants was 65.8 (8.4) years; 61 943 (74.4%) were female. Only 4 trials had prespecified CVD as a primary end point. Vitamin D supplementation compared with placebo was not associated with reduced major adverse cardiovascular events (RR, 1.00 [95% CI, 0.95-1.06]; P = .85) nor the secondary end points of myocardial infarction (RR, 1.00 [95% CI, 0.93-1.08]; P = .92), stroke (RR, 1.06 [95% CI, 0.98-1.15]; P = .16), CVD mortality (RR, 0.98 [95% CI, 0.90-1.07]; P = .68), or all-cause mortality (RR, 0.97 [95% CI, 0.93-1.02]; P = .23). Results were generally consistent by sex, baseline 25-hydroxyvitamin D level, vitamin D dosage, formulation (daily vs bolus dosing), and presence or absence of concurrent calcium administration. Conclusions and Relevance In this updated meta-analysis, vitamin D supplementation was not associated with reduced major adverse cardiovascular events, individual CVD end points (myocardial infarction, stroke, CVD mortality), or all-cause mortality. The findings suggest that vitamin D supplementation does not confer cardiovascular protection and is not indicated for this purpose.
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Affiliation(s)
- Mahmoud Barbarawi
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Babikir Kheiri
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Yazan Zayed
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Owais Barbarawi
- Department of Internal Medicine, Mutah University, Al-Karak, Jordan
| | - Harsukh Dhillon
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Bakr Swaid
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Anitha Yelangi
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Saira Sundus
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | - Ghassan Bachuwa
- Department of Internal Medicine, Hurley Medical Center, Michigan State University, Flint
| | | | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Abstract
Vascular calcification (VC) was defined as the ectopic deposition of calcium-phosphorus complexes on the blood vessel walls. It was a process involving multiple factors and mechanisms, covering the phenotype transition of vascular smooth muscle cells (VSMCs) and release of microvesicles. It was a common end-stage alteration of chronic diseases such as cardiovascular disease and chronic kidney disease. Increasing evidence indicates that mitochondria were involved in the development of VC. Mitochondria provided energy to cells, maintained the stability of cell functions, and participated in a variety of biological behavior. Oxidative stress, autophagy, apoptosis, and mitochondrial DNA (mtDNA) damage could affect the development of VSMCs calcification by alteration of mitochondrial function. This article reviewed the mechanism of calcification and the role of mitochondria in VC, aiming to raise a novel insight into drug development and clinical treatment.
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Bioactive Lipid Signaling in Cardiovascular Disease, Development, and Regeneration. Cells 2020; 9:cells9061391. [PMID: 32503253 PMCID: PMC7349721 DOI: 10.3390/cells9061391] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/23/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022] Open
Abstract
Cardiovascular disease (CVD) remains a leading cause of death globally. Understanding and characterizing the biochemical context of the cardiovascular system in health and disease is a necessary preliminary step for developing novel therapeutic strategies aimed at restoring cardiovascular function. Bioactive lipids are a class of dietary-dependent, chemically heterogeneous lipids with potent biological signaling functions. They have been intensively studied for their roles in immunity, inflammation, and reproduction, among others. Recent advances in liquid chromatography-mass spectrometry techniques have revealed a staggering number of novel bioactive lipids, most of them unknown or very poorly characterized in a biological context. Some of these new bioactive lipids play important roles in cardiovascular biology, including development, inflammation, regeneration, stem cell differentiation, and regulation of cell proliferation. Identifying the lipid signaling pathways underlying these effects and uncovering their novel biological functions could pave the way for new therapeutic strategies aimed at CVD and cardiovascular regeneration.
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Mersa A, Atashbar S, Ahvar N, Salimi A. 1,25‐dihydroxyvitamin D3 prevents deleterious effects of erythromycin on mitochondrial function in rat heart isolated mitochondria. Clin Exp Pharmacol Physiol 2020; 47:1554-1563. [DOI: 10.1111/1440-1681.13328] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 03/31/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Amir Mersa
- Department of Pharmacology and Toxicology School of Pharmacy Ardabil University of Medical Sciences Ardabil Iran
| | - Saman Atashbar
- Department of Pharmacology and Toxicology School of Pharmacy Ardabil University of Medical Sciences Ardabil Iran
| | - Negar Ahvar
- Department of Pharmacology and Toxicology School of Pharmacy Ardabil University of Medical Sciences Ardabil Iran
| | - Ahmad Salimi
- Department of Pharmacology and Toxicology School of Pharmacy Ardabil University of Medical Sciences Ardabil Iran
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Vitamin D supplementation, cardiac events and stroke: A systematic review and meta-regression analysis. IJC HEART & VASCULATURE 2020; 28:100537. [PMID: 32462077 PMCID: PMC7240168 DOI: 10.1016/j.ijcha.2020.100537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/14/2020] [Accepted: 05/10/2020] [Indexed: 12/31/2022]
Abstract
Introduction Observational data has suggested a link between vitamin D deficiency and coronary heart disease (CHD). However, randomized controlled trials (RCTs) have failed to show benefit. The objective of this study is to analyze the RCTs investigating vitamin D supplementation and the risk of CHD and stroke. Methods All RCTs that compared vitamin D supplementation to placebo and evaluated nonfatal myocardial infarction (MI), cardiac mortality, stroke and CHD events (a composite of cardiac mortality, MI, unstable angina and revascularization) were included. Rate ratios (RR) were calculated for each endpoint and to test for heterogeneity of treatment effect (HTE) the Chi2 and I2 tests were used for younger vs. older participants, shorter vs. longer trial duration, vitamin D supplements with vs. without calcium, and daily vs. monthly dosages of vitamin D. A meta-regression was performed with baseline vitamin D concentration as the covariate. Results 22 RCTs were identified (n = 83,200). Vitamin D supplementation had no effect on nonfatal MI (RR 0.98, 95% confidence interval (CI) 0.89–1.08), cardiac death (RR 0.94, CI 0.84–1.06), CHD events (RR 1.00, CI 0.91–1.10), or stroke (RR, 0.97, CI 0.9–1.03). When performing the meta-regression with baseline circulating 25-hydroxyvitamin D (25(OH)D) concentrations as the covariate, vitamin D supplementation’s treatment effect on CVD outcomes was not associated with baseline 25(OH)D. Conclusion Vitamin D did not reduce CHD and stroke. A linear relationship does not exist between baseline 25(OH)D and vitamin D supplementation’s effect on CVD. Vitamin D levels should be checked and repleted in those with an absolute indication.
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91
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Milagres LC, Filgueiras MDS, Rocha NP, Suhett LG, de Albuquerque FM, Juvanhol LL, Franceschini SDCC, de Novaes JF. Cutoff point estimation for serum vitamin D concentrations to predict cardiometabolic risk in Brazilian children. Eur J Clin Nutr 2020; 74:1698-1706. [PMID: 32341487 DOI: 10.1038/s41430-020-0624-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 03/20/2020] [Accepted: 03/25/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND/OBJECTIVES To evaluate serum 25(OH)D concentrations and determine a cutoff point for cardiometabolic risk in children. SUBJECT/METHODS This is a cross-sectional study with a representative sample of 378 8-9-year-old children from all urban schools in the city of Viçosa, MG, Brazil. Sociodemographic data and information on lifestyle, and food consumption were collected. Biochemical evaluation included glucose, triglycerides, leptin, calcidiol [25(OH)D], and parathormone. Body composition was assessed by dual energy X-ray absorptiometry. Cardiometabolic risk was considered when nontraditional risk markers were detected, including triglyceride × glycemia index (TyG index), hyperleptinemia, and hypertriglyceridemic waist phenotype (HWP). The receiver operating characteristic curve (ROC) was used to define the cutoff point for serum 25(OH)D to predict cardiometabolic risk. RESULTS 25(OH)D showed better predictive capacity for grouping of cardiometabolic risk markers than for either single or paired markers. The area under the curve for grouping of risk markers was 0.636 (95% CI: 0.585, 0.685, P < 0.001). The cutoff point to predict cardiometabolic risk was defined as 32.0 ng/mL. CONCLUSION 25(OH)D presented good predictive capacity for cardiometabolic risk and 25(OH)D concentration higher than 32 ng/mL was associated with a 49% reduction of cardiometabolic risk prevalence in prepubertal Brazilian children.
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Affiliation(s)
- Luana Cupertino Milagres
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil.
| | - Mariana De Santis Filgueiras
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Naruna Pereira Rocha
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Lara Gomes Suhett
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Fernanda Martins de Albuquerque
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | - Leidjaira Lopes Juvanhol
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
| | | | - Juliana Farias de Novaes
- Department of Nutrition and Health, Biological Sciences Center, Federal University of Viçosa, Viçosa, Minas Gerais, 36570-900, Brazil
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Abstract
Objective A growing body of research indicates that there exists a correlation between Vit D deficiency and cardiovascular diseases (CVD). In addition to being genetically determined, it is strongly influenced by lifestyle factors. In this study, Vit D and its interrelated factors have been studied as profile marker for identifying the risk of CVD in patients. Methods The present study includes comparison of a total 200 adults CVD patients with the healthy patients as control, by measuring their serum lipid levels and Vit D concentrations with other CVD risk factors. Results The average serum Vit D in CVD patients and controls are found to be 22.55±6.2 ng/ml and 37.62±3.2 ng/ml respectively, showing that 63% of CVD patients and 35% of controls are Vit D deficient. Serum lipids levels were considered as marker for patients having CVD which include high levels of total cholesterol, triglycerides, and low-density lipoprotein-cholesterol while low levels of high-density lipoproteins-cholesterol levels. Other risk factors like hypertension, lifestyle, smoking, dietary factors and nutritional status shows significantly correlation for CVD patients compared to controls. Conclusion Literature supports the relationship between lipid profile and Vit D level by using this as a profile marker for CVD patients. Our study also suggests the same that vitamin D can be used as profile marker for cardiovascular diseases.
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Affiliation(s)
- Deepak Oberoi
- Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Vinit Mehrotra
- Department of Biochemistry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Anurag Rawat
- Department of Pediatrics, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Fam JM, Khoo CY, Lau YH, Lye WK, Cai XJ, Choong LHL, Allen JC, Yeo KK. Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population. Singapore Med J 2020; 62:300-304. [PMID: 32179924 DOI: 10.11622/smedj.2020025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years. RESULTS 274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE. CONCLUSION Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.
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Affiliation(s)
- Jiang Ming Fam
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Chun Yuan Khoo
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Yee How Lau
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | | | - Xinzhe James Cai
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | | | | | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre Singapore, Singapore
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94
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Berardi S, Giardullo L, Corrado A, Cantatore FP. Vitamin D and connective tissue diseases. Inflamm Res 2020; 69:453-462. [PMID: 32172354 DOI: 10.1007/s00011-020-01337-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/04/2020] [Accepted: 03/09/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE AND DESIGN Recently, many studies have shown that the biologically active form of vitamin D-1,25(OH)2 D-is involved in many biological processes, including immune system modulation, and patients affected by various autoimmune diseases, such as connective tissue diseases (CTD), showed low levels of vitamin D. It is not clear if vitamin D deficiency is involved in the pathogenesis of autoimmune diseases or it is a consequence. MATERIAL We carried out a review of literature to summarize the existing connections between 25-OH vitamin D and CTD. METHODS We searched for articles on PubMed by keywords: vitamin D, connective tissue diseases, systemic lupus erythematosus, Sjogren's syndrome, systemic sclerosis, undifferentiated connective tissue disease. RESULTS The relationship between vitamin D and CTD is still not very clear, despite many studies having been performed and some data suggest a connection between these diseases and 25-OH vitamin D levels. CONCLUSIONS The limitations of the study, such as the heterogeneity of patients, methods used to measure vitamin D serum concentration and other biases, do not lead to unequivocal results to demonstrate a direct link between low vitamin D serum levels and autoimmune diseases. Further studies are needed to resolve conflicting results.
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Affiliation(s)
- Stefano Berardi
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy.
| | - Liberato Giardullo
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
| | - Addolorata Corrado
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
| | - Francesco Paolo Cantatore
- Department of Medical and Surgical Sciences, Rheumatology Clinic, Ospedali Riuniti Foggia, University of Foggia, Viale Pinto 1, 71121, Foggia, Italy
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Zhang Q, Wu Y, Lu Y, Fei X. Role of vitamin D in risk factors of patients with type 2 diabetes mellitus. Med Clin (Barc) 2020; 154:151-156. [PMID: 31255367 DOI: 10.1016/j.medcli.2019.04.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Previous observational studies have suggested that low vitamin D status is associated with high circulating C-reactive protein levels, as well as other plasma inflammatory cytokines. However, there is no study to explore the relationship between vitamin D status and Lp-PLA2, a new biomarker of vascular-specific inflammation. The aim of this study was to examine the association between vitamin D status and circulating Lp-PLA2 levels in subjects with type 2 diabetes mellitus. MATERIAL AND METHODS This descriptive cross-sectional study enrolled diabetic subjects who underwent physical examination at Taizhou People's Hospital between August 2016 and January 2017. Blood pressure, anthropometry, metabolic profiles, serum 25(OH)D levels and Lp-PLA2 mass levels were measured in all participants. RESULTS A total of 196 participants were recruited into this study. The vitamin D insufficiency group had higher serum LP-PLA2 levels than the vitamin D sufficiency group (t=-2.765, p=.005). A significant negative correlation was noted between Lp-PLA2 and 25(OH)D in the vitamin D insufficiency group (r=-0.364, p=0.009). However, no significant relationship between serum Lp-PLA2 concentration and 25(OH)D levels was observed in subjects with vitamin D sufficiency. CONCLUSIONS From this cohort of patients with type 2 diabetes, regardless of traditional cardiovascular risk factors, we observed a statistically significant inverse relation between Lp-PLA2 and 25(OH)D at levels <30ng/mL.
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Affiliation(s)
- Qingqing Zhang
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China.
| | - Yucheng Wu
- Department of Cardiology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
| | - Yu Lu
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
| | - Xiaoqiang Fei
- Department of Endocrinology, The Affiliated Taizhou People's Hospital of Nantong University, Taizhou 225300, Jiangsu, China
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Vitamin D Deficient Older Adults Are More Prone to Have Metabolic Syndrome, but Not to a Greater Number of Metabolic Syndrome Parameters. Nutrients 2020; 12:nu12030748. [PMID: 32178228 PMCID: PMC7146307 DOI: 10.3390/nu12030748] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/08/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022] Open
Abstract
This study investigated the relationship between metabolic parameters and low serum 25-hydroxyvitamin D (25(OH)D) levels in older adults (n = 265). They were assessed for anthropometrics and metabolic measurements, including 25(OH)D, insulin, glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG) and other inflammatory markers. Vitamin D deficiency was defined as a 25(OH)D level below 50 nmol/L. Comparisons between groups were performed using Wilcoxon-Mann-Whitney or Pearson's Chi-squared test. A multivariate adjusted Poisson regression was used to model the number of metabolic parameters as a function of a set of explanatory variables. Subjects with 25(OH)D deficiency were predominantly females and presented higher body weight, body mass index, waist circumference, triglycerides and Tumor Necrosis Factor-α (TNF-α), and higher insulin resistance. Metabolic syndrome was also more prevalent among 25(OH)D-deficient subjects. In those without metabolic syndrome, 25(OH)D deficiency was related only to obesity and higher insulin resistance. Female sex, hypertension, higher waist circumference and higher levels of hemoglobin A1C (%), HDL-C, and TG were significantly associated with an increased number of metabolic syndrome parameters after adjusting for covariates, but 25(OH)D was not. The fact that serum 25(OH)D concentration was inversely associated with metabolic syndrome and insulin resistance not only reaffirms the relevance to consider serum 25(OH)D concentration as an influencing factor for insulin resistance, but also the need to actively screen for hypovitaminosis D in all patients with this condition.
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97
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Dibaba DT. Effect of vitamin D supplementation on serum lipid profiles: a systematic review and meta-analysis. Nutr Rev 2020; 77:890-902. [PMID: 31407792 DOI: 10.1093/nutrit/nuz037] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
CONTEXT Vitamin D deficiency is highly prevalent across the world. The existing evidence suggests vitamin D may have beneficial effects on serum lipid profiles and thus cardiovascular health. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the effect of vitamin D supplementation on serum lipid profiles. DATA SOURCE Original randomized controlled trials (RCTs) examining the effect of vitamin D supplementation on serum lipid profiles and published before July 2018 were identified by searching online databases, including PubMed, Google Scholar, and ScienceDirect, using a combination of relevant keywords. DATA EXTRACTION Data on study characteristics, effect size, measure of variation, type of vitamin D supplementation, and duration of follow-up were extracted by the author. DATA ANALYSIS PRISMA guidelines for systematic reviews were followed. Random effects (DerSimonian and Laird [D-V)] models were used to pool standardized mean differences in total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides between the active and the placebo arms of RCT studies. Between-study heterogeneities were assessed using Cochrane Q and I2, and publication bias was assessed using Begg's test, Egger's test, and funnel plot. RESULTS A total of 41 RCTs comprising 3434 participants (n = 1699 in the vitamin D supplementation arm and n = 1735 in the placebo arm) were identified and included in the meta-analysis. Approximately 63.4% of study participants were women, with 14 studies conducted entirely among women. Approximately 24% of the trials had follow-up duration >6 months, whereas the remaining 76% had follow-up duration of <6 months. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) for comparing the change from baseline to follow-up between the vitamin D supplementation arm and the placebo (control) arm were as follows: total cholesterol = -0.17 (-0.28 to -0.06); LDL cholesterol = -0.12 (-0.23 to -0.01); triglycerides = -0.12 (-0.25 to 0.01); and HDL cholesterol = -0.19 (-0.44 to 0.06). After removing a trial that was an outlier based on the magnitude of the effect size, the SMD for triglycerides was -0.15 (-0.24 to -0.06) and that for HDL cholesterol was -0.10 (-0.28 to 0.09). The improvements in total cholesterol and triglycerides were more pronounced in participants with baseline vitamin D deficiency. CONCLUSIONS Vitamin D supplementation appeared to have a beneficial effect on reducing serum total cholesterol, LDL cholesterol, and triglyceride levels but not HDL cholesterol levels. Vitamin D supplementation may be useful in hypercholesterolemia patients with vitamin D insufficiency who are at high risk of cardiovascular diseases.
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Affiliation(s)
- Daniel T Dibaba
- TN-Clinical and Translational Science Institute, University of Tennessee, Health Science Center, Memphis, Tennessee, USA; and the Department of Epidemiology, College of Public Health, and the Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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98
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Kim C, Lee SH, Lim JS, Kim Y, Jang MU, Oh MS, Jung S, Lee JH, Yu KH, Lee BC. Impact of 25-Hydroxyvitamin D on the Prognosis of Acute Ischemic Stroke: Machine Learning Approach. Front Neurol 2020; 11:37. [PMID: 32082247 PMCID: PMC7005206 DOI: 10.3389/fneur.2020.00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/10/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Purpose: Vitamin D is a predictor of poor outcome for cardiovascular disease. We evaluated whether serum 25-hydroxyvitamin D level was associated with poor outcome in patients with acute ischemic stroke (AIS) using machine learning approach. Materials and Methods: We studied a total of 328 patients within 7 days of AIS onset. Serum 25-hydroxyvitamin D level was obtained within 24 h of hospital admission. Poor outcome was defined as modified Rankin Scale score of 3-6. Logistic regression and extreme gradient boosting algorithm were used to assess association of 25-hydroxyvitamin D with poor outcome. Prediction performances were compared with area under ROC curve and F1 score. Results: Mean age of patients was 67.6 ± 13.3 years. Of 328 patients, 59.1% were men. Median 25-hydroxyvitamin D level was 10.4 (interquartile range, 7.1-14.8) ng/mL and 47.2% of patients were 25-hydroxyvitamin D-deficient (<10 ng/mL). Serum 25-hydroxyvitamin D deficiency was a predictor for poor outcome in multivariable logistic regression analysis (odds ratio, 3.38; 95% confidence interval, 1.24-9.18, p = 0.017). Stroke severity, age, and 25-hydroxyvitamin D level were also significant predictors in extreme gradient boosting classification algorithm. Performance of extreme gradient boosting algorithm was comparable to those of logistic regression (AUROC, 0.805 vs. 0.746, p = 0.11). Conclusions: 25-hydroxyvitamin D deficiency was highly prevalent in Korea and low 25-hydroxyvitamin D level was associated with poor outcome in patients with AIS. The machine learning approach of extreme gradient boosting was also useful to assess stroke prognosis along with logistic regression analysis.
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Affiliation(s)
- Chulho Kim
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea.,Chuncheon Translational Research Center, College of Medicine, Hallym University, Chuncheon, South Korea
| | - Sang-Hwa Lee
- Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, South Korea
| | - Jae-Sung Lim
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Yerim Kim
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Min Uk Jang
- Department of Neurology, Dongtan Sacred Heart Hospital, Dongtan, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - San Jung
- Department of Neurology, Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Ju-Hun Lee
- Department of Neurology, Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
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Davey Smith G, Holmes MV, Davies NM, Ebrahim S. Mendel's laws, Mendelian randomization and causal inference in observational data: substantive and nomenclatural issues. Eur J Epidemiol 2020; 35:99-111. [PMID: 32207040 PMCID: PMC7125255 DOI: 10.1007/s10654-020-00622-7] [Citation(s) in RCA: 112] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/09/2020] [Indexed: 12/16/2022]
Abstract
We respond to criticisms of Mendelian randomization (MR) by Mukamal, Stampfer and Rimm (MSR). MSR consider that MR is receiving too much attention and should be renamed. We explain how MR links to Mendel's laws, the origin of the name and our lack of concern regarding nomenclature. We address MSR's substantive points regarding MR of alcohol and cardiovascular disease, an issue on which they dispute the MR findings. We demonstrate that their strictures with respect to population stratification, confounding, weak instrument bias, pleiotropy and confounding have been addressed, and summarise how the field has advanced in relation to the issues they raise. We agree with MSR that "the hard problem of conducting high-quality, reproducible epidemiology" should be addressed by epidemiologists. However we see more evidence of confrontation of this issue within MR, as opposed to conventional observational epidemiology, within which the same methods that have demonstrably failed in the past are simply rolled out into new areas, leaving their previous failures unexamined.
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Affiliation(s)
- George Davey Smith
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK.
| | - Michael V Holmes
- Medical Research Council Population Health Research Unit (MRC PHRU), Department of Population Health, University of Oxford, Nuffield, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Neil M Davies
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK
| | - Shah Ebrahim
- London School of Hygiene and Tropical Medicine, London, UK
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100
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Kim JM, Lee WS, Kim J. Therapeutic strategy for atherosclerosis based on bone-vascular axis hypothesis. Pharmacol Ther 2020; 206:107436. [DOI: 10.1016/j.pharmthera.2019.107436] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 12/19/2022]
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