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Park J, Choi Y, Cho S, Park H, Kim S, Cho HI, Nah EH. Vitamin D Status and Reference Intervals Measured by Liquid Chromatography-Tandem Mass Spectrometry for the Early Adulthood to Geriatric Ages in a South Korean Population during 2017-2022. Nutrients 2024; 16:604. [PMID: 38474732 PMCID: PMC10934696 DOI: 10.3390/nu16050604] [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: 01/30/2024] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
This study aimed to describe the latest 25-hydroxyvitamin D (25(OH)D) status of the South Korean population aged ≥ 20 years using 25(OH)D concentrations measured by liquid chromatography-tandem mass spectrometry and to determine the factors associated with total 25(OH)D concentrations. This cross-sectional, retrospective study consecutively selected 119,335 subjects with a median age of 57 (20-101) years who underwent health checkups among 13 Korean cities during 2017-2022. The total 25(OH)D concentration was 54.5 ± 24.0 nmol/L (mean ± SD). The 7.6%, 47.5%, and 82.9% of participants had 25(OH)D less than 25, 50, and 75 nmol/L, respectively. The prevalence of 25(OH)D deficiency (<25 nmol/L) was higher in females than in males (8.9% vs. 6.1%) and varied between age groups, decreasing in older subjects. Those aged 20-29 years had the highest prevalence of 25(OH)D deficiency (23.0% in females and 20.1% in males), which also varied between cities. In the adjusted model, female sex, older age, summer and autumn seasons, lower body mass index (<25 kg/m2), and lower high-sensitivity C-reactive protein concentration (<1 mg/L) were associated with higher total 25(OH)D concentrations. This study could provide an exact understanding of the status of vitamin D and help devise strategies to prevent vitamin D deficiency among the Korean population.
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Affiliation(s)
- Jooheon Park
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea; (J.P.); (Y.C.)
| | - Yongjun Choi
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea; (J.P.); (Y.C.)
| | - Seon Cho
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul 07572, Republic of Korea; (S.C.); (H.P.); (S.K.)
| | - Hyeran Park
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul 07572, Republic of Korea; (S.C.); (H.P.); (S.K.)
| | - Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul 07572, Republic of Korea; (S.C.); (H.P.); (S.K.)
| | - Han-Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Seoul 07572, Republic of Korea;
| | - Eun-Hee Nah
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun 58128, Republic of Korea; (J.P.); (Y.C.)
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Pludowski P, Grant WB, Karras SN, Zittermann A, Pilz S. Vitamin D Supplementation: A Review of the Evidence Arguing for a Daily Dose of 2000 International Units (50 µg) of Vitamin D for Adults in the General Population. Nutrients 2024; 16:391. [PMID: 38337676 PMCID: PMC10857599 DOI: 10.3390/nu16030391] [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: 01/01/2024] [Revised: 01/26/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Vitamin D deficiency is considered a public health problem due to its worldwide high prevalence and adverse clinical consequences regarding musculoskeletal health. In addition, vitamin D may also be crucial for the prevention of certain extraskeletal diseases. Despite decades of intensive scientific research, several knowledge gaps remain regarding the precise definition of vitamin D deficiency and sufficiency, the health benefits of improving vitamin D status, and the required vitamin D intakes. Consequently, various societies and expert groups have released heterogeneous recommendations on the dosages for vitamin D supplementation. In this brief narrative review, we outline and discuss recent advances regarding the scientific evidence arguing for a daily vitamin D supplementation with 2000 international units (IU) (50 µg) of vitamin D3 to prevent and treat vitamin D deficiency. According to data from randomized controlled trials (RCTs), such a dose may improve some health outcomes and is sufficient to raise and maintain serum 25(OH)D concentrations above 50 nmol/L (20 ng/mL) and above 75 nmol/L (30 ng/mL) in >99% and >90% of the general adult population, respectively. According to large vitamin D RCTs, there are no significant safety concerns in supplementing such a dose for several years, even in individuals with an already sufficient vitamin D status at baseline. A daily vitamin D supplementation with 2000 IU (50 µg) may be considered a simple, effective, and safe dosage to prevent and treat vitamin D deficiency in the adult general population.
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Affiliation(s)
- Pawel Pludowski
- Department of Clinical Biochemistry, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland;
| | - William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA;
| | - Spyridon N. Karras
- Laboratory of Biological Chemistry, Medical School, Aristotle University, 54636 Thessaloniki, Greece;
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen (NRW), Ruhr University Bochum, 32545 Bad Oeynhausen, Germany;
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria
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Yang Y, Yan S, Yao N, Guo Y, Wang H, Sun M, Hu W, Li X, Wang L, Li B. Effects of vitamin D supplementation on the regulation of blood lipid levels in prediabetic subjects: A meta-analysis. Front Nutr 2023; 10:983515. [PMID: 36969817 PMCID: PMC10033891 DOI: 10.3389/fnut.2023.983515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 02/06/2023] [Indexed: 03/11/2023] Open
Abstract
This meta-analysis aimed to systematically investigate whether vitamin D supplementation reduces blood lipid—total cholesterol (TC), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and triglyceride (TG)—levels in prediabetic individuals. Pubmed, Web of Science, Cochrane Library, Embase, CNKI, and WANFANG databases were searched for studies published before 13 February 2022 (including 13 February 2022). Five articles were included. The results showed that vitamin D intervention led to a significant reduction in TG compared with control or placebo treatment (−0.42 [−0.59, −0.25], P < 0.001). Subgroup analyses showed that this effect was particularly significant among the studies that included obese subjects (−0.46 [−0.65, −0.28], P < 0.001), the studies that also included men (not only women) (−0.56 [−0.78, −0.34], P < 0.001), and the studies with intervention durations longer than 1 year (−0.46 [−0.65, −0.28], P < 0.001). Both relatively low doses of 2,857 IU/day (−0.65 [−0.92, −0.38], P < 0.001) and relatively high doses of 8,571 IU/day (−0.28 [−0.54, −0.02] P = 0.04) of vitamin D supplementation reduced TG levels, and the effect was observed both in Northern Europe (−0.65 [−0.92, −0.38], P < 0.001) and Asian (−0.25 [−0.48, −0.03], P = 0.03) country subgroups. No significant effects on TC, HDL-C, and LDL-C were shown. In conclusion, vitamin D supplementation might beneficially affect TG levels in individuals with prediabetes. Particularly longer durations of treatment, more than 1 year, with doses that correct vitamin deficiency/insufficiency, can have a beneficial effect. This meta-analysis was registered at www.crd.york.ac.uk/prospero (CRD42020160780).
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Affiliation(s)
- Yixue Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Shoumeng Yan
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Nan Yao
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Yinpei Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Han Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Mengzi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Wenyu Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiaotong Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Ling Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
- *Correspondence: Bo Li
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An Update on the Effects of Vitamin D on the Immune System and Autoimmune Diseases. Int J Mol Sci 2022; 23:ijms23179784. [PMID: 36077185 PMCID: PMC9456003 DOI: 10.3390/ijms23179784] [Citation(s) in RCA: 57] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/16/2022] Open
Abstract
Vitamin D intervenes in calcium and phosphate metabolism and bone homeostasis. Experimental studies have shown that 1,25-dihydroxyvitamin D (calcitriol) generates immunologic activities on the innate and adaptive immune system and endothelial membrane stability. Low levels of serum 25-hydroxyvitamin D (25(OH)D) are associated with an increased risk of developing immune-related diseases such as psoriasis, type 1 diabetes, multiple sclerosis, and autoimmune diseases. Various clinical trials describe the efficacy of supplementation of vitamin D and its metabolites for treating these diseases that result in variable outcomes. Different disease outcomes are observed in treatment with vitamin D as high inter-individual difference is present with complex gene expression in human peripheral blood mononuclear cells. However, it is still not fully known what level of serum 25(OH)D is needed. The current recommendation is to increase vitamin D intake and have enough sunlight exposure to have serum 25(OH)D at a level of 30 ng/mL (75 nmol/L) and better at 40–60 ng/mL (100–150 nmol/L) to obtain the optimal health benefits of vitamin D.
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Clinical Practice in the Prevention, Diagnosis and Treatment of Vitamin D Deficiency: A Central and Eastern European Expert Consensus Statement. Nutrients 2022; 14:nu14071483. [PMID: 35406098 PMCID: PMC9002638 DOI: 10.3390/nu14071483] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 01/25/2023] Open
Abstract
Vitamin D deficiency has a high worldwide prevalence, but actions to improve this public health problem are challenged by the heterogeneity of nutritional and clinical vitamin D guidelines, with respect to the diagnosis and treatment of vitamin D deficiency. We aimed to address this issue by providing respective recommendations for adults, developed by a European expert panel, using the Delphi method to reach consensus. Increasing the awareness of vitamin D deficiency and efforts to harmonize vitamin D guidelines should be pursued. We argue against a general screening for vitamin D deficiency but suggest 25-hydroxyvitamin D (25(OH)D) testing in certain risk groups. We recommend a vitamin D supplementation dose of 800 to 2000 international units (IU) per day for adults who want to ensure a sufficient vitamin D status. These doses are also recommended for the treatment of vitamin D deficiency, but higher vitamin D doses (e.g., 6000 IU per day) may be used for the first 4 to 12 weeks of treatment if a rapid correction of vitamin D deficiency is clinically indicated before continuing, with a maintenance dose of 800 to 2000 IU per day. Treatment success may be evaluated after at least 6 to 12 weeks in certain risk groups (e.g., patients with malabsorption syndromes) by measurement of serum 25(OH)D, with the aim to target concentrations of 30 to 50 ng/mL (75 to 125 nmol/L).
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Natesan V, Kim SJ. Metabolic Bone Diseases and New Drug Developments. Biomol Ther (Seoul) 2022; 30:309-319. [PMID: 35342038 PMCID: PMC9252877 DOI: 10.4062/biomolther.2022.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/03/2022] [Accepted: 03/05/2022] [Indexed: 11/05/2022] Open
Abstract
Metabolic bone diseases are serious health issues worldwide, since several million individuals over the age of 50 are at risk of bone damage and should be worried about their bone health. One in every two women and one in every four men will break a bone during their lifetime due to a metabolic bone disease. Early detection, raising bone health awareness, and maintaining a balanced healthy diet may reduce the risk of skeletal fractures caused by metabolic bone diseases. This review compiles information on the most common metabolic bone diseases (osteoporosis, primary hyperparathyroidism, osteomalacia, and fluorosis disease) seen in the global population, including their symptoms, mechanisms, and causes, as well as discussing their prevention and the development of new drugs for treatment. A large amount of research literature suggests that balanced nutrition and balanced periodic supplementation of calcium, phosphate, and vitamin D can improve re-absorption and the regrowth of bones, and inhibit the formation of skeletal fractures, except in the case of hereditary bone diseases. Meanwhile, new and improved drug formulations, such as raloxifene, teriparatide, sclerostin, denosumab, and abaloparatide, have been successfully developed and administered as treatments for metabolic bone diseases, while others (romososumab and odanacatib) are in various stages of clinical trials.
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Affiliation(s)
- Vijayakumar Natesan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamil Nadu, India
| | - Sung-Jin Kim
- Department of Pharmacology and Toxicology, Metabolic Diseases Research Laboratory, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
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Individual participant data (IPD)-level meta-analysis of randomised controlled trials to estimate the vitamin D dietary requirements in dark-skinned individuals resident at high latitude. Eur J Nutr 2022; 61:1015-1034. [PMID: 34705075 PMCID: PMC8857035 DOI: 10.1007/s00394-021-02699-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/01/2021] [Indexed: 02/07/2023]
Abstract
CONTEXT AND PURPOSE There is an urgent need to develop vitamin D dietary recommendations for dark-skinned populations resident at high latitude. Using data from randomised controlled trials (RCTs) with vitamin D3-supplements/fortified foods, we undertook an individual participant data-level meta-regression (IPD) analysis of the response of wintertime serum 25-hydroxyvitamin (25(OH)D) to total vitamin D intake among dark-skinned children and adults residing at ≥ 40° N and derived dietary requirement values for vitamin D. METHODS IPD analysis using data from 677 dark-skinned participants (of Black or South Asian descent; ages 5-86 years) in 10 RCTs with vitamin D supplements/fortified foods identified via a systematic review and predefined eligibility criteria. Outcome measures were vitamin D intake estimates across a range of 25(OH)D thresholds. RESULTS To maintain serum 25(OH)D concentrations ≥ 25 and 30 nmol/L in 97.5% of individuals, 23.9 and 27.3 µg/day of vitamin D, respectively, were required among South Asian and 24.1 and 33.2 µg/day, respectively, among Black participants. Overall, our age-stratified intake estimates did not exceed age-specific Tolerable Upper Intake Levels for vitamin D. The vitamin D intake required by dark-skinned individuals to maintain 97.5% of winter 25(OH)D concentrations ≥ 50 nmol/L was 66.8 µg/day. This intake predicted that the upper 2.5% of individuals could potentially achieve serum 25(OH)D concentrations ≥ 158 nmol/L, which has been linked to potential adverse effects in older adults in supplementation studies. CONCLUSIONS Our IPD-derived vitamin D intakes required to maintain 97.5% of winter 25(OH)D concentrations ≥ 25, 30 and 50 nmol/L are substantially higher than the equivalent estimates for White individuals. These requirement estimates are also higher than those currently recommended internationally by several agencies, which are based predominantly on data from Whites and derived from standard meta-regression based on aggregate data. Much more work is needed in dark-skinned populations both in the dose-response relationship and risk characterisation for health outcomes. TRAIL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews (Registration Number: CRD42018097260).
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Levy B, O'Callaghan KM, Qamar H, Mahmud AA, Gernand AD, Islam MM, Roth DE. Basal Vitamin D Status and Supplement Dose Are Primary Contributors to Maternal 25-Hydroxyvitamin D Response to Prenatal and Postpartum Cholecalciferol Supplementation. J Nutr 2021; 151:3361-3378. [PMID: 34302350 PMCID: PMC8562081 DOI: 10.1093/jn/nxab265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/28/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Variability in the 25-hydroxyvitamin D [25(OH)D] response to prenatal and postpartum vitamin D supplementation is an important consideration for establishing vitamin D deficiency prevention regimens. OBJECTIVES We aimed to examine interindividual variation in maternal and infant 25(OH)D following maternal vitamin D supplementation. METHODS In a randomized trial of maternal vitamin D supplementation (Maternal Vitamin D for Infant Growth Trial), healthy pregnant women (n = 1300) received a prenatal cholecalciferol (vitamin D-3) dose of 0, 4200, 16,800, or 28,000 IU/wk from 17 to 24 wk of gestation followed by placebo to 6 mo postpartum. A fifth group received 28,000 IU cholecalciferol/wk both prenatally and postpartum. In a subset of participants, associations of 25(OH)D with hypothesized explanatory factors were estimated in women at delivery (n = 655) and 6 mo postpartum (n = 566), and in their infants at birth (n = 502) and 6 mo of age (n = 215). Base models included initial 25(OH)D and supplemental vitamin D dose. Multivariable models were extended to include other individual characteristics and specimen-related factors. The model coefficient of determination (R2) was used to express the percentage of total variance explained. RESULTS Supplemental vitamin D intake and initial 25(OH)D accounted for the majority of variance in maternal 25(OH)D at delivery and postpartum (R2 = 70% and 79%, respectively). Additional characteristics, including BMI, contributed negligibly to remaining variance (<5% increase in R2). Variance in neonatal 25(OH)D was explained mostly by maternal delivery 25(OH)D and prenatal vitamin D intake (R2 = 82%). Variance in 25(OH)D in later infancy could only partly be explained by numerous biological, sociodemographic, and laboratory-related characteristics, including feeding practices (R2 = 43%). CONCLUSIONS Presupplementation 25(OH)D and vitamin D supplemental dose are the major determinants of the response to maternal prenatal vitamin D intake. Vitamin D dosing regimens to prevent maternal and infant vitamin D deficiency should take into consideration the mean 25(OH)D concentration of the target population.
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Affiliation(s)
- Benjamin Levy
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen M O'Callaghan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Huma Qamar
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Abdullah Al Mahmud
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - M Munirul Islam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
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Li X, Yu J, Wen L, Li Q, Yan J, Tian J, Tong C, Tong Q, Qi H, Saffery R, Kilby MD, Baker PN. Vitamin D status in women with dichorionic twin pregnancies and their neonates: a pilot study in China. BMC Pregnancy Childbirth 2021; 21:279. [PMID: 33832462 PMCID: PMC8034067 DOI: 10.1186/s12884-021-03707-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 03/10/2021] [Indexed: 01/16/2023] Open
Abstract
Background Vitamin D deficiency is a global public health issue in women and children and is associated with adverse impacts on child growth, such as rickets. However, prior studies have mainly focused on measuring vitamin D levels in singleton pregnant women and their offspring, and very limited studies have revealed the prevalence of vitamin D deficiency in twin pregnant women and their offspring. The aim of this study was to investigate vitamin D levels in twin-pregnant women and their neonates. We also explored the correlation of maternal vitamin D levels with neonatal outcomes and infant growth. Methods A prospective subcohort investigation was carried out among 72 dichorionic, diamniotic twin-pregnant mothers and their twin offspring from the Longitudinal Twin Study. Peripheral blood was collected from the mothers in the third trimester, and cord blood was collected from neonates at birth to identify 25[OH]D levels. Data on the characteristics of the mothers and neonates were collected. Infant growth data and food sensitivities were also collected. Results The average maternal 25[OH]D level was 31.78 ng/mL, with 19.4% being deficient and 20.8% insufficient, while the average neonatal 25[OH]D level was 15.37 ng/mL, with 99.3% being deficiency or insufficient. A positive correlation was found between maternal and neonatal 25[OH]D levels (beta-value: 0.43, 95% CI: 0.37, 0.49). Interestingly, the higher the maternal 25[OH]D level was, the smaller the cotwin birthweight discordance (beta-value: -2.67, 95% CI: − 5.11, − 0.23). In addition, the infants of mothers with vitamin D deficiency were more likely to be allergic to foods at 6 months than those of mothers with vitamin D sufficiency. Conclusions Twin neonates were at high risk of vitamin D deficiency, although their mothers’ vitamin D deficiency partially improved. Higher maternal vitamin D levels were associated with smaller discordance of cotwin birthweight. Trial registration Chinese Clinical Trial Registry ChiCTR-OOC-16008203, 1st April 2016. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03707-7.
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Affiliation(s)
- Xin Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Jiaxiao Yu
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Li Wen
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China
| | - Qingshu Li
- State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China.,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Jianying Yan
- Fujian Provincial Maternity and Children's Hospital, affiliated hospital of Fujian Medical University, Fuzhou, 350001, Fujian, China
| | - Jing Tian
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, China
| | - Chao Tong
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Qi Tong
- Chongqing Population and Family Planning Science and Technology Research Institute, 18 Honghuang Rd, Jiangbei District, Chongqing, 400020, China.
| | - Hongbo Qi
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing, 400016, China. .,State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China. .,International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China. .,Department of Pathology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
| | - Richard Saffery
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,Cancer, Disease and Developmental Epigenetics, Murdoch Children's Research Institute, Parkville, Victoria, 3052, Australia
| | - Mark D Kilby
- Centre for Women's and Newborn Health, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, B15 2TT, UK.,Fetal Medicine Centre, Birmingham Women's & Children's Foundation Trust, Edgbaston, Birmingham, B15 2TG, UK
| | - Philip N Baker
- International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.,College of Life Sciences, University of Leicester, Leicester, LE1 7RH, UK
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Kalliokoski P, Widarsson M, Rodhe N, Löfvander M. Positive impact on vitamin D related lifestyle of medical advice in pregnant Somali-born women and new mothers: a mixed method study in Swedish primary care. BMC Public Health 2021; 21:297. [PMID: 33546641 PMCID: PMC7866682 DOI: 10.1186/s12889-021-10277-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 01/19/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A previous study showed that pregnant women/new mothers especially Somali-born and some Swedish-born had extremely low vitamin D levels and poor physical performance. Our study aimed to examine vitamin D related lifestyle, attitudes and behaviour before and after brief information about vitamin D, with special long-term focus on Somali-born women. METHODS A cohort of 91 pregnant women/new mothers having serum hydroxyvitamin D (S-25-OHD) ≤ 50 nmol/L (n = 51 Somali-born with one third < 10 nmol/L of S-25-OHD) in primary health care in Sweden was targeted for intervention. Brief individual oral and visual information on vitamin D was given by doctors at baseline and after four and ten months. Questionnaires with ordinal scales on vitamin D related lifestyle of food, clothing, and outdoor activities were distributed on all occasions. Focus-group interviews with 15 women from the target-group were performed after two years. A Somali interpreter was available. RESULTS Veiled clothing, indoor living, and a low intake of milk, cheese, and fatty fish were common in the target group. Consumption pattern had increased significantly among the Somali-born women at the four-month follow-up but declined to non-significant levels at the ten-month follow-up. The focus-group interviews showed improved understanding of vitamin D deficiency, symptoms and attitudes, but varying applied behaviours related to sun exposure. Sun exposure for the children and increased fish consumption was the most evident positive results. CONCLUSIONS Vitamin D related lifestyle, attitudes and behaviour improved in a Somali-born group of pregnant women/new mothers with severe vitamin D deficiency. The preventive measures suggested in our study may have impact on public health in relation to bone and muscle strength and immunity especially in vitamin D deficiency risk groups. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02922803 . Date of registration: 28 September 2016.
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Affiliation(s)
- P Kalliokoski
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden.
| | - M Widarsson
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - N Rodhe
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden
| | - M Löfvander
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University, Husargatan 3, Postal address: Box 564, 751 22, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
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11
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Missaggia BO, Reales G, Cybis GB, Hünemeier T, Bortolini MC. Adaptation and co-adaptation of skin pigmentation and vitamin D genes in native Americans. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2020; 184:1060-1077. [PMID: 33325159 DOI: 10.1002/ajmg.c.31873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/23/2020] [Accepted: 12/02/2020] [Indexed: 11/06/2022]
Abstract
We carried out an exhaustive review regarding human skin color variation and how much it may be related to vitamin D metabolism and other photosensitive molecules. We discuss evolutionary contexts that modulate this variability and hypotheses postulated to explain them; for example, a small amount of melanin in the skin facilitates vitamin D production, making it advantageous to have fair skin in an environment with little radiation incidence. In contrast, more melanin protects folate from degradation in an environment with a high incidence of radiation. Some Native American populations have a skin color at odds with what would be expected for the amount of radiation in the environment in which they live, a finding challenging the so-called "vitamin D-folate hypothesis." Since food is also a source of vitamin D, dietary habits should also be considered. Here we argue that a gene network approach provides tools to explain this phenomenon since it indicates potential alleles co-evolving in a compensatory way. We identified alleles of the vitamin D metabolism and pigmentation pathways segregated together, but in different proportions, in agriculturalists and hunter-gatherers. Finally, we highlight how an evolutionary approach can be useful to understand current topics of medical interest.
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Affiliation(s)
- Bruna Oliveira Missaggia
- Genetics Departament, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Guillermo Reales
- Genetics Departament, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gabriela B Cybis
- Statistics Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Tábita Hünemeier
- Department of Genetics and Evolutionary Biology, Biosciences Institute, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Cátira Bortolini
- Genetics Departament, Biosciences Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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12
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Martín Giménez VM, Ferder L, Inserra F, García J, Manucha W. Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19. Ther Adv Cardiovasc Dis 2020; 14:1753944720977715. [PMID: 33283618 PMCID: PMC7724257 DOI: 10.1177/1753944720977715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
COVID-19 is said to be a pandemic that does not distinguish between skin color or ethnic origin. However, data in many parts of the world, especially in the United States, begin to show that there is a sector of society suffering a more significant impact from this pandemic. The Black population is more vulnerable than the White population to infection and death by COVID-19, with hypertension and diabetes mellitus as probable predisposing factors. Over time, multiple disparities have been observed between the health of Black and White populations, associated mainly with socioeconomic inequalities. However, some mechanisms and pathophysiological susceptibilities begin to be elucidated that are related directly to the higher prevalence of multiple diseases in the Black population, including infection and death by COVID-19. Plasma vitamin D levels and evolutionary adaptations of the renin-angiotensin-aldosterone system (RAAS) in Black people differ considerably from those of other races. The role of these factors in the development and progression of hypertension and multiple lung diseases, among them SARS-CoV-2 infection, is well established. In this sense, the present review attempts to elucidate the link between vitamin D and RAAS ethnic disparities and susceptibility to infection and death by COVID-19 in Black people, and suggests possible mechanisms for this susceptibility.
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Affiliation(s)
- Virna Margarita Martín Giménez
- Instituto de Investigaciones en Ciencias
Químicas, Facultad de Ciencias Químicas y Tecnológicas, Universidad Católica
de Cuyo, San Juan, Argentina
| | - León Ferder
- Universidad Maimónides, Buenos Aires,
Argentina
| | | | - Joxel García
- AMBITNA, Ambitious Solutions for Health Cures,
Chevy Chase, MD, USA
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de
Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y
Tecnológicas (CONICET), Mendoza, Argentina
- Departamento de Patología, Facultad de Ciencias
Médicas, Área de Farmacología, Universidad Nacional de Cuyo, Libertador 80,
Mendoza, 5500, Argentina
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13
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Cashman KD, Ritz C. Individual participant data (IPD)-level meta-analysis of randomised controlled trials among dark-skinned populations to estimate the dietary requirement for vitamin D. Syst Rev 2019; 8:128. [PMID: 31138301 PMCID: PMC6540379 DOI: 10.1186/s13643-019-1032-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 04/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Estimation of the dietary requirements for vitamin D is crucial from a public health perspective in providing a framework for the prevention of vitamin D deficiency. It has been shown that pooling individual participant-level data (IPD) from selected randomised controlled trials (RCTs) of white children and adults facilitated the generation of more accurate estimates of the vitamin D requirement. Recent RCT data suggest the vitamin D requirement of dark-skinned, particularly black, individuals, an at-risk group of vitamin D deficiency, is greater than those of white counterparts. Thus, we wished to develop a study protocol for the conduct of an IPD-level meta-analysis of vitamin D requirements using data from appropriate vitamin D RCTs in dark-skinned population subgroups. METHODS The study protocol details the steps needed within such an IPD meta-analysis which will include its registration, constituent systematic review to identify all appropriate RCTs on the basis of pre-specified eligibility criteria, the associated data collection, handling, and synthesis, as well as checking the integrity of the IPD, followed by implementation of a one/two-stage IPD meta-analysis and derivation of vitamin D requirement estimates. DISCUSSION As dark-skinned population subgroups are at increased risk of vitamin D deficiency, further investigation of dietary recommendations for vitamin D in these subgroups is needed. We strongly believe that application of an IPD-based meta-analysis is a highly strategic approach by which to undertake some of this further investigation. Such IPD-based analysis, however, will need collaboration across the principal investigators of the identified RCTs meeting with the eligibility criteria, and the availability of this study protocol will be important to highlight the potential of IPD-based analysis for estimation of the dietary requirement for vitamin D for this particular population subgroup as well as for other at-risk target populations. SYSTEMATIC REVIEW REGISTRATION PROSPERO International Prospective Register of Systematic Reviews (registration number: CRD42018092343).
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Affiliation(s)
- Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland. .,Department of Medicine, University College Cork, Frederiksberg C, Ireland.
| | - Christian Ritz
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg C, Denmark
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14
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Kiely M, Cashman KD. Summary Outcomes of the ODIN Project on Food Fortification for Vitamin D Deficiency Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112342. [PMID: 30352957 PMCID: PMC6266662 DOI: 10.3390/ijerph15112342] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/19/2018] [Accepted: 10/19/2018] [Indexed: 12/21/2022]
Abstract
Food-based solutions for optimal vitamin D nutrition and health through the life cycle (ODIN) was a cross-disciplinary, collaborative project, including 30 partners from 19 countries, which aimed to develop evidence-based solutions to prevent low vitamin D status (25-hydroxyvitamin D (25(OH)D) < 30 nmol/L) using a food-first approach. This paper provides a summary overview of some of the important ODIN outcomes and outlines some outstanding data requirements. In a study of almost 56,000 individuals, the first internationally standardised dataset of vitamin D status showed that 13% of EU residents overall, across a latitude gradient of 35° N to 69° N, had serum 25(OH)D < 30 nmol/L and 40% were < 50 nmol/L. The risk of low vitamin D status was several-fold higher among persons of ethnic minority. However, additional data from quality bio-banked sera would be required to improve these estimates. To address the question of dietary requirements for vitamin D among under-researched life-stage and population groups, four dose-response RCTs conducted in Northern Europe showed that vitamin D3 intakes of 8 and 13 μg/day prevented 25(OH)D decreasing below 30 nmol/L in white children and adolescents and 20 and 30 μg/day, respectively, achieved ≥50 nmol/L. Among white women during pregnancy, 30 μg/day is required to prevent umbilical cord 25(OH)D, representing new-born vitamin D status, below 25 nmol/L. While 8 μg/day protected white women in Finland at the 30 nmol/L cut-off, 18 μg/day was needed by women of East African descent to prevent 25(OH)D decreasing below 30 nmol/L during wintertime. Replicate RCTs are needed in young children <5 years and in school-age children, teens and pregnant women of ethnic minority. Using a series of food production studies, food-based RCTs and dietary modelling experiments, ODIN research shows that diverse fortification strategies could safely increase population intakes and prevent low vitamin D status. Building on this solid technological platform, implementation research is now warranted to scale up interventions in real-world settings to eradicate vitamin D deficiency.
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Affiliation(s)
- Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12ND89 Cork, Ireland.
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12ND89 Cork, Ireland.
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