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Hickman NE, Price M, Crespo NC, Feldstein AE. Correlating neighborhood-level deprivation and pediatric metabolic dysfunction-associated steatotic liver disease. J Pediatr Gastroenterol Nutr 2024; 78:1355-1363. [PMID: 38623922 DOI: 10.1002/jpn3.12218] [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: 07/07/2023] [Revised: 02/23/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVES The primary objective of this study is to further explore associations between social influencers of health and markers of disease severity at the time of presentation of patients with pediatric metabolic dysfunction-associated steatotic liver disease (MASLD) using neighborhood-level Area Deprivation Index (ADI) scores. METHODS A retrospective cross-sectional study was conducted among 344 pediatric MASLD patients. Each patient received an ADI score based on their 9-digit zip code. Groups were defined as low (≤5) and high (6≥) ADI. Associations between ADI and symptomatology and laboratory values at presentation, as well as initial liver biopsy pathology were tested via analyses of covariance, χ2 testing, and logistic regressions. RESULTS The mean ADI was 6.54 (standard deviation = 2.09). ADI groups did not significantly differ in age of presentation, type of presentation, or associated conditions, except for the higher ADI group having on average lower vitamin D levels (26.70 vs. 29.91, p = 0.02) and being two times more likely to also be diagnosed with low high-density lipoprotein (HDL) levels (p = 0.04, 95% CI 1.04-3.89). Mean transaminases and histopathologic nonalcoholic fatty liver disease (NAFLD) Activity Scores did not significantly differ between ADI groups. CONCLUSIONS Pediatric patients with MASLD in this study span the entire spectrum of neighborhood deprivation. There were no differences in presentation characteristics or severity of MASLD, aside from lower HDL-cholesterol and vitamin D values in the high ADI group. Area deprivation was not predictive of more severe disease as assessed by serum transaminases and liver biopsy NAFLD activity scores.
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Affiliation(s)
- Nicole E Hickman
- San Diego School of Medicine, University of California, La Jolla, California, USA
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Mason Price
- San Diego School of Medicine, University of California, La Jolla, California, USA
| | - Noe C Crespo
- School of Public Health, Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, California, USA
| | - Ariel E Feldstein
- Division of Gastroenterology Hepatology and Nutrition, Rady Children's Hospital, University of California San Diego (UCSD), La Jolla, California, USA
- Global Drug Discovery, Novo Norodisk, Bagsværd, Denmark
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2
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Choi J, Choe Y, Yang S. Monthly versus daily administration of vitamin D3 in children: a retrospective propensity score-matched study. Front Endocrinol (Lausanne) 2023; 14:1265943. [PMID: 37964965 PMCID: PMC10641215 DOI: 10.3389/fendo.2023.1265943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/04/2023] [Indexed: 11/16/2023] Open
Abstract
Objectives We aimed to evaluate the efficacy and safety of monthly vitamin D3 administration compared to a daily dosing regimen in healthy children with vitamin D deficiency. Methods This retrospective study included vitamin D deficient (serum 25-hydroxyvitamin D [25(OH)D] < 20 ng/mL) children with precocious puberty who received gonadotropin-releasing hormone agonist every 4 weeks between December 2019 and November 2022. We used propensity scores to 1:1 match daily (1,000 IU daily) and monthly (25,000 IU per 4 weeks) administration of vitamin D3 based on age, sex, body mass index Z-scores, season of blood collection, and baseline serum 25(OH)D concentrations. Results Of 299 children, 192 were matched based on propensity scores (126 girls and 66 boys, 10.5 ± 1.4years). After a mean follow-up of 5.9 months (standard deviation [SD] 2.5 months), the monthly group showed a statistically significant increase in serum 25(OH)D concentrations (10.9 ± 5.3 vs. 8.2 ± 7.2 ng/mL; p = 0.018), higher corrected dose-response (12.3 ± 5.9 vs. 8.2 ± 7.2 ng/mL increase per 1,000 IU daily; p = 0.002), and a higher proportion of patients attaining 25(OH)D > 20 ng/mL (78.1% vs. 58.3%,; p=0.005) compared with the daily group. No cases of hypercalcemia were observed in either group. Conclusions Monthly administration of vitamin D3 may be an effective and safe alternative to correct hypovitaminosis D in pediatric population, possibly attributed to enhanced compliance.
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Affiliation(s)
- Jinjoo Choi
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Republic of Korea
| | - Yunsoo Choe
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Republic of Korea
| | - Seung Yang
- Department of Pediatrics, Hanyang University Seoul Hospital, Seoul, Republic of Korea
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Republic of Korea
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3
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Wang C, Li H, Huo L, Wang Q, Zhang T, He X, Hao J, Luo Y, Ren L. Serum 25-Hydroxyvitamin D Levels in Type 2 Diabetes Patients in North China: Seasonality and the Association between Vitamin D Status and Glycosylated Hemoglobin Levels. Int J Clin Pract 2023; 2023:4151224. [PMID: 37188155 PMCID: PMC10181903 DOI: 10.1155/2023/4151224] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/17/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Background and Aims Previous studies have reported a correlation between vitamin D levels and seasonality in healthy populations. However, there are few studies on the seasonal variation in vitamin D levels and its relationship with glycosylated hemoglobin (HbA1c) in patients with type 2 diabetes mellitus (T2DM). The objective of this study was to investigate seasonal changes in serum 25-hydroxyvitamin D [25(OH)D] levels and the associations between these vitamin D concentrations and HbA1c levels in T2DM patients in Hebei, China. Methods A cross-sectional study of 1,074 individuals with T2DM was conducted from May 2018 to September 2021. Levels of 25(OH)D in these patients were assessed based on both sex and season, and relevant clinical or laboratory variables that could impact vitamin D status were also considered. Results In the T2DM patient cohort, the mean blood 25(OH)D levels were 17.05 ng/mL. A total of 698 patients (65.0%) had insufficient serum 25(OH)D levels. The vitamin D deficiency rates were significantly higher in the winter and spring compared to the autumn (P < 0.05), indicating that seasonal fluctuations can have a significant impact on 25(OH)D levels. The levels of vitamin D inadequacy were highest in the winter (74%), and females were more likely than males to be deficient (73.4% vs. 59.5%, P < 0.001). In comparison to the winter and spring, both males and females showed higher 25(OH)D levels in the summer (P < 0.001). HbA1c levels were 8.9% higher in those with vitamin D deficiencies than in nondeficient patients (P < 0.001). HbA1c and vitamin D levels were negatively correlated (r = -0.119, P < 0.001). Conclusion Vitamin D deficiencies are particularly prevalent among T2DM patients in Hebei, China, with exceptionally high rates in the winter and spring. Female T2DM patients were at an elevated risk of vitamin D deficiency, and vitamin D levels were negatively correlated with HbA1c.
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Affiliation(s)
- Chang Wang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Huan Li
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Lijing Huo
- Department of Clinical Laboratory, Hebei General Hospital, Shijiazhuang 050051, China
| | - Qing Wang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
- Graduate School of Hebei Medical University, Shijiazhuang 050017, China
| | - Tian Zhang
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Xiaoyu He
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Jianan Hao
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Yu Luo
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
| | - Luping Ren
- Department of Endocrinology, Hebei General Hospital, Shijiazhuang 050051, China
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4
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Daniel JB, de Farias Costa PR, Pereira M, Oliveira AM. Vitamin D deficiency and cardiometabolic risk factors in adolescents: systematic review and meta-analysis. Rev Endocr Metab Disord 2022; 23:995-1010. [PMID: 35713809 DOI: 10.1007/s11154-022-09736-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Vitamin D deficiency is associated with an increase in the occurrence of cardiometabolic events, but the evidence of this relationship in adolescence is still limited. Thus, we analyzed the association between vitamin D deficiency and cardiometabolic risk factors in adolescents. Observational studies were searching in PubMed/Medline, Embase, Scopus, Web of Science, Science Direct, Lilacs, and Google Scholar database. Random effects models were used to summarize standardized mean differences for as a summary measure. The certainty of the evidence was verified using the Cochrane recommendations. A total of 7537 studies were identified, of which 32 were included in the systematic review and 24 in the meta-analysis.Vitamin D deficiency was associated with increased systolic pressure (SMD = 0.22; 95%CI = 0.10; 0.34), diastolic pressure (SMD = 0.23; 95%CI = 0.10; 0.35), glycemia (SMD = 0.13; 95%CI = 0.05; 0.12), and insulin (SMD = 0.50; 95%CI = 0.15; 0.84), an increase in the HOMA index (SMD = 0.48; 95%CI = 0.36; 0.60), high triglyceride values (SMD = 0.30; 95%CI = 0.11; 0.49), and reduced HDL concentrations (SMD= -0.25; 95%CI = -0.46; -0.04). No statistically significant association was observed for glycated hemoglobin, LDL cholesterol, and total cholesterol. Most of the studies presented low and moderate risks of bias, respectively. The certainty of the evidence was very low for all the outcomes analyzed. Vitamin D deficiency was associated with increased exposure to the factors linked to the occurrence of cardiometabolic diseases in adolescents. Systematic Review Registration: PROSPERO (record number 42,018,086,298).
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Affiliation(s)
- Jonas Baltazar Daniel
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil
| | | | - Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil.
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, 40110-040, Salvador, Bahia, Brazil.
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Lee HW, Kang WY, Jung W, Gwon MR, Cho K, Lee B, Seong SJ, Yoon YR. Pharmacokinetic Drug Interaction Between Raloxifene and Cholecalciferol in Healthy Volunteers. Clin Pharmacol Drug Dev 2022; 11:623-631. [PMID: 34984851 PMCID: PMC9305550 DOI: 10.1002/cpdd.1062] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/07/2021] [Indexed: 12/24/2022]
Abstract
Osteoporosis is a common skeletal disorder, often leading to fragility fracture. Combination therapy with raloxifene, a selective estrogen receptor modulator, and cholecalciferol (vitamin D3) has been proposed to improve the overall efficacy and increase compliance of raloxifene therapy for postmenopausal osteoporosis. To our knowledge, there has been no report of any study on the pharmacokinetic interaction between raloxifene and cholecalciferol. This study aimed to evaluate the possible pharmacokinetic interactions between raloxifene and cholecalciferol in healthy adult male Korean volunteers. Twenty subjects completed this open‐label, randomized, single‐dose, 3‐period, 6‐sequence, crossover phase 1 study with a 14‐day washout period. Serial blood samples were collected from 20 hours before dosing to 96 hours after dosing. The plasma concentrations of raloxifene and cholecalciferol were determined using a validated method for high‐performance liquid chromatography with tandem mass spectrometry. The geometric mean ratios (90%CIs) for area under the plasma concentration–time curve from time 0 to the last quantifiable time point and maximum plasma concentration of raloxifene with or without cholecalciferol were 1.02 (0.87‐1.20) and 0.87 (0.70‐1.08), respectively. For baseline‐corrected cholecalciferol, geometric mean ratios (90%CIs) of area under the plasma concentration–time curve from time 0 to the last quantifiable time point and maximum plasma concentration with or without raloxifene were 1.01 (0.93‐1.09) and 0.99 (0.92‐1.06), respectively. Concurrent treatment with raloxifene and cholecalciferol was generally well tolerated. These results suggest that raloxifene and cholecalciferol have no clinically relevant pharmacokinetic drug‐drug interactions when administered concurrently. All treatments were well tolerated, with no serious adverse events.
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Affiliation(s)
- Hae Won Lee
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Woo Youl Kang
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Wookjae Jung
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Mi-Ri Gwon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Kyunghee Cho
- Analytical Research Division, Biocore Co. Ltd., Seoul, Republic of Korea
| | - Backhwan Lee
- Department of Clinical Development, Alvogen Korea Co. Ltd., Seoul, Republic of Korea
| | - Sook Jin Seong
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Young-Ran Yoon
- Department of Molecular Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.,Department of Clinical Pharmacology, Kyungpook National University Hospital, Daegu, Republic of Korea
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Vitamin D Status and Factors Associated with Vitamin D Deficiency during the First Year of Life in Preterm Infants. Nutrients 2021; 13:nu13062019. [PMID: 34208333 PMCID: PMC8231173 DOI: 10.3390/nu13062019] [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: 04/30/2021] [Revised: 06/05/2021] [Accepted: 06/09/2021] [Indexed: 12/19/2022] Open
Abstract
We aimed to investigate the changes in vitamin D levels and factors associated with vitamin D deficiency (VDD) during the first year of life in Korean preterm infants. We enrolled 333 preterm infants who were born at Kyungpook National University Children’s Hospital between March 2013 and December 2019. 25-hydroxyvitamin D (25-OHD) levels and medical records were collected at birth, 6 months, and 12 months of age. The mean gestational age was 33.4 ± 2.3 weeks and mean 25-OHD levels at birth were 18.2 ± 13.5 ng/mL. The incidence of VDD was 82.8%, 30.6%, and 27.0% at birth, 6 months, and 12 months, respectively. The incidence of severe VDD (25-OHD < 10 ng/mL) was 31.5%, 1.5%, and 0%, at birth, 6 months, and 12 months, respectively. Among infants with severe VDD, the deficiency persisted in 49.6% at 6 months, and 35.3% at 12 months. The strongest predictor of VDD during follow-up was 25-OHD concentration at birth. Vitamin D supplementation at 400 IU/day did not affect vitamin D levels during the first year of life. Therefore, it is important to prevent neonatal VDD through maternal vitamin D supplementation during pregnancy. Further research is needed to determine the optimal vitamin D supplementation dose for Korean preterm infants.
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7
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Önal ZE, Tekin A, Gürbüz T, Sağ Ç, Nuhoğlu Ç. Vitamin D status in pubertal children. Minerva Pediatr (Torino) 2021; 73:173-179. [PMID: 33880905 DOI: 10.23736/s2724-5276.16.04334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Optimal vitamin D status has a great importance in puberty, which is a period of peak bone mineral acquisition. In this study, we aimed to assess the effect of pubertal period on vitamin D status. METHODS The study included totally 200 healthy children, aged between 4 and 14 years. Group 1 included 100 prepubertal, children, aged between 4 and 8 years. Group 2 included 100 pubertal children, aged between 9 and 14 years. They had no chronic illnesses. Ages, heights, weights, genders, Body Mass Indexes (BMIs), socioeconomic and educational status of families were established. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured by high performance liquid chromatography (HPLC). Serum parathyroid hormone (PTH) was evaluated using an immunoradiometric assay kit. Serum calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) levels were measured. RESULTS We determined that 25(OH)D levels were lower with higher PTH levels in the group aged 9 to 14 years (pubertal children), compared to the group aged 4 to 8 (prepubertal children). Gender, weight, height or BMI, family socioeconomic and education status did not affect serum 25(OH)D levels of children in each group. CONCLUSIONS We demonstrated that vitamin D deficiency was more commonly seen in the pubertal children, compared to pre pubertal period. Children should be supported with vitamin D supplements during the puberty, which has a great importance for rapid increase in bone mass.
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Affiliation(s)
- Zehra E Önal
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey -
| | - Abdülkadir Tekin
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Tamay Gürbüz
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Çiğdem Sağ
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | - Çağatay Nuhoğlu
- Department of Pediatrics, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
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Horton-French K, Dunlop E, Lucas RM, Pereira G, Black LJ. Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian adolescents and young adults. Eur J Clin Nutr 2021; 75:1627-1636. [PMID: 33649524 PMCID: PMC7917958 DOI: 10.1038/s41430-021-00880-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 12/20/2022]
Abstract
Background/Objectives Vitamin D deficiency is a public health concern worldwide. Maintaining vitamin D sufficiency during growth periods is essential. We aimed to determine the prevalence and predictors of vitamin D deficiency in Australian adolescents and young adults. Subject/Methods We used data from adolescents (12–17 years, n = 692) and young adults (18–24 years, n = 400) who participated in the nationally representative 2011–2013 Australian Health Survey. Serum 25-hydroxyvitamin D concentrations were measured using a method certified to international standards, with prevalence reported for <50 (vitamin D deficiency), 50–<75, ≥75 and >125 nmol/L. Independent predictors of vitamin D deficiency were determined using a survey-weighted Poisson regression model. Results Overall, 17% of adolescents and 32% of young adults were vitamin D deficient. In models adjusted for sex, age, region of birth, socioeconomic status, BMI and season (and education, smoking status and physical activity in young adults only), the prevalence ratio (PR) for vitamin D deficiency was more than double in participants born outside Australia (adolescents: PR 2.46; 95% confidence interval (CI) = 1.59, 3.81; young adults: PR 2.12; 95% CI = 1.46, 3.07), and also varied by season (adolescents: spring vs summer PR 2.47; 95% CI = 1.22, 5.01 and winter vs summer PR 2.01; 95% CI = 1.03, 3.92; young adults: winter vs summer; PR 3.32; 95% CI = 1.69, 6.53). Other predictors of vitamin D deficiency were overweight compared with healthy weight (adolescents) and lower physical activity (young adults). Conclusions Strategies based on safe sun exposure and dietary approaches are needed to achieve and maintain adequate vitamin D status, particularly in young adults.
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Affiliation(s)
| | - Eleanor Dunlop
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Acton, ACT, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Crawley, WA, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia.,Telethon Kids Institute, Nedlands, WA, Australia.,Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway
| | - Lucinda J Black
- Curtin School of Population Health, Curtin University, Bentley, WA, Australia.
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Ham NS, Hwang SW, Oh EH, Kim J, Lee HS, Park SH, Yang DH, Ye BD, Byeon JS, Myung SJ, Yang SK. Influence of Severe Vitamin D Deficiency on the Clinical Course of Inflammatory Bowel Disease. Dig Dis Sci 2021; 66:587-596. [PMID: 32219610 DOI: 10.1007/s10620-020-06207-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies have shown vitamin D status to be associated with disease activity in patients with inflammatory bowel disease (IBD), but its influence on the clinical course of IBD has not been established. AIMS We aimed to analyze whether the serum 25-hydroxyvitamin D3 [25(OH)D] status is associated with clinical characteristics and affects the risk of surgery in patients with IBD. METHODS From the IBD registry of the Asan Medical Center, we identified all patients who had at least one 25(OH)D measurement; we then analyzed the association between clinical factors and 25(OH)D status. 25(OH)D was considered borderline deficient, deficient, and severely deficient at levels of < 30, < 20, and < 10 ng/mL, respectively. RESULTS We included 711 Crohn's disease (CD) and 764 ulcerative colitis (UC) patients who had not undergone surgery before 25(OH)D was measured. Both in CD and in UC patients, reduced 25(OH)D was associated with higher disease activity scores and CRP levels (p < 0.001). Severe 25(OH)D deficiency was associated with ileocolonic disease and complicated behavior in CD (p < 0.05) and was relevant to the disease extent in UC (p < 0.001). Additionally, severe 25(OH)D deficiency was associated with CMV colitis in patients with UC (p < 0.001). In multivariable analysis, severe deficiency of 25(OH)D was an independent risk factor for surgery in both CD (HR 1.93, 95% confidence interval [CI] 1.38-2.70) and UC (HR 2.77, 95% CI 1.14-6.74). CONCLUSION Severe 25(OH)D deficiency may be a marker of a more aggressive clinical course of IBD.
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Affiliation(s)
- Nam Seok Ham
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Sung Wook Hwang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
- Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
| | - Eun Hye Oh
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Jeongseok Kim
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Ho-Su Lee
- Department of Biochemistry and Molecular Biology, University of Ulsan College of Medicine, Seoul, Korea
| | - Sang Hyoung Park
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
- Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong-Hoon Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Byong Duk Ye
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
- Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeong-Sik Byeon
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Seung-Jae Myung
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Suk-Kyun Yang
- Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
- Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Namazi N, Qorbani M, Shafiee G, Ahmadian MH, Motlagh ME, Ebrahimi M, Asayesh H, Kelishadi R, Heshmat R. Association of Vitamin D Concentrations with subjective health complaints in children and adolescents: the CASPIAN-V study. BMC Public Health 2021; 21:3. [PMID: 33388046 PMCID: PMC7778822 DOI: 10.1186/s12889-020-10020-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 12/08/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is recognized as a global pandemic. Identification, any association between VDD and subjective health complaints (SHC), can be helpful to realize critical mechanisms and improve psychological and somatic symptoms. Given few studies published on this issue and the importance of its clarification, the main objective of this study was to examine the association between VDD and the SHC in children and adolescents. METHODS In this national cross-sectional study, 2596 Iranian children and adolescents aged 8-18 years were included. Data on SHC, anthropometric indices, physical activity, and serum levels of vitamin D were collected. Logistic regression models (crude, adjusted) were applied to examine the association between the VDD and the SHC. Statistical analysis was performed using STATA version 11. P-values< 0.05 were considered as statistically significant. RESULTS Serum levels of vitamin D in approximately 70% of Iranian children and adolescents were lower than 30 ng/mL. Among the SHC, irritability (40.9%) and feeling anxiety (33.7%) were the most prevalent ones. Multiple complaints in students with the VDD was 2.5 times greater than those with sufficient vitamin D concentrations (p < 0.001). Compared to the reference group, the strongest association was found between vitamin D status and difficulties in getting to sleep (OR: 2.5, 95%CI: 1.18, 3.53, p < 0.001). CONCLUSION VDD was observed in the considerable percentage of the study population. There were no significant differences between the two gender groups. In addition, there were significant associations between vitamin D status and most of the somatic and psychological symptoms, particularly for getting to sleep. It seems national interventional programs for vitamin D supplementation or food fortifications can be helpful.
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Affiliation(s)
- Nazli Namazi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.
- Department of Epidemiology, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Gita Shafiee
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Ahmadian
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mehdi Ebrahimi
- Internal Medicine Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Asayesh
- Medical Emergencies, School of Paramedic, Qom University of Medical Sciences, Qom, Iran
| | - Roya Kelishadi
- Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Vafaee-Shahi M, Badv RS, Kazemi A, Noorbakhsh S, Kamali K, Teimourtash S, Tahernia L. Does the Vitamin D Deficiency Have Any Role in Severity or Prolongation of Seizure? A Pilot Study in Iran. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666190912091832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Based on previous studies, vitamin D deficiency could lead to nerve stimulation.
The purpose of the present study was to determine frequency and duration of seizures in children
with idiopathic epilepsy in two groups; normal level of vitamin D versus decreased level of
vitamin D.
Methods:
This pilot, comparative study was carried out in Zanjan University of Medical Sciences on
total 40 children aging between 2 to 12 years old (23 male and 17 female) with the diagnosis of idiopathic
epilepsy. All patients were receiving anti-epileptic drugs. The initial questionnaire was completed
by each parent. Total 40 epileptic cases were examined in close follow-ups every three
months, during total 9 months. Meanwhile, the frequency and duration of each seizure were recorded
in questionnaire at every three-month period. Vitamin D blood samples were analyzed at the beginning
of the study and after 9 months following the study. Serum levels of Vitamin D were analyzed
by ELISA method (Elecsys2010, RocheCo, Germany; STAR FAX; 2100), simultaneously, Vitamin D
level <30 ng/ml (nanogram per milliliter) was defined as Vitamin D deficiency. Cases were divided
into two groups based on Vitamin D level. The frequency and duration of convulsions were compared
in patients with normal level of vitamin D versus children with decreased level of vitamin D.
Data were analyzed by Chi-square and t-test methods.
Results:
In all 40 patients, vitamin D level less than 30 ng/ml was detected in 32% (13 patients) at
the beginning of study and 35% (14 patients) in 9 months later (13 patients were common between
the two groups). There was no significant relationship between the frequency of seizures, the duration
of seizures and vitamin D levels in patients. The relationship between positive family history of
epilepsy and the number of seizures was reported significant. The frequency of vitamin D deficiency
was higher in female cases in final evaluation.
Conclusion:
In the present study, a considerable correlation was detected between the frequency of
seizures and positive history of seizure in the family. The frequency of vitamin D deficiency was
higher in female cases in final analysis. No significant relationship was detected between the number
of seizures, the mean duration of seizures and serum level of Vitamin D in children who received anticonvulsant
drugs. However, vitamin D deficiency in patients was not overlooked in order to prevent
known complications. We recommend a randomized clinical trial in the future with an adequate sample
size. Moreover, a non-epileptic control group in study would be useful.
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Affiliation(s)
- Mohammad Vafaee-Shahi
- Pediatric Growth and Development Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Reza S. Badv
- Department of Pediatric Neurology, Tehran University of Medical, Sciences, Tehran, Iran
| | - Alinaghi Kazemi
- Pediatric and Member of Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Samileh Noorbakhsh
- Research Center of Pediatric Infectious Diseases, Rasul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Koorosh Kamali
- Statistics and Methodology, Member of Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Shahin Teimourtash
- Resident of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran
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12
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Guo Y, Wang Q, Lu C, Fan P, Li J, Luo X, Chen D. New parathyroid function index for the differentiation of primary and secondary hyperparathyroidism: a case-control study. BMC Endocr Disord 2020; 20:5. [PMID: 31914999 PMCID: PMC6950802 DOI: 10.1186/s12902-019-0487-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 12/30/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Patients with primary hyperparathyroidism (PHPT) may be asymptomatic, and some may present with normocalcemic PHPT (NPHPT). Patients with vitamin D deficiency may also be asymptomatic, with normal calcium and elevated PTH concentrations. These latter patients are usually diagnosed with vitamin D deficiency-induced secondary hyperparathyroidism (VD-SHPT). Therefore, it is very difficult to distinguish PHPT and NPHPT from VD-SHPT based on calcium or PTH concentrations in clinical settings. In this case-control study, we aimed to verify the diagnostic power of a new parathyroid function index (PFindex = Ca*PTH/P). METHODS This study enrolled 128 patients with surgically and pathologically confirmed PHPT, including 36 with NPHPT, at a hospital in West China between January 2009 and September 2017. Thirty-seven patients with VD-SHPT and 45 healthy controls were selected from the population of a cross-sectional epidemiological study as the SHPT and healthy groups, respectively. We used the PFindex to describe the characteristics of PHPT, NPHPT, and VD-SHPT.. Differences between the four groups were compared, and a receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of PFindex. RESULTS The PHPT group had the highest PFindex (454 ± 430), compared to the other three groups (NPHPT: 101 ± 111; SHPT: 21.7 ± 6.38; healthy: 12.2 ± 2.98, all p < 0.001). A PFindex cut-off value of 34 yielded sensitivity and specificity rates of 96.9 and 97.6% and of 94.4 and 94.6% for the diagnoses of PHPT and NPHPT, respectively. The use of a PFindex > 34 to differentiate NPHPT from VD-SHPT yielded the highest positive likelihood ratio and lowest negative likelihood ratio. CONCLUSION The PFindex provided excellent diagnostic power for the differentiation of NPHPT from VD-SHPT. This simple tool may be useful for guiding timely decision-making processes regarding the initiation of vitamin D treatment or surgery for PHPT.
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Affiliation(s)
- Yanhong Guo
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
- Endocrinology Department, Hospital of Chengdu Office of People's Government of Tibetan autonomous Region, Chengdu, China
| | - Qin Wang
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
| | - Chunyan Lu
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
| | - Pianpian Fan
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
| | - Ximing Luo
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China
| | - Decai Chen
- Endocrinology Department of West China Hospital, Sichuan University, Chengdu, China.
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13
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Jang SY, Park J, Ryu SY, Choi SW. Low muscle mass is associated with osteoporosis: A nationwide population-based study. Maturitas 2020; 133:54-59. [PMID: 32005424 DOI: 10.1016/j.maturitas.2020.01.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/09/2019] [Accepted: 01/07/2020] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To assess the association between low muscle mass and osteoporosis in the Korean general population. METHODS We analyzed 14,429 participants (6,261 men and 8,168 women) from the 2009-2011 Korean National Health and Nutrition Examination Survey (KNHANES) aged 20 years or more. MAIN OUTCOME MEASURE The association of low muscle mass with osteoporosis was investigated using multivariate logistic regression models that included age, marital status, residence, current smoking, monthly drinking, physical activities, strength exercise, comorbidity, and the use of dietary supplements, and in women postmenopausal status and experience of pregnancy. RESULTS After adjusting for covariates, low muscle mass was significantly associated with osteoporosis in the lumbar spine and femoral neck in both men (lumbar spine: OR 1.73, 95 % CI 1.08-2.76; femoral neck: OR 3.39, 95 % CI 1.69-6.80) and women (lumbar spine: OR 1.52, 95 % CI 1.17-1.97; femoral neck: OR 2.09, 95 % CI 1.56-2.80). Also, the association between low muscle mass and osteoporosis was significant in men and women in every age group except for men aged 50-64 years. CONCLUSION Low muscle mass was significantly associated with osteoporosis in both men and women for all age groups, except for men aged 50-64 years.
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Affiliation(s)
- Sung-Young Jang
- Department of Public Health, Graduate School of Chosun University, 309, Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea
| | - Jong Park
- Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, 309, Pilmun-daero, Dong-gu, Gwangju 61452, Republic of Korea.
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14
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Cho YH, Kim JW, Shim JO, Yang HR, Chang JY, Moon JS, Ko JS. Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population. Pediatr Gastroenterol Hepatol Nutr 2019; 22:233-241. [PMID: 31110956 PMCID: PMC6506433 DOI: 10.5223/pghn.2019.22.3.233] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. METHODS The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008-2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. RESULTS Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07-2.95) after adjusting for age, gender, obesity, and metabolic syndrome. CONCLUSION Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.
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Affiliation(s)
- Young Hoon Cho
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Whi Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ok Shim
- Department of Pediatrics, Korea University Medical Center, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Young Chang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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15
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Cho Y, Lee Y, Choi Y, Jeong S. Association of the Vitamin D Level and Quality of School Life in Adolescents with Irritable Bowel Syndrome. J Clin Med 2018; 7:jcm7120500. [PMID: 30513760 PMCID: PMC6306771 DOI: 10.3390/jcm7120500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 11/23/2018] [Accepted: 11/26/2018] [Indexed: 12/12/2022] Open
Abstract
There is no treatment of choice for irritable bowel syndrome, which affects up to 20% of school-aged children. This cross-sectional study evaluated the difference in the average vitamin D level between subtypes of irritable bowel syndrome, and the relationship between the vitamin D level as well as the severity of irritable bowel syndrome symptoms. We included 124 adolescents aged 10–17 years (68 boys, 56 girls; mean age 12.29 ± 1.92 years) from 2014 to 2016. Patients with irritable bowel syndrome were diagnosed by Rome III criteria and classified by clinical manifestation: irritable bowel syndrome with constipation (n = 29), irritable bowel syndrome with diarrhea (n = 63), and irritable bowel syndrome with constipation and diarrhea (n = 32). The severity of irritable bowel syndrome symptoms and school absence were evaluated. Vitamin D levels were measured by serum 25-hydroxyvitamin D. The chi-square test and analysis of variance were used. The patients’ average vitamin D level was 16.25 ± 6.58 ng/mL. There was a significant negative association of the 25-hydroxyvitamin D level with symptom severity and school absence (p = 0.022 and p < 0.001, respectively). Vitamin D supplementation could be considered as a choice of therapeutic method.
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Affiliation(s)
- Youngsun Cho
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea.
| | - Yoomi Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea.
| | - Youjin Choi
- Department of Pediatrics, Inje University, Ilsan-Paik Hospital, Goyang 10380, Korea.
| | - Sujin Jeong
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Korea.
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16
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Choi MJ, Jung YJ. Effects of Taurine and Vitamin D on Antioxidant Enzyme Activity and Lipids Profiles in Rats Fed Diet Deficient Calcium. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 975 Pt 2:1081-1092. [PMID: 28849524 DOI: 10.1007/978-94-024-1079-2_86] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Calcium deficiency is a worldwide problem affecting both developed and developing countries. The deficiency in calcium leads to a marked decrease of superoxide dismutase. It is known that vitamin D protects cells against oxidative damages while taurine plays an anti-inflammatory and antioxidant role. In this study, we examined whether vitamin D and taurine supplementation had a protective effect on oxidative stress in rats fed calcium deficient diet. Female SD rats (mean weight 60 ∼ 70 g) were divided into four groups; control, taurine, vitamin D, taurine + vitamin D for 6 weeks (taurine: 2 g/100 g diet, vitamin D: 0.5 mg/100 g diet). We then analyzed the level of triglyceride (TG), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) in serum and level of TC, TG in liver. We investigated antioxidative enzyme activities such as catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px). We observed that weight gain was not significantly different in the experimental groups. Food efficiency ratio (FER) was significantly higher in the normal control group than the taurine and vitamin D groups (p < 0.05). The level of liver TC was significantly lower in taurine, vitamin D, taurine + vitamin D groups than control group (p < 0.05). The concentration of malondialdehyde (MDA) was significantly lower in the taurine group than the control group. The activity of SOD was higher in taurine group than other experimental groups (p < 0.05), but GSH-Px and CAT were not significantly different. In conclusion, taurine has a positive effect on SOD activity but not on vitamin D. Also taurine and vitamin D have a protective effect as observed in liver TC in rats fed with a diet which lacks calcium.
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Affiliation(s)
- Mi-Ja Choi
- Department of Food and Nutrition, Keimyung University, Daegu, South Korea.
| | - Yun-Jung Jung
- Department of Food and Nutrition, Keimyung University, Daegu, South Korea
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17
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Guo Y, Ke HJ, Liu Y, Fu M, Ning J, Yu L, Xiao Y, Che D, Chen XY, Deng YH, Wu JL. Prevalence of vitamin D insufficiency among children in southern china: A cross-sectional survey. Medicine (Baltimore) 2018; 97:e11030. [PMID: 29923990 PMCID: PMC6023856 DOI: 10.1097/md.0000000000011030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Vitamin D deficiency is associated with numerous public health issues. Limited data are available for children in southern China, a region that receives abundant sunlight. We aimed to estimate the 25-hydroxyvitamin D (25(OH)D) levels in children in that area, and to determine seasonal variations in serum 25(OH)D levels. A total of 16,755 children aged 0 to 6 years, who visited the Guangdong Women and Children's Hospital for health examination between January 2016 and May 2017, were included in the present study. The serum 25(OH)D levels ranged from 10.5 to 307.4 nmol/L (mean ± standard deviation: 78.5 ± 26.3 nmol/L). The prevalence of vitamin D deficiency and insufficiency were 10.8% and 39.0%, respectively. The mean serum 25(OH)D level in spring (71.8 ± 24.9 nmol/L) was lower than that in other seasons. From January to April, we found a relatively high prevalence of vitamin D deficiency or insufficiency, both of which were also found to increase with age. Logistic regression analysis revealed that vitamin D deficiency and insufficiency were significantly associated with age and season. Deficiency and insufficiency of vitamin D are common among children in southern China, despite the area receiving sufficient sunlight.
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Affiliation(s)
- Yong Guo
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Hai-Jin Ke
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Ying Liu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Min Fu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Jing Ning
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Li Yu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu Xiao
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Di Che
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Xiao-Yan Chen
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu-Hong Deng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie-Ling Wu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
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18
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Han YM, Yoon H, Lim S, Sung MK, Shin CM, Park YS, Kim N, Lee DH, Kim JS. Risk Factors for Vitamin D, Zinc, and Selenium Deficiencies in Korean Patients with Inflammatory Bowel Disease. Gut Liver 2018; 11:363-369. [PMID: 28208007 PMCID: PMC5417778 DOI: 10.5009/gnl16333] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 09/09/2016] [Accepted: 09/22/2016] [Indexed: 01/04/2023] Open
Abstract
Background/Aims Studies on the micronutrient status of Asian patients with inflammatory bowel disease (IBD) are scarce. We evaluated the prevalence of micronutrient deficiency and verified the risk factors for micronutrient deficiency in Korean patients with IBD. Methods We measured the serum levels of 25-hydroxyvitamin D3 [25-(OH)D], zinc, and selenium to analyze the clinical risk factors for micronutrient levels below the reference values. In addition, we compared the 25-(OH)D levels of patients with IBD to those of age- and sex-matched healthy controls. Results Among the 83 patients, 74 (89.2%) had suboptimal serum 25-(OH)D levels. The mean plasma 25-(OH)D level in patients with IBD was significantly reduced compared to that of the healthy controls (12.3±6.2 ng/mL vs 20.0±6.7 ng/mL; p<0.001). The proportions of patients with lower serum zinc and selenium levels were 39.0% and 30.9%, respectively. Female sex (p=0.012) and Crohn’s disease (p=0.012) were associated with vitamin D deficiency. Patients younger than 40 years were at increased risk for zinc deficiency (p=0.045). Female sex (p=0.015) and low serum albumin level (<3.3 g/dL) (p=0.047) were risk factors for selenium deficiency. Conclusions Many Korean patients with IBD have vitamin D, zinc, and selenium deficiencies, suggesting the necessity for monitoring levels of these micronutrients.
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Affiliation(s)
- Yoo Min Han
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
| | - Hyuk Yoon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mi-Kyung Sung
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea
| | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young Soo Park
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nayoung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dong Ho Lee
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joo Sung Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine and Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea
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19
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Bahreynian M, Qorbani M, Motlagh ME, Heshmat R, Khademian M, Kelishadi R. Association of Serum 25-hydroxyvitamin D Levels and Liver Enzymes in a Nationally Representative Sample of Iranian Adolescents: The Childhood and Adolescence Surveillance and Prevention of Adult Noncommunicable Disease Study. Int J Prev Med 2018; 9:24. [PMID: 29619148 PMCID: PMC5869963 DOI: 10.4103/ijpvm.ijpvm_37_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 11/01/2017] [Indexed: 02/06/2023] Open
Abstract
Background: Hypovitaminosis D is highly prevalent and has several adverse health effects. This study aims to assess the relationship of serum concentrations of 25-hydroxyvitamin D (25[OH] D) and liver enzymes in adolescents. Methods: This population-based cross-sectional survey was conducted among a nationally representative multistage sample of 1095 adolescents (52% boys), aged 10–18 years, living in different provinces of Iran. Serum 25(OH)D concentration <30 ng/mL was considered as hypovitaminosis D, and liver enzymes (alanine aminotransaminase [ALT] and aspartate aminotransaminase [AST]) of >40 U/L was considered as high level. To determine the association between serum 25(OH)D categories and elevated levels of liver enzymes, multiple regression models and linear regression analysis were applied, after adjustment for potential confounders. Odds ratios (95% confidence interval) of serum 25(OH)D and elevated liver enzymes were assessed by logistic regression analysis. Results: Higher rates of Vitamin D deficiency were documented among individuals with increased levels of liver enzymes. Compared to boys, median of 25(OH)D was lower in girls with elevated levels of liver function tests (12.75 vs. 25.60 ng/mL for ALT and 13 vs. 14.10 ng/mL for AST), with marginally significant gender differences regarding AST. Conclusions: We found a relatively high frequency of hypovitaminosis D among adolescents with abnormal liver function. Further prospective studies are needed to examine these associations from early life.
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Affiliation(s)
- Maryam Bahreynian
- Department of Nutrition, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Department of Public Health, Alborz University of Medical Sciences, Karaj, Iran.,Department of Epidemiology, Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ramin Heshmat
- Department of Epidemiology, Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Khademian
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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20
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Prevalence of vitamin D deficiency in girls with idiopathic central precocious puberty. Front Med 2017; 12:174-181. [PMID: 28791667 DOI: 10.1007/s11684-017-0544-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/30/2017] [Indexed: 12/15/2022]
Abstract
The relationship between vitamin D deficiency and idiopathic central precocious puberty (ICPP) has been recently documented. In this study, 280 girls diagnosed with ICPP and 188 normal puberty control girls of similar ages were enrolled and retrospectively studied. The ICPP group had significantly lower serum 25-hydroxyvitamin D (25[OH]D) levels than the control group. Furthermore, a nonlinear relationship was found between serum 25[OH]D and ICPP, and a cut-off point for serum 25[OH]D was found at 31.8 ng/ml for ICPP with and without adjusting the different confounding factors. Girls with serum 25[OH]D ≥ 31.8 ng/ml had a lower odds ratio (unadjusted: OR 0.36, 95% CI 0.15 to 0.83, P < 0.05; height and weight adjusted: OR 0.44, 95% CI 0.18 to 1.08, P = 0.072; BMI adjusted: OR 0.36, 95% CI 0.16 to 0.84, P < 0.05). The ICPP subjects with 25[OH]D deficiency had a higher body mass index (BMI) than the subjects from the two other subgroups. Correlation analysis showed that vitamin D level is correlated with BMI and some metabolic parameters in the ICPP group. Our study suggested that vitamin D status may be associated with ICPP risk and may have a threshold effect on ICPP.
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22
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Kim SE. Micronutrients Should Be Monitored in the Real Practice for Korean Inflammatory Bowel Disease Patients. Gut Liver 2017; 11:317-318. [PMID: 28452207 PMCID: PMC5417771 DOI: 10.5009/gnl17135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Seong-Eun Kim
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
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Wang LM, Zheng ZH, Li TF, Han LS, He YJ, Zhang YL, Zeng HL, Liu SY. 25-hydroxyvitamin D is associated with metabolic syndrome among premenopausal women with systemic lupus erythematosus in China. Lupus 2016; 26:403-409. [PMID: 27687025 DOI: 10.1177/0961203316668040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objectives This study aimed to investigate the status of 25-hydroxyvitamin D (25(OH)D) and its association with metabolic syndrome (MS) and different MS components among premenopausal women with systemic lupus erythematosus (SLE) in China. Patients and methods Altogether 113 premenopausal women with SLE and the age-matched healthy cohorts were recruited in this cross-sectional study. Clinical manifestations and laboratory data including serum 25(OH)D concentration were collected. A multivariable analysis was performed to analyze the association of 25(OH)D with MS and its components. Results The prevalence of 25(OH)D deficiency (25(OH)D < 20 ng/ml) and MS were common (24.8% and 30.1%, respectively) in premenopausal patients with SLE in China. Analysis of the association between 25(OH)D, MS and its components demonstrated that the lower level of 25(OH)D was associated with increased MS prevalence (OR = 0.920, p = 0.012), a decreased level of high-density lipoprotein (OR = 1.059, p = 0.033) and a higher level of fasting glucose (OR = 0.810, p = 0.004). These associations were still detectible after adjustment for age, body mass index and SLE-related variables. Conclusion The level of 25(OH)D is associated with MS and its components in premenopausal women with SLE.
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Affiliation(s)
- L-M Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Z-H Zheng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - T-F Li
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - L-S Han
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Y-J He
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Y-L Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - H-L Zeng
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - S-Y Liu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Lim SK, Ha JM, Lee YH, Lee Y, Seo YJ, Kim CD, Lee JH, Im M. Comparison of Vitamin D Levels in Patients with and without Acne: A Case-Control Study Combined with a Randomized Controlled Trial. PLoS One 2016; 11:e0161162. [PMID: 27560161 PMCID: PMC4999291 DOI: 10.1371/journal.pone.0161162] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 07/30/2016] [Indexed: 11/18/2022] Open
Abstract
Background Vitamin D plays an important role in the immune system, and its deficiency has been implicated in various skin diseases, including atopic dermatitis and psoriasis. Acne is a common inflammatory skin disease; however, the association with vitamin D remains unclear. Objectives We evaluated vitamin D levels in patients with acne to determine the effect of vitamin D supplementation. Methods This study included 80 patients with acne and 80 healthy controls. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured, and demographic data were collected. Vitamin D-deficient patients were treated with oral cholecalciferol at 1000 IU/day for 2 months. Results Deficiency in 25(OH)D was detected in 48.8% of patients with acne, but in only 22.5% of the healthy controls. The level of 25(OH)D was inversely associated with the severity of acne, and there was a significant negative correlation with inflammatory lesions. In a subsequent trial, improvement in inflammatory lesions was noted after supplementation with vitamin D in 39 acne patients with 25(OH)D deficiency. Limitations Limitations of the study include the small number of patients in the supplementation study and the natural fluctuation of acne. Conclusions Vitamin D deficiency was more frequent in patients with acne, and serum 25(OH)D levels were inversely correlated with acne severity, especially in patients with inflammatory lesions.
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Affiliation(s)
- Seul-Ki Lim
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeong-Min Ha
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Ho Lee
- Department of Anatomy, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Young-Joon Seo
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Chang-Deok Kim
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Jeung-Hoon Lee
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Myung Im
- Department of Dermatology, School of Medicine, Chungnam National University, Daejeon, Korea
- * E-mail:
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Mohan R, Mohan G, Scott JX, Rajendran A, Paramasivam V, Ravindran M. Vitamin D insufficiency among children with cancer in India. Indian J Med Paediatr Oncol 2016; 37:14-9. [PMID: 27051151 PMCID: PMC4795368 DOI: 10.4103/0971-5851.177009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Vitamin D plays an important role in regulating various homeostatic mechanisms and has yet untapped potential in cancer prevention and prognosis. Only a few studies have been done worldwide in relating the Vitamin D levels in pediatric cancer patients to the general population but none so far in an Indian setting to the best of our knowledge. OBJECTIVE To compare the Vitamin D levels in a group of children with cancer to that of the general pediatric population and to note differences in the prevalence of Vitamin D insufficiency and make inferences arising from demographic and therapeutic variations. MATERIALS AND METHODS Vitamin D levels were found by immuno-chemilumino-metric assay in 102 children (51 cases and 51 controls) over a 6 months period. RESULTS In comparing the Vitamin D levels of children with cancer and controls from a healthy population we found an increased incidence of Vitamin D insufficiency in cancer children (80.39%) when compared to controls (50.98%) and a much lower mean Vitamin D value in cancer children (22.8 ng/ml) when compared to controls (33 ng/dl). It was also found that cancer children above 6 years had a greater chance for developing Vitamin D insufficiency (P = 0.038) as did children suffering from hematological malignancies (P = 0.025). CONCLUSION Our study showed an increased prevalence of Vitamin D insufficiency in children with cancer and hence we suggest routine measurement of Vitamin D levels in children with cancer and subsequent supplementation.
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Affiliation(s)
- Ram Mohan
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Gem Mohan
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Julius Xavier Scott
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Aruna Rajendran
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Venkatraman Paramasivam
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
| | - Manipriya Ravindran
- Department of Pediatrics, Division of Pediatric Hemato Oncology, Sri Ramachandra University, Porur, Chennai, Tamil Nadu, India
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Lee A, Kim SH, Nam CM, Kim YJ, Joo SH, Lee KR. Prevalence of Vitamin D Deficiency and Insufficiency in Korean Children and Adolescents and Associated Factors. ACTA ACUST UNITED AC 2016. [DOI: 10.3343/lmo.2016.6.2.70] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Anna Lee
- Seoul Medical Science Institute, Yongin, Korea
| | - Se Hwi Kim
- Department of Biostatistics and Computing, The Graduate School of Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | | | - Soo-Ho Joo
- Seoul Medical Science Institute, Yongin, Korea
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Colao A, Muscogiuri G, Rubino M, Vuolo L, Pivonello C, Sabatino P, Pizzo M, Campanile G, Fittipaldi R, Lombardi G, Di Somma C. Hypovitaminosis D in adolescents living in the land of sun is correlated with incorrect life style: a survey study in Campania region. Endocrine 2015; 49:521-7. [PMID: 25414070 DOI: 10.1007/s12020-014-0483-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 11/14/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study is to investigate in a population of adolescents living in Regione Campania, undergoing sun exposure at least 9 months per year the prevalence of severe deficiency (<20 ng/ml) or insufficiency (21-29 ng/ml) of 25-Hydroxyvitamin D (25(OH)D) levels and its relationship with individual body weight, use of smoking, and exercise performance. METHODS From October 2012 to October 2013, 373 healthy subjects (153 girls, 223 boys 11-20 years) without chronic diseases were consecutively enrolled in a campaign to prevent metabolic, cardiovascular, and oncological diseases. 25(OH)D assay, BMI, and lifestyle habitudes (smoking and exercise indoor or outdoor) were assessed. RESULTS In this population, median 25(OH) level was 25.0 ng/ml (95 %CI 23.8-25.2) without any difference between girls (25.0 (95 %CI 23.1-25.7)) and boys (24.3 (95 %CI 23.8-25.2)). Severe deficiency was found in 6 girls (0.02 %), while insufficiency was found in 296 patients (110 girls, 79.3 %). Normal levels were found in 71 patients (37 girls, 19 %). Vitamin D levels were significantly correlated with BMI (r = -0.429, p < 0.0001), smoking (r = -0.241; p < 0.0001), and exercise performance (r = 0.791; p < 0.0001). At the multistep regression analysis, Vitamin D levels were best predicted by exercise performance (t = 19.6, p < 0.0001), less smoking addiction (t = -4.97, p < 0.001), and lower BMI (t = -4.69, p < 0.0001). CONCLUSIONS The current study demonstrates that Vitamin D levels are commonly unsatisfactory in adolescents. Lower levels were found in overweight or obese adolescent, smokers and with low or absence of physical activity outdoors.
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Affiliation(s)
- Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli "Federico II", via S. Pansini 5, 80131, Naples, Italy,
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Kwon JH, Lee SE, Lee HA, Kim YJ, Lee HY, Gwak HS, Park EA, Cho SJ, Oh SY, Ha EH, Park H, Kim HS. Relationship of serum 25-Hydroxyvitamin D (25[OH]D) levels and components of metabolic syndrome in prepubertal children. Nutrition 2015; 31:1324-7. [PMID: 26283573 DOI: 10.1016/j.nut.2015.04.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The relationship between 25-hydroxyvitamin D (25[OH]D) levels and the lipid and metabolic levels of the prepubertal normal population is unclear. Our goals were to investigate the association of serum 25(OH)D concentrations with lipid and metabolic levels in Korean prepubertal children ages 7-9 y. METHODS We followed 205 children, ages 7-9 y in the Ewha Birth and Growth Cohort study, a prospective cohort sample established in 2001-2006, from July to August 2011. We studied the association of serum 25-hydroxyvitamin D (25[OH]D) levels with components of metabolic syndrome and insulin resistance indices using multivariate regression analysis adjusted for body mass index (BMI) z-scores. RESULTS The mean age of the 205 subjects was 7.89 ± 0.85 y, and the sample included 109 boys (53.2%). The average 25(OH)D levels of all participants was 25.0 ± 5.4 ng/mL. After adjustment for age and sex, triacylglycerol levels were significantly associated with 25(OH)D (β = -0.02, P = 0.02) concentrations even after adjustment for BMI z-scores (β = -0.02, P = 0.04). However, other metabolic components were not correlated with 25(OH)D status. Those with the lowest quartile of 25(OH)D levels had the highest serum triacylglycerol levels (P = 0.04, Ptrend = 0.01). CONCLUSIONS We found that serum 25(OH)D levels were negatively associated with serum triacylglycerol levels, even independently of adiposity, in prepubertal children. This study suggests that 25(OH)D insufficiency is related to metabolic syndrome via the derangement of triacylglycerol metabolism.
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Affiliation(s)
- Jung Hyun Kwon
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seung Eun Lee
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Ah Lee
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Young Ju Kim
- Department of Obstetrics and Gynecology, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hwa Young Lee
- Department of Anatomy, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hye Sun Gwak
- College of Pharmacy, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Se Young Oh
- Department of Food and Nutrition, Kyung Hee University, Seoul, Korea
| | - Eun Hee Ha
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
| | - Hae Soon Kim
- Department of Pediatrics, School of Medicine, Ewha Womans University, Seoul, Korea.
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Giudici KV, de Souza WN, Martini LA. Vitamin D status and glucose metabolism in youth. Crit Rev Food Sci Nutr 2015; 57:147-151. [DOI: 10.1080/10408398.2013.866069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - Lígia Araújo Martini
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
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Narchi H, Kochiyil J, Al Hamad S, Yasin J, Laleye L, Al Dhaheri A. Hypovitaminosis D in adolescent females--an analytical cohort study in the United Arab Emirates. Paediatr Int Child Health 2015; 35:36-43. [PMID: 25547176 DOI: 10.1179/2046905514y.0000000144] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Despite living in a sunny country, hypovitaminosis D is common in women of reproductive age in Al Ain, United Arab Emirates (UAE). AIMS AND OBJECTIVES To establish the prevalence of hypovitaminosis D in adolescent female Emirati nationals and its risk factors. METHODS This was an analytical prospective cohort study of 350 female Emirati nationals aged 11-18 years attending public schools in Al Ain. Socio-economic status, diet and amount of sun exposure were evaluated by face-to-face interviews. Serum total 25 (OH) vitamin D (D2 + D3) levels were measured by electrochemiluminescence assay. The prevalence of hypovitaminosis D was calculated and the association with risk factors analysed. RESULTS Data were complete for 293 girls. Only one girl [prevalence 0.3%, 95% confidence interval (CI) 0.01-1.9] had vitamin D sufficiency (serum vitamin D levels >75 nmol/L). Three girls (1.0%, 95% CI 0.2-2.9) had vitamin D insufficiency (50-75 nmol/L), 58 (19.8%, 95% CI 15.0-25.5) were deficient (27.5-50 nmol/L) and 231 (78.8%, 95% CI 68.9-89.6) had severe deficiency (<27.5 nmol/L). Serum vitamin D levels declined between the ages of 11 and 13 years before progressively rising until the age of 18 years but without regaining the levels they were at the age of 11. There was no statistically significant difference between the vitamin D status groups in age, body mass index, accommodation type, family income, percentage of surface area unexposed to the sun when outdoors, consumption of oily fish or total vitamin D intake. CONCLUSION The finding of a high prevalence of hypovitaminosis D in adolescent females in UAE is of serious concern for their health and that of their infants during their reproductive lives. Adolescent girls with a similar social and cultural background currently living in less sunny, industrialised countries might also be at risk.
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Seasonal vitamin D status of healthy schoolchildren and predictors of low vitamin D status. J Pediatr Gastroenterol Nutr 2014; 58:654-60. [PMID: 24787093 DOI: 10.1097/mpg.0000000000000274] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES The aim of the study was to assess seasonal prevalence of vitamin D deficiency according to sex and to determine the relations between serum levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) and sociodemographic characteristics in otherwise healthy schoolchildren during spring and autumn. METHODS In a cross-sectional study, 746 healthy students aged between 11 and 18 years were recruited during spring (n = 375) and autumn (n = 371). Sociodemographic data were collected by a questionnaire. Serum 25(OH)D, PTH, calcium, phosphate, and alkaline phosphatase were measured. Serum 25(OH)D levels were categorized as <50 nmol/L (vitamin D deficiency) and <25 nmol/L (severe deficiency). RESULTS Mean ± standard deviation 25(OH)D levels were 22.3 ± 10.5 nmol/L in girls and 28.5 ± 17.0 nmol/L in boys during spring (P < 0.001) and 36.5 ± 20.3 nmol/L in girls and 45.0 ± 18.5 nmol/L in boys during autumn (P < 0.001). The prevalence of vitamin D deficiency was 93% during spring and 71% during autumn. There was a negative correlation between 25(OH)D and PTH levels (P < 0.01). We determined a cutoff point of serum 25(OH)D in which the mean serum PTH concentration began to increase as 35.8 nmol/L (P < 0.0001). The age, sex, and calcium level were found to be independent predictors for vitamin D deficiency. CONCLUSIONS Vitamin D deficiency is prevalent among healthy schoolchildren. It is noteworthy that 25(OH)D levels were significantly lower in girls and during autumn. We recommend vitamin D supplementation for children in addition to more time spent for outdoor activities for sensible sunlight exposure.
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Kang JW, Kim JH, Yoon JH, Kim CH. The association between serum vitamin D level and immunoglobulin E in Korean adolescents. Int J Pediatr Otorhinolaryngol 2014; 78:817-20. [PMID: 24630983 DOI: 10.1016/j.ijporl.2014.02.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Revised: 02/14/2014] [Accepted: 02/17/2014] [Indexed: 01/30/2023]
Abstract
OBJECTIVE Vitamin D has immune modulatory functions, and thus its relationship with allergic disease has been evaluated in a number of studies. However, no concrete link between serum IgE level and vitamin D has been established. Thus, the purpose of study was to confirm the association of serum vitamin D level with the serum IgE (total and Dematophagoides farinae specific IgE) in Korean adolescents. METHODS A total of 365 subjects between 10 and 18 years of age were enrolled through the Korea National Health and Nutrition Examination Survey (KNHANES). Serum levels of vitamin D, total IgE, and Dermatophagoides farinae (Df) specific IgE were measured, and data for potential confounding variables were collected. Multivariate regression analyses were used to determine the independent effects of these variables. RESULTS Levels of both total and Df specific IgE were positively correlated with serum concentration of vitamin D (Spearman's rho (R)=0.126, p=0.016; R=0.152, p=0.004, respectively). These results were confirmed by multivariate linear regression analysis after adjusting for sex, age, and body mass index (coefficient (B): 10.45 95% confidence interval (CI): 0.59-20.31; B: 1.06, 95% CI: 0.31-1.80, respectively). And, the association between serum vitamin D and IgE showed the different results depending on the presence or absence of Df sensitization. CONCLUSIONS Serum concentration of vitamin D was positively associated with levels of both total IgE and Df-specific IgE in Korean adolescents.
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Affiliation(s)
- Ju Wan Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Hong Kim
- Departement of Otorhinolaryngology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Joo-Heon Yoon
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Chang-Hoon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Rafraf M, Hasanabad SK, Jafarabadi MA. Vitamin D status and its relationship with metabolic syndrome risk factors among adolescent girls in Boukan, Iran. Public Health Nutr 2014; 17:803-9. [PMID: 24477119 PMCID: PMC10282248 DOI: 10.1017/s1368980013003340] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 10/15/2013] [Accepted: 10/17/2013] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate vitamin D status and its association with components of the metabolic syndrome (MetS) in adolescent girls attending high school in Boukan, Iran during winter 2012. DESIGN A cross-sectional study. SETTING High schools of Boukan city, Iran. SUBJECTS A sample of 216 girls aged 14-17 years was selected by multistage random sampling from four districts of Boukan. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity and serum 25-hydroxyvitamin D (25(OH)D), fasting blood glucose, TAG and HDL-cholesterol levels of all participants were evaluated. Serum 25(OH)D level <20 ng/ml was defined as vitamin D deficiency. RESULTS Mean serum 25(OH)D was 7.26 (sd 2.81) ng/ml and 96 % of the participants had vitamin D deficiency. According to age-modified definitions of the National Cholesterol Education Program Adult Treatment Panel III, MetS was diagnosed in 10.6% of the participants. In multivariable regression analysis after adjustment for BMI, energy intake and physical activity level, serum 25(OH)D was inversely associated with fasting blood glucose (β = -0.143, P = 0.04). No significant relationship was found between serum 25(OH)D and other components of MetS. CONCLUSIONS The high prevalence of vitamin D deficiency warrants national polices and interventions towards improving this major health problem among adolescent girls. Low 25(OH)D level was significantly associated with increased fasting blood glucose. Prospective studies are needed to determine the effects of vitamin D deficiency on the development of MetS and related metabolic diseases in adolescent girls.
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Affiliation(s)
- Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Saadat Karimi Hasanabad
- Students' Research Committee, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Mohammad Asghari Jafarabadi
- Medical Education Research Center, Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
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Jung SS, Kim MS, Lee DY. Serum vitamin D status in children and adolescence with diabetes according to season and age. Ann Pediatr Endocrinol Metab 2014; 19:13-9. [PMID: 24926458 PMCID: PMC4049551 DOI: 10.6065/apem.2014.19.1.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/14/2013] [Accepted: 12/10/2013] [Indexed: 11/28/2022] Open
Abstract
PURPOSE It is known that children with diabetes have more severe vitamin D deficiency than healthy children. This study aimed to investigate serum vitamin D status and analyze the relationships between serum vitamin D levels and clinical parameters in children with diabetes. METHODS We checked serum vitamin D levels of children with diabetes aged below 18 years who were treated at our Department of Pediatrics between December 2011 and February 2012 (winter) as well as between June 2012 and August 2012 (summer). We retrospectively analyzed relationships between their serum vitamin D levels and clinical parameters. RESULTS The serum 25-hydroxyvitamin D level in children with diabetes during winter was markedly lower than during summer (10.8±5.1 ng/mL vs. 17.6±5.6 ng/mL); vitamin D deficiency was more prevalent during winter (95% vs. 62%). However, there was no difference between children with diabetes and healthy children. In children with type I diabetes mellitus, among all the clinical parameters, age had the greatest negative correlation with serum vitamin D level. CONCLUSION In children with diabetes, serum vitamin D levels showed marked seasonal variation. However, no clear relationship was identified between vitamin D deficiency and diabetes. This was because the control group had an equally high vitamin D deficiency rate. Additional studies including other clinical parameters after vitamin D supplementation in children with diabetes should be considered.
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Affiliation(s)
- Sung Su Jung
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
| | - Min Sun Kim
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
| | - Dae Yeol Lee
- Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea
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Aypak C, Türedi O, Yüce A. The association of vitamin D status with cardiometabolic risk factors, obesity and puberty in children. Eur J Pediatr 2014; 173:367-73. [PMID: 24132388 DOI: 10.1007/s00431-013-2177-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 10/03/2013] [Indexed: 01/19/2023]
Abstract
UNLABELLED Low serum 25-hydroxyvitamin D3 (25(OH)D) levels have been associated with insulin resistance and cardiovascular diseases. The influences of gender, puberty and adiposity on vitamin D status and the relationship between 25(OH)D and cardiometabolic risk factors in obese and non-obese children were studied. A retrospective analysis was carried out on 168 Turkish children during late winter. Age, gender, puberty, body mass index (BMI), 25(OH)D levels and cardiometabolic risk factors including lipid profiles, high-sensitivity C-reactive protein and insulin resistance index calculated by homeostasis model assessment (HOMA-IR) were evaluated. The median age of the study population was 11 (4-16) years, and 102 children (60.7 %) were prepubertal. Overall, 98.2 % of patients had 25(OH)D levels lower than 20 ng/mL (median 10.0 (4.0-21.3) ng/mL). The 25(OH)D levels did not correlate with BMI. However, an inverse correlation was seen between serum 25(OH)D and HOMA-IR (rho = -0.656, p = 0.006) and insulin (rho = -0.715, p = 0.002) in pubertal obese subjects. Female gender and puberty were all negatively associated with 25(OH)D. CONCLUSION The association between vitamin D status and BMI is complex, and it does not seem to be altered by mild obesity. In addition, potential influence of puberty should be kept in mind while assessing the relationship between serum 25(OH)D and cardiometabolic risk factors.
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Affiliation(s)
- Cenk Aypak
- Department of Family Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, 06110, Ankara, Turkey,
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Lee SM, Lee YJ, Won ES, Lee SS. Effects of calcium and vitamin D intake level on lipid metabolism in growing rats. ACTA ACUST UNITED AC 2014. [DOI: 10.4163/jnh.2014.47.2.89] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sun-Min Lee
- Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea
| | - Yeon-Joo Lee
- Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea
| | - Eun-Sook Won
- R&D Planning Team, R&D Center, Seoul Dairy Co., Ansan-Si, Kyunggi-Do 425-839, Korea
| | - Sang-Sun Lee
- Department of Food and Nutrition, Hanyang University, Seoul 133-791, Korea
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Vierucci F, Del Pistoia M, Fanos M, Gori M, Carlone G, Erba P, Massimetti G, Federico G, Saggese G. Vitamin D status and predictors of hypovitaminosis D in Italian children and adolescents: a cross-sectional study. Eur J Pediatr 2013; 172:1607-17. [PMID: 23959324 DOI: 10.1007/s00431-013-2119-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 07/23/2013] [Indexed: 11/25/2022]
Abstract
UNLABELLED Hypovitaminosis D affects children and adolescents all around the world. Italian data on vitamin D status and risk factors for hypovitaminosis D during pediatric age are lacking. Six hundred fifty-two children and adolescents (range 2.0-21.0 years) living in the northwestern area of Tuscany were recruited at the Department of Pediatrics, University Hospital Pisa. None of them had received vitamin D supplementation in the previous 12 months. 25-hydroxyvitamin D (25-OH-D) and parathyroid hormone (PTH) levels were analyzed in all subjects. Severe vitamin D deficiency was defined as serum levels of 25-OH-D<25.0 nmol/L (10.0 ng/mL) and vitamin D deficiency a<50.0 nmol/L (20.0 ng/mL). Serum 25-OH-D levels of 50.0-74.9 nmol/L (20.0-29.9 ng/mL) indicated vitamin D insufficiency, whereas 25-OH-D levels ≥ 75.0 nmol/L (30.0 ng/mL) were considered sufficient. Hypovitaminosis D was defined as 25-OH-D levels<75.0 nmol/L (30.0 ng/mL). The median serum 25-OH-D level was 51.8 nmol/L, range 6.7-174.7 (20.7 ng/mL, range 2.7-70.0), with a prevalence of vitamin D deficiency, insufficiency, and sufficiency of 45.9, 33.6, and 20.5 %, respectively. The prevalence of severe vitamin D deficiency was 9.5 %. Adolescents had lower median 25-OH-D levels (49.8 nmol/L, range 8.1-174.7; 20.0 ng/mL, range 3.2-70.0) than children (55.6 nmol/L, range 6.8-154.6; 22.3 ng/mL, range 2.7-61.9, p=0.006). Non-white individuals (n=37) had median serum 25-OH-D levels in the range of deficiency (28.2 nmol/L, range 8.1-86.2; 11.3 ng/mL, range 3.2-34.5), with 36/37 having hypovitaminosis D. Logistic regression showed significant increased risk of hypovitaminosis D in the following: blood samples taken in winter (odds ratio (OR) 27.20), spring (OR 26.44), and fall (OR 8.27) compared to summer; overweight (OR 5.02) and obese (OR 5.36) subjects compared to individuals with normal BMI; low sun exposure (OR 8.64) compared to good exposure, and regular use of sunscreens (OR 7.06) compared to non-regular use. Gender and place of residence were not associated with vitamin D status. The 25-OH-D levels were inversely related to the PTH levels (r=-0.395, p<0.0001). Sixty-three out of the 652 (9.7 %) subjects showed secondary hyperparathyroidism. CONCLUSION Italian children and adolescents who were not receiving vitamin D supplementation had high prevalence of hypovitaminosis D. Careful identification of factors affecting vitamin D status is advisable to promptly start vitamin D supplementation in children and adolescents.
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Han SW, Kang HR, Kim HG, Kim JH, Uhm JH, Seo JY. Subclinical Vitamin D Insufficiency in Korean School-aged Children. Pediatr Gastroenterol Hepatol Nutr 2013; 16:254-60. [PMID: 24511522 PMCID: PMC3915730 DOI: 10.5223/pghn.2013.16.4.254] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 10/12/2013] [Accepted: 10/29/2013] [Indexed: 01/01/2023] Open
Abstract
PURPOSE Recently, vitamin D insufficiency has increased and has been correlated to growth and puberty in children. This study was conducted to find the prevalence of subclinical vitamin D insufficiency and its influence on school-aged children in Korea. METHODS The subjects of this study were 397 children aged 7 to 15 years who had been tested for 25-OH vitamin D3 among the outpatients of the Department of Pediatrics in Eulji General Hospital from March 2007 to February 2011. Data for age, sex, comorbidities, serum 25-OH vitamin D3, height, weight, body mass index (BMI), and sunlight exposure time were collected before and after 3 months of vitamin D administration, retrospectively. RESULTS Vitamin D insufficiency was present in 343 (86%) of the subjects. In the vitamin D insufficient group, chronological age was 8.96±1.72 years, mean height (z-score [z]) was 0.51±1.26, mean BMI (z) was 0.81±2.20, and bone age was 10.26±1.75 years. In the vitamin D sufficient group, chronological age was 9.61±1.77 years, mean height (z) was-0.66±0.98, mean BMI (z) was-0.01±1.16, and bone age was 9.44±2.12 years. A paired t-test showed that three months after vitamin D administration, the mean 25-OH vitamin D3 level in the insufficient group increased to 24.38 ±10.03 ng/mL and mean BMI (z) decreased to 0.67±1.06. CONCLUSION In Korean school-aged children, vitamin D insufficiency were relatively higher and may be closely related with higher BMI. Insufficient rise of the level of vitamin D after supplementation suggest the new supplementation guidelines, especially for Korean children.
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Affiliation(s)
- Sang Woo Han
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
| | - Ha Ra Kang
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
| | - Han Gyum Kim
- Department of Medicine, Eulji University, Daejeon, Korea
| | - Joo Hyun Kim
- Department of Medicine, Eulji University, Daejeon, Korea
| | - Ji Hyun Uhm
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
| | - Ji Young Seo
- Department of Pediatrics, Eulji General Hospital, Seoul, Korea
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Shin YH, Yu J, Kim KW, Ahn K, Hong SA, Lee E, Yang SI, Jung YH, Kim HY, Seo JH, Kwon JW, Kim BJ, Kim HB, Shim JY, Kim WK, Song DJ, Lee SY, Lee SY, Jang GC, Suh DI, Yang HJ, Kim BS, Choi SJ, Oh SY, Kwon JY, Lee KJ, Park HJ, Lee PR, Won HS, Hong SJ. Association between cord blood 25-hydroxyvitamin D concentrations and respiratory tract infections in the first 6 months of age in a Korean population: a birth cohort study (COCOA). KOREAN JOURNAL OF PEDIATRICS 2013; 56:439-45. [PMID: 24244212 PMCID: PMC3827492 DOI: 10.3345/kjp.2013.56.10.439] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 05/29/2013] [Accepted: 08/30/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE Previous studies suggest that the concentration of 25-hydroxyvitamin D [25(OH)D] in cord blood may show an inverse association with respiratory tract infections (RTI) during childhood. The aim of the present study was to examine the influence of 25(OH)D concentrations in cord blood on infant RTI in a Korean birth cohort. METHODS The levels of 25(OH)D in cord blood obtained from 525 Korean newborns in the prospective COhort for Childhood Origin of Asthma and allergic diseases were examined. The primary outcome variable of interest was the prevalence of RTI at 6-month follow-up, as diagnosed by pediatricians and pediatric allergy and pulmonology specialists. RTI included acute nasopharyngitis, rhinosinusitis, otitis media, croup, tracheobronchitis, bronchiolitis, and pneumonia. RESULTS The median concentration of 25(OH)D in cord blood was 32.0 nmol/L (interquartile range, 21.4 to 53.2). One hundred and eighty neonates (34.3%) showed 25(OH)D concentrations less than 25.0 nmol/L, 292 (55.6%) showed 25(OH)D concentrations of 25.0-74.9 nmol/L, and 53 (10.1%) showed concentrations of ≥75.0 nmol/L. Adjusting for the season of birth, multivitamin intake during pregnancy, and exposure to passive smoking during pregnancy, 25(OH)D concentrations showed an inverse association with the risk of acquiring acute nasopharyngitis by 6 months of age (P for trend=0.0004). CONCLUSION The results show that 89.9% of healthy newborns in Korea are born with vitamin D insufficiency or deficiency (55.6% and 34.3%, respectively). Cord blood vitamin D insufficiency or deficiency in healthy neonates is associated with an increased risk of acute nasopharyngitis by 6 months of age. More time spent outdoors and more intensified vitamin D supplementation for pregnant women may be needed to prevent the onset of acute nasopharyngitis in infants.
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Affiliation(s)
- Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea
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Shin YH, Shin HJ, Lee YJ. Vitamin D status and childhood health. KOREAN JOURNAL OF PEDIATRICS 2013; 56:417-23. [PMID: 24244209 PMCID: PMC3827489 DOI: 10.3345/kjp.2013.56.10.417] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/20/2013] [Indexed: 02/06/2023]
Abstract
Vitamin D is an essential component of bone and mineral metabolism; its deficiency causes growth retardation and skeletal deformities in children and osteomalacia and osteoporosis in adults. Hypovitaminosis D (vitamin D insufficiency or deficiency) is observed not only in adults but also in infants, children, and adolescents. Previous studies suggest that sufficient serum vitamin D levels should be maintained in order to enhance normal calcification of the growth plate and bone mineralization. Moreover, emerging evidence supports an association between 25-hydroxyvitamin D (25[OH]D) levels and immune function, respiratory diseases, obesity, metabolic syndrome, insulin resistance, infection, allergy, cancers, and cardiovascular diseases in pediatric and adolescent populations. The risk factors for vitamin D insufficiency or deficiency in the pediatric population are season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, low socioeconomic status, and female gender. It is recommended that all infants, children, and adolescents have a minimum daily intake of 400 IU (10 µg) of vitamin D. Since the vitamin D status of the newborn is highly related to maternal vitamin D levels, optimal vitamin D levels in the mother during pregnancy should be maintained. In conclusion, given the important role of vitamin D in childhood health, more time spent in outdoor activity (for sunlight exposure) and vitamin D supplementation may be necessary for optimal health in infants, children, and adolescents.
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Affiliation(s)
- Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Hye Jung Shin
- Department of Pediatrics, National Medical Center, Seoul, Korea
| | - Yong-Jae Lee
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Sharifi F, Mousavinasab N, Mellati AA. Defining a cutoff point for vitamin D deficiency based on insulin resistance in children. Diabetes Metab Syndr 2013; 7:210-213. [PMID: 24290086 DOI: 10.1016/j.dsx.2013.10.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Vitamin D deficiency is a common worldwide problem. Low levels of serum 25-hydroxy vitamin D [25(OH)D], as a marker of vitamin D deficiency, have been linked to a wide field of health problems, including metabolic diseases such as insulin resistance, type 1 and type 2 DM. There is no universal definition for cutoff value of vitamin D deficiency and it seems that it varies in different populations. OBJECTIVE Most previous studies have used a start rise of PTH as a criteria to detect threshold of serum 25(OH)D, However, the aim of this study was to determine a cutoff point of serum 25(OH)D for vitamin D deficiency based on HOMA-IR. MATERIALS AND METHODS Two hundred and ninety seven healthy children (aged 7-11 years) were enrolled. Serum 25(OH)D and PTH were measured and HOMA-IR was calculated. The ROC curve was utilized to obtain a cutoff of vitamin D deficiency based on HOMA-IR. RESULTS 25(OH)D concentrations were inversely correlated with HOMA-IR levels (Spearman's r=-0.14, p=0.016). Serum 25(OH)D cutoff point was 11.6ng/mL (29nmol/L) in relation with HOMA-IR >2.1. By using this cutoff value, the prevalence of vitamin D deficiency was 43.4% in this study population of healthy children. CONCLUSION We found that serum 25(OH)D levels are inversely associated with insulin resistance. These results suggest that in MetS patients it may benefit to determine cutoff value of 25(OH)D levels based on HOMA-IR.
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Affiliation(s)
- Faranak Sharifi
- Clinical Endocrinology, Zanjan Metabolic Disease Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
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Yu A, Kim J, Kwon O, Oh SY, Kim J, Yang YJ. The association between serum 25-hydroxyvitamin d concentration and consumption frequencies of vitamin d food sources in korean adolescents. Clin Nutr Res 2013; 2:107-14. [PMID: 23908977 PMCID: PMC3728460 DOI: 10.7762/cnr.2013.2.2.107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 06/21/2013] [Accepted: 06/25/2013] [Indexed: 11/19/2022] Open
Abstract
The objectives of this study were to investigate the status of vitamin D in Korean adolescents and to determine the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and consumption frequencies of vitamin D food sources by season (June to November and December to May). The subjects were 1,579 adolescents aged 12-18 years participating in the 2008-2009 Korean National Health and Nutrition Examination Survey (KNHANES). Consumption frequencies of vitamin D food sources were estimated by using a qualitative food frequency questionnaire (FFQ). Thirteen food items were selected as vitamin D food sources including beef, egg, mackerel, tuna, yellow corvine, pollack, anchovy, mushroom, milk, yoghurt, ice cream, all fish and dairy products from the FFQ based on previous research. The data was analyzed using proc survey procedures. The deficiency (5.25-12 ng/mL), inadequacy (12-20 ng/mL) and sufficiency (> 20 ng/mL) proportions of serum 25(OH)D from June to November and December to May were 9.9%, 51.4%, 38.7%, and 39.4%, 51.4%, 9.2%, respectively. Mean serum 25(OH)D concentration was positively related to the consumption frequencies of mackerel, anchovy, all fish and milk. These results suggest high proportion (> 61%) of Korean adolescents were vitamin D deficiency or inadequacy, and serum 25(OH)D was associated with the consumption of vitamin D food sources including fish and milk.
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Affiliation(s)
- Areum Yu
- Department of Clinical Nutrition, Dongduk Women's University, Seoul 136-714, Korea
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Puberty dysregulation and increased risk of disease in adult life: possible modes of action. Reprod Toxicol 2013; 44:15-22. [PMID: 23791931 DOI: 10.1016/j.reprotox.2013.06.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 03/12/2013] [Accepted: 06/05/2013] [Indexed: 11/22/2022]
Abstract
Puberty is the developmental window when the final maturation of body systems is orchestrated by hormones; lifelong sex-related differences and capacity to interact with the environment are defined during this life stage. Increased incidence in a number of chronic, multifactorial diseases could be related to environmental exposures during puberty: however, insight on the susceptibility of the peripubertal period is still limited. The estrogen/androgen balance is a crucial axis in harmonizing the whole pubertal development, pointing out the significance of exposures to endocrine disruptors. Besides the reproductive system, endocrine-related perturbations may affect the maturation of skeleton, adipose tissues, brain, immune system, as well as cancer predisposition. Thus, risk assessment of environmental stressors should duly consider specific aspects of the pubertal window. Besides endocrine-related mechanisms, suggested research priorities include signaling molecules (e.g., kisspeptins, dopamine) as xenobiotic targets and disturbances of specific pubertal methylation processes potentially involved in neurobehavioral disorders and cancer risk in adulthood.
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Choi YJ, Kim MK, Jeong SJ. Vitamin D deficiency in infants aged 1 to 6 months. KOREAN JOURNAL OF PEDIATRICS 2013; 56:205-10. [PMID: 23741234 PMCID: PMC3668201 DOI: 10.3345/kjp.2013.56.5.205] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 12/07/2012] [Accepted: 01/25/2013] [Indexed: 12/04/2022]
Abstract
Purpose The aim of this study was to recognize the state of vitamin D among healthy infants aged 1 to 6 months in South Korea, and also to identify the risk factors affecting the level of vitamin D. Methods A total of 117 infants were enrolled in this study for 12 months, from March 1, 2011 to February 29, 2012. Serum levels of 25-hydroxyvitamin D (25[OH]D), calcium, phosphorus, and alkaline phosphatase were measured and data including birth weight, body weight, sex, feeding pattern, delivery mode, siblings and maternal age and occupation were collected. Data was mainly analyzed with independent t-test model. Results We determined that the prevalence of vitamin D deficiency (serum 25[OH]D<20 ng/mL [50 mmol/L]) was 48.7% in the population investigated. Particularly in breastfed infants, the prevalence of vitamin D deficiency was strikingly high (90.4%). The mean serum level of 25(OH)D in breastfed infants was lower than that of formula fed infants (9.35 ng/mL vs. 28.79 ng/mL). Also female infants showed lower mean serum level of 25(OH)D than male. Mean serum values of calcium and phosphorus had positive correlation with vitamin D state (P<0.001). Conclusion Vitamin D deficiency was found to be very common in infants aged 1 to 6 months in South Korea, and breast feeding was the most critical risk factor of vitamin D deficiency. Therefore we suggest to start vitamin D supplementation in South Korea, as soon as possible, to all infants, including breastfed and female infants.
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Affiliation(s)
- You Jin Choi
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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