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Tattoli I, Mathew AR, Verrienti A, Pallotta L, Severi C, Andreola F, Cavallucci V, Giorgi M, Massimi M, Bencini L, Fidaleo M. The Interplay between Liver and Adipose Tissue in the Onset of Liver Diseases: Exploring the Role of Vitamin Deficiency. Cells 2024; 13:1631. [PMID: 39404394 PMCID: PMC11475612 DOI: 10.3390/cells13191631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 09/24/2024] [Accepted: 09/24/2024] [Indexed: 10/19/2024] Open
Abstract
The deficiency of vitamins, a condition known as "hidden hunger", causes comprehensive pathological states. Research over the years has identified a relationship between liver diseases and hypovitaminosis or defects in vitamin metabolism. The exact mechanisms remain elusive; however, the crucial involvement of specific vitamins in metabolic functions, alongside the reclassification of liver disease as metabolic dysfunction-associated steatotic liver disease (MASLD), has prompted researchers to investigate the potential cause-effect dynamics between vitamin deficiency and liver disease. Moreover, scientists are increasingly investigating how the deficiency of vitamins might disrupt specific organ crosstalk, potentially contributing to liver disease. Although the concept of a dysmetabolic circuit linking adipose tissue and the liver, leading to liver disease, has been discussed, the possible involvement of vitamin deficiency in this axis is a relatively recent area of study, with numerous critical aspects yet to be fully understood. In this review, we examine research from 2019 to July 2024 focusing on the possible link between liver-adipose tissue crosstalk and vitamin deficiency involved in the onset and progression of non-alcoholic fatty liver disease (NAFLD). Studies report that vitamin deficiency can affect the liver-adipose tissue axis, mainly affecting the regulation of systemic energy balance and inflammation.
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Affiliation(s)
- Ivan Tattoli
- Oncology General Surgery, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (I.T.); (L.B.)
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (M.G.)
| | - Aimee Rachel Mathew
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (M.G.)
| | - Antonella Verrienti
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.V.); (L.P.); (C.S.)
| | - Lucia Pallotta
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.V.); (L.P.); (C.S.)
| | - Carola Severi
- Department of Translational and Precision Medicine, Sapienza University of Rome, 00161 Rome, Italy; (A.V.); (L.P.); (C.S.)
| | - Fausto Andreola
- Liver Failure Group, Institute for Liver and Digestive Health, Royal Free Hospital, University College London, London NW3 2PF, UK;
| | - Virve Cavallucci
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, 00168 Rome, Italy;
| | - Mauro Giorgi
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (M.G.)
| | - Mara Massimi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Lapo Bencini
- Oncology General Surgery, Azienda Ospedaliero Universitaria Careggi, 50139 Florence, Italy; (I.T.); (L.B.)
| | - Marco Fidaleo
- Department of Biology and Biotechnologies “Charles Darwin”, Sapienza University of Rome, 00185 Rome, Italy; (A.R.M.); (M.G.)
- Research Center for Nanotechnology for Engineering of Sapienza (CNIS), Sapienza University of Rome, 00185 Rome, Italy
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Pludowski P, Marcinowska-Suchowierska E, Togizbayev G, Belaya Z, Grant WB, Pilz S, Holick MF. Daily and Weekly "High Doses" of Cholecalciferol for the Prevention and Treatment of Vitamin D Deficiency for Obese or Multi-Morbidity and Multi-Treatment Patients Requiring Multi-Drugs-A Narrative Review. Nutrients 2024; 16:2541. [PMID: 39125420 PMCID: PMC11314300 DOI: 10.3390/nu16152541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
Daily vitamin D supplementation using higher than normal dosing (up to the upper limit value) and intermittent (once or twice per week) dosing were studied in patients with increased risk of vitamin D deficiency. Using a PubMed database, a thorough search for published randomized controlled trials and other studies was conducted, and the results were analyzed. This review provides an overview of the use of 7000 IU daily, 30,000 IU per week or twice weekly, and 50,000 IU weekly of vitamin D for obtaining and maintaining 25(OH)D concentrations of at least 30 ng/mL in patients at high risk of vitamin D deficiency. The abovementioned dosages should be considered in adults with obesity, liver disease or malabsorption syndromes, or multi-diseased patients, mainly seniors requiring multi-drug treatment, including drugs affecting vitamin D metabolism. The simple schedules of 7000 IU/day, 30,000 IU/week or twice weekly, and 50,000 IU/week for use by patients with an increased risk of vitamin D deficiency were provided for consideration. Without monitoring of 25(OH)D, daily doses of 7000 IU or intermittent doses of 30,000 IU/week should be considered for a prolonged time as prophylactic or maintenance doses, mainly in obese patients, patients with liver disease and patients with malabsorption syndromes. For the treatment of possible vitamin D deficiency without assessment of 25(OH)D in these groups, intermittent doses of 30,000 IU twice weekly or 50,000 IU per week should be considered for a 6-8-week period only. The higher daily doses or the intermittent doses suggested above are effective, safe and responsive based on patient's preferences.
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Affiliation(s)
- Pawel Pludowski
- Department of Clinical Biochemistry, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland
| | - Ewa Marcinowska-Suchowierska
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland;
- Department of Geriatrics and Gerontology, School of Public Health, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
| | - Galymzhan Togizbayev
- Department of Rheumatology, Kazakh National Medical University, 050000 Almaty, Kazakhstan;
| | - Zhanna Belaya
- The National Medical Research Center for Endocrinology, 117036 Moscow, Russia;
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA 94109, USA;
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria;
| | - Michael F. Holick
- Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA;
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Peña-Vázquez GI, Arredondo-Arenillas A, Serrano-Sandoval SN, Antunes-Ricardo M. Functional foods lipids: unraveling their role in the immune response in obesity. Crit Rev Food Sci Nutr 2024:1-22. [PMID: 39073763 DOI: 10.1080/10408398.2024.2382942] [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: 07/30/2024]
Abstract
Functional lipids are lipids that are found in food matrices and play an important role in influencing human health as their role goes beyond energy storage and structural components. Ongoing research into functional lipids has highlighted their potential to modulate immune responses and other mechanisms associated with obesity, along with its comorbidities. These lipids represent a new field that may offer new therapeutic and preventive strategies for these diseases by understanding their contribution to health. In this review, we discussed in-depth the potential food sources of functional lipids and their reported potential benefit of the major lipid classification: based on their composition such as simple, compound, and derived lipids, and based on their function such as storage and structural, by investigating the intricate mechanisms through which these lipids interact in the human body. We summarize the key insights into the bioaccessibility and bioavailability of the most studied functional lipids. Furthermore, we review the main immunomodulatory mechanisms reported in the literature in the past years. Finally, we discuss the perspectives and challenges faced in the food industry related to functional lipids.
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Affiliation(s)
- Gloria Itzel Peña-Vázquez
- Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Monterrey, NL, México
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey, Monterrey, NL, México
| | - Ana Arredondo-Arenillas
- Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Monterrey, NL, México
| | - Sayra N Serrano-Sandoval
- Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Monterrey, NL, México
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey, Monterrey, NL, México
| | - Marilena Antunes-Ricardo
- Tecnologico de Monterrey, Centro de Biotecnología FEMSA, Escuela de Ingeniería y Ciencias, Monterrey, NL, México
- Tecnologico de Monterrey, Institute for Obesity Research, Monterrey, Monterrey, NL, México
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Ren Y, Huang P, Zhang L, Tang YF, Luo SL, She Z, Peng H, Chen YQ, Luo JW, Duan WX, Liu LJ, Liu LQ. Dual Regulation Mechanism of Obesity: DNA Methylation and Intestinal Flora. Biomedicines 2024; 12:1633. [PMID: 39200098 PMCID: PMC11351752 DOI: 10.3390/biomedicines12081633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 09/01/2024] Open
Abstract
Obesity is a multifactorial chronic inflammatory metabolic disorder, with pathogenesis influenced by genetic and non-genetic factors such as environment and diet. Intestinal microbes and their metabolites play significant roles in the occurrence and development of obesity by regulating energy metabolism, inducing chronic inflammation, and impacting intestinal hormone secretion. Epigenetics, which involves the regulation of host gene expression without changing the nucleotide sequence, provides an exact direction for us to understand how the environment, lifestyle factors, and other risk factors contribute to obesity. DNA methylation, as the most common epigenetic modification, is involved in the pathogenesis of various metabolic diseases. The epigenetic modification of the host is induced or regulated by the intestinal microbiota and their metabolites, linking the dynamic interaction between the microbiota and the host genome. In this review, we examined recent advancements in research, focusing on the involvement of intestinal microbiota and DNA methylation in the etiology and progression of obesity, as well as potential interactions between the two factors, providing novel perspectives and avenues for further elucidating the pathogenesis, prevention, and treatment of obesity.
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Affiliation(s)
- Yi Ren
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
- Department of Pediatrics, Haikou Hospital of the Maternal and Child Health, Haikou 570100, China
- Department of Children’s Healthcare, Hainan Modern Women and Children’s Medical, Haikou 570100, China
| | - Peng Huang
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Lu Zhang
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yu-Fen Tang
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Sen-Lin Luo
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Zhou She
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Hong Peng
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Yu-Qiong Chen
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Jin-Wen Luo
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Wang-Xin Duan
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Ling-Juan Liu
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
| | - Li-Qun Liu
- Department of Pediatrics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (Y.R.); (P.H.); (L.Z.); (Y.-F.T.); (S.-L.L.); (Z.S.); (H.P.); (Y.-Q.C.); (J.-W.L.); (W.-X.D.); (L.-J.L.)
- Children’s Brain Development and Brain Injury Research Office, The Second Xiangya Hospital of Central South University, Changsha 410011, China
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Jain SK, Justin Margret J, Abrams SA, Levine SN, Bhusal K. The Impact of Vitamin D and L-Cysteine Co-Supplementation on Upregulating Glutathione and Vitamin D-Metabolizing Genes and in the Treatment of Circulating 25-Hydroxy Vitamin D Deficiency. Nutrients 2024; 16:2004. [PMID: 38999752 PMCID: PMC11243476 DOI: 10.3390/nu16132004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/14/2024] Open
Abstract
Vitamin D receptors are expressed in many organs and tissues, which suggests that vitamin D (VD) affects physiological functions beyond its role in maintaining bone health. Deficiency or inadequacy of 25(OH)VD is widespread globally. Population studies demonstrate that a positive association exists between a high incidence of VD deficiency and a high incidence of chronic diseases, including dementia, diabetes, and heart disease. However, many subjects have difficulty achieving the required circulating levels of 25(OH)VD even after high-dose VD supplementation, and randomized controlled clinical trials have reported limited therapeutic success post-VD supplementation. Thus, there is a discordance between the benefits of VD supplementation and the prevention of chronic diseases in those with VD deficiency. Why this dissociation exists is currently under debate and is of significant public interest. This review discusses the downregulation of VD-metabolizing genes needed to convert consumed VD into 25(OH)VD to enable its metabolic action exhibited by subjects with metabolic syndrome, obesity, and other chronic diseases. Research findings indicate a positive correlation between the levels of 25(OH)VD and glutathione (GSH) in both healthy and diabetic individuals. Cell culture and animal experiments reveal a novel mechanism through which the status of GSH can positively impact the expression of VD metabolism genes. This review highlights that for better success, VD deficiency needs to be corrected at multiple levels: (i) VD supplements and/or VD-rich foods need to be consumed to provide adequate VD, and (ii) the body needs to be able to upregulate VD-metabolizing genes to convert VD into 25(OH)VD and then to 1,25(OH)2VD to enhance its metabolic action. This review outlines the association between 25(OH)VD deficiency/inadequacy and decreased GSH levels, highlighting the positive impact of combined VD+LC supplementation on upregulating GSH, VD-metabolizing genes, and VDR. These effects have the potential to enhance 25(OH)VD levels and its therapeutic efficacy.
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Affiliation(s)
- Sushil K. Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA;
| | - Jeffrey Justin Margret
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA;
| | - Steven A. Abrams
- Department of Pediatrics and Dell Pediatric Research Institute, Dell Medical School at the University of Texas at Austin, Austin, TX 78723, USA;
| | - Steven N. Levine
- Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (S.N.L.); (K.B.)
| | - Kamal Bhusal
- Department of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA 71103, USA; (S.N.L.); (K.B.)
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Dominguez LJ, Veronese N, Marrone E, Di Palermo C, Iommi C, Ruggirello R, Caffarelli C, Gonnelli S, Barbagallo M. Vitamin D and Risk of Incident Type 2 Diabetes in Older Adults: An Updated Systematic Review and Meta-Analysis. Nutrients 2024; 16:1561. [PMID: 38892495 PMCID: PMC11173817 DOI: 10.3390/nu16111561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Vitamin D deficiency is very common worldwide, particularly in old age, when people are at the highest risk of the negative adverse consequences of hypovitaminosis D. Additionally to the recognized functions in the regulation of calcium absorption, bone remodeling, and bone growth, vitamin D plays a key role as a hormone, which is supported by various enzymatic, physiological, metabolic, and pathophysiological processes related to various human organs and systems. Accruing evidence supports that vitamin D plays a key role in pancreatic islet dysfunction and insulin resistance in type 2 diabetes. From an epidemiological viewpoint, numerous studies suggest that the growing incidence of type 2 diabetes in humans may be linked to the global trend of prevalent vitamin D insufficiency. In the past, this association has raised discussions due to the equivocal results, which lately have been more convincing of the true role of vitamin D supplementation in the prevention of incident type 2 diabetes. Most meta-analyses evaluating this role have been conducted in adults or young older persons (50-60 years old), with only one focusing on older populations, even if this is the population at greater risk of both hypovitaminosis D and type 2 diabetes. Therefore, we conducted an update of the previous systematic review and meta-analysis examining whether hypovitaminosis D (low serum 25OHD levels) can predict incident diabetes in prospective longitudinal studies among older adults. We found that low 25OHD was associated with incident diabetes in older adults even after adjusting for several relevant potential confounders, confirming and updating the results of the only previous meta-analysis conducted in 2017.
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Affiliation(s)
- Ligia J. Dominguez
- Department of Medicine and Surgery, “Kore” University of Enna, 94100 Enna, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
| | - Eliana Marrone
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
| | - Carla Di Palermo
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
| | - Candela Iommi
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
| | - Rosaria Ruggirello
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
| | - Carla Caffarelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (C.C.); (S.G.)
| | - Stefano Gonnelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy; (C.C.); (S.G.)
| | - Mario Barbagallo
- Geriatric Unit, Department of Medicine, University of Palermo, 90127 Palermo, Italy; (N.V.); (E.M.); (C.D.P.); (C.I.); (R.R.); (M.B.)
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da Cruz SP, da Cruz SP, Pereira S, Saboya C, Ramalho A. Vitamin D and the Metabolic Phenotype in Weight Loss After Bariatric Surgery: A Longitudinal Study. Obes Surg 2024; 34:1561-1568. [PMID: 38459277 DOI: 10.1007/s11695-024-07148-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE To evaluate the influence of vitamin D (VD) concentrations coupled with metabolic phenotypes preoperatively and 6 months after Roux-en-Y gastric bypass (RYGB) on body variables and weight loss. MATERIALS AND METHODS A longitudinal, retrospective, analytical study comprising 30 adult individuals assessed preoperatively (T0) and 6 months (T1) after undergoing Roux-en-Y gastric bypass. The participants were distributed preoperatively into metabolically healthy obese (MHO) and metabolically unhealthy obese individuals (MUHO) according to the HOMA-IR classification, as well as the adequacy and inadequacy of vitamin D concentrations in the form of 25(OH)D. All participants were assessed for weight, height, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), visceral adiposity index (VAI), body circularity index (BCI), body adiposity index (BAI), weight loss, and assessment of 25(OH)D and 1,25(OH)2D concentrations using high-performance liquid chromatography with an ultraviolet detector (HPLC-UV). The statistical program used was SPSS version 21. RESULTS VD adequacy and a healthy phenotype in the preoperative period may play an important role concerning body fat distribution, as the body averages for WHtR (0.020*) and BCI (0.020*) were lower in MHO participants. In comparison, those with VD inadequacy and MUHOs had higher BAI averages (0.000*) in the postoperative period. Furthermore, it is possible that VD inadequacy before and after RYGB, even in the presence of an unhealthy phenotype, may contribute to the increase in VAI values (0.029*) after this surgery. Only those with inadequate VD and MUHOs had higher 25(OH)D concentrations. Besides, this unhealthy phenotype had a greater reduction in BMI in the early postoperative period (p < 0.001). CONCLUSION This study suggests that VD adequacy and the presence of a healthy phenotype appear to have a positive impact on the reduction of visceral fat in the context of pre- and postoperative obesity. In addition, there was a greater weight reduction in those with VD inadequacy and in MUHO, which suggests that the volumetric dilution effect of VD and catabolism after bariatric surgery is more pronounced in this specific metabolic phenotype.
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Affiliation(s)
- Suelem Pereira da Cruz
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil.
| | - Sabrina Pereira da Cruz
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil
| | - Silvia Pereira
- Multidisciplinary Center for Bariatric and Metabolic Surgery, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil
| | - Carlos Saboya
- Brazilian Society of Bariatric and Metabolic Surgery, Rio de Janeiro, 22280-020, Brazil
| | - Andréa Ramalho
- Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil
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Holt R, Jorsal MJ, Yahyavi SK, Qin S, Juul A, Jørgensen N, Blomberg Jensen M. High-dose cholecalciferol supplementation to obese infertile men is sufficient to reach adequate vitamin D status. Br J Nutr 2024; 131:642-647. [PMID: 37811573 DOI: 10.1017/s0007114523002222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Obesity is associated with low vitamin D status, and the optimal supplement and dosage of cholecalciferol (vitamin D3) or calcidiol (25OHD) for individuals with obesity have been debated. We aimed to determine the effect of high-dose vitamin D3 supplementation on achieving adequate vitamin D levels among infertile men with normal weight v. obesity. Here, we present secondary end points from a single-centre, double-blinded, randomised clinical trial, comprising 307 infertile men randomised to active or placebo treatment for 150 days. Men in the active group initially received an oral bolus of 300 000 mg of vitamin D3, followed by daily supplementation with 1400 mg of vitamin D3 and 500 mg of calcium. Baseline BMI was listed as a predefined subgroup. At baseline, serum 25OHD was significantly higher in men with normal weight (BMI < 25 kg/m2) compared with men with overweight (BMI 25-30 kg/m2) and obesity (BMI > 30 kg/m2) (48 nmol/l v. 45 nmol/l and 39 nmol/l, respectively; P = 0·024). After the intervention, men with normal weight, overweight and obesity treated with vitamin D3 had a significantly higher serum 25OHD compared with corresponding placebo-treated men (BMI < 25 kg/m2: 92 nmol/l v. 53 nmol/l, BMI = 25-30 kg/m2: 87 nmol/l v. 49 nmol/l and BMI > 30 kg/m2: 85 nmol/l v. 48 nmol/l; P < 0·001 for all, respectively). In conclusion, we show that high-dose vitamin D3 supplementation to infertile men with obesity and low vitamin D status is sufficient to achieve adequate serum 25OHD levels.
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Affiliation(s)
- Rune Holt
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Mads Joon Jorsal
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Sam Kafai Yahyavi
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Simeng Qin
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
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9
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Spyksma EE, Alexandridou A, Mai K, Volmer DA, Stokes CS. An Overview of Different Vitamin D Compounds in the Setting of Adiposity. Nutrients 2024; 16:231. [PMID: 38257127 PMCID: PMC10820956 DOI: 10.3390/nu16020231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
A large body of research shows an association between higher body weight and low vitamin D status, as assessed using serum 25-hydroxyvitamin D concentrations. Vitamin D can be metabolised in adipose tissue and has been reported to influence gene expression and modulate inflammation and adipose tissue metabolism in vitro. However, the exact metabolism of vitamin D in adipose tissue is currently unknown. White adipose tissue expresses the vitamin D receptor and hydroxylase enzymes, substantially involved in vitamin D metabolism and efficacy. The distribution and concentrations of the generated vitamin D compounds in adipose tissue, however, are largely unknown. Closing this knowledge gap could help to understand whether the different vitamin D compounds have specific health effects in the setting of adiposity. This review summarises the current evidence for a role of vitamin D in adipose tissue and discusses options to accurately measure vitamin D compounds in adipose tissue using liquid chromatography tandem mass spectrometry (LC/MS-MS).
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Affiliation(s)
- Eva E. Spyksma
- Food and Health Research Group, Faculty of Life Sciences, Humboldt University Berlin, 14195 Berlin, Germany;
- Bioanalytical Chemistry, Department of Chemistry, Humboldt University Berlin, 12489 Berlin, Germany; (A.A.); (D.A.V.)
| | - Anastasia Alexandridou
- Bioanalytical Chemistry, Department of Chemistry, Humboldt University Berlin, 12489 Berlin, Germany; (A.A.); (D.A.V.)
| | - Knut Mai
- Department of Endocrinology & Metabolism, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany;
- German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, 10785 Berlin, Germany
- German Center for Diabetes Research, 90451 Nuremberg, Germany
- Department of Human Nutrition, German Institute of Human Nutrition, 14558 Nuthetal, Germany
| | - Dietrich A. Volmer
- Bioanalytical Chemistry, Department of Chemistry, Humboldt University Berlin, 12489 Berlin, Germany; (A.A.); (D.A.V.)
| | - Caroline S. Stokes
- Food and Health Research Group, Faculty of Life Sciences, Humboldt University Berlin, 14195 Berlin, Germany;
- Department of Molecular Toxicology, German Institute of Human Nutrition, 14558 Nuthetal, Germany
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10
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Povaliaeva A, Zhukov A, Tomilova A, Bondarenko A, Ovcharov M, Antsupova M, Ioutsi V, Shestakova E, Shestakova M, Pigarova E, Rozhinskaya L, Mokrysheva N. Dynamic Evaluation of Vitamin D Metabolism in Post-Bariatric Patients. J Clin Med 2023; 13:7. [PMID: 38202014 PMCID: PMC10779498 DOI: 10.3390/jcm13010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND findings from the previously conducted studies indicate altered regulatory mechanisms of calcium and vitamin D metabolism in obese patients and a role for bariatric surgery in regulating vitamin D metabolism; however, the available data is controversial and does not provide an adequate understanding of the subject. METHODS we evaluated serum parameters of vitamin D and mineral metabolism (vitamin D metabolites (25(OH)D3, 25(OH)D2, 1,25(OH)2D3, 3-epi-25(OH)D3, and 24,25(OH)2D3), vitamin D-binding protein (DBP), free 25(OH)D, fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), total calcium, albumin, phosphorus, creatinine, magnesium) in 30 patients referred for bariatric surgery in comparison with 30 healthy volunteers of similar age, sex and baseline 25(OH)D3. Patients were also followed up with repeated laboratory assessments 3 months and 6 months after surgery. During the first 3 months, patients were prescribed high-dose cholecalciferol therapy (50,000 IU per week), with subsequent correction based on the results of the 3-month visit examination. RESULTS Preoperatively, patients with morbid obesity were characterized by a high prevalence of vitamin D deficiency (median 25(OH)D3 level 11.9 (6.8; 22.2) ng/mL), significantly lower levels of active vitamin D metabolite 1,25(OH)2D3 (20 (10; 37) vs. 39 (33; 50) pg/mL, p < 0.001), lower serum albumin-adjusted calcium levels (2.24 (2.20; 2.32) vs. 2.31 (2.25; 2.35) mmol/L, p = 0.009) and magnesium levels (0.79 (0.72; 0.82) vs. 0.82 (0.78; 0.85) mmol/L, p = 0.043) with simultaneous similar PTH levels (p = 0.912), and higher DBP levels (328 (288; 401) vs. 248 (217; 284) mg/L, p < 0.001). The 25(OH)D3 levels remained suboptimal (24.5 (14.7; 29.5) ng/mL at the 3-month visit and 17.9 (12.4; 21.0) ng/mL at the 6-month visit, p = 0.052) despite recommended high-dose cholecalciferol supplementation. Patients also demonstrated an increase in 1,25(OH)2D3 levels (38 (31; 52) pg/mL at the 3-month visit and 49 (29; 59) pg/mL at the 6-month visit, p < 0.001) without a change in PTH or calcium levels during the follow-up. CONCLUSION our results of a comprehensive laboratory evaluation of vitamin D status and mineral metabolism in patients undergoing bariatric surgery highlight the importance of improving current clinical guidelines, as well as careful monitoring and education of patients.
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Affiliation(s)
| | - Artem Zhukov
- The National Medical Research Centre for Endocrinology, 117292 Moscow, Russia; (A.P.); (A.T.); (A.B.); (M.O.); (M.A.); (V.I.); (E.S.); (M.S.); (E.P.); (L.R.); (N.M.)
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11
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Liu Z, Huang S, Yuan X, Wang Y, Liu Y, Zhou J. The role of vitamin D deficiency in the development of paediatric diseases. Ann Med 2023; 55:127-135. [PMID: 36495273 PMCID: PMC9744225 DOI: 10.1080/07853890.2022.2154381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Children's Vitamin D (VitD) fortification and supplementation are diminishing due to less outdoor exercise and insufficient VitD intake (low exogenous intake and endogenous malabsorption induced by gastrointestinal disease). Consequently, children in many developed countries suffer from VitD deficiency, which may contribute to many paediatric disorders. Our review briefly introduced the metabolic process of VitD, summarized the role of VitD in paediatric diseases such as autism, obesity, rickets and asthma. We sought to identify the link between VitD deficiency and these diseases.
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Affiliation(s)
- Zhu Liu
- Department of Nursing, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shiming Huang
- Department of Nursing, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiaoli Yuan
- Department of Nursing, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yan Wang
- Department of Burn and Plastic Surgery Ward, The Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yannan Liu
- Nursing School, Hunan University of Medicine, Huaihua, China
| | - Jing Zhou
- Department of Nursing, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
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12
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Zhao J, Fu S, Chen Q. Association between the serum vitamin D level and prevalence of obesity/abdominal obesity in women with infertility: a cross-sectional study of the National Health and Nutrition Examination Survey data. Gynecol Endocrinol 2023; 39:2217251. [PMID: 37267998 DOI: 10.1080/09513590.2023.2217251] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/13/2023] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
AIMS To explore the relationship between vitamin D and obesity and abdominal obesity in women with infertility. MATERIAL AND METHODS We screened the data from National Health and Nutrition Examination Survey (NHANES) 2013-2016. A total of 201 infertile women between the ages of 20 and 40 years were included in our study. To estimate the independent association of vitamin D with obesity and abdominal obesity, we used weighted multivariate logistic regression models and cubic spline analyses. RESULTS Among infertile women in the NHANES 2013-2016 database, serum vitamin D levels were significantly and negatively associated with body mass index (ß= -0.96, 95% CI: -1.40, -0.51, p < 0.001)and waist circumference (ß= -0.40, 95% CI: -0.59, -0.22, p < 0.001), respectively. After multivariable adjustment, lower vitamin D levels were found to be associated with a higher prevalence of obesity (OR: 8.290, 95% CI: 2.451-28.039, p for trend = 0.001) and abdominal obesity (OR: 4.820, 95%CI: 1.351-17.194, p for trend =0.037). Spline regression showed linearity of the associations between vitamin D and obesity/abdominal obesity (p for nonlinearity > 0.05). CONCLUSION Our findings suggested that a decreased vitamin D might correspond to a higher prevalence of obesity in infertile women, which reminded us to pay more attention to the supplement of vitamin D in obese infertile women.
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Affiliation(s)
- Jinyan Zhao
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shengyu Fu
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qing Chen
- Department of Obstetrics and Gynecology, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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13
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Bakhuraysah MM, Gharib AF, Hassan AF, Al Harthi GK, Al Thobaiti RF, Al Adwani MM, Alharbi AD, Alzahrani AS, Alsubei KM, Al-Asiri RF. Novel Insight Into the Relationship of Vitamin D Hydroxylase and Vitamin D With Obesity in Patients With Type 2 Diabetes Mellitus. Cureus 2023; 15:e49950. [PMID: 38179344 PMCID: PMC10765456 DOI: 10.7759/cureus.49950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND In patients with type 2 diabetes mellitus (T2DM) and obesity, there is often a vitamin D deficiency, which is crucial for many physiological processes. The enzyme 25-D hydroxylase activates vitamin D, and its status has been linked to glucose and lipid metabolism in these patients. This study investigates the correlation between the levels of 25-D hydroxylase and 25-hydroxyvitamin D, and their impact on glucose and lipid metabolism in Saudi patients with T2DM and obesity. METHODS This study involved 150 Saudi participants (ages 35-70) of both genders from King Faisal Medical Complex in Taif. The participants were divided into control, type 2 diabetic, and obese diabetic patient groups, with 50 subjects in each group. Serum levels of 25(OH) vitamin D and 25-D hydroxylase were measured using ELISA. In contrast, an automatic analyzer for chemistry tests was used to measure fasting blood glucose (FBG), aspartate transaminase (AST), alanine transaminase (ALT), and lipid profile levels. Hemoglobin A1c (HbA1c)% was analyzed using the automatic glycosylated hemoglobin analyzer. In addition, the body mass index (BMI) value was calculated using the equation (BMI = weight in kilograms/height in meters squared). RESULTS In obese with T2DM and T2DM patient groups, there were significant increases (p < 0.0001) in BMI, FBG, HbA1c%, total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), AST, and ALT levels and significant decreases (p < 0.0001) in 25(OH) vitamin D, 25-D hydroxylase, and high-density lipoprotein cholesterol (HDL-C) levels compared to the control group. There were significant positive correlations between vitamin D with 25-D hydroxylase and HDL-C and negative correlations with HbA1c%, FBG, TC, TG, LDL-C, ALT, AST, and BMI in the studied patient groups. CONCLUSIONS This study shows that lower levels of the enzyme 25-D hydroxylase are linked to reduced vitamin D levels in people with T2DM and obese diabetic patients. Additionally, there was a notable correlation between vitamin D levels and BMI, lipid profile, FBG, HbA1c%, AST, and ALT levels.
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Affiliation(s)
- Maha M Bakhuraysah
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Amal F Gharib
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Asmaa F Hassan
- Physiology, College of Medicine, Taif University, Taif, SAU
| | - Ghadi K Al Harthi
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Raghad F Al Thobaiti
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | - Maha M Al Adwani
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
| | | | | | | | - Rana F Al-Asiri
- Clinical Laboratory Sciences, College of Applied Medical Sciences, Taif University, Taif, SAU
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14
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Boucher BJ. Comment on Lopes et al. Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022, 14, 3260. Nutrients 2023; 15:4952. [PMID: 38068811 PMCID: PMC10707851 DOI: 10.3390/nu15234952] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
This interesting report [...].
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Affiliation(s)
- Barbara Joan Boucher
- The Blizard Institute, School of Medicine & Dentistry, Queen Mary University of London, London E1 2AT, UK
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15
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López-Moreno M, Garcés-Rimón M, Miguel-Castro M, Fernández-Martínez E, Iglesias López MT. Effect of Nutrition Education on Health Science University Students to Improve Cardiometabolic Profile and Inflammatory Status. Nutrients 2023; 15:4685. [PMID: 37960339 PMCID: PMC10648054 DOI: 10.3390/nu15214685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023] Open
Abstract
The inadequate lifestyle associated with university life may have a negative impact on various cardiometabolic factors. The aim of this study was to evaluate the effect of a one-year nutrition education course on cardiometabolic parameters in undergraduate health science students. During the 2021-22 academic year, 1.30 h nutrition sessions were conducted twice a week. Capillary blood samples were collected and centrifuged to measure cardiometabolic and inflammatory biomarkers in serum. The sample studied consisted of 49 students: 20.4% male and 79.6% female. The nutritional intervention resulted in changes in dietary patterns, with increased consumption of vegetables, nuts and legumes. After the course, females showed an increase in HDL-cholesterol levels (p = 0.007) and no change in LDL-cholesterol levels (p = 0.189). On the other hand, males showed significant changes in HDL-cholesterol (p = 0.001) and LDL-cholesterol (p = 0.043) levels. The atherogenic index was also significantly reduced (p < 0.001) in both males (p = 0.009) and females (p = 0.002). Differences were also observed in the increase in vitamin D levels in both males and females, although the magnitude of the increase was greater in the men (Δ = 7.94, p = 0.016 in men vs. Δ = 4.96, p = 0.001 in women). The monocyte-to-HDL ratio (MHR) showed a significant reduction, although these differences were only significant in males. Students with low vitamin D levels had higher LDL-cholesterol values (p = 0.01) and atherogenic index (p = 0.029). Adjusted linear regression analysis showed a significant association between post-course vitamin D MHR (β = -0.42, IC: -0.29, -0.06, p < 0.01). These findings suggest the importance of including nutrition education programs during the university stage for the prevention of long-term health problems.
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Affiliation(s)
- Miguel López-Moreno
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Garcés-Rimón
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
- Grupo de Investigación en Biotecnología Alimentaria, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | - Marta Miguel-Castro
- Instituto de Investigación en Ciencias de Alimentación, Consejo Superior de Investigaciones Científicas, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (M.L.-M.); (M.G.-R.); (M.M.-C.)
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16
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Wimalawansa SJ. Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency. Nutrients 2023; 15:3623. [PMID: 37630813 PMCID: PMC10459179 DOI: 10.3390/nu15163623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency-they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging.
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Affiliation(s)
- Sunil J Wimalawansa
- Department of Medicine, CardioMetabolic & Endocrine Institute, North Brunswick, NJ 08902, USA
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17
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Chatterjee R, Davenport CA, Vickery EM, Johnson KC, Kashyap SR, LeBlanc ES, Nelson J, Dagogo-Jack S, Pittas AG, Hughes BD. Effect of intratrial mean 25(OH)D concentration on diabetes risk, by race and weight: an ancillary analysis in the D2d study. Am J Clin Nutr 2023; 118:59-67. [PMID: 37001590 PMCID: PMC10447481 DOI: 10.1016/j.ajcnut.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 03/09/2023] [Accepted: 03/20/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND Higher serum 25-hydroxyvitamin D [25(OH)D] is associated with lower type 2 diabetes risk. 25(OH)D varies due to skin pigmentation and weight. OBJECTIVES This analysis aims to determine whether the effect of vitamin D differs among people of color and those with overweight/obesity (who have higher diabetes risk) compared with individuals who are White or have normal weight. METHODS The D2d study is a randomized clinical trial in people with prediabetes that tested the effects of daily vitamin D3 4000 IU vs. placebo on diabetes risk (median followup 2.5 y). We compared baseline and intratrial mean 25(OH)D concentrations, defined as the mean of all available annual 25(OH)D values, among groups defined by self-reported race and body mass index (BMI). We used Cox proportional hazards models to assess the associations between intratrial mean 25(OH)D and diabetes risk by race- and BMI-based groups. RESULTS Asian (n=130), Black (n=616), and White (n=1616) participants were included. Both baseline and intratrial mean 25(OH)D concentrations differed significantly by race groups (both P < 0.001) and were lower in Asian and Black vs. White participants, and in those with higher vs. lower BMI adjusted for race (both P < 0.001). Compared with those with lower concentrations, Black and White participants with intratrial mean 25(OH)D ≥ 40 ng/mL had significantly reduced diabetes risk [HR (95% CI): Black: 0.51 (0.29, 0.92); White: 0.42 (0.30, 0.60)] and with a similar reduction in diabetes risk among Asian participants: 0.39 (0.14, 1.11). Compared with those with lower concentrations, participants with baseline BMI < 40 kg/m2 who achieved intratrial mean 25(OH)D concentrations ≥ 40 ng/mL had a significantly reduced diabetes risk. There was no statistically significant interaction between intratrial 25(OH)D and race or between intratrial 25(OH)D and BMI on diabetes risk. CONCLUSIONS Among people with prediabetes, particularly for Black and White race groups and those with BMI < 40 kg/m2, the optimal 25(OH)D concentration may be ≥ 40 ng/mL to optimize diabetes-prevention efforts. This trial was registered at clinicaltrials.gov as NCT01942694.
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Affiliation(s)
- Ranee Chatterjee
- Department of Medicine, Duke University School of Medicine, Durham, NC, United States.
| | - Clemontina A Davenport
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, United States
| | - Ellen M Vickery
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, United States
| | - Karen C Johnson
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sangeeta R Kashyap
- Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, OH, United States
| | - Erin S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR, United States
| | - Jason Nelson
- BERD Center, Tufts Medical Center, Boston, MA, United States
| | - Samuel Dagogo-Jack
- Division of Endocrinology, Diabetes and Metabolism, The University of Tennessee Health Science Center, Memphis, TN, United States
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, United States
| | - Bess Dawson Hughes
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, United States; Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
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18
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Carbone F, Liberale L, Libby P, Montecucco F. Vitamin D in atherosclerosis and cardiovascular events. Eur Heart J 2023; 44:2078-2094. [PMID: 36943351 PMCID: PMC10281557 DOI: 10.1093/eurheartj/ehad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/30/2023] [Accepted: 03/04/2023] [Indexed: 03/23/2023] Open
Abstract
Both experimental and clinical findings linking vitamin D to cardiovascular (CV) risk have prompted consideration of its supplementation to improve overall health. Yet several meta-analyses do not provide support for the clinical effectiveness of this strategy. Meanwhile, the understanding of the roles of vitamin D in the pathophysiology of CV diseases has evolved. Specifically, recent work has revealed some non-classical pleiotropic effects of vitamin D, increasing the complexity of vitamin D signalling. Within particular microenvironments (e.g. dysfunctional adipose tissue and atherosclerotic plaque), vitamin D can act locally at cellular level through intracrine/autocrine/paracrine feedforward and feedback circuits. Within atherosclerotic tissues, 'local' vitamin D levels may influence relevant systemic consequences independently of its circulating pool. Moreover, vitamin D links closely to other signalling pathways of CV relevance including those driving cellular senescence, ageing, and age-related diseases-among them CV conditions. This review updates knowledge on vitamin D biology aiming to clarify the widening gap between experimental and clinical evidence. It highlights the potential reverse causation confounding correlation between vitamin D status and CV health, and the need to consider novel pathophysiological concepts in the design of future clinical trials that explore the effects of vitamin D on atherosclerosis and risk of CV events.
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Affiliation(s)
- Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
| | - Peter Libby
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa—Italian Cardiovascular Network, Genoa, Italy
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Corbin KD, Pittas AG, Desouza C, Grdinovac KK, Herzig KH, Kashyap SR, Kim SH, Nelson J, Rasouli N, Vickery EM, Knowler WC, Pratley RE. Indices of hepatic steatosis and fibrosis in prediabetes and association with diabetes development in the vitamin D and type 2 diabetes study. J Diabetes Complications 2023; 37:108475. [PMID: 37104979 PMCID: PMC10683797 DOI: 10.1016/j.jdiacomp.2023.108475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
AIMS Non-alcoholic fatty liver disease (NAFLD) is a common comorbidity that leads to poor outcomes in people at high risk for development of type 2 diabetes (T2D). Vitamin D is a possible mediator. In the vitamin D and type 2 diabetes study (D2d), we investigated the relationship of baseline indices of NAFLD with incident T2D and whether the effect of vitamin D on diabetes was modified by NAFLD. METHODS Cross-sectional associations of indices of NAFLD with glycemia and vitamin D status were assessed in 3972 individuals screened for the D2d study. In those with prediabetes randomized to vitamin D or placebo (n = 2423), we examined longitudinal associations of NAFLD indices with incident T2D. We used validated non-invasive scores to assess steatosis [(hepatic steatosis index (HSI); NAFLD-liver fat score (NAFLD-LFS)] and advanced fibrosis [fibrosis-4 (FIB-4) index; AST to Platelet Ratio Index (APRI)]. RESULTS Eighty-five percent of screened participants had likely steatosis by HSI and 71 % by NAFLD-LFS; 3 % were likely to have advanced fibrosis by FIB-4 and 1.2 % by APRI. FIB-4 indicated that 20.4 % of individuals require further follow up to assess liver health. Steatosis and fibrosis scores were higher among participants with worse glycemia. The NAFLD-LFS and APRI predicted development of diabetes (hazard ratios [95%CI] 1.35 [1.07, 1.70]; P = 0.012) and 2.36 (1.23, 4.54; P = 0.010), respectively). The effect of vitamin D on diabetes risk was not modified by baseline NAFLD indices. Individuals with likely steatosis had a smaller increase in serum 25-hydroxyvitamin D level in response to vitamin D than those without steatosis. CONCLUSIONS The predicted high prevalence of steatosis, the need for further fibrosis workup, and the relationship between liver health and incident T2D suggest that routine screening with clinically accessible scores may be an important strategy to reduce disease burden.
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Affiliation(s)
- Karen D Corbin
- AdventHealth Translational Research Institute, Orlando, FL, United States of America.
| | | | - Cyrus Desouza
- The University of Nebraska Medical Center and Omaha Veterans Affairs Medical Center, Omaha, NE, United States of America
| | | | - Karl-Heinz Herzig
- Research Unit of Biomedicine and Internal Medicine, Faculty of Medicine, and Medical Research Center, University of Oulu and Oulu University Hospital, 90220 Oulu, Finland; Department of Pediatric Gastroenterology and Metabolic Diseases, Pediatric Institute, Poznan University of Medical Sciences, 60-572 Poznań, Poland
| | | | - Sun H Kim
- Stanford University Medical Center, Stanford, CA, United States of America
| | - Jason Nelson
- Tufts Medical Center, Boston, MA, United States of America
| | - Neda Rasouli
- The University of Colorado School of Medicine, Aurora, CO, United States of America; The Veterans Affairs Eastern Colorado Health Care System, Aurora, CO, United States of America
| | | | - William C Knowler
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States of America
| | - Richard E Pratley
- AdventHealth Translational Research Institute, Orlando, FL, United States of America.
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AlSedairy SA, Al-Harbi LN, Binobead MA, Athinarayanan J, Arzoo S, Al-Tamimi DS, Shamlan G, Alshatwi AA, Periasamy VS. Association of CYP2R1 and CYP27B1 genes with the risk of obesity and vitamin D metabolism in Saudi women. J Genet Eng Biotechnol 2023; 21:59. [PMID: 37184736 DOI: 10.1186/s43141-023-00508-7] [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: 06/12/2022] [Accepted: 04/20/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Epigenome, genetic variants, and other environmental factors involved in gene regulation are highly inter-dependent in several chronic diseases, including obesity, cardiovascular disease, and diabetes. The present study aimed at testing the associations and the mechanism involved in silencing of CYP2R1 gene in normal and obese Saudi women patients. Height, weight, BMI, 25-hydroxy vitamin D, parathyroid hormone, glycemic status, and lipid profile (TG, LDL, HDL, and TC) of CYP2R1 were measured in 100 women (31 normal and 69 obese patients). RESULTS Our result shows that hypermethylation in site 2 of the CYP2R1 gene with body weight (p < 0.004), BMI (p < 0.002), waist circumference (p < 0.002), total-LDL (p < 0.027), total cholesterol (p < 0.022), and vitamin D (VD) (close to borderline significance p < 0.06) and site 4 of CYP2R1 with LDL (p < 0.041) in the four tested sites among normal and obese women was significantly associated. Moreover, we tested five different CpG sites in the CYP27B1 gene where site 5 correlated significantly with VD levels. CONCLUSION Our present study clearly indicates that hypermethylation of specific sites in the CYP2R1 and CYP27B1 genes might regulate gene expression with special reference to the risk of obesity and vitamin D metabolism.
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Affiliation(s)
- Sahar Abdulaziz AlSedairy
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Laila Naif Al-Harbi
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Manal Abdulaziz Binobead
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Jegan Athinarayanan
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Shaista Arzoo
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Dalia Saade Al-Tamimi
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Ghalia Shamlan
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Ali Abdullah Alshatwi
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Vaiyapuri Subbarayan Periasamy
- Department of Food Science & Nutrition, College of Food and Agricultural Sciences, King Saud University, Riyadh, 11451, Saudi Arabia.
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21
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Bouillon R, Quesada Gomez JM. Comparison of calcifediol with vitamin D for prevention or cure of vitamin D deficiency. J Steroid Biochem Mol Biol 2023; 228:106248. [PMID: 36646151 DOI: 10.1016/j.jsbmb.2023.106248] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Vitamin D deficiency remains prevalent, with about 7% of the world's population living with severe vitamin D deficiency and about one third with mild deficiency. We compare the relative merits of calcifediol or 25-hydroxyvitamin D (25OHD) compared to vitamin D itself for supplementation as to prevent or cure vitamin D deficiency. The intestinal absorption of calcifediol is nearly 100% and thus higher than that of vitamin D itself. Moreover, calcifediol is absorbed by the intestinal cells and transported through the portal vein and thus immediately accessible to the circulation, while vitamin D is transported with chylomicrons through the lymph system. Therefore, in case of fat malabsorption or after bariatric surgery, calcifediol is much better absorbed in comparison with vitamin D itself. Serum 25OHD increases linearly with increasing doses of calcifediol, whereas serum 25OHD reaches a plateau when higher oral doses of vitamin D are used. Calcifediol, on a weight basis, is about 3 times more potent than vitamin D in subjects with mild vitamin D deficiency. This potency is even 6-8 times higher than vitamin D when baseline serum 25OHD is higher or when large doses are compared. In conclusion, calcifediol is an alternative option to correct vitamin D deficiency and may even be the preferred strategy in case of intestinal fat malabsorption, after bariatric surgery or in case of other conditions with suspected impaired 25-hydroxylase activity in the liver.
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Affiliation(s)
- Roger Bouillon
- Department of Chronic Diseases, Metabolism and Ageing, Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Herestraat, ON 1/902, 3000 Leuven, Belgium.
| | - Jose Manuel Quesada Gomez
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) & Unidad de Gestión Clínica (UGC) de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Universidad de Córdoba, Avda. Menéndez Pidal s/n, 14004 Córdoba, Spain.; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
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22
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Zittermann A, Pilz S, Morshuis M, Gummert JF, Milting H. Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant. Int J Artif Organs 2023; 46:235-240. [PMID: 36895121 DOI: 10.1177/03913988231154939] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023]
Abstract
Driveline infection is a frequent complication in recipients of durable left ventricular assist devices (LVAD), but its cause is largely unclear. Since vitamin D supplementation can reduce the risk of infections, we aimed at investigating the association of vitamin D deficiency with driveline infection. In 154 patients with continuous flow LVAD implants, we assessed 2-year risk of driveline infection according to vitamin D status (circulating 25-hydroxyvitamin D < 25 nmol/L or ⩾25 nmol/L). Of the study cohort, 34% (n = 53) had 25-hydroxyvitamin D concentrations <25 nmol/L. Kaplan-Meir estimates of 2-year freedom from driveline infection were in the vitamin D deficient and vitamin D non-deficient groups 49.7% and 74.2%, respectively (p = 0.017). Covariate-adjusted hazard ratio of driveline infection for the vitamin D deficient versus non-deficient group was 2.51 [95% CI: 1.11-5.69; p = 0.028). Circulating concentrations of endocrine regulators of calcium and phosphorus metabolism such as parathyroid hormone, 1,25-dihydroxyvitamin D, and fibroblast growth factor-23 were not significantly associated with the risk of driveline infection (p-values > 0.15). In total, our data indicate that in LVAD recipients deficient vitamin D status is a predictor of driveline infection, but future studies are needed to investigate whether these associations are causal.
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Affiliation(s)
- Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Ruhr-University Bochum, Germany
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Michiel Morshuis
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Ruhr-University Bochum, Germany
| | - Jan F Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Ruhr-University Bochum, Germany
| | - Hendrik Milting
- Clinic for Thoracic and Cardiovascular Surgery, Erich & Hanna Klessmann-Institute for Research and Development, Herz- und Diabeteszentrum NRW, Bad Oeynhausen, Ruhr-University Bochum, Germany
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23
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Jodar E, Campusano C, de Jongh RT, Holick MF. Calcifediol: a review of its pharmacological characteristics and clinical use in correcting vitamin D deficiency. Eur J Nutr 2023; 62:1579-1597. [PMID: 36862209 PMCID: PMC9979899 DOI: 10.1007/s00394-023-03103-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 01/31/2023] [Indexed: 03/03/2023]
Abstract
BACKGROUND In addition to the role of vitamin D in bone mineralization, calcium and phosphate homeostasis, and skeletal health, evidence suggests an association between vitamin D deficiency and a wide range of chronic conditions. This is of clinical concern given the substantial global prevalence of vitamin D deficiency. Vitamin D deficiency has traditionally been treated with vitamin D3 (cholecalciferol) or vitamin D2 (ergocalciferol). Calcifediol (25-hydroxyvitamin D3) has recently become available more widely. METHODS By means of targeted literature searches of PubMed, this narrative review overviews the physiological functions and metabolic pathways of vitamin D, examines the differences between calcifediol and vitamin D3, and highlights clinical trials conducted with calcifediol in patients with bone disease or other conditions. RESULTS For supplemental use in the healthy population, calcifediol can be used at doses of up to 10 µg per day for children ≥ 11 years and adults and up to 5 µg/day in children 3-10 years. For therapeutic use of calcifediol under medical supervision, the dose, frequency and duration of treatment is determined according to serum 25(OH)D concentrations, condition, type of patient and comorbidities. Calcifediol differs pharmacokinetically from vitamin D3 in several ways. It is independent of hepatic 25-hydroxylation and thus is one step closer in the metabolic pathway to active vitamin D. At comparable doses to vitamin D3, calcifediol achieves target serum 25(OH)D concentrations more rapidly and in contrast to vitamin D3, it has a predictable and linear dose-response curve irrespective of baseline serum 25(OH)D concentrations. The intestinal absorption of calcifediol is relatively preserved in patients with fat malabsorption and it is more hydrophilic than vitamin D3 and thus is less prone to sequestration in adipose tissue. CONCLUSION Calcifediol is suitable for use in all patients with vitamin D deficiency and may be preferable to vitamin D3 for patients with obesity, liver disease, malabsorption and those who require a rapid increase in 25(OH)D concentrations.
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Affiliation(s)
- Esteban Jodar
- grid.119375.80000000121738416Department of Endocrinology and Nutrition, Quirón Salud Madrid and Ruber Juan Bravo University Hospitals, Universidad Europea de Madrid, Madrid, Spain
| | - Claudia Campusano
- grid.440627.30000 0004 0487 6659Department of Internal Medicine, Endocrine Section, Clínica Universidad de los Andes and School of Medicine, Universidad de los Andes, Santiago, Chile
| | - Renate T. de Jongh
- grid.12380.380000 0004 1754 9227Department of Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Michael F. Holick
- grid.189504.10000 0004 1936 7558Vitamin D, Skin, and Bone Research Laboratory, Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, 85 E Newton St, M-1013, Boston, MA 02118 USA
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24
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Soltani S, Beigrezaei S, Abdollahi S, Clark CCT, Ashoori M. Oral vitamin D supplementation and body weight in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Eur J Pediatr 2023; 182:1977-1989. [PMID: 36856888 DOI: 10.1007/s00431-023-04889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/02/2023]
Abstract
This study was designed to ascertain whether oral vitamin D supplementation (oral supplementation and fortified foods) is associated with changes in body weight measures in children and adolescents, using a systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Scopus, Cochrane, and Web of Science databases were searched from inception to October 28, 2022. The mean difference and corresponding 95% confidence interval (CI) of interested outcomes were pooled using a random-effects model. Twenty-one RCTs were included in the meta-analysis, and the results showed a significant decrease in body mass index (BMI) following vitamin D supplementation in children and adolescents (n = 9 studies, 1029 participants; weighted mean difference: - 0.43 kg/m2, 95% CI: - 0.79, - 0.08; P = 0.02; I2 = 58.5%). Overall, oral vitamin D supplementation had no significant effect on body weight and other anthropometric indices, including fat mass, lean mass, waist circumference, BMI Z-score, and height. Although results of body weight changed to significant after sensitivity analysis (WMD = 0.39 kg, 95% CI = 0.01, 0.78; P = 0.04; I2 = 0%, P-heterogeneity = 0.71), we also found significant weight gain in healthy pediatric population, and when the dose of vitamin D supplementation was up to 600 IU/day, the certainty of evidence was very low for weight, moderate for height and BMI, and low for the remaining outcomes. CONCLUSION Our results suggest that vitamin D supplementation may lead to a statistically significant weight gain in children and adolescents, while BMI was reduced. Although no significant change was observed in height, it seems vitamin D supplementation may elicit these changes by increasing skeletal growth; however, this remains to be verified. Further high-quality RCTs, with longer duration and larger sample sizes, are needed to yield more certain evidence in this regard. WHAT IS KNOWN • Available evidence indicates an inverse association between body weight/fat mass and vitamin D status in children and adolescents; however, findings regarding the effect of vitamin D supplementation on anthropometric measurements in children are controversial. WHAT IS NEW • Our results showed a significant decrease in BMI following vitamin D supplementation in children. • A significant weight gain also was observed after sensitivity analysis, and in healthy pediatric population, and when the dose of vitamin D supplementation was up to 600 IU/day.
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Affiliation(s)
- Sepideh Soltani
- Yazd Cardiovascular Research Center, Non-Communicable Diseases Research Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sara Beigrezaei
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shima Abdollahi
- Department of Nutrition, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Marziyeh Ashoori
- Rasool Akram Medical Complex Clinical Research Development Center, Iran University Of Medical Sciences, Tehran, Iran.
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Pittas AG, Kawahara T, Jorde R, Dawson-Hughes B, Vickery EM, Angellotti E, Nelson J, Trikalinos TA, Balk EM. Vitamin D and Risk for Type 2 Diabetes in People With Prediabetes : A Systematic Review and Meta-analysis of Individual Participant Data From 3 Randomized Clinical Trials. Ann Intern Med 2023; 176:355-363. [PMID: 36745886 DOI: 10.7326/m22-3018] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The role of vitamin D in people who are at risk for type 2 diabetes remains unclear. PURPOSE To evaluate whether administration of vitamin D decreases risk for diabetes among people with prediabetes. DATA SOURCES PubMed, Embase, and ClinicalTrials.gov from database inception through 9 December 2022. STUDY SELECTION Eligible trials that were specifically designed and conducted to test the effects of oral vitamin D versus placebo on new-onset diabetes in adults with prediabetes. DATA EXTRACTION The primary outcome was time to event for new-onset diabetes. Secondary outcomes were regression to normal glucose regulation and adverse events. Prespecified analyses (both unadjusted and adjusted for key baseline variables) were conducted according to the intention-to-treat principle. DATA SYNTHESIS Three randomized trials were included, which tested cholecalciferol, 20 000 IU (500 mcg) weekly; cholecalciferol, 4000 IU (100 mcg) daily; or eldecalcitol, 0.75 mcg daily, versus matching placebos. Trials were at low risk of bias. Vitamin D reduced risk for diabetes by 15% (hazard ratio, 0.85 [95% CI, 0.75 to 0.96]) in adjusted analyses, with a 3-year absolute risk reduction of 3.3% (CI, 0.6% to 6.0%). The effect of vitamin D did not differ in prespecified subgroups. Among participants assigned to the vitamin D group who maintained an intratrial mean serum 25-hydroxyvitamin D level of at least 125 nmol/L (≥50 ng/mL) compared with 50 to 74 nmol/L (20 to 29 ng/mL) during follow-up, cholecalciferol reduced risk for diabetes by 76% (hazard ratio, 0.24 [CI, 0.16 to 0.36]), with a 3-year absolute risk reduction of 18.1% (CI, 11.7% to 24.6%). Vitamin D increased the likelihood of regression to normal glucose regulation by 30% (rate ratio, 1.30 [CI, 1.16 to 1.46]). There was no evidence of difference in the rate ratios for adverse events (kidney stones: 1.17 [CI, 0.69 to 1.99]; hypercalcemia: 2.34 [CI, 0.83 to 6.66]; hypercalciuria: 1.65 [CI, 0.83 to 3.28]; death: 0.85 [CI, 0.31 to 2.36]). LIMITATIONS Studies of people with prediabetes do not apply to the general population. Trials may not have been powered for safety outcomes. CONCLUSION In adults with prediabetes, vitamin D was effective in decreasing risk for diabetes. PRIMARY FUNDING SOURCE None. (PROSPERO: CRD42020163522).
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Affiliation(s)
- Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts (A.G.P., E.M.V., J.N.)
| | - Tetsuya Kawahara
- Department of Internal Medicine, Kokura Medical Association Health Testing Center, Kitakyushu, Japan (T.K.)
| | - Rolf Jorde
- Institute of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway (R.J.)
| | - Bess Dawson-Hughes
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts (B.D.)
| | - Ellen M Vickery
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts (A.G.P., E.M.V., J.N.)
| | | | - Jason Nelson
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, Massachusetts (A.G.P., E.M.V., J.N.)
| | - Thomas A Trikalinos
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island (T.A.T., E.M.B.)
| | - Ethan M Balk
- Center for Evidence Synthesis in Health, Brown University School of Public Health, Providence, Rhode Island (T.A.T., E.M.B.)
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Guevara-Ramírez P, Cadena-Ullauri S, Ruiz-Pozo VA, Tamayo-Trujillo R, Paz-Cruz E, Simancas-Racines D, Zambrano AK. Genetics, genomics, and diet interactions in obesity in the Latin American environment. Front Nutr 2022; 9:1063286. [PMID: 36532520 PMCID: PMC9751379 DOI: 10.3389/fnut.2022.1063286] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 08/25/2023] Open
Abstract
Obesity is a chronic disease characterized by abnormal or excessive fat accumulation that could impact an individual's health; moreover, the World Health Organization (WHO) has declared obesity a global epidemic since 1997. In Latin America, in 2016, reports indicated that 24.2% of the adult population was obese. The environmental factor or specific behaviors like dietary intake or physical activity have a vital role in the development of a condition like obesity, but the interaction of genes could contribute to that predisposition. Hence, it is vital to understand the relationship between genes and disease. Indeed, genetics in nutrition studies the genetic variations and their effect on dietary response; while genomics in nutrition studies the role of nutrients in gene expression. The present review represents a compendium of the dietary behaviors in the Latin American environment and the interactions of genes with their single nucleotide polymorphisms (SNPs) associated with obesity, including the risk allele frequencies in the Latin American population. Additionally, a bibliographical selection of several studies has been included; these studies examined the impact that dietary patterns in Latin American environments have on the expression of numerous genes involved in obesity-associated metabolic pathways.
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Affiliation(s)
- Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Santiago Cadena-Ullauri
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Viviana A. Ruiz-Pozo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Elius Paz-Cruz
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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Mirza I, Mohamed A, Deen H, Balaji S, Elsabbahi D, Munasser A, Naquiallah D, Abdulbaseer U, Hassan C, Masrur M, Bianco FM, Ali MM, Mahmoud AM. Obesity-Associated Vitamin D Deficiency Correlates with Adipose Tissue DNA Hypomethylation, Inflammation, and Vascular Dysfunction. Int J Mol Sci 2022; 23:ijms232214377. [PMID: 36430854 PMCID: PMC9694734 DOI: 10.3390/ijms232214377] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamin D (VD) deficiency is a hallmark of obesity and vascular dysfunction. We sought to test the hypothesis that VD deficiency may contribute to obesity-related vascular dysfunction by inducing adipokine hypomethylation and augmented expression. To this end, we collected blood and adipose tissues (ATs) from a cohort of 77 obese participants who were classified as having mild, moderate, or severe VD deficiency. The body composition, vascular reactivity, cardiometabolic profiles, and DNA methylation of 94 inflammation-related adipokines were measured. Our results show that higher degrees of VD deficiency were associated with lower DNA methylation and induced the expression of inflammatory adipokines such as B-cell lymphoma 6 (BCL6), C-X-C Motif Chemokine Ligand 8 (CXCL8), histone deacetylase 5 (HDAC5), interleukin 12A (IL12A), and nuclear factor κB (NFκB) in the ATs. They were also associated with higher BMI and total and visceral fat mass, impaired insulin sensitivity and lipid profiles, AT hypoxia, and higher concentrations of circulating inflammatory markers. Moderate and severe VD deficiency correlated with impaired vasoreactivity of the brachial artery and AT-isolated arterioles, reduced nitric oxide generation, and increased arterial stiffness. In a multivariate regression analysis, the VD deficiency level strongly predicted the adipokine methylation score, systemic inflammation, and microvascular dysfunction. In conclusion, our findings suggest that VD deficiency is a possible contributor to obesity-related adipokine hypomethylation, inflammation, and vascular dysfunction.
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Affiliation(s)
- Imaduddin Mirza
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Ariej Mohamed
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Hania Deen
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Swetha Balaji
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Duaa Elsabbahi
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Amier Munasser
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Dina Naquiallah
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Uzma Abdulbaseer
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Chandra Hassan
- Department of Surgery, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Mario Masrur
- Department of Surgery, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Francesco M. Bianco
- Department of Surgery, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Mohamed M. Ali
- Department of Physical Therapy, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Abeer M. Mahmoud
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, The University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, The University of Illinois at Chicago, Chicago, IL 60612, USA
- Correspondence:
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Hasan M, Oster M, Reyer H, Ponsuksili S, Murani E, Wolf P, Fischer DC, Wimmers K. Tissue-Wide Expression of Genes Related to Vitamin D Metabolism and FGF23 Signaling following Variable Phosphorus Intake in Pigs. Metabolites 2022; 12:metabo12080729. [PMID: 36005601 PMCID: PMC9413461 DOI: 10.3390/metabo12080729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Calcium (Ca) and phosphorus (P) homeostasis is maintained by several regulators, including vitamin D and fibroblast growth factor 23 (FGF23), and their tissue-specific activation and signaling cascades. In this study, the tissue-wide expression of key genes linked to vitamin D metabolism (CYP2R1, CYP27A1, CYP27B1, CYP24A1, GC, VDR) and FGF23 signaling (FGF23, FGFR1-4, KL) were investigated in pigs fed conventional (trial 1) and divergent P diets (trial 2). The tissue set comprised kidney, liver, bone, lung, aorta, and gastrointestinal tract sections. Expression patterns revealed that non-renal tissues and cells (NRTC) express genes to form active vitamin D [1,25(OH)2D3] according to site-specific requirements. A low P diet resulted in higher serum calcitriol and increased CYP24A1 expression in the small intestine, indicating local suppression of vitamin D signaling. A high P diet prompted increased mRNA abundances of CYP27B1 for local vitamin D synthesis, specifically in bone. For FGF23 signaling, analyses revealed ubiquitous expression of FGFR1-4, whereas KL was expressed in a tissue-specific manner. Dietary P supply did not affect skeletal FGF23; however, FGFR4 and KL showed increased expression in bone at high P supply, suggesting regulation to balance mineralization. Specific NRTC responses influence vitamin D metabolism and P homeostasis, which should be considered for a thrifty but healthy P supply.
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Affiliation(s)
- Maruf Hasan
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Michael Oster
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Henry Reyer
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Siriluck Ponsuksili
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Eduard Murani
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
| | - Petra Wolf
- Faculty of Agricultural and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6b, 18059 Rostock, Germany
| | - Dagmar-Christiane Fischer
- Department of Pediatrics, Rostock University Hospital, Ernst-Heydemann-Str. 8, 18057 Rostock, Germany
| | - Klaus Wimmers
- Research Institute for Farm Animal Biology (FBN), Wilhelm-Stahl-Allee 2, 18196 Dummerstorf, Germany
- Faculty of Agricultural and Environmental Sciences, University of Rostock, Justus-von-Liebig-Weg 6b, 18059 Rostock, Germany
- Correspondence: ; Tel.: +49-38208-68600
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Wimalawansa SJ. Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections-Sepsis and COVID-19. Nutrients 2022; 14:2997. [PMID: 35889955 PMCID: PMC9319502 DOI: 10.3390/nu14142997] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D deficiency is a global public health problem, a pandemic that commonly affects the elderly and those with comorbidities such as obesity, diabetes, hypertension, respiratory disorders, recurrent infections, immune deficiency, and malignancies, as well as ethnic minorities living in temperate countries. The same groups were worst affected by COVID-19. Since vitamin D deficiency weakens the immune system, it increases the risk of infections, complications, and deaths, such as from sepsis and COVID-19. Deficiency can be remedied cost-effectively through targeted food fortification, supplementation, and/or daily safe sun exposure. Its endocrine functions are limited to mineral metabolism, musculoskeletal systems, specific cell membrane interactions, and parathyroid gland functions. Except for the rapid, endocrine, and cell membrane-based non-genomic functions, all other biological and physiological activities of vitamin D depend on the adequate intracellular synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells via the genome. Calcitriol mediates autocrine (intracrine) and paracrine signalling in immune cells, which provides broader, protective immune functions crucial to overcoming infections. The synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells is dependent on diffusion and endocytosis of D3 and 25(OH)D from the circulation into them, which requires maintenance of serum 25(OH)D concentration above 50 ng/mL. Therefore, in acute infections such as sepsis and respiratory infections like COVID-19, it is necessary to rapidly provide its precursors, D3 and 25(OH)D, through the circulation to generate adequate intracellular calcitriol. Immune defence is one of the crucial non-hormonal functions of vitamin D. A single oral (bolus) dose or divided upfront loading doses between 100,000 and 500,000 IU, using 50,000 IU vitamin D3 increase the serum 25(OH)D concentrations to a therapeutic level of above 50 ng/mL that lasts between two to three months. This takes three to five days to raise serum 25(OH)D. In contrast, a single oral dose of calcifediol (0.014 mg/kg body weight) can generate the needed 25(OH)D concentration within four hours. Considering both D3 and 25(OH)D enter immune cells for generating calcitriol, using the combination of D3 (medium-term) and calcifediol (immediate) is cost-effective and leads to the best clinical outcome. To maximise protection against infections, particularly to reduce COVID-19-associated complications and deaths, healthcare workers should advise patients on safe sun exposure, adequate vitamin D supplementation and balanced diets containing zinc, magnesium, and other micronutrients to support the immune system. Meanwhile, governments, the World Health Organisation, the Centers for Disease Control, and governments should consider similar recommendations to physicians and the public, change the outdated vitamin D and other micronutrient recommendations directed to their population, and organise targetted food fortification programs for the vulnerable groups. This article discusses a rational approach to maintaining a sustained serum 25(OH)D concentration above 50 ng/mL, necessary to attain a robust immune system for overcoming infections. Such would cost-effectively improve the population’s health and reduce healthcare costs. It also describes three cost-effective, straightforward protocols for achieving and sustaining therapeutic serum 25(OH)D concentrations above 50 ng/mL (>125 nmol/L) to keep the population healthy, reduce absenteeism, improve productivity, and lower healthcare costs.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08873, USA
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Elkhwanky MS, Kummu O, Hakkola J. Streptozotocin-induced Diabetes Represses Hepatic CYP2R1 Expression but Induces Vitamin D 25-Hydroxylation in Male Mice. Endocrinology 2022; 163:6582260. [PMID: 35524739 PMCID: PMC9155637 DOI: 10.1210/endocr/bqac060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Indexed: 11/19/2022]
Abstract
Vitamin D deficiency [ie, low plasma 25-hydroxyvitamin D (25-OH-D)] associates with the prevalence of metabolic diseases including type 1 diabetes; however, the molecular mechanisms are incompletely understood. Recent studies have indicated that both fasting and metabolic diseases suppress the cytochrome P450 (CYP) 2R1, the major hepatic vitamin D 25-hydroxylase. We specifically studied the effect of a mouse model of type 1 diabetes on the regulation of Cyp2r1 and vitamin D status. We show that streptozotocin-induced diabetes in mice suppresses the expression of the Cyp2r1 in the liver. While insulin therapy normalized the blood glucose levels in the diabetic mice, it did not rescue the diabetes-induced suppression of Cyp2r1. Similar regulation of Cyp2r1 was observed also in the kidney. Plasma 25-OH-D level was not decreased and was, in contrast, higher after 4 and 8 weeks of diabetes. Furthermore, the vitamin D 25-hydroxylase activity was increased in the livers of the diabetic mice, suggesting compensation of the Cyp2r1 repression by other vitamin D 25-hydroxylase enzymes. Cyp27b1, the vitamin D 1α-hydroxylase, expression in the kidney and the plasma 1α,25-dihydroxyvitamin D level were higher after 4 weeks of diabetes, while both were normalized after 13 weeks. In summary, these results indicate that in the mouse model of type 1 diabetes suppression of hepatic Cyp2r1 expression does not result in reduced hepatic vitamin D 25-hydroxylase activity and vitamin D deficiency. This may be due to induction of other vitamin D 25-hydroxylase enzymes in response to diabetes.
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Affiliation(s)
- Mahmoud-Sobhy Elkhwanky
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Outi Kummu
- Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Jukka Hakkola
- Correspondence: Jukka Hakkola, MD, PhD, Research Unit of Biomedicine, Pharmacology and Toxicology, University of Oulu, POB 5000, FI-90014 University of Oulu, Finland.
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Bennour I, Haroun N, Sicard F, Mounien L, Landrier JF. Vitamin D and Obesity/Adiposity—A Brief Overview of Recent Studies. Nutrients 2022; 14:nu14102049. [PMID: 35631190 PMCID: PMC9143180 DOI: 10.3390/nu14102049] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Observational studies classically find an inverse relationship between human plasma 25-hydroxyvitamin D concentration and obesity. However, interventional and genetic studies have failed to provide clear conclusions on the causal effect of vitamin D on obesity/adiposity. Likewise, vitamin D supplementation in obese rodents has mostly failed to improve obesity parameters, whereas several lines of evidence in rodents and prospective studies in humans point to a preventive effect of vitamin D supplementation on the onset of obesity. Recent studies investigating the impact of maternal vitamin D deficiency in women and in rodent models on adipose tissue biology programming in offspring further support a preventive metabolically driven effect of vitamin D sufficiency. The aim of this review is to summarize the state of the knowledge on the relationship between vitamin D and obesity/adiposity in humans and in rodents and the impact of maternal vitamin D deficiency on the metabolic trajectory of the offspring.
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Affiliation(s)
- Imene Bennour
- Aix-Marseille Université, C2VN, INRAE, INSERM, 13000 Marseille, France; (I.B.); (N.H.); (F.S.); (L.M.)
| | - Nicole Haroun
- Aix-Marseille Université, C2VN, INRAE, INSERM, 13000 Marseille, France; (I.B.); (N.H.); (F.S.); (L.M.)
| | - Flavie Sicard
- Aix-Marseille Université, C2VN, INRAE, INSERM, 13000 Marseille, France; (I.B.); (N.H.); (F.S.); (L.M.)
- PhenoMARS Aix-Marseille Technology Platform, CriBiom, 13000 Marseille, France
| | - Lourdes Mounien
- Aix-Marseille Université, C2VN, INRAE, INSERM, 13000 Marseille, France; (I.B.); (N.H.); (F.S.); (L.M.)
- PhenoMARS Aix-Marseille Technology Platform, CriBiom, 13000 Marseille, France
| | - Jean-François Landrier
- Aix-Marseille Université, C2VN, INRAE, INSERM, 13000 Marseille, France; (I.B.); (N.H.); (F.S.); (L.M.)
- PhenoMARS Aix-Marseille Technology Platform, CriBiom, 13000 Marseille, France
- Correspondence: ; Tel.: +33-4-9129-4275
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Treatment of Vitamin D Deficiency with Calcifediol: Efficacy and Safety Profile and Predictability of Efficacy. Nutrients 2022; 14:nu14091943. [PMID: 35565910 PMCID: PMC9102909 DOI: 10.3390/nu14091943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 12/12/2022] Open
Abstract
Calcifediol (25-OH-vitamin D3) is the prohormone of the vitamin D endocrine system. It is used to prevent and treat vitamin D deficiency. Calcifediol, as well as cholecalciferol (vitamin D3), is efficient and safe in the general population, although calcifediol has certain advantages over cholecalciferol, such as its rapid onset of action and greater potency. This review analyzed studies comparing the efficacy and safety of both calcifediol and cholecalciferol drugs in the short and long term (>6 months). Calcifediol was found to be more efficacious, with no increase in toxicity. We also assessed the predictability of both molecules. A 25OHD increase depends on the dose and frequency of calcifediol administration. In contrast, after cholecalciferol administration, 25OHD increase depends on more factors than dose and frequency of administration, also phenotypic aspects (such as obesity and malabsorption), and genotypic factors impacts in this increase.
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Trimarco V, Manzi MV, Mancusi C, Strisciuglio T, Fucile I, Fiordelisi A, Pilato E, Izzo R, Barbato E, Lembo M, Morisco C. Insulin Resistance and Vitamin D Deficiency: A Link Beyond the Appearances. Front Cardiovasc Med 2022; 9:859793. [PMID: 35369303 PMCID: PMC8968037 DOI: 10.3389/fcvm.2022.859793] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/17/2022] [Indexed: 12/23/2022] Open
Abstract
Vitamin D is a steroid hormone that plays a key role in the regulation of body homeostasis, including cardiovascular function. Although the chronic deficiency of vitamin D is associated with cardiovascular risk factors, as well as with an adverse prognosis, randomized controlled trials have failed in demonstrating that dietary vitamin D supplementation could ameliorate the prognosis of patients with cardiovascular diseases, and suggested that vitamin D deficiency is the expression of the effects of other determinants of cardiovascular risk. Thus, the supplementation of vitamin D is not sufficient to improve the cardiovascular risk profile and prognosis. Insulin resistance is a complex phenomenon that plays a key role in the pathogenesis of conventional cardiovascular risk factors. Interestingly, defects of vitamin D and insulin resistance have a superimposable epidemiological distribution. According to the common view, Insulin resistance is considered the direct or indirect consequence of vitamin D deficiency. However, it is also reasonable to speculate that the deficit or the impaired action of vitamin D, in some circumstances, could be the result of the same pathogenic mechanisms responsible of insulin resistance development. In this case, vitamin D deficiency could be considered an epiphenomenon of insulin resistance. Insulin resistance is a reversible condition, being possibly ameliorated by physical activity and hypocaloric diets. Notably, both physical exercise and energy-restricted dietary regimens are associated with an increase of vitamin D levels. These findings indicate that improving insulin resistance condition is a necessary step to ameliorate vitamin D supplementation-based strategies in cardiovascular prevention.
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Affiliation(s)
- Valentina Trimarco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Virginia Manzi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Teresa Strisciuglio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Ilaria Fucile
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonella Fiordelisi
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emanuele Pilato
- Department of Cardiac Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Emanuele Barbato
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
| | - Maria Lembo
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
- *Correspondence: Maria Lembo
| | - Carmine Morisco
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy
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Li Z, Tang Y, Liu Z, Fan Q, Chen M, Lin Z, Zhao C, Lin R. Hepatotoxicity induced by PPⅥ and PPⅦ in zebrafish were related to the Cholesterol disorder. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 95:153787. [PMID: 34782205 DOI: 10.1016/j.phymed.2021.153787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/15/2021] [Accepted: 09/29/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND PPⅥ2 and PPⅦ3 were a group of Pennogenin compounds extracted from the Paris polyphylla and caused hepatotoxicity in human, while the potential underlying mechanism was unclear. PURPOSE To evaluated the adverse effects of PPⅥ and PPⅦ on the liver in the zebrafish. METHOD In this study, 4dpf zebrafish were used for acute toxicity test, LC0 was calculated, and 1/2LC0 and 3/5LC0 were selected for pathological section and liver area measurement to verify the hepatotoxicity of PPⅥ and PPⅦ. Etabonomics study was then conducted to further explore the mechanism of hepatotoxicity of PPⅥ and PPⅦ. Lovastatin was used as an inhibitor, and PCR was used to verify the results. RESULT The result showed that under the condition of sub-lethal concentration exposure, hepatotoxicity-included changes in liver phenotype (liver area), hepatocyte swelling and degeneration, liver cell apoptosis and disturbed biochemical index were observed in zebrafish treated with PPⅥ and PPⅦ. Furthermore, the transcriptome was conducted to confirm the toxicity mechanism shared with PPⅥ and PPⅦ, and we found that steroid biosynthesis process and the related target genes were mainly affected. While, lovastatin treatment effectively ameliorated PPⅦ-induced zebrafish liver injury by improving the liver tissue structure and regulate the expression of associated genes including HMGCRA, SREBP, LSS, CYP2R1, PIK3R3A, GDPD1 and PFKFB-2. CONCLUSION This study was the first investigation to provide the direct evidence of hepatotoxicity of PPⅥ and PPⅦ in vivo zebrafish model, which were related to the steroid biosynthesis. furthermore, in lovastatin played an important role in protection against hepatotoxicity induced by PPVI and PPⅦ by regulating the cholesterol metabolism.
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Affiliation(s)
- Zhiqi Li
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China; Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Yang Tang
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Zhenquan Liu
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Qiqi Fan
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China; Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Meilin Chen
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China; Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Zili Lin
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China
| | - Chongjun Zhao
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China; Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China.
| | - Ruichao Lin
- Beijing University of Chinese Medicine, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China; Beijing Key Lab for Quality Evaluation of Chinese Materia Medica, No. 11 Beisanhuan East Road, Chaoyang, Beijing 100102, China.
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Karampela I, Sakelliou A, Vallianou N, Christodoulatos GS, Magkos F, Dalamaga M. Vitamin D and Obesity: Current Evidence and Controversies. Curr Obes Rep 2021; 10:162-180. [PMID: 33792853 DOI: 10.1007/s13679-021-00433-1] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/11/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Evidence from observational studies suggests that obesity is associated with low vitamin D. As both obesity and hypovitaminosis D present an alarmingly increased prevalence worldwide, there is an intense research interest to clarify all aspects of this association. This review summarizes current evidence from meta-analyses investigating vitamin D status in obesity, including the effects of weight loss and bariatric surgery on vitamin D status and the outcomes of vitamin D supplementation on body weight. We also discuss potential pathophysiologic mechanisms and important controversies. RECENT FINDINGS Data from meta-analyses consistently support an inverse association of vitamin D levels with body weight. However, the impact of weight loss on improving vitamin D status is small, while studies on the supplementation with vitamin D after bariatric surgery have shown conflicting results regarding vitamin D status. Moreover, interventional studies do not support a beneficial effect of vitamin D supplementation on body weight. These findings warrant a cautious interpretation due to important methodological limitations and confounding factors, such as high heterogeneity of studies, variable methods of determination of vitamin D and definition of deficiency/insufficiency, use of various adiposity measures and definitions of obesity, and inadequate adjustment for confounding variables influencing vitamin D levels. The underlying pathogenetic mechanisms associating low vitamin D in obesity include volumetric dilution, sequestration into adipose tissue, limited sunlight exposure, and decreased vitamin D synthesis in the adipose tissue and liver. Experimental studies have demonstrated that low vitamin D may be implicated in adipose tissue differentiation and growth leading to obesity either by regulation of gene expression or through modulation of parathyroid hormone, calcium, and leptin. Obesity is associated with low vitamin D status but weight loss has little effect on improving this; vitamin D supplementation is also not associated with weight loss. Evidence regarding vitamin D status after bariatric surgery is contradicting. The link between vitamin D and obesity remains controversial due to important limitations and confounding of studies. More research is needed to clarify the complex interplay between vitamin D and adiposity.
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Affiliation(s)
- Irene Karampela
- Second Department of Critical Care, Medical School, Attikon General University Hospital, National and Kapodistrian University of Athens, 1 Rimini St, Haidari, 12462, Athens, Greece.
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece.
| | - Alexandra Sakelliou
- Second Department of Critical Care, Medical School, Attikon General University Hospital, National and Kapodistrian University of Athens, 1 Rimini St, Haidari, 12462, Athens, Greece
| | - Natalia Vallianou
- First Department of Internal Medicine, Evangelismos General Hospital, 45-47 Ypsilantou St, 10676, Athens, Greece
| | - Gerasimos-Socrates Christodoulatos
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece
| | - Faidon Magkos
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Maria Dalamaga
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Mikras Asias 75, Goudi, 11527, Athens, Greece
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Infante M, Buoso A, Pieri M, Lupisella S, Nuccetelli M, Bernardini S, Fabbri A, Iannetta M, Andreoni M, Colizzi V, Morello M. Low Vitamin D Status at Admission as a Risk Factor for Poor Survival in Hospitalized Patients With COVID-19: An Italian Retrospective Study. J Am Coll Nutr 2021; 41:250-265. [PMID: 33600292 PMCID: PMC7899172 DOI: 10.1080/07315724.2021.1877580] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Preliminary findings suggest a relationship between lower serum 25-hydroxyvitamin D [25(OH)D] levels and incidence and severity of COVID-19. The aim of this study was to evaluate the relationship between vitamin D status at admission and different markers of inflammation, coagulation, and sepsis in hospitalized patients with COVID-19. METHOD We conducted a retrospective study on 137 consecutive patients with SARS-CoV-2 infection and available data on serum 25(OH)D levels, who were admitted to our Institution between March 1 and April 30, 2020. Patients were divided into two groups: survivors (n = 78; 57%) and non-survivors (n = 59; 43%). RESULTS At admission, all patients showed hypovitaminosis D. Median total serum 25(OH)D levels at admission were significantly higher in survivors than non-survivors (12 ng/mL vs 8 ng/mL; p < 0.01). Non-survivors exhibited significantly higher median levels of white blood cell (WBC) count, neutrophil-to-lymphocyte count ratio (NLR), high-sensitivity C-reactive protein (hsCRP), ferritin, interleukin 6 (IL-6), D-dimer, fibrinogen, and procalcitonin (PCT) compared to survivors at three different time points during hospitalization. In a multivariate analysis performed by a logistic regression model, serum 25(OH)D levels were significantly inversely associated with risk of COVID-19-related in-hospital mortality (odds ratio, 0.91; 95% confidence interval, 0.85-0.98; p = 0.01). According to receiver operating characteristic curve analysis, hsCRP, NLR, ferritin, and D-dimer were the best predictive biomarkers for poor prognosis of COVID-19, whereas IL-6, PCT, fibrinogen, 25(OH)D, WBC count, and tumor necrosis factor alpha (TNF-α) may serve as supportive biomarkers for worse clinical course of the disease. CONCLUSIONS We found a markedly high prevalence (100%) of hypovitaminosis D in patients admitted to hospital with COVID-19, suggesting a possible role of low vitamin D status in increasing the risk of SARS-CoV-2 infection and subsequent hospitalization. The inverse association between serum 25(OH)D levels and risk of in-hospital mortality observed in our cohort suggests that a lower vitamin D status upon admission may represent a modifiable and independent risk factor for poor prognosis in COVID-19.
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Affiliation(s)
- Marco Infante
- Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), CTO Hospital ASL Roma 2, University of Rome Tor Vergata, Rome, Italy.,UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome, Italy
| | - Andrea Buoso
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Massimo Pieri
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Santina Lupisella
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marzia Nuccetelli
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Andrea Fabbri
- Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), CTO Hospital ASL Roma 2, University of Rome Tor Vergata, Rome, Italy
| | - Marco Iannetta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Vittorio Colizzi
- UNESCO Chair of Biotechnology & Bioethics, University of Rome Tor Vergata, Rome, Italy
| | - Maria Morello
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
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