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AlShaibani T, Abdul Razzaq R, Radhi A, Meer H, Aljawder A, Jaradat A, Naguib YM. Ethnic-Based Assessment of Vitamin D and Magnesium Status in the Kingdom of Bahrain. Cureus 2024; 16:e55967. [PMID: 38469368 PMCID: PMC10927250 DOI: 10.7759/cureus.55967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Vitamin D deficiency is a major global health problem. Most previous studies focused attention on the significant role of sunlight exposure in the homeostasis of vitamin D and calcium blood levels. Magnesium is pivotal in the proper functioning of vitamin D, and the physiologic functions of different organs require a balanced vitamin D and magnesium status. The relationship between sunlight exposure and blood levels of vitamin D and magnesium has often been overlooked. The aim of this study was to evaluate vitamin D and magnesium status based on sunlight exposure and ethnicity in Bahraini and expatriate workers. METHODS A cross-sectional study was conducted between October 2018 and September 2019. One hundred and seventy-four subjects participated in this study were subdivided based on their ethnicity and work environment-dependent exposure to sunlight into four groups: (1) Bahraini exposed (n=94), (2) Bahraini non-exposed (n=25), (3) expatriate exposed (n=31), and (4) expatriate non-exposed (n=24). Blood levels of vitamin D and magnesium were evaluated for all the participants. RESULTS Independent of ethnicity, vitamin D levels were insignificantly different among the studied groups and were all below the normal reference range. Yet, there was still a sunlight-dependent increase in vitamin D level that could be seen only in Bahraini workers. Magnesium levels were significantly higher in expatriates when compared to Bahraini workers. Sunlight-exposed expatriates had significantly higher magnesium levels than their Bahraini counterparts, while there was no significant difference between both ethnicities in the non-exposed groups. CONCLUSION Country- and ethnic-specific definitions for vitamin D status and sunlight exposure are recommended. The assessment of magnesium status is pivotal in the overall assessment of vitamin D status.
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Affiliation(s)
| | | | - Ameera Radhi
- Pathology Department, Salmaniya Medical Complex, Manama, BHR
| | - Hussain Meer
- Radiology Department, Alhakeem Radiology Center, Manama, BHR
| | | | - Ahmed Jaradat
- Family and Community Medicine Department, Arabian Gulf University, Manama, BHR
| | - Yahya M Naguib
- Physiology Department, Arabian Gulf University, Manama, BHR
- Clinical Physiology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, EGY
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Mbadu Lelo S, Musungayi Kajingulu FP, Makulo JR, Mayamba Nlandu Y, Busanga Bukabau J, Koso Mbulupasu P, Luzayadio Longo A, Losa Luse JN, Momeme Mokoli V, Kiswaya Sumaili E, Mangani Nseka N. 25 [OH] Vitamin D and Intact Parathyroid Hormone in Congolese Hemodialysis Patients: Evaluation of KDIGO Targets. Int J Nephrol Renovasc Dis 2024; 17:71-79. [PMID: 38405026 PMCID: PMC10887870 DOI: 10.2147/ijnrd.s440809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024] Open
Abstract
Background Data on 25 [OH] vitamin D and intact parathyroid hormone [iPTH] in hemodialysis patients are very limited in sub-Saharan African countries. The present study aimed to assess the magnitude of hypovitaminosis D, and to evaluate the achievement of iPTH KDIGO 2017 targets among chronic hemodialysis patients followed in Kinshasa. Methods We conducted a multicenter cross-sectional study in 6 hospitals in Kinshasa. All patients followed on hemodialysis for more than 3 months were included. Hypovitaminosis D was defined as <30 ng/mL (insufficiency = 20-29 ng/mL; deficiency if <20 ng/mL) and the targets for iPTH values were based on the 2017 KDIGO guidelines. The determinants for hypovitaminosis D were evaluated by logistic regression. Results 251 patients [mean age 56 ± 14 years, 72.5% men, 63% hypertensive, 31% diabetic, 100% supplemented with native 25 [OH] vitamin D + CaCO3 were included. Hypovitaminosis D was found in 79.7% (deficiency 47.4%) and was associated with the male gender aOR 2.7 [1.4-5.2], p = 0.004, the low-permeability dialyzer 2.2 [1.1-4.2], p = 0.025 and anemia 3.9 [1.2-12.7], p = 0.022. Only 40% of patients with 25 [OH] vitamin D deficiency had iPTH according to KDIGO targets vs 6% of patients with severe hyperparathyroidism (iPTH > 600 pg/mL), 45% with levels between 16 and 150 pg/mL and 9% a iPTH ≤ 15 pg/mL. Conclusion Despite a sunny environment, a large proportion of Congolese hemodialysis patients have hypovitaminosis D, in particular a deficiency. Among them, less than half have target iPTH values. These results show the benefit of regular monitoring of these parameters in order to optimize treatment.
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Affiliation(s)
- Samuel Mbadu Lelo
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Hemodialysis Center, Ngaliema Medical Center, Kinshasa, Democratic Republic of the Congo
| | - François-Pantaléon Musungayi Kajingulu
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Dialysis Center, HJ Hospital, Kinshasa, Democratic Republic of the Congo
- Department of Internal Medicine, Saint-Joseph Hospital, Kinshasa, Democratic Republic of the Congo
| | - Jean-Robert Makulo
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Hemodialysis Center, Ngaliema Medical Center, Kinshasa, Democratic Republic of the Congo
| | - Yannick Mayamba Nlandu
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Hemodialysis Center, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Justine Busanga Bukabau
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Hemodialysis Center, Centre Médical de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Pierre Koso Mbulupasu
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Department of Internal Medicine, Clinique Ngaliema, Kinshasa, Democratic Republic of the Congo
| | - Augustin Luzayadio Longo
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Jeanine Nina Losa Luse
- Hemodialysis Center, Hôpital Général de Référence de Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Vieux Momeme Mokoli
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
- Hemodialysis Center, Ngaliema Medical Center, Kinshasa, Democratic Republic of the Congo
| | - Ernest Kiswaya Sumaili
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
| | - Nazaire Mangani Nseka
- Hemodialysis Center, Division of Nephrology, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
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Kotepui KU, Mahittikorn A, Wilairatana P, Masangkay FR, Kotepui M. Regional and Age-Related Variations in Blood Calcium Levels among Patients with Plasmodium falciparum and P. vivax malaria: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4522. [PMID: 37960176 PMCID: PMC10650696 DOI: 10.3390/nu15214522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Despite several studies examining the relationship between calcium levels and malaria, inconsistencies and varied results remain in the literature. This study aimed to synthesize the evidence on the association between blood calcium levels and malaria severity. A systematic literature search was conducted in the Embase, Scopus, PubMed, Ovid, and Google Scholar databases. The studies that investigated calcium levels in participants with malaria were reviewed and included for synthesis. The quality of included studies was assessed based on a standardized checklist by the Joanna Briggs Institute (JBI) critical appraisal checklists. The thematic synthesis had been used for qualitative synthesis. For the quantitative synthesis, the meta-analysis was performed to estimate the pooled effect sizes for differences in calcium levels between groups of participants using a random effect model using Hedge's g as a measure of effect size. Out of the 4574 identified records, 14 studies were reviewed. The thematic synthesis across these studies noted a consistent theme: reduced calcium levels in malaria patients compared to uninfected controls. However, the meta-analysis encompassing three specific analyses-comparing calcium levels between malaria patients and controls, severe and non-severe malaria cases, and fatal cases versus survivors-showed no significant difference in calcium levels. The statistics were as follows: (1) p = 0.15, Hedge's g: -1.00, 95% CI: -2.37-0.38, I2: 98.97, 9 studies; (2) p = 0.35, Hedge's g: -0.33, 95% CI: -1.02-0.36, I2: 81.61, 3 studies; and (3) p = 0.71, Hedge's g: -0.14, 95% CI: -0.91-0.62, I2: 87.05, 3 studies. Subgroup analyses indicated that regional disparities, especially between Africa and Asia, and participant age groups may influence these outcomes. While a trend of decreased calcium levels in malaria patients was observed, the meta-analytical results suggest regional and age-related variations. Further investigations should emphasize these differences to better guide clinical management, prognostic applications, and the crafting of policies concerning malaria's metabolic effects.
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Affiliation(s)
- Kwuntida Uthaisar Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
| | - Aongart Mahittikorn
- Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Polrat Wilairatana
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | | | - Manas Kotepui
- Medical Technology, School of Allied Health Sciences, Walailak University, Thasala, Nakhon Si Thammarat 80160, Thailand
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Mengistu GT, Terefe AB, Gudeta TG, Mengistu BK. Factors associated with infants' sunlight exposure among mothers attending the EPI unit of Wolkite University Specialized Hospital. PLoS One 2022; 17:e0277349. [PMID: 36395250 PMCID: PMC9671437 DOI: 10.1371/journal.pone.0277349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 10/25/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Infant sunlight exposure in their early infancy is essential for the cutaneous synthesis of vitamin D. Vitamin D deficiency is highly prevalent due to inadequate exposure to sunlight. In Ethiopia, one in thirteen children had rickets, which could be prevented by sunlight exposure or supplementation. This study aimed to identify the practice of infants' sunlight exposure and associated factors among mothers attending the Expanded program immunization unit of Wolkite University Specialized Hospital. METHOD This study employed an institutional-based cross-sectional study design to collect data. Data were collected from 220 mothers using an interviewer-administered questionnaire. The study employed a systematic random sampling technique to reach the study participants. The collected data were entered into a computer using the software Epidata 3.1 version and exported to SPSS version 23 for statistical analysis. Descriptive and inferential analysis was conducted. Logistic regression analysis was done, and a statistical association was declared at a p-value < 5% and a 95% confidence interval(CI). Then the results were presented using a frequency table, figures, and description. RESULT A total of 220 infant-coupled mothers who visited the Expanded program immunization unit were included in the study. According to the current study, 67.3% of mothers had good practice with infants' sunlight exposure. Mothers' practice of infant sunlight exposure was affected by age of mothers 30-34 years, [AOR = 3.10, 95%CI (1.13, 8.51)], and age ≥35 years, [AOR = 4.49, 95%CI (1.20, 16.86)], and living in urban, [AOR = 1.94, 95%CI (1.053, 3.57)]. CONCLUSION The current study showed that two-thirds (67.3%) of mothers had good practice of sunlight exposure to their infants. Factors that affect mothers' practice of infants' sunlight exposure are age and place of residence. Health professionals should provide health education for mothers on the benefits of infants' sunlight exposure.
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Affiliation(s)
- Girma Teferi Mengistu
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
- * E-mail: ,
| | - Ayana Benti Terefe
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tolesa Gemeda Gudeta
- Department of Nursing, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Bizunesh Kefale Mengistu
- Department of Statistics, College of Natural and Computational Science, Ambo University, Ambo, Ethiopia
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Kibirige D, Sekitoleko I, Balungi P, Kyosiimire-Lugemwa J, Lumu W. Clinical, metabolic, and immunological characterisation of adult Ugandan patients with new-onset diabetes and low vitamin D status. BMC Endocr Disord 2022; 22:230. [PMID: 36109715 PMCID: PMC9479372 DOI: 10.1186/s12902-022-01148-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low vitamin D concentrations are associated with metabolic derangements, notably insulin resistance and pancreatic beta-cell dysfunction in Caucasian populations. Studies on its association with the clinical, metabolic, and immunologic characteristics in black African adult populations with new-onset diabetes are limited. This study aimed to describe the clinical, metabolic, and immunologic characteristics of a black Ugandan adult population with recently diagnosed diabetes and hypovitaminosis D. METHODS Serum vitamin D concentrations were measured in 327 participants with recently diagnosed diabetes. Vitamin D deficiency, vitamin D insufficiency, and normal vitamin D status were defined as serum 25 hydroxyvitamin D levels of < 20 ng/ml, 21-29 ng/ml, and ≥ 30 ng/ml, respectively. RESULTS The median (IQR) age, glycated haemoglobin, and serum vitamin D concentration of the participants were 48 years (39-58), 11% (8-13) or 96 mmol/mol (67-115), and 24 ng/ml (18-30), respectively. Vitamin D deficiency, vitamin D insufficiency, and normal vitamin D status were noted in 105 participants (32.1%), 140 participants (42.8%), and 82 participants (25.1%), respectively. Compared with those having normal serum vitamin D levels, participants with vitamin D deficiency and insufficiency had higher circulating concentrations of interleukin (IL) 6 (29 [16-45] pg/ml, 23 [14-40] pg/ml vs 18 [14-32] pg/ml, p = 0.01), and IL-8 (24 [86-655] pg/ml, 207 [81-853] pg/ml vs 98 [67-224], p = 0.03). No statistically significant differences were noted in the markers of body adiposity, insulin resistance, and pancreatic beta-cell function between both groups. CONCLUSION Vitamin D deficiency and insufficiency were highly prevalent in our study population and were associated with increased circulating concentrations of pro-inflammatory cytokines. The absence of an association between pancreatic beta-cell function, insulin resistance, and low vitamin D status may indicate that the latter does not play a significant role in the pathogenesis of type 2 diabetes in our adult Ugandan population.
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Affiliation(s)
- Davis Kibirige
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. BOX 49, Plot 51-59, Nakiwogo Road, Entebbe, Uganda
- Department of Non-Communicable Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Isaac Sekitoleko
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. BOX 49, Plot 51-59, Nakiwogo Road, Entebbe, Uganda
| | - Priscilla Balungi
- Non-Communicable Diseases Program, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, P.O. BOX 49, Plot 51-59, Nakiwogo Road, Entebbe, Uganda
- Clinical Diagnostics Laboratory Services, Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Jacqueline Kyosiimire-Lugemwa
- Clinical Diagnostics Laboratory Services, Medical Research Council/Uganda Virus Research Institute, and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - William Lumu
- Department of Medicine, Mengo Hospital, Kampala, Uganda
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Mba CM, Koulman A, Forouhi NG, Sharp SJ, Imamura F, Jones K, Meadows SR, Assah F, Mbanya JC, Wareham NJ. Association between circulating 25-hydroxyvitamin D and cardiometabolic risk factors in adults in rural and urban settings. Nutr Diabetes 2022; 12:34. [PMID: 35906229 PMCID: PMC9338254 DOI: 10.1038/s41387-022-00215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/04/2022] [Accepted: 07/15/2022] [Indexed: 11/09/2022] Open
Abstract
Background An inverse association between vitamin D status and cardiometabolic risk has been reported but this relationship may have been affected by residual confounding from adiposity and physical activity due to imprecise measures of these variables. We aimed to investigate the relationship between serum 25-hydroxyvitamin D (25(OH)D) and cardiometabolic risk factors, with adjustment for objectively-measured physical activity and adiposity. Methods This was a population-based cross-sectional study in 586 adults in Cameroon (63.5% women). We assessed markers of glucose homoeostasis (fasting blood glucose (BG), 2 h post glucose load BG, HOMA-IR)) and computed a metabolic syndrome score by summing the sex‐specific z‐scores of five risk components measuring central adiposity, blood pressure, glucose, HDL cholesterol and triglycerides. Results Mean±SD age was 38.3 ± 8.6 years, and serum 25(OH)D was 51.7 ± 12.5 nmol/L. Mean 25(OH)D was higher in rural (53.4 ± 12.8 nmol/L) than urban residents (50.2 ± 12.1 nmol/L), p = 0.002. The prevalence of vitamin D insufficiency (<50 nmol/L) was 45.7%. There was an inverse association between 25(OH)D and the metabolic syndrome score in unadjusted analyses (β = −0.30, 95% CI −0.55 to −0.05), which became non-significant after adjusting for age, sex, smoking status, alcohol intake and education level. Serum 25(OH)D was inversely associated with fasting BG (−0.21, −0.34 to −0.08)), which remained significant after adjustment for age, sex, education, smoking, alcohol intake, the season of data collection, BMI and physical activity (−0.17, −0.29 to −0.06). There was an inverse association of 25(OH)D with 2-h BG (−0.20, −0.34 to −0.05) and HOMA-IR (−0.12, −0.19 to −0.04) in unadjusted analysis, but these associations became non-significant after adjustment for potential confounders. Conclusion Vitamin D insufficiency was common in this population. This study showed an inverse association between vitamin D status and fasting glucose that was independent of potential confounders, including objectively measured physical activity and adiposity, suggesting a possible mechanism through insulin secretion.
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Affiliation(s)
- Camille M Mba
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom. .,Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
| | - Albert Koulman
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.,National Institute for Health Research Biomedical Research Centre Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Stephen J Sharp
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Kerry Jones
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.,National Institute for Health Research Biomedical Research Centre Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Sarah R Meadows
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.,National Institute for Health Research Biomedical Research Centre Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Felix Assah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Jean Claude Mbanya
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon
| | - Nick J Wareham
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Yang W, Ge M, Wang Y, Pang X, Wang C. Spatial distribution differences of 25-hydroxyvitamin D in healthy elderly people under the influence of geographical environmental factors. Sci Rep 2022; 12:12781. [PMID: 35896722 PMCID: PMC9326152 DOI: 10.1038/s41598-022-17198-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/21/2022] [Indexed: 11/09/2022] Open
Abstract
The main targets of this were to screen the factors that may influence the distribution of 25-hydroxyvitamin D[25(OH)D] reference value in healthy elderly people in China, and further explored the geographical distribution differences of 25(OH)D reference value in China. In this study, we collected the 25(OH)D of 25,470 healthy elderly from 58 cities in China to analyze the correlation between 25(OH)D and 22 geography secondary indexes through spearman regression analysis. Six indexes with significant correlation were extracted, and a ridge regression model was built, and the country’s urban healthy elderly’25(OH)D reference value was predicted. By using the disjunctive Kriging method, we obtained the geographical distribution of 25(OH)D reference values for healthy elderly people in China. The reference value of 25(OH)D for healthy elderly in China was significantly correlated with the 6 secondary indexes, namely, latitude (°), annual temperature range (°C), annual sunshine hours (h), annual mean temperature (°C), annual mean relative humidity (%), and annual precipitation (mm). The geographical distribution of 25(OH)D values of healthy elderly in China showed a trend of being higher in South China and lower in North China, and higher in coastal areas and lower in inland areas. This study lays a foundation for further research on the mechanism of different influencing factors on the reference value of 25(OH)D index. A ridge regression model composed of significant influencing factors has been established to provide the basis for formulating reference criteria for the treatment factors of the vitamin D deficiency and prognostic factors of the COVID-19 using 25(OH)D reference value in different regions.
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Affiliation(s)
- Wenjie Yang
- Institute of Health Geography, School of Geographical Sciences and Tourism, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Miao Ge
- Institute of Health Geography, School of Geographical Sciences and Tourism, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China.
| | - Yabo Wang
- Institute of Health Geography, School of Geographical Sciences and Tourism, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Xinrui Pang
- Institute of Health Geography, School of Geographical Sciences and Tourism, Shaanxi Normal University, Xi'an, 710119, Shaanxi, China
| | - Congxia Wang
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710119, Shaanxi, China
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Yang Q, Ciebiera M, Bariani MV, Ali M, Elkafas H, Boyer TG, Al-Hendy A. Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment. Endocr Rev 2022; 43:678-719. [PMID: 34741454 PMCID: PMC9277653 DOI: 10.1210/endrev/bnab039] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Indexed: 11/24/2022]
Abstract
Uterine fibroids are benign monoclonal neoplasms of the myometrium, representing the most common tumors in women worldwide. To date, no long-term or noninvasive treatment option exists for hormone-dependent uterine fibroids, due to the limited knowledge about the molecular mechanisms underlying the initiation and development of uterine fibroids. This paper comprehensively summarizes the recent research advances on uterine fibroids, focusing on risk factors, development origin, pathogenetic mechanisms, and treatment options. Additionally, we describe the current treatment interventions for uterine fibroids. Finally, future perspectives on uterine fibroids studies are summarized. Deeper mechanistic insights into tumor etiology and the complexity of uterine fibroids can contribute to the progress of newer targeted therapies.
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Affiliation(s)
- Qiwei Yang
- Qiwei Yang, Ph.D. Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, M167, Billings, Chicago, IL 60637, USA.
| | - Michal Ciebiera
- Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, ul. Cegłowska 80, 01-809, Warsaw, Poland
| | | | - Mohamed Ali
- Clinical Pharmacy Department, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt
| | - Hoda Elkafas
- Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Pharmacology and Toxicology, Egyptian Drug Authority, formerly National Organization for Drug Control and Research, Cairo 35521, Egypt
| | - Thomas G Boyer
- Department of Molecular Medicine, Institute of Biotechnology, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229-3900, USA
| | - Ayman Al-Hendy
- Correspondence: Ayman Al-Hendy, MD, Ph.D. Department of Obstetrics and Gynecology, University of Chicago, 5841 S. Maryland Ave, N112, Peck Pavilion, Chicago, IL 60637. USA.
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El-Shaheed AA, N. Mahfouz N, Abushady MM, El-Alameey IR. Relation of Serum Micronutrients to Growth and Nutritional Habits of School-Aged Children in Egypt. BIOMEDICAL AND PHARMACOLOGY JOURNAL 2022; 15:775-783. [DOI: 10.13005/bpj/2415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Proper growth of children depends on several micronutrients. A fundamental role of Zinc and vitamins as A, B12 and D is crucial to prevent a failure to thrive. To study the relationship between Egyptian school aged children growth, nutritional habits and micronutrients deficiencies. Materials and methods: A case control research involved 60 school aged children (age ranged from 6 to 12 years). Group 1 (malnourished) compared with group II (apparently healthy children of matched peers). Serum concentrations of Zinc, Copper, and vitamins as A, B12, and D were measured using ELISA kits. Compared to controls, the cases showed significantly lower serum concentrations of Zinc, vitamin A, B12, and D (P<0.000 in all), while serum concentration of Copper was significantly higher. In the patient's group, serum vitamin B12, and Zinc concentrations showed significant positive correlation with height for age z- score, while serum Copper concentration showed significant negative correlation with BMI for age z- score. Serum Zinc, vitamin B12, and D concentrations were significantly correlated positively with serum vitamin A. Multiple logistic regression showed statistically significant association of high serum Copper and weekly consumption of sweetened beverages among the studied patients (P < 0.01). Vitamins and Zinc deficiencies showed high prevalence among the school children. Serum vitamin B12 and Zinc concentrations showed significant positive correlation with height. The significant association between high serum Copper and sugary beverages among the studied patients may be due to contained preservatives.
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Affiliation(s)
- Azza Abd El-Shaheed
- 1Department of Child Health-Medical Research and Clinical Studies Institute, National Research Centre, 33rd El Buhouth Street, Former El Tahrir Street, Dokki, PO 12622, and Medical Research Centre of Excellence (MRCE), Cairo, Egypt
| | - Nermine N. Mahfouz
- 1Department of Child Health-Medical Research and Clinical Studies Institute, National Research Centre, 33rd El Buhouth Street, Former El Tahrir Street, Dokki, PO 12622, and Medical Research Centre of Excellence (MRCE), Cairo, Egypt
| | - Mones M Abushady
- 1Department of Child Health-Medical Research and Clinical Studies Institute, National Research Centre, 33rd El Buhouth Street, Former El Tahrir Street, Dokki, PO 12622, and Medical Research Centre of Excellence (MRCE), Cairo, Egypt
| | - Inas R El-Alameey
- 2Faculty of Applied Medical Sciences, Clinical Nutrition Department, Taibah University, Saudi Arabia
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Senbanjo IO, Owolabi AJ, Oshikoya KA, Hageman JHJ, Adeniyi Y, Samuel F, Melse-Boonstra A, Schaafsma A. Effect of a Fortified Dairy-Based Drink on Micronutrient Status, Growth, and Cognitive Development of Nigerian Toddlers- A Dose-Response Study. Front Nutr 2022; 9:864856. [PMID: 35571933 PMCID: PMC9097016 DOI: 10.3389/fnut.2022.864856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/31/2022] [Indexed: 11/24/2022] Open
Abstract
Malnutrition results in a high prevalence of stunting, underweight, and micronutrient deficiencies. This study investigated the effect of a multi-nutrient fortified dairy-based drink on micronutrient status, growth, and cognitive development in malnourished [height-for-age z-score (HAZ) and/or weight-for-age z-score (WAZ) < -1 SD and >−3 SD] Nigerian toddlers (n = 184, 1–3 years). The product was provided in different daily amounts (200, 400, or 600 ml) for 6 months. At baseline and endline, venous blood and urine samples were collected to determine micronutrient status. Bodyweight, height, waist, and head circumference were measured, and corresponding Z-scores were calculated. The Bayley-III Screening Test was used to classify the cognitive development of the children. In a modified per-protocol (PP) population, the highest prevalence's of micronutrient deficiencies were found for vitamin A (35.5%) and selenium (17.9%). At endline, there were no significant improvements in iodine, zinc, vitamin B12, and folate status in any of the three groups. Regarding vitamin D status (25OHD), consumption of 600 and 400 ml resulted in an improved status as compared to baseline, and in a difference between the 600- and 200-ml groups. Consumption of 600 ml also increased vitamin A and selenium status as compared to baseline, but no differences were found between groups. Within the groups, WAZ, weight-for-height z-score (WHZ), and BMI-for-age z-score (BAZ) improved, but without differences between the groups. For HAZ, only the 600 ml group showed improvement within the group, but it was not different between groups. For the absolute weight, height, and head circumference only trends for differences between groups were indicated. Cognition results did not differ between the groups. Within groups, all showed a decline in the per cent of competent children for receptive language. To study the effects of a nutritional intervention on linear growth and cognition, a longer study duration might be necessary. Regarding the improvement of micronutrient status, 600 ml of fortified dairy-based drink seems most effective.
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Affiliation(s)
- Idowu Odunayo Senbanjo
- Department of Paediatrics and Child Health, Paediatric Gastroenterology, Hepatology and Nutrition Unit, Lagos State University College of Medicine, Lagos, Nigeria
| | - Adedotun J. Owolabi
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Kazeem Adeola Oshikoya
- Department of Pharmacology, Therapeutic and Toxicology, Lagos State University College of Medicine, Lagos, Nigeria
| | | | - Yetunde Adeniyi
- Department of Child and Adolescent Psychiatry, University College Hospital, Ibadan, Nigeria
| | - Folake Samuel
- Department of Human Nutrition, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Alida Melse-Boonstra
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, Netherlands
| | - Anne Schaafsma
- FrieslandCampina, Amersfoort, Netherlands
- *Correspondence: Anne Schaafsma
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11
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Shaka MF, Hussen kabthymer R, Meshesha MD, Borde MT. Vitamin D deficiency among apparently healthy children and children with common medical illnesses in Sub-Saharan Africa: A systematic review and meta-analysis. Ann Med Surg (Lond) 2022; 75:103403. [PMID: 35386789 PMCID: PMC8977889 DOI: 10.1016/j.amsu.2022.103403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/12/2022] [Accepted: 02/21/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Mohammed Feyisso Shaka
- Dilla University, College of Health Sciences and Medicine, School of Public Health, Dilla, Ethiopia
| | - Robel Hussen kabthymer
- Dilla University, College of Health Sciences and Medicine, School of Public Health, Dilla, Ethiopia
- Corresponding author.
| | - Meiraf Daniel Meshesha
- Dilla University, College of Health Sciences and Medicine, School of Medicine, Dilla, Ethiopia
| | - Moges Tadesse Borde
- Dilla University, College of Health Sciences and Medicine, School of Public Health, Dilla, Ethiopia
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12
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Nausheen S, Habib A, Bhura M, Rizvi A, Shaheen F, Begum K, Iqbal J, Ariff S, Shaikh L, Raza SS, Soofi SB. Impact evaluation of the efficacy of different doses of vitamin D supplementation during pregnancy on pregnancy and birth outcomes: a randomised, controlled, dose comparison trial in Pakistan. BMJ Nutr Prev Health 2022; 4:425-434. [PMID: 35028513 PMCID: PMC8718848 DOI: 10.1136/bmjnph-2021-000304] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/06/2021] [Indexed: 12/30/2022] Open
Abstract
Background Vitamin D deficiency during pregnancy is a public health problem in Pakistan and is prevalent among most women of reproductive age in the country. Vitamin D supplementation during pregnancy is suggested to prevent adverse pregnancy outcomes and vitamin D deficiency in both the mother and her newborn. Methods We conducted a double-blinded, randomised controlled trial in Karachi, Pakistan to evaluate the effect of different doses of vitamin D supplementation during pregnancy on biochemical markers (serum 25(OH)D, calcium, phosphorus and alkaline phosphatase) in women and neonates, and on pregnancy and birth outcomes (gestational diabetes, pre-eclampsia, low birth weight, preterm births and stillbirths). Results Pregnant women (N=350) in their first trimester were recruited and randomised to three treatment groups of vitamin D supplementation: 4000 IU/day (group A, n=120), 2000 IU/day (group B, n=115) or 400 IU/day (group C, n=115). Women and their newborn in group A had the lowest vitamin D deficiency at endline (endline: 75.9%; neonatal: 64.9%), followed by group B (endline: 84.9%; neonatal: 73.7%) and then the control group (endline: 90.2%; neonatal: 91.8%). Vitamin D deficiency was significantly lower in group A than in group C (p=0.006) among women at endline and lower in both groups A and B than in the control group (p=0.001) in neonates. Within groups, serum 25(OH)D was significantly higher between baseline and endline in group A and between maternal baseline and neonatal levels in groups A and B. Participant serum 25(OH)D levels at the end of the trial were positively correlated with those in intervention group A (4000 IU/day) (β=4.16, 95% CI 1.6 to 6.7, p=0.002), with food group consumption (β=0.95, 95% CI 0.01 to 1.89, p=0.047) and with baseline levels of serum 25(OH)D (β=0.43, 95% CI 0.29 to 0.58, p<0.0001). Conclusion The evidence provided in our study indicates that vitamin D supplementation of 4000 IU/day was more effective in reducing vitamin D deficiency among pregnant women and in improving serum 25(OH)D levels in mothers and their neonates compared with 2000 IU/day and 400 IU/day. Trial registration number NCT02215213.
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Affiliation(s)
- Sidrah Nausheen
- Department of Obstetrics and Gynecology, The Aga Khan University, Karachi, Pakistan
| | - Atif Habib
- Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Maria Bhura
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Arjumand Rizvi
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Fariha Shaheen
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Kehkashan Begum
- Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Junaid Iqbal
- Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Shabina Ariff
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Lumaan Shaikh
- Department of Obstetrics and Gynecology, The Aga Khan University, Karachi, Pakistan
| | - Syed Shamim Raza
- Department of Pharmacy, The Aga Khan University, Karachi, Pakistan
| | - Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan.,Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Vearing RM, Hart KH, Darling AL, Probst Y, Olayinka AS, Mendis J, Ribeiro H, Thakur S, Mendes M, Charlton K, Lanham-New SA. Global Perspective of the Vitamin D Status of African-Caribbean Populations: A Systematic Review and Meta-analysis. Eur J Clin Nutr 2022; 76:516-526. [PMID: 34282293 PMCID: PMC8993683 DOI: 10.1038/s41430-021-00980-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/08/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Vitamin D deficiency remains a global public health issue, particularly in minority ethnic groups. This review investigates the vitamin D status (as measured by 25(OH)D and dietary intake) of the African-Caribbean population globally. SUBJECTS/METHODS A systematic review was conducted by searching key databases (PUBMED, Web of Science, Scopus) from inception until October 2019. Search terms included 'Vitamin D status' and 'African-Caribbean'. A random effects and fixed effects meta-analysis was performed by combining means and standard error of the mean. RESULT The search yielded 19 papers that included n = 5670 African-Caribbean participants from six countries. A meta-analysis found this population to have sufficient (>50 nmol/L) 25(OH)D levels at 67.8 nmol/L, 95% CI (57.9, 7.6) but poor dietary intake of vitamin D at only 3.0 µg/day, 95% CI (1.67,4.31). For those living at low latitudes 'insufficient' (as defined by study authors) 25(OH)D levels were found only in participants with type 2 diabetes and in those undergoing haemodialysis. Suboptimal dietary vitamin D intake (according to the UK recommended nutrient intake of 10 µg/day) was reported in all studies at high latitudes. Studies at lower latitudes, with lower recommended dietary intakes (Caribbean recommended dietary intake: 2.5 µg/day) found 'sufficient' intake in two out of three studies. CONCLUSIONS 25(OH)D sufficiency was found in African-Caribbean populations at lower latitudes. However, at higher latitudes, 25(OH)D deficiency and low dietary vitamin D intake was prevalent.
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Affiliation(s)
- Rebecca M. Vearing
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK ,grid.1007.60000 0004 0486 528XSchool of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia
| | - Kathryn H. Hart
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Andrea L. Darling
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Yasmine Probst
- grid.1007.60000 0004 0486 528XSchool of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia ,grid.510958.0Illawarra Health and Medical Research Institute, Wollongong, NSW Australia
| | - Aminat S. Olayinka
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jeewaka Mendis
- grid.5475.30000 0004 0407 4824Surrey Clinical Trials Unit, University of Surrey, Guildford, UK
| | - Helena Ribeiro
- School of Public Health, University of São Paulo, São Paulo, USA
| | - Siddhartha Thakur
- grid.40803.3f0000 0001 2173 6074College of Veterinary Medicine, North Carolina State University, Raleigh, NC USA
| | - Marcela Mendes
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK ,grid.7632.00000 0001 2238 5157School of Nutrition, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil
| | - Karen Charlton
- grid.1007.60000 0004 0486 528XSchool of Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, NSW Australia ,grid.510958.0Illawarra Health and Medical Research Institute, Wollongong, NSW Australia
| | - Susan A. Lanham-New
- grid.5475.30000 0004 0407 4824School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Vitamin D Status of the British African-Caribbean Residents: Analysis of the UK Biobank Cohort. Nutrients 2021; 13:nu13114104. [PMID: 34836358 PMCID: PMC8620024 DOI: 10.3390/nu13114104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 11/17/2022] Open
Abstract
The vitamin D status of the United Kingdom (UK) African-Caribbean (AC) population remains under-researched, despite an increased risk of vitamin D deficiency due to darker skin phenotypes and living at a high latitude. This cross-sectional study explored the vitamin D status and intake of AC individuals (n = 4046 with a valid serum 25(OH)D measurement) from the UK Biobank Cohort, aged ≥40 years at baseline (2006-2010). Over one third of the population were deficient (<25 nmol/L), 41.1% were insufficient (25-50 nmol/L) and 15.9% were sufficient (>50 nmol/L). Median (IQR) 25(OH)D was 30.0 (20.9) nmol/L. Logistic regression showed that brown/black skin phenotype, winter blood draw, not consuming oily fish and not using vitamin D supplements predicted increased odds of vitamin D deficiency, whilst older age and a summer or autumn blood draw were significantly associated with reduced odds of vitamin D deficiency. Vitamin D deficiency and insufficiency were prevalent in this AC population and is of considerable concern given the individual and societal implications of increased morbidity. Public health messaging for this group should focus on year-round vitamin D supplementation and increasing intakes of culturally appropriate vitamin D-rich foods. These data also support the urgent requirement for a revised vitamin D RNI for ethnic groups.
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15
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Tunau KA, Garba JA, Panti AA, Shehu CE, Adamu AN, AbdulRahman MB, Ahmad MK. Low plasma vitamin D as a predictor of uterine fibroids in a nigerian population. Niger Postgrad Med J 2021; 28:181-186. [PMID: 34708704 DOI: 10.4103/npmj.npmj_495_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Uterine fibroid is the most common benign tumour of the uterus and the exact cause is unknown. Vitamin D has been found to inhibit cell proliferation and enhance apoptosis in vitro. Aim The aim of this study is to compare the plasma level of Vitamin D among women with uterine fibroids and those without uterine fibroids. Materials and Methods This was an analytical cross-sectional study conducted among women with uterine fibroids and those without uterine fibroids. An interviewer-administered questionnaire was used to obtain relevant information. Five millilitres of venous blood was obtained for plasma Vitamin D assay. Data analysis was performed using the SPSS version 22. Level of significance was set at P < 0.05. Results There were 100 participants recruited for the study. The mean age of the participants with uterine fibroid was 35.06 ± 6.6 years and that of controls was 33.28 ± 7 years. The mean plasma level of Vitamin D for all the participants was 12.47 ± 7.53 ng/ml. The mean plasma level of Vitamin D in those with uterine fibroids was significantly lower than in those without uterine fibroid (10.16 ± 7.78 vs. 14.35 ± 6.8; t = 2.517, P = 0.014). It also shows that 1 unit increase in Vitamin D level will reduce the risk of developing uterine fibroids by 8% (odds ratio = 0.92, 95% confidence interval = 0.86-0.99). Conclusion The predictors of uterine fibroids were fewer hours spent outdoors, middle social class and low Vitamin D levels.
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Affiliation(s)
- Karima Abubakar Tunau
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Jamila Abubakar Garba
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State,, Nigeria
| | - Abubakar Abubakar Panti
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Constance Egondu Shehu
- Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Aisha Nana Adamu
- Department of Obstetrics and Gynaecology, Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria
| | - Muhammad Bashir AbdulRahman
- Department of Chemical Pathology, Usmanu Danfodiyo University/Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
| | - Mohammad Kaoje Ahmad
- Department of Chemical Pathology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria
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16
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Abed MN, Alassaf FA, Qazzaz ME, Alfahad M, Jasim MHM. Insights into the Perspective Correlation Between Vitamin D and Regulation of Hormones: Thyroid and Parathyroid Hormones. Clin Rev Bone Miner Metab 2021. [DOI: 10.1007/s12018-021-09279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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17
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Mogire RM, Morovat A, Muriuki JM, Mentzer AJ, Webb EL, Kimita W, Ndungu FM, Macharia AW, Cutland CL, Sirima SB, Diarra A, Tiono AB, Lule SA, Madhi SA, Sandhu MS, Prentice AM, Bejon P, Pettifor JM, Elliott AM, Adeyemo A, Williams TN, Atkinson SH. Prevalence and predictors of vitamin D deficiency in young African children. BMC Med 2021; 19:115. [PMID: 34011341 PMCID: PMC8136043 DOI: 10.1186/s12916-021-01985-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/16/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Children living in sub-Saharan Africa have a high burden of rickets and infectious diseases, conditions that are linked to vitamin D deficiency. However, data on the vitamin D status of young African children and its environmental and genetic predictors are limited. We aimed to examine the prevalence and predictors of vitamin D deficiency in young African children. METHODS We measured 25-hydroxyvitamin D (25(OH)D) and typed the single nucleotide polymorphisms, rs4588 and rs7041, in the GC gene encoding the vitamin D binding protein (DBP) in 4509 children aged 0-8 years living in Kenya, Uganda, Burkina Faso, The Gambia and South Africa. We evaluated associations between vitamin D status and country, age, sex, season, anthropometric indices, inflammation, malaria and DBP haplotypes in regression analyses. RESULTS Median age was 23.9 months (interquartile range [IQR] 12.3, 35.9). Prevalence of vitamin D deficiency using 25(OH)D cut-offs of < 30 nmol/L and < 50 nmol/L was 0.6% (95% CI 0.4, 0.9) and 7.8% (95% CI 7.0, 8.5), respectively. Overall median 25(OH)D level was 77.6 nmol/L (IQR 63.6, 94.2). 25(OH)D levels were lower in South Africa, in older children, during winter or the long rains, and in those with afebrile malaria, and higher in children with inflammation. 25(OH)D levels did not vary by stunting, wasting or underweight in adjusted regression models. The distribution of Gc variants was Gc1f 83.3%, Gc1s 8.5% and Gc2 8.2% overall and varied by country. Individuals carrying the Gc2 variant had lower median 25(OH)D levels (72.4 nmol/L (IQR 59.4, 86.5) than those carrying the Gc1f (77.3 nmol/L (IQR 63.5, 92.8)) or Gc1s (78.9 nmol/L (IQR 63.8, 95.5)) variants. CONCLUSIONS Approximately 0.6% and 7.8% of young African children were vitamin D deficient as defined by 25(OH)D levels < 30 nmol/L and < 50 nmol/L, respectively. Latitude, age, season, and prevalence of inflammation and malaria should be considered in strategies to assess and manage vitamin D deficiency in young children living in Africa.
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Affiliation(s)
- Reagan M Mogire
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- KEMRI-Wellcome Trust Research Programme - Accredited Research Centre, Open University, Kilifi, Kenya.
| | - Alireza Morovat
- Department of Clinical Biochemistry, Oxford University Hospitals, Oxford, UK
| | - John Muthii Muriuki
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Alexander J Mentzer
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Li Ka Shing Centre for Health Information and Discovery, Big Data Institute, University of Oxford, Oxford, UK
| | - Emily L Webb
- Medical Research Council (MRC) Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Wandia Kimita
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Francis M Ndungu
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Alex W Macharia
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Clare L Cutland
- African Leadership in Vaccinology Expertise (Alive), Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sodiomon B Sirima
- Groupe de Recherche Action en Sante (GRAS), 06, 06 BP 10248, Ouagadougou, Burkina Faso
| | - Amidou Diarra
- Groupe de Recherche Action en Sante (GRAS), 06, 06 BP 10248, Ouagadougou, Burkina Faso
| | - Alfred B Tiono
- Groupe de Recherche Action en Sante (GRAS), 06, 06 BP 10248, Ouagadougou, Burkina Faso
| | - Swaib A Lule
- Medical Research Council (MRC) Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Shabir A Madhi
- South African Medical Research Council Vaccines and Infectious Diseases Analytical Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Andrew M Prentice
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia
| | - Philip Bejon
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - John M Pettifor
- South African Medical Research Council/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Alison M Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Adebowale Adeyemo
- Centre for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, South Drive, MSC 5635, Bethesda, Maryland, 20891-5635, USA
| | - Thomas N Williams
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Infectious Diseases and Institute of Global Health Innovation, Imperial College, London, UK
| | - Sarah H Atkinson
- Kenya Medical Research Institute (KEMRI) Centre for Geographic Medicine Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Department of Paediatrics, University of Oxford, Oxford, UK.
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Iron, iodine and vitamin D deficiencies during pregnancy: epidemiology, risk factors and developmental impacts. Proc Nutr Soc 2021; 80:290-302. [PMID: 33988109 DOI: 10.1017/s0029665121001944] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Micronutrient deficiency persists throughout the world, and although the burden is higher in low-resource settings, it is also prevalent in wealthy countries, a phenomenon termed 'hidden hunger'. Due to their high requirements for vitamins and minerals relative to their energy intake, young women and children are particularly vulnerable to hidden hunger. As they share several risk factors and impact on overlapping outcomes, we consider how deficiency of iron, iodine and vitamin D can have profound impacts on perinatal health and infant development. We review the epidemiology of these micronutrient deficiencies during pregnancy, including social, environmental and dietary risk factors. We identify the main challenges in defining nutritional status of these nutrients using validated diagnostic criteria linked with meaningful clinical outcomes. Public health strategies are urgently required to improve the overall health and nutritional status of women of reproductive age. Obesity prevention and early detection of malnutrition with standardised screening methods would detect pregnant women at increased risk of iron deficiency. Development of sensitive, individual biomarkers of iodine status is required to protect maternal health and fetal/infant brain development. Risk assessments of vitamin D requirements during pregnancy need to be revisited from the perspective of fetal and neonatal requirements. International consensus on standardised approaches to micronutrient assessment, analysis and reporting as well as sensitive, clinically validated infant and child neuro-behavioural outcomes will enable progression of useful observational and intervention studies.
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Fakhfakh R, Feki S, Elleuch A, Neifar M, Marzouk S, Elloumi N, Hachicha H, Abida O, Bahloul Z, Ayadi F, Masmoudi H. Vitamin D status and CYP27B1-1260 promoter polymorphism in Tunisian patients with systemic lupus erythematosus. Mol Genet Genomic Med 2021; 9:e1618. [PMID: 33594806 PMCID: PMC8104169 DOI: 10.1002/mgg3.1618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/09/2021] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Aim An association between serum vitamin D (Vit D) levels and systemic lupus erythematosus (SLE) has been reported by several studies that suggested the involvement of genetically determined characteristics of enzymes of vitamin D metabolism. Our study aimed to evaluate the relationship between 25 hydroxyvitamin D (25[OH]D) level, the most representative metabolite of VitD status, and polymorphism of the cytochrome P450, CYP27B1 gene, which influence vitamin D metabolism, and serum levels, in SLE Tunisian patients. Material and Methods A cross‐sectional study has been conducted in SLE patients (supplemented and not supplemented patients), matched to healthy controls by age and gender. The 25[OH]D serum level was measured by chemiluminescence assay and CYP27B1‐1260 genetic polymorphism was carried out using PCR‐RFLP methods. Statistical analysis was made using Shesis and SPSS.20 Software. Results Controls and Vit D not supplemented patients’ groups presented the highest percentage of hypovitaminosis D. A significant difference in the mean level of circulating 25[OH]D between Vit D supplemented SLE patients and controls was observed (23.91 ng/ml and 7.18 ng/ml, respectively p = 3.4 105). Our results showed a correlation of high 25[OH]D level with complement component 3 levels and prednisolone drug. Moreover, the analysis of CYP27B1‐1260 polymorphism in SLE patients and controls revealed a nonsignificant allelic or genotypic association. Conclusion Despite the sunny climate, the high prevalence of Vit D deficiency is common in Tunisia. This hypovitaminosis D feature may affect the Vit D levels in our SLE patients but a direct association with the disease or with the genetically determined features remains unclear. More studies are needed to establish thresholds and susceptibility genes according to the characteristics of each population.
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Affiliation(s)
- Raouia Fakhfakh
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Sawsan Feki
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Aida Elleuch
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Manel Neifar
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Sameh Marzouk
- Internal Medicine Department, HediChaker University Hospital, Sfax, Tunisia
| | - Nesrine Elloumi
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Hend Hachicha
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Olfa Abida
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
| | - Zouhir Bahloul
- Internal Medicine Department, HediChaker University Hospital, Sfax, Tunisia
| | - Fatma Ayadi
- Biochemistry Department, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Hatem Masmoudi
- Autoimmunity, Cancer and immunogenetics research laboratory, University hospital Habib Bourguiba of Sfax, Sfax, Tunisia
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Kuti BP, Akinwumi AI, Kuti DK, Amoo KO. Relationship between serum 25-hydroxyvitamin D, total antioxidant capacity and pneumonia incidence, severity and outcome in Nigerian children. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2020. [DOI: 10.1186/s43168-020-00029-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The pathologic basis of childhood community-acquired pneumonia (CAP) involves the generation of reactive oxygen species by immune cells leading to cellular damage and lung congestion. Serum antioxidants and vitamin D with immunomodulatory properties therefore hold prospects in the prevention and management of pneumonia in children. This case–control study set out to compare the serum 25-hydroxyvitamin D (25-OHD) and total antioxidant capacity (TAC) in Nigerian children with CAP and age- and sex-matched controls and to relate these parameters with pneumonia severity and outcome—length of hospital stay (LOH).
Results
A total of 160 children (80 each for CAP and controls) were recruited. The median (IQR) age was 1.8 (0.6–4.0) years, male:female 1.7:1, 63 (78.8%) and 11 (13.8%) of CAP group had severe pneumonia and parapneumonic effusions, respectively. Serum 25-OHD (33.8 (18.3) ng/ml vs. 41.9 (12.3) ng/ml; p = 0.010) and TAC (6.1 (4.4–8.1) ng/dl vs. 7.2 (4.7–17.5) ng/dl; p = 0.023) were lower in children with CAP than controls. Lower serum 25-OHD was observed in severe than non-severe pneumonia (30.5(17.1) ng/ml vs. 46.3 (17.6) ng/ml; p = 0.001) but LOH did not correlate with serum 25-OHD and TAC.
Conclusion
Children with CAP had lower serum vitamin D and antioxidants than controls, and severe pneumonia was significantly associated with suboptimal serum vitamin D. They however were not related to pneumonia outcome. Optimal serum vitamin D and antioxidants may play a role in reducing the incidence of childhood CAP in Nigerian children.
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Abstract
OBJECTIVE To determine the prevalence and predictors of hypocalcaemia in under-five children (1-59 months) hospitalised with severe acute malnutrition (SAM). DESIGN A cross-sectional study was designed to determine the prevalence of hypocalcaemia among children hospitalised with SAM. Serum Ca and 25-hydroxycholecalciferol (25-(OH)D) were estimated. Hypocalcaemia was defined as serum Ca (albumin-adjusted) <2·12 mmol/l. To identify the clinical predictors of hypocalcaemia, a logistic regression model was constructed taking hypocalcaemia as a dependent variable, and sociodemographic and clinical variables as independent variables. SETTING A tertiary care hospital in Delhi, between November 2017 and April 2019. PARTICIPANTS One-hundred and fifty children (1-59 months) hospitalised with SAM were enrolled. RESULTS Hypocalcaemia was documented in thirty-nine (26 %) children hospitalised with SAM, the prevalence being comparable between children aged <6 months (11/41, 26·8 %) and those between 6 and 59 months (28/109, 25·7 %) (P = 0·887). Vitamin D deficiency (serum 25-(OH)D <30 nmol/l) and clinical rickets were observed in ninety-eight (65·3 %) and sixty-three (42 %) children, respectively. Hypocalcaemia occurred more frequently in severely malnourished children with clinical rickets (OR 6·6, 95 % CI 2·54, 17·15, P < 0·001), abdominal distension (OR 4·5, 95 % CI 1·39, 14·54, P = 0·012) and sepsis (OR 2·6, 95 % CI 1·00, 6·57, P = 0·050). CONCLUSION Rickets and hypocalcaemia are common in children with SAM. Routine supplementation of vitamin D should be considered for severely malnourished children. Ca may be empirically prescribed to severely malnourished children with clinical rickets, abdominal distension and/or sepsis.
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Mogire RM, Mutua A, Kimita W, Kamau A, Bejon P, Pettifor JM, Adeyemo A, Williams TN, Atkinson SH. Prevalence of vitamin D deficiency in Africa: a systematic review and meta-analysis. Lancet Glob Health 2020; 8:e134-e142. [PMID: 31786117 PMCID: PMC7024961 DOI: 10.1016/s2214-109x(19)30457-7] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/25/2019] [Accepted: 10/16/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Vitamin D deficiency is associated with non-communicable and infectious diseases, but the vitamin D status of African populations is not well characterised. We aimed to estimate the prevalence of vitamin D deficiency in children and adults living in Africa. METHODS For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, African Journals Online, and African Index Medicus for studies on vitamin D prevalence, published from database inception to Aug 6, 2019, without language restrictions. We included all studies with measured serum 25-hydroxyvitamin D (25[OH]D) concentrations from healthy participants residing in Africa. We excluded case reports and case series, studies that measured 25(OH)D only after a clinical intervention, and studies with only a meeting abstract or unpublished material available. We used a standardised data extraction form to collect information from eligible studies; if the required information was not available in the published report, we requested raw data from the authors. We did a random-effects meta-analysis to obtain the pooled prevalence of vitamin D deficiency in African populations, with use of established cutoffs and mean 25(OH)D concentrations. We stratified meta-analyses by participant age group, geographical region, and residence in rural or urban areas. The study is registered with PROSPERO, number CRD42018112030. FINDINGS Our search identified 1692 studies, of which 129 studies with 21 474 participants from 23 African countries were included in the systematic review and 119 studies were included in the meta-analyses. The pooled prevalence of low vitamin D status was 18·46% (95% CI 10·66-27·78) with a cutoff of serum 25(OH)D concentration less than 30 nmol/L; 34·22% (26·22-43·68) for a cutoff of less than 50 nmol/L; and 59·54% (51·32-67·50) for a cutoff of less than 75 nmol/L. The overall mean 25(OH)D concentration was 67·78 nmol/L (95% CI 64·50-71·06). There was no evidence of publication bias, although heterogeneity was high (I2 ranged from 98·26% to 99·82%). Mean serum 25(OH)D concentrations were lower in populations living in northern African countries or South Africa compared with sub-Saharan Africa, in urban areas compared with rural areas, in women compared with men, and in newborn babies compared with their mothers. INTERPRETATION The prevalence of vitamin D deficiency is high in African populations. Public health strategies in Africa should include efforts to prevent, detect, and treat vitamin D deficiency, especially in newborn babies, women, and urban populations. FUNDING Wellcome Trust and the DELTAS Africa Initiative.
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Affiliation(s)
- Reagan M Mogire
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Open University, KEMRI-Wellcome Trust Research Programme Affiliated Research Centre, Kilifi, Kenya
| | - Agnes Mutua
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Wandia Kimita
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Alice Kamau
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Philip Bejon
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - John M Pettifor
- South African Medical Research Council and Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - Adebowale Adeyemo
- Centre for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Thomas N Williams
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Medicine, Imperial College London, London, UK
| | - Sarah H Atkinson
- Kenya Medical Research Institute (KEMRI), Centre for Geographic Medicine Research-Coast, KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Department of Paediatrics, University of Oxford, Oxford, UK.
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Karau PB, Kirna B, Amayo E, Joshi M, Ngare S, Muriira G. The prevalence of vitamin D deficiency among patients with type 2 diabetes seen at a referral hospital in Kenya. Pan Afr Med J 2019; 34:38. [PMID: 31762905 PMCID: PMC6859033 DOI: 10.11604/pamj.2019.34.38.18936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/31/2019] [Indexed: 01/15/2023] Open
Abstract
Introduction The prevalence of diabetes mellitus is rising at an alarming rate, calling for more insights into its pathogenetic mechanisms, and other factors involved in its progression. The prevalence of vitamin D deficiency is higher in diabetic compared to non-diabetic patients, and is associated with poor glycaemic control. This has not been documented among diabetic patients in Kenya. Aims: to determine the prevalence of hypovitaminosis D among type 2 diabetic patients at Kenyatta National Hospital in Nairobi, Kenya. Methods We recruited type 2 diabetic patients on follow-up at Kenyatta National Hospital. Measurements of height, weight and waist/hip ratios were taken. We drew 6mls of peripheral blood to determine vitamin D, zinc and HbA1c levels. Results A total of 151 participants were recruited, with 69.5% females and mean age of 58.2 years. Hypertension was found in 72.8% of the participants, and obesity in 37.7%. The mean HbA1c levels were 8.46%, and 62.9% had poor glycaemic control. The mean vitamin D level was 31.40ng/ml. Vitamin D deficiency and insufficiency was found in 38.4% and 21.9% of the participants respectively. We found a significant inverse correlation between vitamin D and glycaemic control (r = -0.09, p = 0.044) and vitamin D and BMI (r = - 0.145, p = 0.045). Conclusion In this study population on long-term follow-up for diabetes, there was high prevalence of vitamin D deficiency. This forms a basis for further management of patients with poor glycaemic control. Further studies are needed to document the causal association between poor glycaemic control and vitamin D deficiency.
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Affiliation(s)
- Paul Bundi Karau
- Kenya Methodist University, School of Medicine, Department of Internal Medicine, Kenya
| | - Bhatt Kirna
- The University of Nairobi, Department of Clinical Medicine and Therapeutics, Nairobi, Kenya
| | - Erastus Amayo
- The University of Nairobi, Department of Clinical Medicine and Therapeutics, Nairobi, Kenya
| | - Mark Joshi
- The University of Nairobi, Department of Clinical Medicine and Therapeutics, Nairobi, Kenya
| | - Stanley Ngare
- Kenyatta National Hospital, Department of Medicine, Nairobi, Kenya
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Dharmshaktu P, Saha S, Kar P, Sreenivas V, Ramakrishnan L, Goswami R. Absence of vitamin D deficiency among common outdoor workers in Delhi. Clin Endocrinol (Oxf) 2019; 91:356-362. [PMID: 31087795 DOI: 10.1111/cen.14012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/15/2019] [Accepted: 05/13/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is reservation about accepting the notion of widespread vitamin D deficiency (VDD) in sunny countries because information base is largely urban indoors, and the cut-off serum 25(OH)D > 75.0 nmol/L to define sufficiency is perceived as high. OBJECTIVE We assessed the vitamin D status of subjects engaged in six types of outdoor jobs with freedom to seek shade, when needed. DESIGN Descriptive observational study. SUBJECTS AND METHODS A total of 573 outdoors, (hawkers, n = 144; auto-rickshaw drivers, n = 113; manual rickshaw pullers, n = 49; fuel-station attendants, n = 84; gardeners, n = 96; traffic police personnel, n = 87) were assessed for serum 25(OH)D, iPTH and total calcium during summer and winter. Bank employees were indoor controls (n = 72). Serum 25(OH)D was defined as sufficient if ≥50.0 nmol/L and deficient when <30.0 nmol/L, as per 'Institute of Medicine'. RESULTS Mean serum 25(OH)D of 573 outdoors was 44.8 ± 19.6 nmol/L and showed a physiological inverse relation with iPTH (P < 0.001). 77.5% of the outdoors did not have VDD. Hawkers, gardeners, fuel-station attendants and rickshaw pullers had sufficient or near sufficient serum 25(OH)D. The mean serum 25(OH)D (30.6 ± 23.2 nmol/L) of indoors though lower by 12.7 nmol/L than outdoors was above the cut-off of VDD. Proportions with supranormal iPTH were comparable between outdoors and indoors (14.0% vs 20.8%). Despite winter dip, the mean serum 25(OH)D (31.2 ± 14.3 nmol/l) of outdoors was not deficient. CONCLUSIONS Vitamin D deficiency is not universal. Most urban outdoor workers do not have VDD.
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Affiliation(s)
- Pramila Dharmshaktu
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Soma Saha
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Parmita Kar
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | | | - Lakshmy Ramakrishnan
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Ravinder Goswami
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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Nikoghosyan M, Hakobyan S, Hovhannisyan A, Loeffler-Wirth H, Binder H, Arakelyan A. Population Levels Assessment of the Distribution of Disease-Associated Variants With Emphasis on Armenians - A Machine Learning Approach. Front Genet 2019; 10:394. [PMID: 31105750 PMCID: PMC6498285 DOI: 10.3389/fgene.2019.00394] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/11/2019] [Indexed: 12/25/2022] Open
Abstract
Background: During the last decades a number of genome-wide association studies (GWASs) has identified numerous single nucleotide polymorphisms (SNPs) associated with different complex diseases. However, associations reported in one population are often conflicting and did not replicate when studied in other populations. One of the reasons could be that most GWAS employ a case-control design in one or a limited number of populations, but little attention was paid to the global distribution of disease-associated alleles across different populations. Moreover, the majority of GWAS have been performed on selected European, African, and Chinese populations and the considerable number of populations remains understudied. Aim: We have investigated the global distribution of so far discovered disease-associated SNPs across worldwide populations of different ancestry and geographical regions with a special focus on the understudied population of Armenians. Data and Methods: We have used genotyping data from the Human Genome Diversity Project and of Armenian population and combined them with disease-associated SNP data taken from public repositories leading to a final dataset of 44,234 markers. Their frequency distribution across 1039 individuals from 53 populations was analyzed using self-organizing maps (SOM) machine learning. Our SOM portrayal approach reduces data dimensionality, clusters SNPs with similar frequency profiles and provides two-dimensional data images which enable visual evaluation of disease-associated SNPs landscapes among human populations. Results: We find that populations from Africa, Oceania, and America show specific patterns of minor allele frequencies of disease-associated SNPs, while populations from Europe, Middle East, Central South Asia, and Armenia mostly share similar patterns. Importantly, different sets of SNPs associated with common polygenic diseases, such as cancer, diabetes, neurodegeneration in populations from different geographic regions. Armenians are characterized by a set of SNPs that are distinct from other populations from the neighboring geographical regions. Conclusion: Genetic associations of diseases considerably vary across populations which necessitates health-related genotyping efforts especially for so far understudied populations. SOM portrayal represents novel promising methods in population genetic research with special strength in visualization-based comparison of SNP data.
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Affiliation(s)
- Maria Nikoghosyan
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan, Armenia
- Research Group of Bioinformatics, Institute of Molecular Biology NAS RA, Yerevan, Armenia
| | - Siras Hakobyan
- Research Group of Bioinformatics, Institute of Molecular Biology NAS RA, Yerevan, Armenia
| | - Anahit Hovhannisyan
- Laboratory of Ethnogenomics, Institute of Molecular Biology NAS RA, Yerevan, Armenia
| | - Henry Loeffler-Wirth
- Interdisciplinary Centre for Bioinformatics, University of Leipzig, Leipzig, Germany
| | - Hans Binder
- Interdisciplinary Centre for Bioinformatics, University of Leipzig, Leipzig, Germany
| | - Arsen Arakelyan
- Institute of Biomedicine and Pharmacy, Russian-Armenian University, Yerevan, Armenia
- Research Group of Bioinformatics, Institute of Molecular Biology NAS RA, Yerevan, Armenia
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Cavalier E, Sagou Yayo E, Attoungbre-Hauhouot ML, Konan JL, Yao-Yapo C, Monnet D, Gnionsahé A, Souberbielle JC, Delanaye P. Vitamin D, bone alkaline phosphatase and parathyroid hormone in healthy subjects and haemodialysed patients from West Africa: impact of reference ranges and parathyroid hormone generation assays on the KDIGO guidelines. Clin Kidney J 2019; 12:288-293. [PMID: 30976410 PMCID: PMC6452202 DOI: 10.1093/ckj/sfy074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend targets based on multiples of the upper limit of normal (ULN) of parathyroid hormone (PTH) concentration. However, the ULN has not always been correctly established by manufacturers. While it is known that the ULN is supposed to be higher in African Americans than in Caucasians, it is largely unknown in Africans. METHODS We established the ULN of PTH concentration in a population of 240 healthy Ivorians using second- and third-generation PTH assays before and after supplementation with 100 000 IU of cholecalferol. We measured the levels of PTH, bone alkaline phosphatase, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in 100 haemodialysed Ivorian patients. RESULTS The prevalence of vitamin D deficiency in Ivory Coast is low. The ULN obtained using the third-generation PTH assay was similar to that obtained in Caucasians but was higher when PTH was measured using the second-generation PTH assay. According to the KDIGO guidelines, ∼20% of the haemodialysed patients were below twice the ULN and 30% were above nine times the ULN. Approximately 25% of the patients were even >12 times the ULN. We observed a discrepancy in the results between the two PTH assays (14%) that was relatively more important than what we observed from previous studies in Caucasians using the same strategy. CONCLUSIONS We found a low prevalence of vitamin D deficiency in a tropical country like Ivory Coast. We also established the PTH reference range, which could prove useful for the follow-up of haemodialysed patients, particularly for the large number of patients suffering from secondary hyperparathyroidism who are at high risk of adverse bone events.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Liège, Belgium
| | - Eric Sagou Yayo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Marie-Laure Attoungbre-Hauhouot
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Jean-Louis Konan
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Carine Yao-Yapo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Dagui Monnet
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | - Appolinaire Gnionsahé
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
- Département de Néphrologie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | | | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liège, CHU de Liège, Liège, Belgium
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Kibirige D, Lumu W, Jones AG, Smeeth L, Hattersley AT, Nyirenda MJ. Understanding the manifestation of diabetes in sub Saharan Africa to inform therapeutic approaches and preventive strategies: a narrative review. Clin Diabetes Endocrinol 2019; 5:2. [PMID: 30783538 PMCID: PMC6376682 DOI: 10.1186/s40842-019-0077-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 02/05/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Globally, the burden of diabetes mellitus has increased to epidemic proportions. Estimates from the International Diabetes Federation predict that the greatest future increase in the prevalence of diabetes mellitus will occur in Africa. METHODS This article reviews literature on the manifestation of diabetes in adult patients in sub-Saharan Africa highlighting the distinct phenotypes, plausible explanations for this unique manifestation and the clinical significance of comprehensively defining and understanding the African diabetes phenotype. RESULTS There are few studies on the manifestation or phenotype of diabetes in Africa. The limited data available suggests that, compared to the Western world, the majority of patients with diabetes in Africa are young and relatively lean in body size. In addition, hyperglycaemia in most cases is characterised by a significantly blunted acute first phase of insulin secretion in response to an oral or intravenous glucose load and pancreatic beta cell secretory dysfunction, rather than peripheral insulin resistance predominates. Genetic and environmental factors like chronic infections/inflammation, early life malnutrition and epigenetic modifications are thought to contribute to these distinct differences in manifestation. CONCLUSIONS While published data is limited, there appears to be distinct phenotypes of diabetes in sub-Saharan Africa. Large and more detailed studies are needed especially among newly diagnosed patients to fully characterize diabetes in this region. This will further improve the understanding of manifestation of diabetes and guide the formulation of optimal therapeutic approaches and preventive strategies of the condition on the continent.
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Affiliation(s)
- Davis Kibirige
- Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51-59, Nakiwogo Road, P.O. BOX 49 Entebbe, Uganda
- Department of Medicine, Uganda Martyrs hospital Lubaga, Kampala, Uganda
| | - William Lumu
- Department of Medicine, Mengo Hospital, Kampala, Uganda
| | - Angus G. Jones
- National Institute for Health Research, Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK
| | - Liam Smeeth
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew T. Hattersley
- National Institute for Health Research, Exeter Clinical Research Facility, University of Exeter Medical School, Exeter, UK
| | - Moffat J. Nyirenda
- Non-Communicable Diseases Theme, Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Plot 51-59, Nakiwogo Road, P.O. BOX 49 Entebbe, Uganda
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Ahmed JH, Makonnen E, Fotoohi A, Yimer G, Seifu D, Assefa M, Tigeneh W, Aseffa A, Howe R, Aklillu E. Vitamin D Status and Association of VDR Genetic Polymorphism to Risk of Breast Cancer in Ethiopia. Nutrients 2019; 11:nu11020289. [PMID: 30699973 PMCID: PMC6412905 DOI: 10.3390/nu11020289] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 01/20/2019] [Accepted: 01/22/2019] [Indexed: 12/18/2022] Open
Abstract
Emerging evidence associates vitamin D deficiency and vitamin D receptor (VDR) genetic variations with risk for breast cancer. This study investigated the prevalence of vitamin D deficiency and its association with tumor characteristics and the implications of VDR genetic variations for risk of breast cancer in Ethiopia. This unmatched case–control study involved 392 female breast cancer patients and 193 controls. The plasma 25-hydroxyvitamin D (25(OH)D3) level was quantified in chemotherapy-naïve (N = 112) and tamoxifen-treated patients (N = 89). Genotyping for the VDR common variant alleles rs7975232 (ApaI), rs2228570 (FokI), and rs731236 (TaqI) was done. Eighty-six percent of the patients were vitamin D deficient (<50 nmol/L). Chemotherapy-naïve breast cancer patients had a higher prevalence of vitamin D deficiency (91.9% vs. 78.3%) compared to the tamoxifen-treated group (p < 0.001). The prevalence of severe vitamin D deficiency (<25 nmol/L) was significantly higher in chemotherapy-naïve (41.1%) than tamoxifen-treated (11.2%) patients. Vitamin D deficiency was not significantly associated with tumor characteristics or VDR genotype. The rs2228570 GG genotype was associated with increased risk of breast cancer (OR = 1.44, 95% confidence interval = 1.01−2.06). Our result indicates that rs2228570 might be a moderate risk factor for breast cancer development in the Ethiopian population. The high prevalence of severe vitamin D deficiency in treatment-naïve breast cancer patients indicates the need for nutritional supplementation of vitamin D at the time of chemotherapy initiation.
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Affiliation(s)
- Jemal Hussien Ahmed
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
- Department of Pharmacy, Jimma University, P.O. Box 378 Jimma, Ethiopia.
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden.
| | - Eyasu Makonnen
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
- Center for Innovative Drug Development and Therapeutic Trials, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
| | - Alan Fotoohi
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden.
- Division of Clinical Pharmacology, Department of Medicine, Karolinska Institutet, 171 76 Solna, Stockholm, Sweden.
| | - Getnet Yimer
- Department of Pharmacology and Clinical Pharmacy, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
- Ohio State Global One Health initiative, Office of international affairs, Ohio State University, Pobox 9842 Addis Ababa, Ethiopia.
| | - Daniel Seifu
- Department of Biochemistry, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
| | - Mathewos Assefa
- Radiotherapy center, Addis Ababa University, P.O. Box 9086 Addis Ababa, Ethiopia.
| | | | - Abraham Aseffa
- Armauer Hansen Research Institute, P.O. Box 1005 Addis Ababa, Ethiopia.
| | - Rawleigh Howe
- Armauer Hansen Research Institute, P.O. Box 1005 Addis Ababa, Ethiopia.
| | - Eleni Aklillu
- Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, 141 86 Stockholm, Sweden.
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Husain NE, Badie Suliman AA, Abdelrahman I, Bedri SA, Musa RM, Osman HE, Mustafa AH, Gafer N, Farah E, Satir AA, Ahmed MH, Osman M, Khalil AA, Agaimy A. Vitamin D level and its determinants among Sudanese Women: Does it matter in a sunshine African Country? J Family Med Prim Care 2019; 8:2389-2394. [PMID: 31463263 PMCID: PMC6691462 DOI: 10.4103/jfmpc.jfmpc_247_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background: Vitamin D deficiency is a worldwide concern. The aim of the current study was to determine the vitamin D level and its contributing factors in Sudanese women. Methods: In this cross-sectional study, 251 Sudanese women attending Family Health Centers in Khartoum, Sudan were interviewed. Following the exclusion of confounding factors, samples from 190 women were analzsed. Serum 25 hydroxyvitamin D “25(OH) D” was quantified using competitive electrochemiluminescence immunoassay. Results: Participants’ age ranged from 18 to 85 years with a mean age (±SD) of 40.2 (±14.06) years. The mean (±SD) vitamin D level was 13.4 (±6.72) ng/ml, ranged 3.00–36.5 ng/ml and the median was 12.7 ng/mL. In total, 157 out of 190 (82.6%) had vitamin D serum levels below 20 ng/ml (deficient); of whom, 52 (27.4%) were in the age group 21–30 years (P value = 0.228). The correlation between vitamin D level and residence outside Khartoum, sun-exposed face and hands, and face and limbs in comparison with being completely covered were found to be statistically significant (p values 0.008, 0.023, and 0.036). Conclusion: This study displayed a high percentage (82.6%.) of vitamin D deficiency among women in Sudan, and this in part may indicate that sunshine alone cannot guarantee vitamin D sufficiency in the tropics. Family physicians in tropical countries should screen those with clinical presentations related to vitamin D deficiency.
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Affiliation(s)
| | | | | | - Shahinaz A Bedri
- Department of Pathology, Faculty of Medicine, Ahfad University for Women, Omdurman, Sudan
| | - Rasha M Musa
- Department of Medical Laboratories and Blood Bank, National Ribat University Hospital, Sudan
| | - Hind E Osman
- Department of Pathology, Faculty of Veterinary Medicine, Sudan University for Science and Technology, Sudan
| | - Ayda H Mustafa
- Combined Clinic, Radiation and Isotope Center, Khartoum (RICK) and Department of Surgery, Alneelain University, Sudan
| | - Nahla Gafer
- Radiation and Isotope Center, Khartoum (RICK), Sudan
| | - Ehab Farah
- Department of Statistics, Faculty of Sciences, University of Tabouk, Saudi Arabia
| | | | - Mohamed H Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University, Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
| | - Mugtaba Osman
- Armed Forces Centre for Psychiatric Care, Taif, Saudi Arabia
| | - Atif A Khalil
- Nephrology Department, Noble's Hospital, Isle of Man IM44RJ, UK
| | - Abbas Agaimy
- Institute of Pathology, University of Erlangen, Germany
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Vitamin D Status and Analysis of Specific Correlates in Preschool Children: A Cross-Sectional Study in Southern Croatia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112503. [PMID: 30413103 PMCID: PMC6266977 DOI: 10.3390/ijerph15112503] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 11/02/2018] [Accepted: 11/06/2018] [Indexed: 12/18/2022]
Abstract
Vitamin D deficiency is a globally important problem, particularly in children, but there is a lack of information regarding this deficiency in preschool children from southeastern Europe. This study aimed to establish the levels of 25-hydroxyvitamin D (25(OH)D) and associations of gender, time spent outdoors, physical activity (PA), and body mass index (as predictors) with the 25(OH)D level (outcome) in healthy preschool children. The participants were preschoolers (all 5⁻6 years of age) from southern Croatia. All the participants were tested during their mandatory medical examination 6⁻7 months prior to school enrollment. The PA was obtained using the preschool-age physical activity questionnaire (Pre-PAQ), which categorizes PA into five levels (from sedentary to vigorous PA). The prevalence of 25(OH)D deficiency was high: 58% of the children had 25(OH)D levels of <50 nmol/L (deficiency), and an additional 29% had an insufficient level of 25(OH)D (50⁻75 nmol/L). Boys had higher levels of 25(OH)D than girls. A multinomial regression using 25(OH)D categories as the outcome and a sufficient level (>75 nmol/L) as the reference value identified gender as the only significant predictor of 25(OH)D status, with boys being at lower risk for 25(OH)D deficiency than girls. These results showed a high prevalence of 25(OH)D deficiency in preschoolers from the southern part of Croatia, which is additionally alarming based on the geographical position of the studied region (42° N) and its high number of sunshine hours (>2600 h per year). Future studies examining other potential correlates of 25(OH)D in the region are warranted.
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Kagotho E, Omuse G, Okinda N, Ojwang P. Vitamin D status in healthy black African adults at a tertiary hospital in Nairobi, Kenya: a cross sectional study. BMC Endocr Disord 2018; 18:70. [PMID: 30305067 PMCID: PMC6180659 DOI: 10.1186/s12902-018-0296-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 09/13/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D has been known since the twentieth Century for its benefits in bone health. Recent observational studies have demonstrated its benefits in infectious diseases such as tuberculosis and non-communicable diseases such as diabetes mellitus, cardiovascular diseases and cancer. This has led to a dramatic increase in testing among adults. The cut-offs for vitamin D deficiency have been debated for decades and the current cut off is derived from a Caucasian population. Studies done among black African adults in Africa are few with vitamin D deficiency ranging from 5 to 91%. A few cut- offs have correlated vitamin D deficiency to physiological markers such as parathyroid hormone (PTH), calcium and phosphate with varying results. METHODS This was a cross sectional study carried out among blood donors at Aga Khan University hospital, Nairobi (AKUHN) from March to May 2015. Vitamin D (25(OH)D) levels were assayed and correlated with PTH, calcium and phosphate. RESULTS A total of 253 individuals were included in the final analysis. The proportion of study participants who had a 25(OH) D level of < 20 ng/ml thus classified as vitamin D deficient was 17.4% (95% C.I 12.73-22.07). The 25(OH) D level that coincided with a significant increase in PTH was 30 ng/ml. Males were less likely to be vitamin D deficient (O.R 0.48 (C.I 0.233-0.993) p 0.04). Sunshine exposure for ≥3 h per day reduced the odds of being Vitamin D deficient though this was not statistically significant after multivariate regression analysis. CONCLUSIONS We found a much lower prevalence of Vitamin D deficiency compared to many similar studies carried out in sub-Saharan Africa possibly due to the recruitment of healthy individuals and the proximity of Nairobi to the equator which allows for considerable exposure to sunshine. Vitamin D levels below 30 ng/mL was associated with a significant rise in PTH levels, suggesting that this cut off could be appropriate for defining Vitamin D deficiency in the population served by our laboratory.
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Affiliation(s)
- Elizabeth Kagotho
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya.
| | - Geoffrey Omuse
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Nancy Okinda
- Department of Pathology, Aga Khan University Hospital Nairobi, P.O. Box 30270-00100, Nairobi, Kenya
| | - Peter Ojwang
- Department of Pathology, Maseno University, P.O. Box Private Bag, Maseno, Kenya
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Vitamin D in Neurological Diseases: A Rationale for a Pathogenic Impact. Int J Mol Sci 2018; 19:ijms19082245. [PMID: 30065237 PMCID: PMC6121649 DOI: 10.3390/ijms19082245] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 07/25/2018] [Accepted: 07/26/2018] [Indexed: 12/22/2022] Open
Abstract
It is widely known that vitamin D receptors have been found in neurons and glial cells, and their highest expression is in the hippocampus, hypothalamus, thalamus and subcortical grey nuclei, and substantia nigra. Vitamin D helps the regulation of neurotrophin, neural differentiation, and maturation, through the control operation of growing factors synthesis (i.e., neural growth factor [NGF] and glial cell line-derived growth factor (GDNF), the trafficking of the septohippocampal pathway, and the control of the synthesis process of different neuromodulators (such as acetylcholine [Ach], dopamine [DA], and gamma-aminobutyric [GABA]). Based on these assumptions, we have written this review to summarize the potential role of vitamin D in neurological pathologies. This work could be titanic and the results might have been very fuzzy and even incoherent had we not conjectured to taper our first intentions and devoted our interests towards three mainstreams, demyelinating pathologies, vascular syndromes, and neurodegeneration. As a result of the lack of useful therapeutic options, apart from the disease-modifying strategies, the role of different risk factors should be investigated in neurology, as their correction may lead to the improvement of the cerebral conditions. We have explored the relationships between the gene-environmental influence and long-term vitamin D deficiency, as a risk factor for the development of different types of neurological disorders, along with the role and the rationale of therapeutic trials with vitamin D implementation.
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Wali S, Alsafadi S, Abaalkhail B, Ramadan I, Abulhamail B, Kousa M, Alshamrani R, Faruqui H, Faruqui A, Alama M, Hamed M. The Association Between Vitamin D Level and Restless Legs Syndrome: A Population-Based Case-Control Study. J Clin Sleep Med 2018; 14:557-564. [PMID: 29609719 DOI: 10.5664/jcsm.7044] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/20/2017] [Indexed: 01/02/2023]
Abstract
STUDY OBJECTIVES The pathophysiology of restless legs syndrome (RLS) may be related to abnormalities in central dopamine pathways. Vitamin D may play a role in the pathophysiology of RLS by modulating the dopaminergic system. The aim of our study is to examine the possible link between RLS and vitamin D deficiency. METHODS The total number of subjects enrolled was 201, including 78 patients with RLS based on the International RLS Study Group (IRLSSG) diagnostic criteria and 123 controls. Serum 25-hydroxy vitamin D levels were measured in both groups. RLS severity was assessed in all cases using the IRLSSG symptom severity rating scale. RESULTS Fifty-nine patients with RLS (75.6%) and 52 controls (42.3%) had a diagnosis of vitamin D deficiency, P < .001. The odds ratio (OR) of the development of RLS was 4.24 for those with a vitamin D level < 50 nmol/L compared to those with a vitamin D level ≥ 50 nmol/L (P < .001, 95% confidence interval [CI] 2.3-7.9). After adjusting for all other significant factors in the multivariate logistic model, vitamin D was significantly associated with RLS (OR 3.1, P < .002, 95% CI 1.51-6.38). Moreover, a dark or black skin color (OR 3.4, P < .001, 95% CI 1.5-6.3) and working as a teacher (OR 8.8, P < .001, 95% CI 3.4-23.5) were also independently significantly associated with RLS. CONCLUSIONS Our study identified an association between vitamin D deficiency and RLS. Consequently, vitamin D deficiency should be considered in the management of RLS. However, further studies are needed to evaluate the causality relationship between vitamin D level and RLS.
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Affiliation(s)
- Siraj Wali
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Samah Alsafadi
- Family and Community Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bahaa Abaalkhail
- Family and Community Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Iman Ramadan
- Family and Community Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Badr Abulhamail
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Moaiyyad Kousa
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Reem Alshamrani
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Hanan Faruqui
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Abdulaziz Faruqui
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mohamed Alama
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mohamed Hamed
- Sleep Medicine and Research Center, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Hamza RT, Hamed AI, Sallam MT. Vitamin D status in prepubertal children with isolated idiopathic growth hormone deficiency: effect of growth hormone therapy. J Investig Med 2018; 66:1-8. [PMID: 29478008 DOI: 10.1136/jim-2017-000618] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2018] [Indexed: 01/13/2023]
Abstract
Few studies, and with controversial results, analyzed vitamin D status in children before and after growth hormone (GH) treatment. Thus, we aimed to assess vitamin D status in prepubertal children with idiopathic growth hormone deficiency (GHD), and to evaluate the effect of GHD and GH treatment on vitamin D levels. Fifty prepubertal children with isolated GHD were compared with 50 controls. All were subjected to history, anthropometric assessment and measurement of 25 hydroxyvitamin D (25(OH)D), serum calcium, phosphorous, alkaline phosphatase and parathyroid hormone (PTH) at diagnosis and 1 year after GH therapy. Serum 25(OH)D levels <30 ng/mL and 20 ng/mL were defined as vitamin D insufficiency and deficiency, respectively. 25(OH)D was lower in cases than controls. Forty per cent of children with GHD were 25(OH)D insufficient and 44% deficient, while 16% were sufficient at baseline. There was a positive correlation between 25(OH)D and peak GH levels. Peak GH was a significant predictor of 25(OH)D levels. After 1 year of GH therapy, 25(OH)D increased (18.42±5.41 vs 34.5±10.1 ng/mL; P<0.001). Overall, 22% of cases remained insufficient and 24% deficient, with an increase in prevalence of children with normal levels (54%; P<0.001). 25(OH) correlated negatively with PTH (r=-0.71, P=0.01). In conclusion, hypovitaminosis D is prevalent in children with GHD and significantly improved 1 year after GH therapy. 25(OH)D should be assessed in children with GHD at diagnosis and during follow-up.
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Affiliation(s)
- Rasha Tarif Hamza
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Amira I Hamed
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mahmoud T Sallam
- Department of Clinical and Chemical Pathology, National Research Center, Cairo, Egypt
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Hoan NX, Tong HV, Song LH, Meyer CG, Velavan TP. Vitamin D deficiency and hepatitis viruses-associated liver diseases: A literature review. World J Gastroenterol 2018; 24:445-460. [PMID: 29398866 PMCID: PMC5787780 DOI: 10.3748/wjg.v24.i4.445] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/08/2018] [Accepted: 01/16/2018] [Indexed: 02/06/2023] Open
Abstract
The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses (HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response (SVR) to interferon (IFN) plus ribavirin (RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBV- and HCV-related chronic liver diseases. Furthermore, current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.
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Affiliation(s)
- Nghiem Xuan Hoan
- Institute of Clinical Infectious Diseases, 108 Military Central Hospital, Hanoi 10004, Vietnam
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
| | - Hoang Van Tong
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Institute of Biomedicine and Pharmacy, Vietnam Military Medical University, Hanoi 10004, Vietnam
| | - Le Huu Song
- Institute of Clinical Infectious Diseases, 108 Military Central Hospital, Hanoi 10004, Vietnam
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
| | - Christian G Meyer
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Medical Faculty, Duy Tan University, Da Nang, Vietnam
| | - Thirumalaisamy P Velavan
- Molecular Genetics of Infectious Diseases, Institute of Tropical Medicine, University of Tübingen, Tübingen 72074, Germany
- Vietnamese-German Center of Medical Research (VG-CARE), Hanoi 10004, Vietnam
- Medical Faculty, Duy Tan University, Da Nang, Vietnam
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Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur J Nutr 2018; 58:433-453. [PMID: 29344677 DOI: 10.1007/s00394-018-1607-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Vitamin D deficiency has been receiving increasing attention as a potential public health concern in low and lower-middle income countries (LMICs), of which there are currently 83. We aimed to conduct a comprehensive systematic literature review (SLR) of available data on vitamin D status and prevalence of vitamin D deficiency in all 83 LMICs. METHODS We followed the general methodology for SLRs in the area of serum 25-hydroxyvitamin D. Highest priority was placed on identifying relevant population-based studies, followed by cross-sectional studies, and to a lesser extent case-control studies. We adopted the public health convention that a prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D < 25/30 nmol/L) at > 20% in the entire population and/or at-risk population subgroups (infants, children, women of child-bearing age, pregnancy) constitutes a public health issue that may warrant intervention. RESULTS Our SLR revealed that of the 83 LMICs, 65% (n = 54 countries) had no published studies with vitamin D data suitable for inclusion. Using data from the remaining third, a number of LMICs had evidence of excess burden of vitamin D deficiency in one or more population subgroup(s) using the above convention (Afghanistan, Pakistan, India, Tunisia and Mongolia) as well as possibly other LMICs, albeit with much more limited data. Several LMICs had no evidence of excess burden. CONCLUSION Vitamin D deficiency is a public health issue in some, but certainly not all, LMICs. There is a clear need for targeting public health strategies for prevention of vitamin D deficiency in those LMICs with excess burden.
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Uwitonze AM, Murererehe J, Ineza MC, Harelimana EI, Nsabimana U, Uwambaye P, Gatarayiha A, Haq A, Razzaque MS. Effects of vitamin D status on oral health. J Steroid Biochem Mol Biol 2018; 175:190-194. [PMID: 28161532 DOI: 10.1016/j.jsbmb.2017.01.020] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/25/2017] [Accepted: 01/30/2017] [Indexed: 01/20/2023]
Abstract
Normal humans of all ages have the innate ability to produce vitamin D following sunlight exposure. Inadequate vitamin D status has shown to be associated with a wide variety of diseases, including oral health disorders. Insufficient sunlight exposure may accelerate some of these diseases, possibly due to impaired vitamin D synthesis. The beneficial effects of vitamin D on oral health are not only limited to the direct effects on the tooth mineralization, but are also exerted through the anti-inflammatory functions and the ability to stimulate the production of anti-microbial peptides. In this article, we will briefly discuss the genesis of various oral diseases due to inadequate vitamin D level in the body and elucidate the potential benefits of safe sunlight exposure for the maintenance of oral and general health.
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Affiliation(s)
- Anne Marie Uwitonze
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Julienne Murererehe
- Department of Oral Maxillofacial Surgery & Oral Pathology, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Marie Claire Ineza
- Department of Restorative & Prosthetic Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Eliane Ingabire Harelimana
- Department of Restorative & Prosthetic Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Usiel Nsabimana
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Peace Uwambaye
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Agnes Gatarayiha
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda
| | - Afrozul Haq
- Research & Development, Gulf Diagnostic Center Hospital, Abu Dhabi, UAE
| | - Mohammed S Razzaque
- Department of Preventive & Community Dentistry, University of Rwanda College of Medicine & Health Sciences, School of Dentistry, Kigali, Rwanda; Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA, USA; Department of Oral Health Policy & Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
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Abstract
Vitamin D deficiency occurs all over the world, mainly in the Middle East, China, Mongolia, and India. This article focuses on the vitamin D status in adults. Risk groups include older persons, pregnant women, and non-Western immigrants. Adequate vitamin D status, defined as serum 25-hydroxyvitamin D greater than 50 nmol/L, is present in less than 50% of the world population, at least in winter. Preventative strategies, such as increasing fish consumption, fortification of foods, use of vitamin D supplements, and advice for moderate sunlight exposure, are warranted.
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Affiliation(s)
- Natasja van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Van der Boechorststraat 7, Amsterdam 1081 BT, The Netherlands.
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, PO Box 7057, Amsterdam 1007 MB, The Netherlands
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Chiang D, Kramer H, Luke A, Cooper R, Aloia J, Bovet P, Plange-Rhule J, Forrester T, Lambert V, Camacho P, Dugas L, Durazo-Arvizu R. 25-Hydroxyvitamin D and blood pressure: a plateau effect in adults with African ancestry living at different latitudes. J Hypertens 2017; 35:968-974. [PMID: 28118279 DOI: 10.1097/hjh.0000000000001263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study examined the association of 25-hydroxyvitamin D [25(OH)D] levels and blood pressure above and below 25(OH)D levels of 20 ng/ml in young adults with African ancestry. METHODS This cross-sectional analysis utilized data from a pooled sample of 2242 adults with African ancestry from five different latitudes (403 in the United States, 474 in South Africa, 479 in Ghana, 448 in Jamaica, and 438 in Seychelles). Piecewise linear regression models with a single knot were fitted to determine above and below a 25(OH)D level of 20 ng/ml the slope of SBP and DBP while adjusting for covariates including calcium intake and site. RESULTS The mean age was 34.4 (6.1) years, and 46.3% were men. Mean SBP and DBP were 118.1 (15.6) and 73.2 (12.2) mmHg, respectively, and were significantly higher among the United States vs Ghana, Jamaica, and Seychelles groups (P < 0.001 for all comparisons). 25(OH)D levels were significantly lower in the United States vs all other sites (P < 0.001 for all comparisons). When 25(OH)D levels were less than 20 ng/ml, slopes of SBP [-0.33 (95% confidence interval (CI) -0.57, -0.07)] and DBP [-0.21 (95% CI -0.40, -0.02)] were negative and significantly different from zero after adjustment for covariates. In contrast, with 25(OH)D levels above 20 ng/ml, the slopes of SBP [-0.03 (95% CI -0.13, 0.06)] and DBP [-0.04 (-0.11, 0.03)] did not differ significantly from zero. CONCLUSION The cross-sectional association of 25(OH)D with blood pressure is strongest when 25(OH)D levels are less than 20 ng/ml in young adults with African ancestry.
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Affiliation(s)
- Daniel Chiang
- aDepartment of Public Health Sciences bDivision of Nephrology and Hypertension, Department of Medicine cDivision of Endocrinology, Stritch School of Medicine, Loyola University Chicago, Maywood, Illinois dBone Mineral Research Center, Winthrop University Hospital, Mineola, New York, USA eInstitute of Social & Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland fMinistry of Health, Victoria, Republic of Seychelles gDepartment of Physiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana hTropical Medicine Research Institute, University of the West Indies, Kingston, Jamaica iDepartment of Human Biology, Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa
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Fondjo LA, Owiredu WKBA, Sakyi SA, Laing EF, Adotey-Kwofie MA, Antoh EO, Detoh E. Vitamin D status and its association with insulin resistance among type 2 diabetics: A case -control study in Ghana. PLoS One 2017; 12:e0175388. [PMID: 28423063 PMCID: PMC5396912 DOI: 10.1371/journal.pone.0175388] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 03/25/2017] [Indexed: 12/13/2022] Open
Abstract
Background Vitamin D plays a major role in physiological processes that modulate mineral metabolism and immune function with probable link to several chronic and infectious conditions. Emerging data suggests a possible influence of vitamin D on glucose homeostasis. This study sought to provide preliminary information on vitamin D status among Ghanaian type 2 diabetics and assessed its association with glucose homeostasis. Methods In a case control study, 118 clinically diagnosed Type 2 Diabetes Mellitus (T2DM) patients attending Diabetic Clinic at the Nkawie Government Hospital were enrolled between October and December 2015. Hundred healthy non-diabetics living in Nkawie district were selected as controls. Structured questionnaires were administered to obtain socio-demographic data. Venous blood samples were taken from both cases and controls to estimate their FBG, Lipid profile spectrophotometrically and IPTH, 25OHD by ELISA. Statistical analyses were performed using SPSS v20.0 Statistics. Results The average age of the study participants was 58.81years for cases and 57.79year for controls. There was vitamin D deficiency of 92.4% among T2DM cases and 60.2% among the non diabetic controls. Vitamin D deficiency did not significantly associate with HOMA-β [T2DM: r2 = 0.0209, p = 0.1338 and Control: r2 = 0.0213, p = 0.2703] and HOMA-IR [T2DM: r2 = 0.0233, p = 0.1132 and Control: r2 = 0.0214, p = 0.2690] in both the controls and the cases. Conclusion Vitamin D deficiency is prevalent in both T2DM and non-diabetics. There is no association between vitamin D deficiency and insulin resistance or beta cell function in our study population. Vitamin D supplementation among type 2 diabetics is recommended.
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Affiliation(s)
- Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail:
| | - William K. B. A. Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edwin Ferguson Laing
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Acquaye Adotey-Kwofie
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Enoch Odame Antoh
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Detoh
- Nkawie Government Hospital, Kumasi, Ghana
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Karras SN, Anagnostis P, Naughton D, Annweiler C, Petroczi A, Goulis DG. Vitamin D during pregnancy: why observational studies suggest deficiency and interventional studies show no improvement in clinical outcomes? A narrative review. J Endocrinol Invest 2015. [PMID: 26219612 DOI: 10.1007/s40618-015-0363-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A considerable number of studies have examined vitamin D status during pregnancy. Although data from observational studies denote vitamin D hypovitaminosis (deficiency or insufficiency) during pregnancy is associated with a plethora of adverse maternal and neonatal outcomes, data from interventional (supplementation) trials fail to reveal a significant impact on maternal and offspring health. The aim of this narrative review was to critically appraise the methodology of the most representative published randomized controlled trials in an attempt to explain the difference between observational and supplementation results. We found that this difference could be attributed to a variety of factors, namely: (i) study design (lack of a specific outcome in conjunction with timing of supplementation, enrolment of participants with heterogeneous vitamin D status); (ii) pitfalls in the interpretation of vitamin D equilibrium (lack of determination of plasma half-life); (iii) supplementation regimen (administration of a wide range of regimens, in terms of dose, bolus and form); (iv) geographical characteristics (vitamin D needs could vary significantly within a country, particularly in areas with a wide range of latitude gradient); (v) adaptations of vitamin D metabolism during pregnancy (vitamin D and calcium equilibrium are changed during pregnancy compared with the non-pregnant state) and (vi) supplementation of populations with low baseline 25(OH)D values would likely manifest beneficial effects. All these parameters should be taken into consideration in the design of future vitamin D supplementation trials.
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Affiliation(s)
- S N Karras
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - P Anagnostis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D Naughton
- School of Life Sciences, Kingston University, Kingston upon Thames, London, UK
| | - C Annweiler
- Robarts Research Institute, The University of Western Ontario, London, ON, Canada
- Department of Geriatric Medicine, UPRES EA 4638, University Hospital Angers, Angers, France
| | - A Petroczi
- School of Life Sciences, Kingston University, Kingston upon Thames, London, UK
| | - D G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Kiggundu DS, Mutebi E, Kibirige D, Boxer R, Kakande B, Kigozi BK, Katabira E. Vitamin D deficiency and its characteristics among patients with acute stroke at a national referral hospital in Kampala Uganda. BMC Endocr Disord 2015; 15:53. [PMID: 26437924 PMCID: PMC4594645 DOI: 10.1186/s12902-015-0053-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 10/01/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Vitamin D deficiency has been associated with acute stroke and other cardiovascular diseases in the developed world. Low 25-hydroxyvitamin D (25OHD) has been described in some populations in Sub-Saharan Africa (SSA) in spite of adequate sunshine all year round. There is no information on the magnitude of vitamin D deficiency among patients with stroke and other cardiovascular diseases in Uganda or SSA. The aim of this study was to determine the burden and characteristics of vitamin D deficiency among patients with acute stroke, the most common form of cardiovascular events in SSA. METHODS We conducted a cross-sectional study between October 2012 and March 2013. We consecutively recruited 142 subjects with acute stroke admitted to the medical wards of Mulago hospital. We administered a pre-tested questionnaire to the study participants, and did a detailed physical examination and laboratory evaluation. Serum levels of 25OHD were determined using an electrochemiluminescence assay. Data were analyzed using STATA version 12 software. RESULTS The prevalence of vitamin D deficiency (25OHD < 20 ng/ml) was 15 %. Longer hours of sunshine exposure decreased the likelihood vitamin D deficiency significantly (adjusted OR 0.85, p = 0.03). Higher HDL cholesterol had a significant inverse association with vitamin D deficiency (adjusted OR 0.15, p = 0.02). In addition, the likelihood of vitamin D deficiency increased with rising age (adjusted OR 1.03, p = 0.05). CONCLUSIONS There was a relatively low burden of vitamin D deficiency among patients with acute stroke in Uganda. With increasing longevity and indoor lifestyles vitamin D deficiency may assume a greater role in stroke and other cardiovascular diseases in tropical sub Saharan Africa. Future studies on the mechanisms of vitamin D deficiency and its relationship to outcomes among patients with stroke may be necessary.
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Affiliation(s)
- Daniel S Kiggundu
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Edrisa Mutebi
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Davis Kibirige
- Department of Medicine, Uganda Martyrs Hospital, Lubaga, Kampala, Uganda.
| | - Rebecca Boxer
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | | | | | - Elly Katabira
- Department of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
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Wright CY, Wilkes M, du Plessis JL, Reeder AI, Albers PN. In multiple situational light settings, visual observation for skin colour assessment is comparable with colorimeter measurement. Skin Res Technol 2015; 22:305-10. [PMID: 26346825 DOI: 10.1111/srt.12261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Finding inexpensive and reliable techniques for assessing skin colour is important, given that it is related to several adverse human health outcomes. Visual observation is considered a subjective approach assessment and, even when made by trained assessor, concern has been raised about the need for controlled lighting in the study venue. The aim of this study is to determine whether visual skin colour assessments correlate with objective skin colour measurements in study venues with different lighting types and configurations. METHODS Two trained investigators, with confirmed visual acuity, visually classified the inner, upper arm skin colour of 556 adults using Munsell(®) colour classifications converted to Individual Typology Angle (°ITA) values based on published data. Skin colour at the same anatomic site was also measured using a colorimeter. Each participant was assessed in one of 10 different buildings, each with a different study day. Munsell(®) -derived °ITA values were compared to colorimeter °ITA values for the full sample and by building/day. RESULTS We found a strong positive, monotonic correlation between Munsell(®) derived °ITA values and colorimeter °ITA values for all participants (Spearman ρ = 0.8585, P < 0.001). Similar relationships were found when Munsell(®) and colorimeter °ITA values were compared for participants assessed in the same building for all 10 buildings (Spearman ρ values ranged from 0.797 to 0.934, all correlations were statistically significant at P < 0.001). CONCLUSION It is possible to visually assess individual skin colour in multiple situational lighting settings and retrieve results that are comparable with objective measurements of skin colour. This was true for individuals of varying population groups and skin pigmentation.
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Affiliation(s)
- C Y Wright
- Environment & Health Research Unit, South African Medical Research Council, Department of Geography, Meteorology and Geoinformatics, University of Pretoria, Pretoria, South Africa
| | - M Wilkes
- Department of Chemistry and Chemical Biology, Cornell University, Ithaca, NY, USA
| | - J L du Plessis
- Occupational Hygiene and Health Research Initiative, North-West University, Potchefstroom, South Africa
| | - A I Reeder
- Cancer Society of New Zealand Social and Behavioural Research Unit, Department of Preventive and Social Medicine, University of Otago Medical School, Dunedin, New Zealand
| | - P N Albers
- Environment & Health Research Unit, South African Medical Research Council, Pretoria, South Africa
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Nabeta HW, Kasolo J, Kiggundu RK, Kiragga AN, Kiguli S. Serum vitamin D status in children with protein-energy malnutrition admitted to a national referral hospital in Uganda. BMC Res Notes 2015; 8:418. [PMID: 26346815 PMCID: PMC4562347 DOI: 10.1186/s13104-015-1395-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/31/2015] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is a world-wide epidemic with recent estimates indicating that greater than 50% of the global population is at risk. In Uganda, 80% of healthy community children in a survey were found to be vitamin D insufficient. Protein-energy malnutrition is likely to be associated with vitamin D intake deficiency. The aim of this study was to determine the prevalence of vitamin D deficiency and the associated factors among children admitted with protein-energy malnutrition to the pediatrics wards of Mulago hospital in Kampala, Uganda. METHODS Consecutive sampling was done with 158 children, aged 6-24 months, enrolled in a cross sectional study. One hundred and seventeen malnourished and 41 non malnourished children were enrolled from the Acute Care unit, pediatrics in-patient wards, outpatient and immunization clinics, following informed consent obtained from the children's parents/guardians. Children with protein energy malnutrition were categorized based on anthropometric measurements of weight-for-height and weight for length compared with the recommended WHO reference Z-score. Serum 25-hydroxyvitamin D, calcium and phosphate were assayed. RESULTS One hundred seventeen malnourished and 41 non malnourished children were enrolled. The majority of study participants were male, 91 (57.6%). The mean serum vitamin D levels among the malnourished was 32.5 mmol/L (±12.0 SD) and 32.2 mmol/L (10.9 SD) among the malnourished, p = 0.868. Fifteen (36.6%) of the non malnourished children and 51 (43.6%) of the malnourished had suboptimal levels, p = 0.689. Malnourished children admitted with meningitis and cerebral palsy had lower serum vitamin D levels than those with other infections. CONCLUSION There was no statistically significant difference in vitamin D values between the malnourished and non malnourished children. Clinicians should actively screen for children for serum vitamin D levels regardless of nutritional status.
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Affiliation(s)
- Henry W Nabeta
- Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Josephine Kasolo
- Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Reuben K Kiggundu
- Department of Physiology, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Agnes N Kiragga
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Sarah Kiguli
- Department of Pediatrics and Child Health, College of Health Sciences, Makerere University, Kampala, Uganda.
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Keflie TS, Nölle N, Lambert C, Nohr D, Biesalski HK. Vitamin D deficiencies among tuberculosis patients in Africa: A systematic review. Nutrition 2015; 31:1204-12. [PMID: 26333888 DOI: 10.1016/j.nut.2015.05.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 04/11/2015] [Accepted: 05/08/2015] [Indexed: 10/23/2022]
Abstract
The aim of this study was to explore the existence of vitamin D deficiency (VDD) in tuberculosis (TB) patients living in Africa and to identify its predictor variables. PRISMA guidelines and checklists were used. The sources of the data were Medline/PubMed, Web of Science, Scopus, and Google Scholar databases. We identified 23 articles, of which 15 reported the status of vitamin D in TB with TB. The definition of serum vitamin D status was summarized as severe, deficient, and insufficient when the concentration of 25-hydroxyvitamin (OH)-D ≤25, ≤50, and ≤75 nmol/L, respectively. The reports showed that up to 88.9% and 96.3% of patients with TB tested by radioimmunoassay had VDD and vitamin D insufficiency, respectively. Statistically significant variables such as lack of sun exposure, inadequate dietary intake, season, clothing, comorbidities, low body mass index, age, skin pigmentation, use of antiretroviral therapy and anti-TB drugs, and socioeconomic status were identified as the main predictor variables of vitamin D status. VDD and vitamin D insufficiency were highly prevalent in TB patients in Africa. Further case-control studies are warranted to clarify the cause-effect relationship between vitamin D and TB and thereby, design valuable strategies to manage VDD among TB patients in Africa.
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Affiliation(s)
- Tibebeselassie Seyoum Keflie
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany; Food Security Center, University of Hohenheim, Stuttgart, Germany.
| | - Nils Nölle
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
| | - Christine Lambert
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
| | - Donatus Nohr
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, Germany; Food Security Center, University of Hohenheim, Stuttgart, Germany
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Vitamin D status during pregnancy: time for a more unified approach beyond borders? Eur J Clin Nutr 2015; 69:874-7. [DOI: 10.1038/ejcn.2015.33] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 12/18/2022]
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Garf KE, Marzouk H, Farag Y, Rasheed L, Garf AE. Vitamin D status in Egyptian patients with juvenile-onset systemic lupus erythematosus. Rheumatol Int 2015; 35:1535-40. [DOI: 10.1007/s00296-015-3245-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/03/2015] [Indexed: 10/23/2022]
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Herrador Z, Sordo L, Gadisa E, Buño A, Gómez-Rioja R, Iturzaeta JM, de Armas LF, Benito A, Aseffa A, Moreno J, Cañavate C, Custodio E. Micronutrient deficiencies and related factors in school-aged children in Ethiopia: a cross-sectional study in Libo Kemkem and Fogera districts, Amhara Regional State. PLoS One 2014; 9:e112858. [PMID: 25546056 PMCID: PMC4278675 DOI: 10.1371/journal.pone.0112858] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 10/15/2014] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The present study describes the distribution of selected micronutrients and anaemia among school-aged children living in Libo Kemkem and Fogera (Amhara State, Ethiopia), assessing differences by socio-demographic characteristics, health status and dietary habits. METHODS A cross-sectional survey was carried out during May-December 2009. Socio-demographic characteristics, health status and dietary habits were collected. Biomarkers were determined for 764 children. Bivariate and multivariable statistical methods were employed to assess micronutrient deficiencies (MD), anaemia, and their association with different factors. RESULTS More than two thirds of the school-aged children (79.5%) had at least one MD and 40.5% had two or more coexisting micronutrient deficiencies. The most prevalent deficiencies were of zinc (12.5%), folate (13.9%), vit A (29.3%) and vit D (49%). Anaemia occurred in 30.9% of the children. Children living in rural areas were more likely to have vit D insufficiency [OR: 5.9 (3.7-9.5)] but less likely to have folate deficiency [OR: 0.2 (0.1-0.4)] and anaemia [OR: 0.58 (0.35-0.97)]. Splenomegaly was positively associated with folate deficiency and anaemia [OR: 2.77 (1.19-6.48) and 4.91 (2.47-9.75)]. Meat and fish consumption were inversely correlated with zinc and ferritin deficiencies [OR: 0.2 (0.1-0.8) and 0.2 (0.1-0.9)], while oil consumption showed a negative association with anaemia and deficiencies of folate and vitamin A [0.58 (0.3-0.9), OR: 0.5 (0.3-0.9) and 0.6 (0.4-0.9)]. Serum ferritin levels were inversely correlated to the presence of anaemia (p<0.005). CONCLUSION There is a high prevalence of vitamin A deficiency and vitamin D insufficiency and a moderate prevalence of zinc and folate deficiencies in school-aged children in this area. The inverse association of anaemia and serum ferritin levels may be due to the presence of infectious diseases in the area. To effectively tackle malnutrition, strategies should target not only isolated micronutrient supplementation but also diet diversification.
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Affiliation(s)
- Zaida Herrador
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
| | - Luis Sordo
- National Centre of Epidemiology, ISCIII, Madrid, Spain
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Complutense University, Madrid, Spain
- Network Biomedical Research Centers, Epidemiology and Public Health (CIBERESP in Spanish), Madrid, Spain
| | | | | | | | | | | | - Agustín Benito
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
| | - Abraham Aseffa
- Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Javier Moreno
- National Centre of Microbiology, ISCIII, Madrid, Spain
| | | | - Estefania Custodio
- National Centre of Tropical Medicine, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Tropical Diseases Research Network (RICET in Spanish), Madrid, Spain
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Diro E, Lynen L, Gebregziabiher B, Assefa A, Lakew W, Belew Z, Hailu A, Boelaert M, van Griensven J. Clinical aspects of paediatric visceral leishmaniasis in North-west Ethiopia. Trop Med Int Health 2014; 20:8-16. [PMID: 25329449 DOI: 10.1111/tmi.12407] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients. METHODS A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted. RESULTS A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%). CONCLUSION While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.
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Affiliation(s)
- Ermias Diro
- University of Gondar, Gondar, Ethiopia; Institute of Tropical Medicine, Antwerp, Belgium
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Effect of adiposity, season, diet and calcium or vitamin D supplementation on the vitamin D status of healthy urban African and Asian-Indian adults. Br J Nutr 2014; 112:590-9. [PMID: 24877635 DOI: 10.1017/s0007114514001202] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency has been implicated in the aetiology of infectious diseases and metabolic syndrome. These diseases are prevalent in the African and Asian-Indian populations of South Africa; however, there is limited data on 25-hydroxyvitamin D (25(OH)D) concentrations in these populations. The aim of the present study was to assess the vitamin D status and its predictors in healthy adults in Johannesburg. We assessed the vitamin D status of 730 adult African and Asian-Indian subjects residing in Johannesburg. The contributions of sun exposure, season, dietary intake of Ca and vitamin D, total body fat and body fat distribution to 25(OH)D concentrations were assessed. The concentrations of 25(OH)D were measured by HPLC. The contribution of 25(OH)D₃ to total 25(OH)D concentrations was assessed. The mean age of the subjects was 42·6 (SD 13·1) years (range: 18-65). Concentrations of 25(OH)D < 30 nmol/l were found in 28·6 % of the Asian-Indian subjects in comparison with 5·1 % of the African subjects (P< 0·0001). Parathyroid hormone (PTH) concentrations were negatively associated with 25(OH)D concentrations, while season and sun exposure were positive predictors explaining 16 % of the variance in 25(OH)D concentrations (P< 0·0001) in the African subjects. In the Asian-Indian subjects, PTH concentrations were negatively associated with 25(OH)D concentrations, while male sex, season and Ca supplementation were positive predictors and explained 17 % of the variance in 25(OH)D concentrations (P< 0·0001). In the multivariate regression analysis, neither total body fat nor body fat distribution was predictive of 25(OH)D concentrations in either group. In conclusion, factors such as sun exposure, dietary supplement use and ethnicity are important determinants of plasma 25(OH)D concentrations.
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