Potential Role of Vitamin D for the Management of Depression and Anxiety

Effectiveness of Vitamin D on Neurological and Mental Disorders

(1) Background: Mental disorders are conditions that affect a person's cognition, mood, and behaviour, such as depression, anxiety, bipolar disorder, and schizophrenia. In contrast, neurological disorders are diseases of the brain, spinal cord, and nerves. Such disorders include strokes, epilepsy, Alzheimer's, and Parkinson's. Both mental and neurological disorders pose significant global health challenges, impacting hundreds of millions worldwide. Research suggests that certain vitamins, including vitamin D, may influence the incidence and severity of these disorders; (2) Methods: This systematic review examined the potential effects of vitamin D supplementation on various mental and neurological disorders. Evidence was gathered from databases like PubMed, Cochrane, and Google Scholar, including multiple randomized controlled trials comparing vitamin D supplementation to placebo or no treatment for conditions like depression, bipolar disorder, epilepsy, schizophrenia, and neuroinflammation; (3) Results: The findings strongly indicate that vitamin D supplementation may benefit a range of mental health and neurological disorders. The magnitude of the beneficial impact varied by specific disorder, but the overall pattern strongly supports the therapeutic potential of vitamin D on these disorders; (4) Conclusions: This review provides valuable insight into the role vitamin D may play in the management of critical brain-related health issues.

Vitamin D supplementation during pregnancy and the role of maternal prenatal depression

BACKGROUND

The current study sought to investigate the correlation between vitamin D supplementation in pregnant women with vitamin D deficiency in early pregnancy and the incidence of prenatal depression prior to delivery.

METHODS

This is a retrospective, single-center study that was conducted at a tertiary hospital in Chengdu, China. We conducted an analysis on pregnant women who were initially diagnosed with vitamin D deficiency at 12-14 weeks of gestation. After starting vitamin D supplementation at a dose of 800 IU daily from 14 weeks onwards, we measured both their vitamin D concentration and depression scores again during median gestational week 39 prior to delivery.

RESULTS

The study cohort comprised 1365 women who had been diagnosed with vitamin D deficiency at 12-14 weeks of gestation between November 1st, 2021 to November 1st, 2022. 537 pairs were matched based on a propensity score to control for other confounding factors. After propensity score matching, the baseline vitamin D levels were made consistent between the groups (P = 0.512). The incidence of depression in patients in vitamin D deficiency group following vitamin D supplementation was significantly higher than insufficiency group and reached statistical significance (P < 0.001). Additionally, we observed that serum 25-(OH) D concentration achieving insufficiency status after supplementation was 59.12%.

CONCLUSION

Our study indicates that daily supplementation of 800IU of vitamin D can improve the depressive symptoms of individuals who are vitamin D deficiency during early pregnancy but achieve vitamin D insufficiency after supplementation during prenatal period.

Interaction between Fokl polymorphism and vitamin D deficiency in the symptoms of mental disorders in adults: a population-based study

Mental disorders are intricate and multifaceted and encompass social, economic, environmental, and biological factors. This study aimed to explore the potential association between vitamin D deficiency and anxiety and depression symptoms in adults, considering the role of the vitamin D receptor gene polymorphism FokI (rs2228570). This was a population-based cross-sectional study with stratified and cluster sampling, evaluating anxiety symptoms (AS) and depression symptoms (DS) in 1637 adults. Vitamin D levels were measured using electrochemiluminescence and were considered deficient when < 20 ng/mL in a healthy population or < 30 ng/mL in at-risk groups. Genotyping was performed using real-time polymerase chain reaction with TaqMan probes. The prevalence rates of AS, DS, and vitamin D deficiency were 23.5%, 15.8%, and 30.9%, respectively. No direct association was observed between vitamin D deficiency and AS or DS. However, interaction analysis revealed a combined effect of vitamin D deficiency and FokI for DS but not for AS. Individuals with vitamin deficiency and one or two copies of the altered allele of the FokI exhibited a higher prevalence of DS than individuals homozygous for the wild-type allele and vitamin D sufficiency. The interaction between vitamin D deficiency and the FokI polymorphism was associated with DS.

The relationship between nature exposure and depression among Chinese prisoners: a moderated mediation model

Aim

This study examined the association between self-reported nature exposure and depression among Chinese prisoners, as well as the mediating and moderating effects of meaning in life and callous-unemotional (CU) traits, respectively.

Background

Prisoners are more likely to experience depression than any other mental illness. Exposure to nature has been proposed as a highly cost-effective method of treating their depressive symptoms. However, the mechanism underlying the link between nature exposure and depression among prisoners needs further investigation, as the findings may provide new insights into how to address depression in incarcerated populations.

Method

Data were collected through a survey conducted in four prisons in southern China from April to May 2022. The participants were 574 prisoners who anonymously completed four questionnaires about nature exposure, meaning in life, depression, and CU traits.

Results

The results show that: (1) meaning in life significantly mediates the association between nature exposure and depression, and (2) CU traits moderate the connection between nature exposure and meaning in life.

Conclusion

The current study uncovered that prisoners who contact more with the natural environment have a higher meaning in life and lower depression, and individuals with higher CU traits can benefit more from nature exposure.

Seasonal and Treatment-Related Variation in 25-Hydroxy Vitamin D Concentration in Patients with Rheumatoid Arthritis

Background/Objectives: 25-hydroxy vitamin D (25-OH-D) is a fat-soluble compound that plays many essential functions, including bone formation, neuromuscular functions, and prevention of osteoporosis and inflammation. Recent data indicate that its metabolites are associated with rheumatoid arthritis (RA) progression and neuropathic pain in RA patients. We aimed to assess the effect of RA pharmacotherapy and seasonal variation on serum levels of 25-OH-D in RA patients who received treatment with methotrexate (MTX) or leflunomide (LEF) for at least one year. Methods: This study is a retrospective analysis of data collected from 101 patients with RA who received treatment for at least one year. All of them have supplemented 25-OH-D (2000 IU daily) for at least one year. Results: We observed a significant seasonal variation in 25-OH-D concentration (p = 0.004). Moreover, there were significant differences (p = 0.03) between LEF (50.63 ± 17.73 ng/mL) and MTX (34.73 ± 14.04 ng/mL) treatment groups, but only for the summer population. A correlation was observed between 25-OH-D and RA duration-once again, in the summer population (the whole group-r = -0.64; treatment subgroups-r = -0.82 for LEF and -0.61 for MTX). Deficiency of 25-OH-D (below 20 ng/mL) was confirmed in 28.7% of patients, while 18.8% had suboptimal 25-OH-D levels (20-30 ng/mL). Conclusions: Our results showed that both RA pharmacotherapy and seasonal variation affect the serum levels of 25-OH-D in patients with active RA.

Biomarkers and Tourette syndrome: a systematic review and meta-analysis

Objective

This research aims to investigate whether peripheral biomarkers might differentiate individuals with Tourette syndrome (TS) from those without the condition.

Methods

A broad range of databases was searched through November 2022. This study employed a systematic literature review and subsequent meta-analysis of case-control studies that assessed the aberration of biomarkers of patients with TS and controls.

Results

A total of 81 studies were identified, out of which 60 met the eligibility criteria for inclusion in the meta-analysis. Following a meticulous screening procedure to determine the feasibility of incorporating case-control studies into the meta-analysis, 13 comparisons were statistically significant [CD3+ T cell, CD4+ T cell, CD4+ T cell to CD8+ T cell ratio, NK-cell, anti-streptolysin O antibodies, anti-DNase antibodies, glutamic acid (Glu), aspartic acid (Asp), ferritin (Fe), zinc (Zn), lead (Pb), vitamin D, and brain-derived neurotrophic factor (BDNF)]. Publication bias was found for anti-streptolysin O antibodies. Suggestive associations were evidenced for norsalsolinol (NSAL), neuron-specific enolase (NSE), and S100B.

Conclusion

In this study, we present empirical evidence substantiating the link between several peripheral biomarkers and the early diagnosis of TS. Larger and more standardized studies are necessary to replicate the observed results, elucidate the specificity of the biomarkers for TS, and evaluate their precision for use in clinical settings.

The Associations of Vitamin D with Ovarian Reserve Markers and Depression: A Narrative Literature Review

Since the identification of vitamin D receptors in both the female reproductive tract and the central nervous system, further data have shown that vitamin D is involved in the processes of reproductive and mental health. This paper reviews current research on the associations of vitamin D with ovarian reserve markers and depression and discusses the potential role of vitamin D in their relationships. There have been numerous studies reporting that vitamin D was significantly related to ovarian reserve markers and depression in basic or clinical research, but some observational and interventional clinical studies have shown inconsistent results. Nevertheless, recent meta-analyses of interventional studies have provided promising results showing that vitamin D supplementation significantly improves ovarian reserve metrics, especially in a subgroup of women with normal or diminished ovarian reserve, and decreases depressive symptoms and risk. The demonstration of an association of vitamin D with both ovarian reserve and depression could suggest that vitamin D may be another important key in explaining female reproductive depression. Larger-scale studies in standardized settings will be needed in order to gain further insight into the role of vitamin D in female reproduction and depression.

Association between the Serum Vitamin D Concentration and All-Cause and Cancer-Specific Mortality in Individuals with Cancer

We aimed to explore the association between the serum 25-hydroxyvitamin D concentration and all-cause and cancer-specific mortality in 2,463 adult patients with cancer from the National Health and Nutrition Examination Survey 2007-2018. We linked mortality data from the survey to the National Death Index records up to December 31, 2019. During a median follow-up period of 70 months, 567 patients died, of whom 194 died due to cancer. Multivariate adjustment was performed for demographic characteristics, lifestyle, dietary factors, 25-hydroxyvitamin D testing period, and cancer site. Higher serum 25-hydroxyvitamin D concentrations up to 75 nmol/L significantly reduced the risk of all-cause and cancer-specific mortality. When 25-hydroxyvitamin D quartiles were compared, the multivariable-adjusted hazard ratios were 0.59 (95% confidence interval: 0.42, 0.84) for all-cause mortality (P for trend <0.001) and 0.48 (95% confidence interval: 0.29, 0.79) for cancer-specific mortality (P for trend = 0.037) in quartile 3 (79.3-99.2 nmol/L). A threshold of 75 nmol/L for serum 25-hydroxyvitamin D may represent an intervention target to reduce mortalities in patients with cancer, and maintaining 25(OH)D concentrations within range (79.3-99.2 nmol/L) is beneficial for reducing all-cause and cancer-specific mortality.

Molecular Regulation of the CNS by Vitamin D

Vitamin D is a lipid-soluble vitamin that can be found in some foods. It is also produced endogenously (in the presence of ultraviolet light), transported through the blood to the targets organs and this is the reason to consider vitamin D as a hormone. It is known that vitamin D has genomic and non-genomic effects. This review is focused mainly on the vitamin D receptors, the importance of vitamin D as a neuromodulator, the role of vitamin D in the pathophysiology of devastating neurological disorders such as Alzheimer's disease, multiple sclerosis, amyotrophic lateral sclerosis, Parkinson's disease and the benefit of vitamin D and its derivates in alleviating these disorders.

Vitamin D levels and anxiety symptomatology in pregnancy and the postpartum

Anxiety and vitamin D deficiency are both common in pregnancy, but research into the relationship between vitamin D levels and perinatal anxiety is sparse. We sought to examine whether an association exists and compare the distribution of vitamin D levels in women with and without anxiety symptoms. We analyzed 25-hydroxyvitamin D using ab213966 25(OH) vitamin D enzyme-linked immunosorbent assay in 54 women with and 47 women without anxiety symptoms at the first, second, and third trimesters and at 6 weeks postpartum. We conducted univariate and chi-square analyses to compare the frequencies of non-optimal and optimal vitamin D levels between the anxiety and non-anxiety groups at each timepoint. Overall, vitamin D levels were lower in the first and second trimesters than in the third trimester. In the first trimester only, the non-anxiety group had a marginally higher proportion of women with optimal vitamin D levels when compared to the anxiety group. Many pregnant women have insufficient or deficient levels of vitamin D, and our exploratory findings point to the need for further research into whether this differs between women with anxiety compared to healthy women.

Mental Health Conditions, Including Depression and Stress, Are Associated with Increased Odds of Gastric Cancer-Insights into the Role of Diet: A Case-Control Study

Several risk factors, including nutritional/lifestyle ones, play a role in gastric cancer etiology. Further interactions with mental health have also been emphasized. We hypothesized that individuals with mental disorders would exhibit compromised nutrient intake, increasing their risk of gastric cancer. The state of mental health was evaluated in 82 patients with gastric cancer and 95 healthy controls using the 21-item Depression-Anxiety-Stress Scale. The participants' dietary intakes were evaluated by a 168-item food frequency questionnaire. Based on fully adjusted logistic regressions, there was a significant association between depression (OR = 1.938, CI 95%: 1.009-3.723) and stress (OR = 2.630, CI 95%: 1.014-6.819) with increased odds of gastric cancer. According to fully adjusted multinomial regressions, vitamins A and B6, beta-carotene, and black tea decreased the odds of depression, based on comparing the control group with cases of depression, while sugar and salt increased its odds. The highest significant association was found for salt intake and anxiety in cases with present anxiety (OR = 4.899, 95% CI: 2.218-10.819), and the highest significant protective effect was found for vitamin B6 and depression in cases with present depression (OR = 0.132, 95% CI: 0.055-0.320). However, considering causal relationships and clarifying the underlying mechanisms is imperative and requires further investigation. Advising healthy dietary patterns, e.g., a Mediterranean diet rich in vitamins, minerals, and phytochemicals such as vitamin A, B6, beta-carotene, and fiber, is expected to reduce the odds of gastric cancer, possibly related to lower levels of anxiety and depression.

Severe Vitamin D Deficiency-A Possible Cause of Resistance to Treatment in Psychiatric Pathology

In the last few years, vitamin D functions have been studied progressively, and along with their main role in regulating calcium homeostasis, the potential function in the nervous system and the link between different psychiatric disorders and vitamin D deficiency have been revealed. The discovery of vitamin D receptors in multiple brain structures, like the hippocampus, led to the hypothesis that vitamin D deficiency could be responsible for treatment resistance in psychiatric diseases. The aim of this study was to analyze the current knowledge in the literature regarding vitamin D deficiency among individuals afflicted with psychiatric disorders and assess the potential therapeutic benefits of vitamin D supplementation. A systematic search was conducted on the PubMed database for articles published in the last five years (2016-2022) in English, focusing on human subjects. Results show that vitamin D deficiency has implications for numerous psychiatric disorders, affecting mood and behavior through its influence on neurotransmitter release, neurotrophic factors, and neuroprotection. It also plays a role in modulating inflammation, which is often elevated in psychiatric disorders. In conclusion, vitamin D deficiency is prevalent and has far-reaching implications for mental health. This review underscores the importance of exploring the therapeutic potential of vitamin D supplementation in individuals with psychiatric disorders and highlights the need for further research in this complex field.

Effect of Vitamin D in Long COVID Patients

Vitamin D deficiency has been studied in the context of acute coronavirus disease 2019 (COVID-19), revealing associations with increased severity and mortality. Yet, the influence of vitamin D on long COVID symptoms remains unknown. The purpose of this study is to examine the effect of vitamin D on long COVID symptoms. Over the study period, 50,432 individuals within the catchment area of the outpatient COVID-19 clinic tested positive for SARS-CoV-2 via PCR, with 547 patients subsequently referred to a specialized Post-COVID Clinic, and 447 of them enrolled in the study. Patient-reported symptoms and paraclinical measures including vitamin D were evaluated in 442 patients. The majority of participants were female (72%, n = 320/442). The consumption of alcohol and number of current smokers were low. Low vitamin D was observed in 26% (n = 115/442) of the patients, most commonly in male participants (odds ratio (OR) = 1.77, 95% confidence interval (CI) (1.12, 2.79), p = 0.014). Additionally, low vitamin D was correlated with a younger mean age of 41 years (standard deviation (SD) = 12) as opposed to 48 years (SD = 13) in patients with normal vitamin D levels (OR = 0.96, 95% CI (0.94, 0.97), p < 0.001). While our study population indicated a potentially higher prevalence of vitamin D insufficiency in this population compared to the general population, no significant differences in prevalence of symptom or symptom severity scores were observed between the low and normal vitamin D groups. In patients in a Post-COVID Clinic, we found no association between vitamin D levels and long COVID symptoms.

Pathogenesis and treatment of depression: Role of diet in prevention and therapy

In recent years, there has been a significant increase in depression, which is related to, among other things, the COVID-19 pandemic. Depression can be fatal if not treated or if treated inappropriately. Depression is the leading cause of suicide attempts. The disease is multifactorial, and pharmacotherapy often fails to bring satisfactory results. Therefore, increasingly more importance is attached to the natural healing substances and nutrients in food, which can significantly affect the therapy process and prevention of depressive disorders. A proper diet is vital to preventing depression and can be a valuable addition to psychological and pharmacologic treatment. An inadequate diet may reduce the effectiveness of antidepressants or increase their side effects, leading to life-threatening symptoms. This study aimed to review the literature on the pathogenesis of the development and treatment of depression, with particular emphasis on dietary supplements and the role of nutrition in the prevention and treatment of depressive disorders.

Vitamin D Deficiency (VDD) and Benefits of Supplementation in Veterans with IBS-D

Many veterans deployed to Gulf War areas suffer from persistent chronic diarrhea that is disabling and affects their quality of life. The causes for this condition have eluded investigators until recently and recent literature has shed light on the effect of vitamin D on the brain-gut axis. This study focused on determining clinical causes contributing to diarrhea and assessed whether reversing the identified causes, specifically vitamin D deficiency (VDD), could reduce the incidence of diarrhea in Gulf War veterans (GWVs). All patients completed a workup that included serologies (IBD, celiac), routine laboratory tests (CBC, chemistry panels, TSH, T4, CRP), cultures for enteric pathogens (C diff, bacteria, viruses, small intestinal bacterial overgrowth (SIBO)), and upper and lower endoscopies with histology and a trial of cholestyramine to exclude choleretic diarrhea and rifaximin for dysbiosis. A total of 4221 veterans were screened for chronic diarrhea, yielding 105 GWVs, of which 69 GWVs had irritable bowel syndrome with diarrhea (IBS-D). Paired t-tests demonstrated that all GWVs had VDD (t-11.62, df68 and sig(2-tailed) 0.0001) (defined as a vitamin D level less than 30 ng/mL with normal ranges of 30-100 ng/mL) but no positive serologies, inflammatory markers, abnormal endoscopies, cultures, or histology to explain their persistent diarrhea. There was no correlation with age, BMI, or inflammation. Some zip codes had a higher frequency of GWVs with VDD, but the number of deployments had no impact. Treatment with vitamin D supplementation (3000-5000 units), given in the morning, based on weight, reduced the number of bowel movements per day (p < 0.0001) without causing hypercalcemia. We suggest that VDD is important in the etiology of IBS-D in GWVs and that vitamin D supplementation significantly reduces diarrhea.

The association of vitamin D deficiency, age and depression in US adults: a cross-sectional analysis

BACKGROUND

Depression is an important public health burden, its risk of occurrence is associated with vitamin D deficiency and may also increase with age, while serum vitamin D levels are closely related to age.

OBJECTIVE

The purpose of this study was to evaluate whether vitamin D and age are associated with depression after adjustment for each other.

MATERIALS AND METHODS

We extracted data from NHANES 2013-2018, including demographic characteristics, depression level, vitamin D level, physical activity, and body measures. A total of 15,156 adults aged 20 years or older (mean age 49.81 ± 17.67 years, 7301 males and 7855 females) were included. Depression was screened by PHQ-9. Vitamin D deficiency was defined by a serum vitamin D level < 30nmol/L. We performed binary logistic regression models to analyze the association between vitamin D, age and depression, respectively.

RESULTS

Vitamin D levels were negatively associated with depression (P < 0.001). Vitamin D had a significant effect on depression (OR = 0.776, 95%CI: 0.682-0.884, P < 0.001), the effect remained significant after adjusted for confounding variables (OR = 0.761, 95%CI: 0.663-0.874, P < 0.001). Age was positively associated with depression (P < 0.001) and had a significant effect on depression (OR = 1.079, 98%CI: 1.032-1.128, P = 0.001), the effect remained significant after adjusted for confounding variables (OR = 1.092, 95%CI: 1.040-1.146, P < 0.001). Age and vitamin D levels were positively correlated (P < 0.001), and older age had a significant effect on vitamin D level (OR = 1.526, 95%CI: 1.416-1.645, P < 0.001), the effect remained significant after adjusted for confounding variables (OR = 1.371, 95%CI: 1.263-1.487, P < 0.001). In addition, the prevalence of depression was higher in females (2312/7855, 29.43%) than in males (1571/7301, 21.52%), and the difference was statistically significant (P < 0.001).

CONCLUSIONS

Vitamin D deficiency and older age are both associated with higher risk of depression, while older age is a protective factor for vitamin D deficiency.

Brain function mediates the association between low vitamin D and neurocognitive status in female patients with major depressive disorder

BACKGROUND

Vitamin D is engaged in various neural processes, with low vitamin D linked to depression and cognitive dysfunction. There are gender differences in depression and vitamin D level. However, the relationship between depression, gender, vitamin D, cognition, and brain function has yet to be determined.

METHODS

One hundred and twenty-two patients with major depressive disorder (MDD) and 119 healthy controls underwent resting-state functional MRI and fractional amplitude of low-frequency fluctuations (fALFF) was calculated to assess brain function. Serum concentration of vitamin D (SCVD) and cognition (i.e. prospective memory and sustained attention) were also measured.

RESULTS

We found a significant group-by-gender interaction effect on SCVD whereby MDD patients showed a reduction in SCVD relative to controls in females but not males. Concurrently, there was a female-specific association of SCVD with cognition and MDD-related fALFF alterations in widespread brain regions. Remarkably, MDD- and SCVD-related fALFF changes mediated the relation between SCVD and cognition in females.

CONCLUSION

Apart from providing insights into the neural mechanisms by which low vitamin D contributes to cognitive impairment in MDD in a gender-dependent manner, these findings might have clinical implications for assignment of female patients with MDD and cognitive dysfunction to adjuvant vitamin D supplementation therapy, which may ultimately advance a precision approach to personalized antidepressant choice.

Vitamin D supplementation for depression in older adults: a meta-analysis of randomized controlled trials

Background

In older adults, depression is associated with several other clinical problems such as cognitive impairment and low quality of life. Several studies have evaluated the relationship between vitamin D and depression in older adults; however, the results have been controversial thus far.

Objective

This study aimed to investigate the effects of vitamin D supplementation on depressive symptom improvement among individuals aged ≥60 years with or without a diagnosis of depression or depressive symptoms based on a meta-analysis of randomized controlled trials (RCTs).

Methods

RCTs were identified to analyze the relationship between vitamin D supplementation and depressive symptoms. MEDLINE, CENTRAL, Embase, and PsycINFO were systematically searched for relevant articles published from inception to November 2022. RCTs that evaluated the effect of vitamin D supplementation in participants aged ≥60 years compared to placebo were included. A random effects model was used in this meta-analysis because of the differences between the included RCTs. The quality of the RCTs was assessed using Risk of Bias 2.

Results

Seven trials were included in the analyses. The primary outcome of pre-post score changes included five trials with a total of 752 participants. The secondary outcome of post-intervention score included all seven trials with a total of 4,385 participants. No significant improvement in depressive symptoms in either pre-post score changes [standardized mean difference (SMD) = -0.49; 95% confidence interval (CI) -1.07-0.09; p = 0.10] or post-intervention score (SMD = -0.10; 95% CI -0.28-0.07; p = 0.25) was found.

Conclusion

Vitamin D supplementation in older adults was not associated with an improvement in depressive symptoms. More studies in older adults are needed to evaluate the association between vitamin D supplementation and depression.

MC-Au/MSS-Z8 porous network assisted advanced electrochemical immunosensing of 25-hydroxyvitamin D3

On-site monitoring of vitamin D levels is subject matter of immediate attention owing to the serious aftermath of its long standing deficiency. Therefore, a novel and efficient voltammetric immunosensing of 25-hydroxyvitamin D₃ (25(OH)VD₃) has been experimented based on an advanced sensing platform composed of meso-microporous silica-zeolitic imidazolate framework-8 (MSS-Z8) with highly enhanced surface area (S_{BET, MSS-Z8} (643.4 m²g^-1) > S_{BET, MSS} (49.95 m²g^-1)), embedded with gold particles (mass loading of 82 μg), particularly of microcubic morphology (MC-Au). Further, the MC-Au/MSS-Z8/FTO platform was fashioned with antibody specific to 25(OH)VD₃ via interaction between Au and abundant -SH groups present on the antibody surface. After optimization of operational parameters, the Ab/MC-Au/MSS-Z8/FTO immunosensor was employed for the determination of 25(OH)VD₃ within 0.01-10⁶ pg mL^-1 concentration range through differential pulse voltammetry technique in [Fe(CN)₆]^3-/4-. Thus, 0.01 pg mL^-1 concentration of 25(OH)VD₃ was the experimental limit of detection of the immunosensor. Further, upon examination of various analytical parameters, it turns out that the immunosensor exhibited low theoretical LOD (0.23 pg mL^-1) and LOQ (0.76 pg mL^-1), wide linear range (0.01-10⁶ pg mL^-1), ultra-sensitivity (143.9 μA [log (pg mL^-1)]^-1 cm^-2), adequate reproducibility (RSD ≤1.23%) and acceptable shelf life. Most importantly, the immunosensor presented proficient performance with spiked human serum samples (Recovery = 97.20-100.7%, RSD value < 5.6%), evincing the adequacy of present biosensing approach.

The influence of vitamin D on handgrip strength in elderly trauma patients

BACKGROUND AND OBJECTIVES

The treatment of elderly patients is an increasing challenge and the long-term sequelae often affect activities of daily living and quality of life in those patients. Handgrip strength (HGS) appears as a promising value to predict the outcome after trauma in elderly patients and to assess the overall muscle strength. Besides the possible role of psychological and hormonal factors, vitamin D may have a positive influence. Furthermore, some data suggest that Vitamin D is beneficial regarding muscle strength and possibly prevents further falls and injuries in orthogeriatric patients. The purpose of this study was to identify if Vitamin D is an influencing factor for HGSin elderly trauma patients.

MATERIALS AND METHODS

94 elderly patients in a Level I Trauma Center aged 60 years or older were prospectively enrolled and HGS as well as serum 25-OH Vitamin D concentration (VDC) were measured. In addition, the standardized questionnaires Barthel Index (BI), Parker Mobility Score (PMS), Short Physical Performance Battery (SPPB), Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) and European Quality of Life 5 Dimensions 5 Levels Questionnaire (EQ-5D-5L), were used to record mental health status and demographic data.

RESULTS

HGS is mainly related to age and sex in elderly trauma patients. HGS was higher in men (mean_male = 27.31 kg (± 8.11), mean_female = 15.62 kg (± 5.63), p < 0.001 and decreased with age (β_age = - 0.58, p < 0.001). A significant negative correlation between HGS and VDC exists in the overall sample (β_VDC = - 0.27, p_VDC < 0.008), which still remains after adjusting for age (p_VDC < 0.004), but is not significant after adjustment for both main confounders, age and sex (p_VDC < 0.08). Furthermore, the HGS was lower in pateints who reported frequent falls, stumbling, dizziness or a late onset of menopause, and decreased if patients felt anxious or depressed during measurements (β_{anxiety+depression} = - 0.26, p_{anxiety+depression} < 0.01).

CONCLUSIONS

These results do not support the hypothesis that Vitamin D has a positive influence on muscle strength measured by HGS. Nevertheless, this study could confirm the usefulness of HGS as a tool to detect the risk for frequent falls or stumbling. Furthermore, HGS seems to be associated with dizziness and age at onset of menopause. A significant decrease of HGS could also be shown in patients with anxiety and depression. This underlines the importance of interdisciplinary treatment of elderly trauma patients and needs to be taken into account for further studies, as especially the psychological motivation seems to have a significant influence and is sometimes not considered enough in elderly musculo-skeletal patients.

Physical Activity, Sun Exposure, Vitamin D Intake and Perceived Stress in Italian Adults

The last decades of global development have, due to rapid urbanization, pressuring entire populations to changes in lifestyle and dietary habits, led to an increase in the prevalence of mental disorders, including stress. This study explored how lifestyle and dietary factors, such as physical activity, sun exposure, and vitamin D intake are related to perceived stress in a Mediterranean-based population. Physical activity level was evaluated using the international physical activity questionnaires (IPAQ), sun exposure was evaluated using the sunlight exposure measurement questionnaire (SEM-Q), and validated food frequency questionnaires (FFQs) were used to assess dietary intakes. The perceived stress of the study participants was evaluated using the perceived stress scale (PSS). Multivariate logistic regression models were used to test for potential associations. In the most adjusted model, an inverse association between physical activity level, sunlight exposure, vitamin D intake, and high perceived stress was found (OR = 0.72, 95% CI: 0.51, 1.00, OR = 0.72, 95% CI: 0.52, 0.99, OR = 0.69, 95% CI: 0.53, 0.89, respectively). However, when stratifying the population by level of physical activity, the retrieved associations with sunlight exposure and dietary vitamin D intake were significant only among those individuals reporting being moderately to highly physically active (OR = 0.16, 95% CI: 0.08, 0.33 and OR = 0.46, 95% CI: 0.28, 0.76, respectively), while results on low physically active participants were null. In conclusion, this study demonstrated that higher dietary intake of vitamin D and sunlight exposure are associated with a lower likelihood of having high perceived stress among physically active individuals.

Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance

Patients with a generalized anxiety disorder (GAD) often report preeminent sleep disturbances. Recently, calcium homeostasis gained interest because of its role in the regulation of sleep-wake rhythms and anxiety symptoms. This cross-sectional study aimed at investigating the association between calcium homeostasis imbalance, anxiety, and quality of sleep in patients with GAD. A total of 211 patients were assessed using the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Insomnia Severity Index (ISI) scales. Calcium, vitamin D, and parathyroid hormone (PTH) levels were evaluated in blood samples. A correlation and linear regression analysis were run to evaluate the association of HAM-A, PSQI, and ISI scores with peripheral markers of calcium homeostasis imbalance. Significant correlations emerged between HAM-A, PSQI, ISI, PTH, and vitamin D. The regression models showed that patients with GAD displaying low levels of vitamin D and higher levels of PTH exhibit a poor subjective quality of sleep and higher levels of anxiety, underpinning higher psychopathological burden. A strong relationship between peripheral biomarkers of calcium homeostasis imbalance, insomnia, poor sleep quality, and anxiety symptomatology was underlined. Future studies could shed light on the causal and temporal relationship between calcium metabolism imbalance, anxiety, and sleep.

Assessing the interaction effects of brain structure longitudinal changes and life environmental factors on depression and anxiety

Disrupted brain structures and several life environmental factors have been shown to influence depression and anxiety, but their interactions with anxiety and depression remain elusive. Genome-wide association study datasets of 15 brain structure longitudinal changes (N = 15,640) were obtained from the published study. Genotype and phenotype-related data of depression, anxiety, and life environmental factors (including smoking, alcohol drinking, coffee intake, maternal smoking, physical activity, vitamin D, insomnia, sleep duration, and family satisfaction) were collected from UK Biobank. We calculated the polygenic risk scores (PRS) of 15 brain structure changes and then conducted linear regression analyses to explore the interactions of brain structure changes and life environmental factors on depression and anxiety using 15 brain structure change-related PRS, life environmental factors and interactions of them as instrumental variables, and depression score or anxiety score as outcomes. Sex stratification in all analyses was performed to reveal sex-specific differences in the interactions. We found 14 shared interactions related to both depression and anxiety in total sample, such as alcohol drinking × cerebellum white matter 3 (WM; beta = -.003, p = .018 for depression; beta = -003, p = .008 for anxiety) and maternal smoking × nucleus accumbens 2 (beta = .088, p = .002 for depression; beta = .070, p = .008 for anxiety). We also observed sex-specific differences in the interactions, for instance, alcohol drinking × cerebellum WM 3 was negatively associated with depression and anxiety in males (beta = -.004, p = .020 for depression; beta = -.005, p = .002 for anxiety). Our study results reveal the important interactions between brain structure changes and several life environmental factors on depression and anxiety, which may help to explore the pathogenesis of depression and anxiety.

Perinatal depression and serum vitamin D status: A cross-sectional study in urban China

BACKGROUND

Although vitamin D has been found to be associated with perinatal depression, the results are inconsistent. The aim of this cross-sectional study was to examine the association between vitamin D and PND in Chinese pregnant women and lactating women.

METHODS

A total of 1773 participants were included, including 907 lactating women and 866 pregnant women. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PND, and those with scores ≥13 were considered to have PND. Serum 25-hydroxyvitamin D concentrations were assessed with high-performance liquid chromatography.

RESULTS

The prevalence of postpartum depression (PPD) and antenatal depression (AD) were 15.9 % and 9.8 %, respectively. Compared with individuals with sufficient vitamin D, those with vitamin D deficiency were associated with a higher prevalence of PPD in lactating women (OR = 1.71, 95%CI: 1.01-2.88, p = 0.044). The serum 25(OH)D of lactating women was inversely associated with the scores of the factor "depressive mood" of the EPDS (ORper 5 ng/mL = -0.10, 95%CI: -0.19 to -0.01, p = 0.032). No significant association between serum 25-hydroxyvitamin D and AD was observed.

LIMITATIONS

First, this study is a cross-sectional design, which can only determine associations but not causality. Secondly, this study only included participants from urban areas. Thirdly, there are still some possible confounding factors that have not been considered.

CONCLUSION

In conclusion, this study suggested a significant association between vitamin D status and PPD; however, the association between vitamin D status and AD was not significant.

The antidepressant-like effect elicited by vitamin D3 is associated with BDNF/TrkB-related synaptic protein synthesis

Vitamin D₃ (cholecalciferol) has been shown to exert antidepressant-like responses, but the role BDNF/TrkB-related synaptic plasticity in this effect remains to be established. Thus, this study investigated the time-course antidepressant-like response of vitamin D₃ in female and male mice and the possible role of BDNF/TrkB signaling in this response. The repeated (7 and 21 days), but not acute (60 min), administration of vitamin D₃ (2.5 μg/kg, p.o.) exerted an antidepressant-like effect in female and male mice subjected to the tail suspension test, without altering the basal locomotor activity in the open-field test. Notably, vitamin D₃ caused a similar time-dependent antidepressant-like effect in male and female mice, suggesting that this behavioral response in the tail suspension test might not be affected by sex differences. Vitamin D₃ administration for 21 days, but not for 7 days or 1 h, augmented BDNF levels in the hippocampus and prefrontal cortex of mice. No effects on phospho-CREB/CREB levels were detected in the hippocampus and prefrontal cortex after chronic vitamin D₃ administration. Additionally, vitamin D₃ increased TrkB, GluA1, and PSD-95 levels in the prefrontal cortex, but not in the hippocampus. Furthermore, an upregulation of synapsin level was observed in both brain regions after vitamin D₃ administration. These findings reinforce and extend the notion that vitamin D₃ is effective to produce antidepressant-like responses in male and female mice and provide novel evidence that this effect could be associated with BDNF/TrkB-related synaptic protein synthesis. Finally, vitamin D₃ could be a feasible nutritional strategy for the management of depression.

Vitamin D protects against depression: Evidence from an umbrella meta-analysis on interventional and observational meta-analyses

Meta-analyses of interventional and observational studies investigating the efficacy and the relationship between vitamin D and depression provided inconsistent results. The current umbrella meta-analysis was conducted to assess the available evidence and provide a conclusive outcome in this regard. The following international databases were systematically searched till March 2022: PubMed, Scopus, Embase, Web of Science, and Google Scholar. Random-effects model was carried out to calculate the pooled point estimates and their respective 95 % confidence intervals (CI). Ten meta-analyses of randomised controlled trials (RCTs) revealed significant reduction in depression symptoms comparing participants on vitmain D supplements to those on placebo (Pooled standardised mean difference: - 0.40; 95 % CI: - 0.60, - 0.21, p < 0.01: I² = 89.1 %, p < 0.01). Four meta-analyses of cohort studies (with one having two subgroups) revealed that participants with lower levels of serum vitamin D were at increased odds of depression than those with higher levels of serum vitamin D (Pooled odds ratio: 1.60; 95 % CI: 1.08, 2.36, p < 0.01; I² = 91.3 %, p < 0.01). The present umbrella meta-analysis confirms the potential benefits of vitamin D supplementation and higher serum vitamin D levels in reducing the development and symptoms of depression.

Short-term effects of extreme meteorological factors on daily outpatient visits for anxiety in Suzhou, Anhui Province, China: a time series study

Anxiety disorders are a major public health concern in China. Previous studies have provided evidence for associations between ambient temperature and anxiety outpatient visits, but no studies have examined short-term effects of other meteorological factors such as sunshine duration, wind speed, and precipitation on increased anxiety outpatient visits. We aimed to assess the association between climatic factors and outpatient visits for anxiety in Suzhou, a city with a temperate climate in Anhui Province, China. Daily anxiety outpatient visits, meteorological factors, and air pollutants from 2017 to 2019 were collected. A quasi-Poisson generalized linear regression model combined with distributed lag non-linear model (DLNM) was used to quantify the effects of extreme meteorological factors (sunshine duration, wind speed, and precipitation) on anxiety outpatient visits. All effects were presented as relative risk (RR), with the 90th and 10th percentiles of meteorological factors compared to the median. Subgroup analyses by age and gender were performed to identify susceptible subgroups. A total of 11,323 anxiety outpatient visits were reported. Extremely low sunshine duration and low and high wind speed increased the risk of anxiety outpatient visits. The strongest cumulative effects occurred at lag 0-14 days, and the corresponding RRs of extremely low sunshine duration and low and high wind speed were 1.417 (95% CI: 1.056-1.901), 1.529 (95% CI: 1.028-2.275), and 1.396 (95% CI: 1.007-1.935), respectively. Subgroup analyses showed that males and people aged ≥45 years appeared to be more susceptible to the cumulative effects of extremely low sunshine duration. In addition, the adverse effects of extreme wind speed were more pronounced in the cold season. This study provides evidence that extreme climatic factors have a lagged effect on anxiety outpatient visits. In the context of climate change, these findings may help develop weather-based early warning systems to minimize the effects of extreme meteorological factors on anxiety.

The relationship between vitamin D receptor gene polymorphisms and ankylosing spondylitis: a systematic review, meta-analysis and trial sequential analysis

The relation between vitamin D receptor (VDR) gene polymorphisms and ankylosing spondylitis (AS) remains unclear. A systematic review and meta-analysis were conducted using six databases, including PubMed, Web of Science, EMBASE, CNKI, Wanfang and Cochrane Library. The selection of each study was based on inclusion and exclusion criteria. The Newcastle-Ottawa Scale was applied to assess the quality of the included studies, while the strength was evaluated by odds ratios and 95% confidence intervals. The following contrasts were used: allele contrast (H vs h), homozygous contrast (HH vs hh), heterozygous contrast (Hh vs hh), dominant contrast (HH + Hh vs hh) and recessive contrast (HH vs Hh + hh). For the BsmI-rs1544410 polymorphism, three studies were included of 782 cases and 863 controls. The data showed a significant relationship under allele contrast H vs h (OR = 1.66, 95% CI 1.20-2.30 (P = 0.002)). For the TaqI-rs731236 polymorphism, 675 cases and 697 controls were included in two studies. The data showed a significant relationship under allele contrast H vs h (OR = 1.57, 95% CI 1.11-2.21 (P < 0.05)), homozygous contrast Hh vs hh (OR = 1.65, 95% CI 1.12-2.43 (P < 0.05)), and recessive contrast HH + Hh vs hh (OR = 1.66, 95% CI 1.13-2.43 (P < 0.05)). There were significant relationships between VDR gene BsmI-rs1544410 and TaqI-rs731236 polymorphisms and AS, while no associations were found between FokI-rs2228570 and ApaI-rs7975232 polymorphisms and AS. In the future, additional studies with larger case numbers are need.

Habitual dairy consumption is inversely associated with depressive and social anxiety symptoms among children and adolescents aged 7-17 years: Findings from a cross-sectional study in Beijing, China

BACKGROUND

Knowledge remains limited about dairy consumption and childhood depression and social anxiety, which is our purpose.

METHODS

A cross-sectional study including children and adolescents aged 7-17 years was conducted in 2020 in Beijing. Depression and social anxiety were assessed using the Children's Depression Inventory and the social anxiety scale for children. Habitual dairy consumption was defined as ≥6 days/week. Multivariate linear and logistic regression models were employed to analyze the associations between dairy consumption and depression and social anxiety. Subgroup analyses were conducted to test the robustness of the main results.

RESULTS

A total of 1353 participants were included, with a mean age of 12.06 (SD = 3.10) years old. There were 53.58 % habitual dairy consumers and nearly 11.01 % consumed of ≤1 day/week. The prevalence of depression and social anxiety was 14.04 % and 29.64 %. Compared to participants with less dairy intake, the scores of depression and social anxiety in habitual dairy consumers decreased by 1.725 (95 % CI: -2.939, -0.512) and 1.083 (95 % CI: -1.821, -0.345). Correspondingly, habitual dairy consumption was inversely correlated with depression (OR = 0.602, 95%CI: 0.369-0.982) and social anxiety (OR = 0.622, 95%CI: 0.418-0.923). Such inverse associations were more pronounced in younger participants, those without siblings, with higher parental education and higher consumption of fruits or vegetables.

LIMITATIONS

Conclusions about causality remain speculative due to the cross-sectional design.

CONCLUSIONS

Habitual dairy consumption is inversely associated with childhood depression and social anxiety. A potential attempt could be implemented when recommending dairy products as an adjuvant therapy for childhood mental disorders.

Effects of vitamin D supplementation on depression and some selected pro-inflammatory biomarkers: a double-blind randomized clinical trial

BACKGROUND

Both augmented inflammatory reaction and low vitamin D status are associated with depression but the magnitude of their relationships is unclear. This study was, therefore, conducted to evaluate the effects of vitamin D supplementation on serum 25(OH)D concentration, depression severity and some pro-inflammatory biomarkers in patients with mild to moderate depression.

METHODS

An 8-week double-blind randomized clinical trial (RCT) was performed on 56 (18-60 yrs) patients with mild to moderate depression, randomly assigned to intervention (50,000 IU cholecalciferol 2wks^-1) and control (placebo) groups. Serum 25(OH)D, intact parathyroid hormone (iPTH), interlukin (IL)-1β, IL-6, high-sensitivity C-reactive protein (hs-CRP) and depression severity (Beck Depression Inventory-II) (BDI-II)) were initially and finally assessed.

RESULTS

At the end point, statistically significant changes were observed only in intervention group as compared with controls including increased 25(OH)D concentration (+ 40.83 ± 28.57 vs. + 5.14 ± 23.44 nmol L^-1, P < 0.001) and decreased depression severity (-11.75 ± 6.40 vs. -3.61 ± 10.40, P = 0.003). No significant within- or between group differences were observed in serum IL-1β, IL-6 and hs-CRP concentrations.

CONCLUSION

Increased circulating 25(OH)D concentrations following 8-week vitamin D supplementation (50,000 IU 2wks^-1) resulted in a significant decrease in BDI-II scores in patients with mild to moderate depression. However, this effect was independent of the serum concentrations of the studied inflammatory biomarkers.

TRIAL REGISTRATION

The clinical trial registration code was obtained from the Iranian Registry of Clinical Trials (date of registration: 17/09/2018, registration number: IRCT20170926036425N1) and ClinicalTrials.gov (date of registration: 04/12/2018, registration number: NCT03766074).

Fat-soluble vitamins: updated review of their role and orchestration in human nutrition throughout life cycle with sex differences

Age and Gender are vital determinants for the micronutrient demands of normal indviduals. Among these micronutrients are vitamins that are required in small amounts for optimum metabolism, homeostasis, and a healthy lifestyle, acting as coenzymes in several biochemical reactions. The majority of previous studies have examined such issues that relates to a specific vitamin or life stage, with the majority merely reporting the effect of either excess or deficiency. Vitamins are classified into water-soluble and fat-soluble components. The fat-soluble vitamins include vitamins (A, D, E, and K). Fat-soluble vitamins were found to have an indisputable role in an array of physiological processes such as immune regulation, vision, bone and mental health. Nonetheless, the fat-soluble vitamins are now considered a prophylactic measurement for a multitude of diseases such as autism, rickets disease, gestational diabetes, and asthma. Herein, in this review, a deep insight into the orchestration of the four different fat-soluble vitamins requirements is presented for the first time across the human life cycle beginning from fertility, pregnancy, adulthood, and senility with an extensive assessment ofthe interactions among them and their underlying mechanistic actions. The influence of sex for each vitamin is also presented at each life stage to highlight the different daily requirements and effects.

Role of Reactive Oxygen Species in Aging and Age-Related Diseases: A Review

Research on the role of reactive oxygen species (ROS) in the aging process has advanced significantly over the last two decades. In light of recent findings, ROS takes part in the aging process of cells along with contributing to various physiological signaling pathways. Antioxidants being cells' natural defense mechanism against ROS-mediated alteration, play an imperative role to maintain intracellular ROS homeostasis. Although the complete understanding of the ROS regulated aging process is yet to be fully comprehended, current insights into various sources of cellular ROS and their correlation with the aging process and age-related diseases are portrayed in this review. In addition, results on the effect of antioxidants on ROS homeostasis and the aging process as well as their advances in clinical trials are also discussed in detail. The future perspective in ROS-antioxidant dynamics on antiaging research is also marshaled to provide future directions for ROS-mediated antiaging research fields.

The reduction of vitamin D in females with major depressive disorder is associated with worse cognition mediated by abnormal brain functional connectivity

Low vitamin D is linked to major depressive disorder (MDD) through affecting the brain. Gender difference is apparent in MDD and vitamin D level. We aimed to examine the association between gender, vitamin D, clinical presentations, and brain functional connectivity in a large cohort of MDD patients and comparison subjects. Resting-state functional MRI data from 122 patients and 119 controls were collected to perform a combined analysis of functional connectivity density (FCD) and seed-based functional connectivity (FC). Peripheral venous blood samples were obtained to measure serum concentration of vitamin D (SCVD). Clinical presentations (symptoms profiles and cognition) were also assessed. We found an interaction of group and gender on SCVD in which MDD patients demonstrated lower SCVD than controls in females rather than males. Concurrently, lower SCVD was associated with worse cognitive performance (prospective memory and sustained attention). Compared with controls, female MDD patients showed reduced FCD and FC of the left middle frontal gyrus, which were related to lower SCVD. Importantly, these FCD and FC changes mediated the relationship between lower SCVD and cognitive dysfunction. Our findings suggest that functional connectivity abnormalities may serve as neural substrates underlying the associations between low vitamin D and cognitive impairments in female MDD patients, providing unique insight into treatment and prevention of MDD and its related cognitive dysfunction from the perspective of regulating circulating vitamin D.

Anxiety Disorders and Prediction of Their Development in Patients with Hypothyroidism and Autoimmune Thyroiditis

Objective: Since the association between thyroid dysfunction and neuropsychiatric disorders has been known for many years, it is important to analyze the associations of the BDNF gene polymorphism (rs6265), the VDR gene polymorphism (rs2228570), and the NMDA gene polymorphism (rs4880213) with the anxiety in patients with autoimmune thyroiditis and hypothyroidism in the Western Ukrainian population and predict the development of anxiety disorders in these patients. Methods: The study involved a total of 153 patients with various forms of thyroid pathology. BDNF levels in the sera of the patients and healthy individuals were quantified using an enzyme-linked immunosorbent assay with a highly sensitive Human BDNF ELISA Kit (Elabscience®, United States, Catalog No: E-EL-H0010) on E.I.A. Reader Sirio S (Seac, Italy). Genotyping of the VDR (rs2228570), BDNF (rs6265), and NMDA (rs4880213) gene polymorphism using TaqMan probes and TaqMan Genotyping Master Mix (4371355) on CFX96™Real-Time PCR Detection System (Bio-Rad Laboratories, Inc., USA). Polymerase chain reaction (PCR) for TaqMan genotyping was carried out according to the kit instructions (Applied Biosystems, USA). Results: According to the data obtained when comparing the presence of anxiety on the Hamilton scale on SNP statistically significant differences were revealed depending on BDNF gene polymorphism (rs6265) (p < 0.001). When comparing the presence of anxiety on the Hamilton scale on SNP depending on VDR gene polymorphism (rs2228570), NMDA gene polymorphism (rs4880213) no statistically significant differences were revealed (p = 0.782, p = 0.677 respectively) We identified an inverse strong correlation between the presence of anxiety on Hamilton scale and BDNF, 25-OH Vitamin D levels, and fT4 in the blood (p <0.001) and a direct moderate correlation between the presence of anxiety on Hamilton scale and TSH, GRIN2B, and anti-TPO (p <0.001). Conclusion: Indicators such as BDNF, GRIN2B, fT4, anti-TG, and 25-OH levels of vitamin D are prognostically significant risk criteria for anxiety.

Poor sleep quality, vitamin D deficiency and depression in the stroke population: A cohort study

BACKGROUND

Depression is a common psychiatric complication after stroke. However, the relationships among sleep quality, vitamin D status and depression are unclear in stroke patients. The aim of this study was to explore the impact of poor sleep quality and vitamin D status on post-stroke depression (PSD).

METHODS

In the present study, 233 stroke patients completed the one-month follow-up. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) both at admission and 1 month after stroke. Depressive symptom was measured by the Hamilton Depression Scale (HAMD) at 1 month after stroke. Serum vitamin D levels were measured at admission. Multivariable logistic regression and mediation analysis were used to examine the mediating and moderating effects of sleep quality and vitamin D status on PSD.

RESULTS

The incidence of PSD was higher in patients with poor sleep quality than those with good sleep quality. Vitamin D levels were negatively correlated with HAMD score (r = -0.244, P < 0.001). Prestroke poor sleep quality was associated with an increased risk of PSD in the vitamin D deficiency group after adjustment for potential confounders (OR = 4.047, 95%CI = 1.300-12.600, P = 0.016), while this association was not significant in the vitamin D sufficiency group. In mediation analysis, the relationship between vitamin D deficiency and PSD was mediated by poststroke sleep quality.

LIMITATIONS

Vitamin D levels were measured only at admission.

CONCLUSIONS

The combination of poor sleep quality and vitamin D deficiency is associated with a substantially increased risk of PSD.

Molecular Basis Underlying the Therapeutic Potential of Vitamin D for the Treatment of Depression and Anxiety

Major depressive disorder and anxiety disorders are common and disabling conditions that affect millions of people worldwide. Despite being different disorders, symptoms of depression and anxiety frequently overlap in individuals, making them difficult to diagnose and treat adequately. Therefore, compounds capable of exerting beneficial effects against both disorders are of special interest. Noteworthily, vitamin D deficiency has been associated with an increased risk of developing depression and anxiety, and individuals with these psychiatric conditions have low serum levels of this vitamin. Indeed, in the last few years, vitamin D has gained attention for its many functions that go beyond its effects on calcium–phosphorus metabolism. Particularly, antioxidant, anti-inflammatory, pro-neurogenic, and neuromodulatory properties seem to contribute to its antidepressant and anxiolytic effects. Therefore, in this review, we highlight the main mechanisms that may underlie the potential antidepressant and anxiolytic effects of vitamin D. In addition, we discuss preclinical and clinical studies that support the therapeutic potential of this vitamin for the management of these disorders.

Involvement of serotonergic neurotransmission in the antidepressant-like effect elicited by cholecalciferol in the chronic unpredictable stress model in mice

Cholecalciferol deficiency has been associated with stress-related psychiatric disorders, particularly depression. Therefore, the present study investigated the antidepressant-like effect of cholecalciferol in female mice and the possible role of the serotonergic system in this response. The ability of cholecalciferol to elicit an antidepressant-like effect and to modulate serotonin levels in the hippocampus and prefrontal cortex of mice subjected to chronic unpredictable stress (CUS) was also investigated. The administration of cholecalciferol (2.5, 7.5, and 25 µg/kg, p.o.) for 7 days, similar to fluoxetine (10 mg/kg, p.o., serotonin reuptake inhibitor), reduced the immobility time in the tail suspension test, without altering the locomotor performance in the open-field test. Moreover, the administration of p-chlorophenylalanine methyl ester (PCPA - 100 mg/kg, i.p., for 4 days, a selective inhibitor of tryptophan hydroxylase, involved in the serotonin synthesis) abolished the antidepressant-like effect of cholecalciferol and fluoxetine in the tail suspension test, demonstrating the involvement of serotonergic system. Additionally, CUS protocol (21 days) induced depressive-like behavior in the tail suspension test and decreased serotonin levels in the prefrontal cortex and hippocampus of mice. Conversely, the administration of cholecalciferol and fluoxetine in the last 7 days of CUS protocol completely abolished the stress-induced depressive-like phenotype. Cholecalciferol was also effective to abrogate CUS-induced reduction on serotonin levels in the prefrontal cortex, but not in the hippocampus. Our results indicate that cholecalciferol has an antidepressant-like effect in mice by modulating the serotonergic system and support the assumption that cholecalciferol may have beneficial effects for the management of depression.

The efficacy of vitamin D supplementation for irritable bowel syndrome: a systematic review with meta-analysis

BACKGROUND

Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder involving gut-brain interactions with limited effective treatment options. Vitamin D deficiency is commonly observed in patients with IBS, but whether vitamin D supplementation ameliorates IBS is controversial in randomized controlled trials. The present systematic review and meta-analysis explored the efficacy of vitamin D supplementation in patients with IBS.

METHODS

We performed a systematic search of potentially relevant publications from PubMed, EMBASE, the Cochrane Central Register of Controlled Studies and the Web of Science up until January 2022. We assessed the weighted mean difference (WMD) and 95% confidence interval (95% CI) of the IBS severity scoring system (IBS-SSS), IBS quality of life (IBS-QoL) and IBS total score (IBS-TS) before and after vitamin D supplementation intervention.

RESULTS

We included four randomized, placebo-controlled trials involving 335 participants. The differences in IBS-SSS score between participants in the intervention group and the placebo group increased after intervention (WMD: -55.55, 95% CI: -70.22 to -40.87, I² = 53.7%, after intervention; WMD: -3.17, 95% CI: -18.15 to 11.81, I² = 0.0%, before intervention). Participants receiving vitamin D supplementation showed greater improvement in IBS-SSS after intervention than participants receiving placebo treatment (WMD: -84.21, 95% CI: -111.38 to -57.05, I² = 73.2%; WMD: -28.29, 95% CI: -49.95 to -6.62, I² = 46.6%, respectively). Vitamin D supplementation was also superior to placebo in IBS-QoL improvement (WMD: 14.98, 95% CI: 12.06 to 17.90, I² = 0.0%; WMD: 6.55, 95% CI: -2.23 to 15.33, I² = 82.7%, respectively). Sensitivity analyses revealed an unstable pooled effect on IBS-TS in participants receiving vitamin D supplementation. Therefore, we did not evaluate the efficacy of vitamin D intervention in IBS-TS.

CONCLUSIONS

This systematic review and meta-analysis suggested that vitamin D supplementation was superior to placebo for IBS treatment.

Higher IgG level correlated with vitamin D receptor in the hippocampus of a pristane-induced lupus model

INTRODUCTION/OBJECTIVES

Patients with systemic lupus erythematosus (SLE) may have neurological complications, characterizing neuropsychiatric lupus (NPSLE). Studies have investigated alternative therapies such as vitamin D, which has an effect on the immune system and brain, to control manifestations of SLE. Experimental lupus models may be a good alternative to best study the immunological mechanisms underlying the development of NPSLE, and the animal model of pristane-induced lupus (PIL) may mimic SLE symptoms in humans. Our objective was to evaluate central nervous system involvement and vitamin D supplementation in a PIL model.

METHOD

Female BALB/c mice were divided into controls (CO; n = 7), PIL (n = 9), and PIL supplemented with vitamin D (VD; n = 7). The hippocampus area was measured and immunoassays were performed for detecting vitamin D receptor (VDR) and IgG.

RESULTS

The PIL group had a higher hippocampal IgG infiltrate when compared to the CO group. Vitamin D showed potential for reducing IgG infiltration. The hippocampus area was similar in all groups. No differences in VDR expression were observed between groups. A positive correlation was observed between the expression of VDR and IgG in the hippocampus.

CONCLUSION

Our data suggest that increased IgG infiltration into the hippocampus indicated an inflammatory process that may have stimulated VDR expression. Key Points • IgG infiltrate is higher in PIL animals than controls • VDR increases along with IgG infiltrate • Hippocampal VDR expression does not increase with vitamin D supplementation.

The Relationship Between Vitamin D, Clinical Manifestations, and Functional Network Connectivity in Female Patients With Major Depressive Disorder

Evidence suggests the pivotal role of vitamin D in the pathophysiology of major depressive disorder (MDD) via its effects on the brain. Gender differences exist in both depression and vitamin D level. Our objective was to investigate the association between gender, vitamin D, clinical manifestations, and functional network connectivity in a large sample of MDD patients and healthy controls. Resting-state functional MRI data were collected from 122 patients and 119 controls, with independent component analysis adopted to examine large-scale inter- and intranetwork functional connectivity. Serum concentration of vitamin D (SCVD) and clinical manifestations were also assessed. MDD patients exhibited lower SCVD than controls in females but not males. Moreover, we identified a female-specific association between lower SCVD and poorer cognitive performance. Concurrently, MDD-related functional network connectivity changes were correlated with SCVD in females as well as depression and anxiety symptoms in female patients. Remarkably, MDD- and SCVD-related functional network connectivity alterations mediated the associations between SCVD and cognition in females. Aside from providing evidence for a female-specific neurobiological mechanism whereby low vitamin D might contribute to MDD and its associated clinical characteristics, our findings inform a novel conceptualization that adjuvant vitamin D supplementation therapy may yield clinical benefits in improving treatment outcomes in female patients with MDD.

Association between bruxism severity and serum concentrations of 25-hydroxyvitamin D levels

Objectives

The aim of this study was to investigate the possible relationship between bruxism and blood levels of 25‐hydroxyvitamin D.

Material and Methods

One hundred male and female patients from Damascus joined the study. Their ages were in the range of 18–40 years. Two groups were considered in this study, the first group included patients who were already suffering from bruxism (76 patients) and the second group consisted of patients who were not suffering from any bruxism (24 patients). The analysis of the blood samples for 25‐hydroxyvitamin D levels of the two groups was carried out.

Results

The recorded results showed that there is a relationship between the levels of bruxism and 25‐hydroxyvitamin D concentration in the blood (p < .05), enhancing that the bruxism activity has been shown the associated deficiency in 25‐hydroxyvitamin D levels, which can be divided into five different categories.

Conclusions

Within the limitations of this study in spite of the number of patients (one hundred), according to the reported study, it appears that there is a significant relationship between bruxism and the level of 25‐hydroxyvitamin D in the blood.

Vitamin D attenuates COVID-19 complications via modulation of proinflammatory cytokines, antiviral proteins, and autophagy

INTRODUCTION

Global emergence of coronavirus disease-19 (COVID-19) has clearly shown variable severity, mortality, and frequency between and within populations worldwide. These striking differences have made many biological variables attractive for future investigations. One of these variables, vitamin D, has been implicated in COVID-19 with rapidly growing scientific evidence.

AREAS COVERED

The review intended to systematically explore the sources, and immunomodulatory role of vitamin D in COVID-19. Search engines and data sources including Google Scholar, PubMed, NCBI, Scopus, and Web of Science were used for data collection. The search terms used were Vitamin D, COVID-19, immune system, and antiviral mechanism. Overall, 232 sources of information were collected and 188 were included in this review.

EXPERT OPINION

Interaction of vitamin D and vitamin D receptor (VDR) triggers the cellular events to modulate the immune system by regulation of many genes. Vitamin D operates as a double-edged sword against COVID-19. First, in macrophages, it promotes the production of antimicrobial and antiviral proteins like β-defensin 2 and cathelicidin, and these proteins inhibit the replication of viral particles and promote the clearance of virus from the cells by autophagy. Second, it suppresses cytokine storm and inflammatory processes in COVID-19.

The Evaluation of the Neuroprotective Effect of a Single High-Dose Vitamin D3 in Patients with Moderate Ischemic Stroke

INTRODUCTION

Vitamin D insufficiency is highly prevalent and is a negative predictor for survival in ischemic stroke patients. We evaluated the effect of a high dose of vitamin D3 on the Neuron-Specific Enolase (NSE) level, National Institute of Health Stroke Scale (NIHSS), and Barthel Index (BI) scoring system in moderate ischemic stroke patients.

METHODS

This prospective, double-blind, randomized clinical trial (RCT) study was conducted from April 2020 to March 2021. Patients with moderate ischemic stroke (NIHSS 5 to 15) who had vitamin D deficiency (serum 25-OH vitamin D ≤30 ng/mL) were recruited and randomized into intervention and control groups. Subjects in the intervention group received a single dose, intramuscular (IM) injection of 600000 international unit (IU) vitamin D3, in addition to the standard treatment. NSE level and NIHSS were evaluated at baseline and 48 hours after the intervention. The BI was monitored three months after discharge.

RESULTS

During the study period, 570 patients were assessed; finally, forty-one patients completed the study. Except for the age which was higher in the control group (p = 0.04), there were no statistically significant differences in other baseline characteristics between the two groups. After 48 hours, the NIHSS score was significantly lower in the intervention group (median 8 vs. 6.5, p = 0.008 in the control and intervention groups, respectively), but there was no significant difference in the NSE level (p = 0.80). Three months after discharge, the BI was significantly higher in the intervention group (median 8 vs. 9, p = 0.03 in the control and intervention groups, respectively).

CONCLUSIONS

Administration of a single 600000 IU of vitamin D3 could have neuroprotective effects in patients with moderate ischemic stroke, according to its significantly positive effects on functional clinical outcomes (NIHSS and BI), but this effect on the biomarker related to neural damage (NSE) was not significant.

Vitamin D2 protects acute and repeated noise stress induced behavioral, biochemical, and histopathological alterations: Possible antioxidant effect

Noise is an environmental stressor which causes distress and hearing loss in individuals residing in urban areas. Psychological deficits such as anxiety, depression, impaired memory and cognitive decline are caused by noise stress. Different vitamins have been used as a potential antioxidant for neuronal protection. In this study we investigate the anxiolytic, antidepressant and memory enhancing effect of vitamin D2 (Vit D2) following noise stress. Thirty-six albino rats were randomly divided into six groups. (i) Unstressed + corn oil (ii) Unstressed + Vit D2 (iii) Acute noise stress + corn oil (iv) Acute noise stress + Vit D2 (v) Repeated noise stress + corn oil (vi) Repeated noise stress + Vit D2. 600 IU/kg body weight of Vit D2 dosage was prepared in corn oil. Corn oil is used as vehicle and all the drugs administered via oral gavage till end of the experiment (day 16). Recorded sound of generator which was amplified by speakers and had 100 dB intensity was used as noise stress. Repeated stressed animals were exposed to noise (4-hrs) daily for 14 days, while acute stressed animals were exposed to noise (4-hrs) once after 14 days. Behavioral tests (elevated plus maze, light dark box, tail suspension test and Morris water maze) of all groups were performed after15 days treatment period. After behavioral tests rats received their last dosage and decapitated after 1-hr. Brain of all animals was removed and used for biochemical (oxidative stress biomarker, antioxidant enzymes and acetylcholinesterase) and histopathological estimations. Results show that Vit D2 decreased time spent in light box and open arm of light dark activity box and elevated plus maze test respectively (used for anxiety evaluation), decreased immobility time in tail suspension test (for depression) and improved cognitive ability evaluated by Morris water maze test in acute and repeated noise stressed rats. Furthermore, increased antioxidant enzymes activity, decreased lipid peroxidation and acetylcholinesterase activity were also observed in Vit D2 treated animals following acute and repeated noise stress. Normalization in histopathological studies was also observed in Vit D2 treated following acute and repeated noise stress. It is concluded that Vit D2 protects from noise stress induced behavioral, biochemical and histopathological impairment through its antioxidant potential.

Is Vitamin D Important in Anxiety or Depression? What Is the Truth?

PURPOSE OF REVIEW

Depression and anxiety are mood disorders that affect health and therefore quality of life and increase the global burden of disease. One of the possible mechanisms in the pathophysiology of these mood disorders has been reported as oxidative stress and inflammation. In the light of this information, it is important to determine the relationship between antioxidant nutrients (such as vitamin D) and these diseases. There are points where the brain regions involved in the pathophysiology of depression and anxiety and vitamin D metabolism intersect.

RECENT FINDINGS

Low vitamin D levels are associated with increased symptoms of depression and anxiety. For this reason, vitamin D screening should be performed in the prevention and treatment planning of these mood disorders. Vitamin D, which has antioxidant properties and activity in brain tissue, is important for mood disorders preventions or treatments but serum levels must be followed.

Analysis of Serum Vitamin D Level and Related Factors in Patients With Restless Legs Syndrome

Objective: This study aimed to detect serum vitamin D (VitD) levels in patients with primary restless legs syndrome (RLS). The further objective was to analyze the relationship of VitD levels with the severity of RLS symptoms, sleep, anxiety, and depression.

Methods: The serum 25-hydroxyvitamin D [25(OH)D] levels of 57 patients with primary RLS and the healthy physical examinees in our hospital during the same period were detected. The International Restless Legs Syndrome Study Group (IRLSSG) rating scale for measuring RLS severity and Pittsburgh Sleep Quality Index (PSQI) Scale, 24-item Hamilton Depression Rating Scale (HAMD₂₄), and 14-item Hamilton Anxiety Scale (HAMA₁₄) were used to assess the severity of symptoms, sleep, and emotional state of patients with RLS. Based on VitD level and IRLSSG score, they were grouped for analysis.

Results: The serum 25(OH)D level was significantly lower in patients with RLS than in healthy controls, and the incidence of insufficient serum VitD levels was significantly higher in patients with RLS than in healthy people (both P < 0.05). The serum VitD level was significantly lower in (extremely) severe patients with RLS than in mild to moderate patients with RLS (P < 0.05). The IRLSSG scale score and HAMD₂₄ score were significantly higher in patients with RLS with insufficient serum VitD levels than those with normal serum VitD levels (both P < 0.05). Correlation analysis of IRLSSG scale score with serum VitD level and each scale score in patients with RLS showed that IRLSSG scale score was negatively correlated with VitD level, but positively correlated with PSQI, HAMA₁₄, and HAMD₂₄ scores. The results of correlation analysis between serum VitD levels and each scale score in patients with RLS indicated that serum VitD levels were negatively correlated with IRLSSG scale scores, PSQI scores, and HAMD₂₄ scores.

Conclusion: The serum VitD level is generally lower in patients with RLS than in healthy people, and lower serum VitD level is associated with more severe symptoms of RLS, worse quality of sleep, and worse depression.

Parameters of Oxidative Stress, Vitamin D, Osteopontin, and Melatonin in Patients with Lip, Oral Cavity, and Pharyngeal Cancer

Lip, oral cavity, and pharyngeal cancers (LOCP) constitute a group of rare neoplasms with unfavorable prognosis. So far, not much is known about the role of vitamin D and oxidative stress in the pathogenesis of LOCP in the European population. The aim of the study was to determine the concentrations of vitamin D, osteopontin, melatonin, and malondialdehyde (MDA) as markers of oxidative stress and/or inflammation, as well as the activities of antioxidant enzymes in the course of LOCP. The vitamin D, melatonin, and osteopontin concentrations in blood serum, the MDA levels in erythrocytes and blood plasma, and the activities of superoxide dismutase (SOD-1), catalase (CAT), and glutathione peroxidase (GPx) in erythrocytes were measured in blood samples taken from 25 LOCP patients of middle age (YCG), 20 LOCP elderly patients (OCG), and 25 healthy middle-aged volunteers. In both cancer groups, decreases in vitamin D and CAT, as well as increases in osteopontin and blood plasma MDA, were observed. An increase in GPx activity in YCG and a decrease in melatonin level in OCG were found. The results indicate the vitamin D deficiency and disturbed oxidant-antioxidant homeostasis in LOCP patients. Osteopontin seems to be associated with LOCP carcinogenesis and requires further research.

Vitamin D3 reduces hippocampal NR2A and anxiety in nicotine withdrawal mice

Nicotine withdrawal symptoms, mainly anxiety, cause high level of relapse rate after quitting smoking. Vitamin D supplementation has shown its potential for the prevention and treatment of anxiety disorders; however, neurobiological studies about the effect of vitamin D on nicotine withdrawal-induced anxiety are limited. To investigate the effect and molecular mechanism of vitamin D3 supplement by dietary on anxiety-like behavior during nicotine withdrawal, male C57/BL6 mice were divided into four groups: vehicle, nicotine only, vitamin D3 only, and nicotine plus vitamin D3. Mice were administrated with nicotine in drinking water (200 µg/mL), and vitamin D3 in feed for 6 weeks. During nicotine withdrawal, vitamin D3-treated mice showed significantly less anxiety-like behavior by an open-field test and marble buried test that performed an increase in the duration of the central zone and a decrease buried marble, respectively. Moreover, vitamin D3 supplementation attenuated the hippocampal NR2A expression on both protein and mRNA levels in nicotine and vitamin D3-treated mice. Our data showed that dietary supplementation with vitamin D3 ameliorated nicotine withdrawal-induced anxiety, which may be related to downregulation of NR2A expression in hippocampus. Vitamin D3 may provide a new dietary intervention with the easy access for smoking cessation.