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Ye H, Li Y, Liu S, Zhang X, Liang H, Wang Y, Wang R, Liu H, Wen Y, Jing C, Wang L. Association between serum 25-hydroxyvitamin D and vitamin D dietary supplementation and risk of all-cause and cardiovascular mortality among adults with hypertension. Nutr J 2024; 23:33. [PMID: 38459491 PMCID: PMC10924411 DOI: 10.1186/s12937-024-00914-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 01/09/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND The relationship between vitamin D status and mortality among adults with hypertension remains unclear. METHODS This prospective cohort study involved a sample of 19,500 adults with hypertension who participated in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. We utilized a weighted COX proportional hazard model to assess the association between vitamin D status and mortality. This statistical model calculates hazard ratios (HR) and their corresponding 95% confidence intervals (95% CI). RESULTS The study indicated that lower serum 25(OH)D concentration was associated with an increased risk of all-cause mortality among individuals with hypertension. Specially. Those with concentrations between 25.0 and 49.9 nmol/L (HR = 1.71, 95%CI = 1.22-2.40) and less than 25.0 nmol/L (HR = 1.97, 95%CI = 1.15-3.39) had higher hazard ratios for all-cause mortality. Individuals with hypertension who took vitamin D supplements had a lower risk of all-cause mortality, but not the risk of CVD mortality (HR 0.75, 95%CI 0.54-1.03), compared to those who did not supplement (HR = 0.76, 95%CI = 0.61-0.94). Subgroup analysis further revealed that vitamin D supplementation was associated with a reduced risk of all-cause mortality among individuals without diabetes (HR = 0.65, 95%CI = 0.52-0.81) and individuals without CVD (HR = 0.75, 95%CI = 0.58-0.97), and a decreased risk of CVD mortality among individuals without diabetes (HR = 0.63, 95%CI = 0.45-0.88) and without CVD (HR = 0.61, 95%CI = 0.40-0.92). Furthermore, higher-dose vitamin D supplementation was also associated with a greater reduction in all-cause mortality among hypertensive individuals, and there was the potential synergistic effect of combining normal-dose calcium and vitamin D supplementation, showing a superior effect on mortality compared to low-dose supplementation in adults with hypertension. CONCLUSIONS This prospective cohort study demonstrated a significant association between lower serum 25 (OH)D concentration and increased all-cause mortality among adults with hypertension. Furthermore, the study found that vitamin D supplementation had a strong and significantly positive correlation with reduced all-cause and CVD mortality among hypertensive individuals without diabetes or CVD. This positive correlation suggests that vitamin D supplementation could potentially be an effective strategy to reduce the risk of mortality in this specific group of people.
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Affiliation(s)
- Haowen Ye
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yexin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Shaomin Liu
- Department of Oncology Medilcal Center, The First People's Hospital of Zhaoqing, Zhaoqing, China
| | - Xiaofang Zhang
- Department Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Huanzhu Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China
| | - Ying Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ruxin Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Han Liu
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yun Wen
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Chunxia Jing
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Ave West, Guangzhou, Guangdong, 510632, China.
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
| | - Lihong Wang
- Department of Endocrinology and Metabolism, First Affiliated Hospital of Jinan University, Guangzhou, China.
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Lin HR, Xu F, Chen D, Xie K, Yang Y, Hu W, Li BY, Jiang Z, Liang Y, Tang XY, Zheng JS, Chen YM. The gut microbiota-bile acid axis mediates the beneficial associations between plasma vitamin D and metabolic syndrome in Chinese adults: A prospective study. Clin Nutr 2023; 42:887-898. [PMID: 37086617 DOI: 10.1016/j.clnu.2023.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND & AIMS Previous studies have suggested that circulating 25-hydroxyvitamin D (25 [OH]D, VD) and the gut microbiota-bile acid axis play crucial roles in metabolic health. Exploring the mediating role of the gut microbiota-bile acid axis would improve our understanding of the mechanisms underlying the effects of VD on human metabolic health. This study examined the association between plasma 25(OH)D and the prevalence/incidence of metabolic syndrome (MetS) and the mediating role of the gut microbiota-bile acid axis. METHODS This prospective study included 3180 participants with plasma 25(OH)D data at baseline and 2966 participants with a 9-year follow-up. MetS was determined every three years. The gut microbiota was analyzed by 16S rRNA sequencing in 1752 participants, and targeted bile acid metabolites in feces were further determined in 974 participants using UPLC‒MS/MS at the middle of the study. Mediating roles of microbiota and bile acids in the VD-MetS associations were analyzed using mediation/path analyses adjusted for potential confounders. RESULTS Among the 2966 participants who were followed-up, 1520, 193, 647, and 606 were MetS-free (normal), recovered, had incident MetS, and had persistent MetS, respectively. The multivariable-adjusted ORs (95% CIs) of MetS prevalence were 0.65 (0.50, 0.84) for baseline MetS and 0.46 (0.33, 0.65) for 9-year persistent MetS in quartile 4 (compared to quartile 1) of plasma 25(OH)D (median: 37.7 vs. 19.6, ng/ml). The corresponding HR (95% CI) of 9-year MetS incidence was 0.71 (0.56, 0.90) (all P-trend < 0.05). Higher VD concentrations were associated with greater α-diversity of the gut microbiota, which was inversely correlated with MetS risk. The groups classified by VD and MetS status had significantly different β-diversity. Ruminiclostridium-6 and Christensenellaceae R-7 group were enriched in the high-VD group and were inversely associated with MetS. However, opposite associations were observed for Lachnoclostridium and Acidaminococcus. The overlapping differential microbial score (ODMS) developed from the four differential genera explained 12.2% of the VD-MetS associations (Pmediation = 0.015). Furthermore, the fecal bile acid score created from 11 differential bile acids related to ODMS and MetS mediated 34.2% of the association between ODMS and MetS (Pmediation = 0.029). Path analyses showed that the inverse association between plasma 25(OH)D and MetS could be mediated by the gut microbiota-bile acid axis. CONCLUSIONS The findings suggest that the gut microbiota-bile acid axis partially mediates the beneficial association between plasma 25(OH)D and the risk of persistent MetS and incident MetS in the Chinese population.
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Affiliation(s)
- Hong-Rou Lin
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Fengzhe Xu
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Danyu Chen
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Keliang Xie
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Yingdi Yang
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Wei Hu
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Bang-Yan Li
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China
| | - Zengliang Jiang
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Yuhui Liang
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China
| | - Xin-Yi Tang
- The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China.
| | - Ju-Sheng Zheng
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou 310024, China.
| | - Yu-Ming Chen
- Department of Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou 510275, China.
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3
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Wu Z, Wu Y, Rao J, Hu H, Wang C, Wu J, Shi Y, Fu Y, Cheng X, Li P. Associations among vitamin D, tobacco smoke, and hypertension: A cross-sectional study of the NHANES 2001-2016. Hypertens Res 2022; 45:1986-1996. [PMID: 36202982 DOI: 10.1038/s41440-022-01023-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 11/09/2022]
Abstract
The interrelationships among vitamin D, tobacco smoking, and hypertension are currently unknown. This study was conducted to determine the relationship between vitamin D levels and hypertension and the effect of tobacco smoke exposure levels on this relationship among US adults. We performed a cross-sectional analysis of adult participants from the 2001-2016 National Health and Nutrition Examination Survey (NHANES). Serum 25-hydroxyvitamin D concentration was used as a biomarker of vitamin D status, and tobacco smoke exposure levels were objectively evaluated by serum cotinine levels. Among 22,875 eligible adults who were not receiving antihypertensive medications, the prevalence of hypertension, vitamin D deficiency (<50 mmol/L), and cotinine ≥3 ng/mL was 13.9%, 34.9%, and 29.4%, respectively. Serum cotinine and vitamin D levels were independently associated with hypertension risk after controlling for confounders (P < 0.05). When stratified by the cotinine group (<0.05, 0.05-3 and ≥3 ng/mL), we found that the risk of hypertension associated with vitamin D deficiency was higher among subjects with cotinine levels ≥3 ng/mL compared with the other strata [OR (95% CI) 1.30 (1.09, 1.54) vs. 1.53 (1.19, 1.96) vs. 1.64 (1.30, 2.06); P for heterogeneity test <0.05]. Furthermore, serum cotinine levels were negatively correlated with vitamin D levels. These findings suggested that the increased risk of hypertension could be partly attributed to low vitamin D levels induced by tobacco smoke exposure, in addition to the effects of tobacco smoke exposure and vitamin D deficiency themselves.
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Affiliation(s)
- Zuxiang Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yingxing Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Jingan Rao
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Huan Hu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Chenxi Wang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Ji Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yumeng Shi
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Yang Fu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China
| | - Xiaoshu Cheng
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China.,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ping Li
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China. .,Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, Jiangxi, China. .,Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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Huang W, Ma X, Chen Y, Zheng J, Li H, Nizhamu A, Hong Q, Guo X. Dietary Magnesium Intake Modifies the Association Between Vitamin D and Systolic Blood Pressure: Results From NHANES 2007–2014. Front Nutr 2022; 9:829857. [PMID: 35284447 PMCID: PMC8908235 DOI: 10.3389/fnut.2022.829857] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 01/10/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction Although the association between blood pressure and vitamin D has been well studied, the effects of dietary magnesium intake on this relationship are still unclear. Thus, this study aimed to determine the effects of dietary magnesium intake on the association between vitamin D and blood pressure. Methods The present study analyzed data from the continuous the National Health and Nutrition Examination Survey (NHANES) 2007–2014. We included 8,799 participants aged 20 years or older. Multivariable linear regression was performed to assess the association between vitamin D and systolic blood pressure (SBP) and diastolic blood pressure (DBP). Dietary magnesium intake was stratified by low magnesium intake (<299 mg/d) and high magnesium intake (≥299 mg/d). Effect modification by dietary magnesium intake was assessed through interaction tests between vitamin D and SBP in the multivariable linear regression. Results In this cross-sectional study, we found that vitamin D was negatively related to SBP, but not to DBP. The relationship between vitamin D and SBP was different in the low and high magnesium intake group (β: −0.25 95%Cl: −0.4~0.07 vs β: −0.32 95%Cl: −0.52~-0.12). Furthermore, magnesium intake significantly modified the negative relationship between vitamin D and SBP in most of the models. Conclusion Our research showed that magnesium and vitamin D have an interactive effect in reducing SBP, which may have great importance for clinical medication.
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Affiliation(s)
- Weichao Huang
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xiaoman Ma
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Yue Chen
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Jiayi Zheng
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Haojia Li
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Ayinigaer Nizhamu
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Second Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Qingting Hong
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
| | - Xuguang Guo
- Department of Clinical Laboratory Medicine, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Laboratory Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Clinical Laboratory Medicine, Key Laboratory of Reproduction and Genetics of Guangdong Higher Education Institutes, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Xuguang Guo
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5
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Shen Q, Xu Q, Li G, Ren L, Zhang Z, Zhang Y, Zhong Z, Li X, Wang Q. Joint effect of 25-hydroxyvitamin D and secondhand smoke exposure on hypertension in non-smoking women of childbearing age: NHANES 2007-2014. Environ Health 2021; 20:117. [PMID: 34781965 PMCID: PMC8591921 DOI: 10.1186/s12940-021-00803-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Vitamin D deficiency (VDD) may increase the risk of hypertension in women of childbearing age, who may be exposed to secondhand smoke (SHS) simultaneously. Till now, few studies have investigated the joint effects of VDD and SHS on hypertension in this population. We evaluated whether exposure to SHS modified the association between VDD and hypertension. METHODS Data from National Health and Nutrition Examination Surveys (NHANES) 2007-2014 were analyzed. Our research subjects were 2826 nonsmoking and nonpregnant women of childbearing age (20-44 years old). Hypertension was defined based either on systolic blood pressure (SBP) ≥ 130 mmHg and/or diastolic blood pressure (DBP) ≥ 80 mmHg or on now taking prescribed medicine for hypertension. The directed acyclic graphs (DAG) and the back-door criterion were used to select a minimal sufficient adjustment set of variables (MSAs) that would identify the unconfounded effect of 25(OH)D and hypertension. The interactive effect of VDD and SHS on hypertension was evaluated by using logistic regression models, followed by strata-specific analyses. RESULTS The prevalence of VDD in the hypertension group was significantly higher than that in the non-hypertension group (48.2% vs 41.0%, P = 0.008), as well as the exposure rate of SHS (39.1% vs 33.8%, P = 0.017). VDD was independently associated with nearly 50% increased risk of hypertension [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.01, 2.04], while no significant association was observed between SHS and hypertension. However, SHS showed a significant synergistic effect on VDD with a higher aOR of 1.79 (95% CI: 1.14, 2.80) (Pinteraction = 0.011). This synergistic effect was more obvious when stratified by BMI (in overweight women, aOR, 95% CI =4.74, 1.65-13.60 for interaction vs 2.33, 1.01-5.38 for VDD only) and race (in Non-Hispanic Black women, aOR, 95% CI =5.11, 1.58-16.54 for interaction vs 2.69, 1.10-6.62 for VDD only). CONCLUSION There exist synergistic effects of SHS and VDD on the prevalence of hypertension in American women of childbearing age, with more significant effects in women who were overweight or Non-Hispanic Black. Further studies are warranted to verify this finding in other populations, and the molecular mechanisms underlying the joint effect of SHS and VDD need to be elucidated.
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Affiliation(s)
- Qianqian Shen
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Qian Xu
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Lisheng Ren
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhenhong Zhang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Yangting Zhang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Zhaoyi Zhong
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Xiaona Li
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Qiuzhen Wang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China.
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Al-Sumaih I, Johnston B, Donnelly M, O'Neill C. The relationship between obesity, diabetes, hypertension and vitamin D deficiency among Saudi Arabians aged 15 and over: results from the Saudi health interview survey. BMC Endocr Disord 2020; 20:81. [PMID: 32503594 PMCID: PMC7275458 DOI: 10.1186/s12902-020-00562-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/28/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Obesity and diabetes are related conditions, the prevalence of which has increased globally in recent years. These conditions have been linked to hypertension and vitamin D deficiency though the nature of the relationship remains unclear and is likely to vary between identifiable groups and specific contexts. The aim of this paper is to examine the relationships between obesity, type 2 diabetes, hypertension and vitamin D, among Saudis citizens aged 15 and over. METHODS Self-reported and measured data were taken from the 2013 Saudi Health Interview Survey and analysed using a series of seemingly unrelated bivariate probit regression (SURBVP) analyses. Sensitivity analyses were undertaken in which the selection and specification of covariates and outcomes were varied. RESULTS In the main analysis data on 957 women and 1127 men were analysed. Differences were evident between men and women in the prevalence of type 2 diabetes, obesity, central obesity, hypertension and vitamin D deficiency. While men were more likely to experience diabetes and hypertension, women were more likely to experience obesity, central obesity and vitamin D deficiency. In multivariable analyses obesity and age were found to significantly predict hypertension risk in women; central obesity to predict diabetes risk in men and women, as well as hypertension risk in men. Vitamin D was not found to predict diabetes risk nor hypertension risk in either sex. Milk consumption and sun exposure were found to predict vitamin D deficiency in women but not men. While there was evidence of unobserved heterogeneity in models predicting diabetes and hypertension, there was no evidence of unobserved heterogeneity between these and those predicting vitamin D deficiency. Results did not materially change over a range of sensitivity analyses. CONCLUSION While there is strong evidence of distinct patterns in the relationship between diabetes, hypertension and obesity among men and women in Saudi Arabia and in the risk of vitamin D deficiency, we found no evidence of a relationship between vitamin D levels and risk of either diabetes or hypertension.
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Affiliation(s)
- Ibrahim Al-Sumaih
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Brian Johnston
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
- Belfast Health and Social Care Trust, Belfast, UK
| | - Michael Donnelly
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
- Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, BT12 6BA, UK.
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Gu JW, Liu JH, Xiao HN, Yang YF, Dong WJ, Zhang QB, Liu L, He CS, Wu BH. Relationship between plasma levels of 25-hydroxyvitamin D and arterial stiffness in elderly Chinese with non-dipper hypertension: An observational study. Medicine (Baltimore) 2020; 99:e19200. [PMID: 32049858 PMCID: PMC7035115 DOI: 10.1097/md.0000000000019200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Elderly individuals with non-dipper hypertension are at high risk of cardiovascular disease because of increased stiffness of peripheral arteries. Since, vitamin D deficiency is prevalent in elderly Chinese. We examined whether reduced plasma levels of 25-hydroxyvitamin D [25(OH)D] may help promote this stiffness.Hypertensive patients at least 60 years old without history of peripheral arterial disease at our hospital were retrospectively divided into dipper and non-dipper groups according to the results of 24-hour ambulatory blood pressure monitoring. Plasma levels of 25(OH)D were measured by enzyme immunoassay. Peripheral arterial stiffness was measured based on the cardio-ankle vascular index (CAVI).Of the 155 patients enrolled, 95 (61.3%) were diagnosed with non-dipper hypertension and these patients had significantly lower plasma levels of 25(OH)D than the 60 patients with dipper hypertension (19.58 ± 5.97 vs 24.36 ± 6.95 nmol/L, P < .01) as well as significantly higher CAVI (8.46 ± 1.65 vs 7.56 ± 1.08 m/s, P < .01). Vitamin D deficiency was significantly more common among non-dipper patients (57.9% vs 31.7%, P < .01). Multivariate regression showed that age and 25(OH)D were independently related to CAVI, with each 1-ng/ml decrease in 25(OH)D associated with a CAVI increase of +0.04 m/s.Non-dipper hypertension is associated with vitamin D deficiency and reduced plasma levels of 25(OH)D. The latter may contribute to stiffening of peripheral arteries, increasing the risk of cardiovascular disease.
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Affiliation(s)
- Jian-Wei Gu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Ju-Hua Liu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
- Department of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Hui-Neng Xiao
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Yun-Feng Yang
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Wen-Ju Dong
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Quan-Bo Zhang
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Li Liu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Cheng-Shi He
- Department of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Bi-Hua Wu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
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Durazo-Arvizu RA, Pacheco-Dominguez RL, Sempos CT, Kramer H, Hoofnagle AN, Pirzada A, Cooper RS, Daviglus ML. The Association between Cardiovascular Disease Risk Factors and 25-Hydroxivitamin D and Related Analytes among Hispanic/Latino Adults: A Pilot Study. Nutrients 2019; 11:E1959. [PMID: 31434350 PMCID: PMC6723220 DOI: 10.3390/nu11081959] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/18/2022] Open
Abstract
Although the association of vitamin D levels with cardiovascular risk profiles among Hispanics/Latinos has been studied, little is known about this association among Hispanics/Latinos with chronic conditions. This pilot study determined serum vitamin D and parathyroid hormone (PTH) levels in a sample of participants from the University of Illinois at the Chicago Cohort of Patients, Family and Friends (UIC Cohort) and examined their association with traditional cardiovascular disease risk factors. From July 2012 to June 2016, the UIC Cohort study enrolled and conducted clinical examinations on men and women ages 18 years and older, who had one or more diagnosed chronic diseases/conditions (excluding cancer). This pilot study sample included 40 participants from the six main Hispanic/Latino background groups in the United States, namely Dominican, Cuban, Puerto Rican, Mexican, Central American, and South American, and were grouped by Caribbean or mainland origin. No substantial differences were noted in the vitamin D-related measures by Hispanic/Latino background, but the PTH levels were somewhat higher in the Caribbean vs. mainland group (43.0 ± 4.6 vs. 38.6 ± 2.7 pg/mL). The associations between selected CVD risk factors (systolic and diastolic blood pressure (SBP, DBP), total cholesterol, glucose) and PTH and vitamin D-related analytes were investigated using interval-censored multivariate regression models adjusted for age, sex, percent body fat, serum albumin/calcium, and Hispanic/Latino background. A negative association between total 25[OH]D and blood pressure was corroborated (SBP: β = -1.2, 95%CI = -2.0, -0.3; DBP: β = -0.7, 95% CI = -1.2, -0.1), whereas a positive association with total cholesterol was observed (β = 1.9, 95% CI = 0.02, 3.7). Levels of 1, 25[OH]2D were not associated with CVD risk factors, whereas 24, 25[OH]2D3 was associated with blood pressure (SBP: β = -13.0, 95% CI = -20.7, -5.2; DBP: β = -6.3, 95% CI = -11.6, -1.0). Estimated free 25[OH]D was inversely associated with both SBP (β = -3.5, 95% CI = -6.1, -0.9) and DBP (β = -2.1, 95% CI = -3.8, -0.3). Similarly, calculated bioavailable 25[OH]D was inversely associated with both SBP (β = -9.2, 95% CI = -15.9, -2.4) and DBP(β = -5.3, 95% CI = -9.8, -0.8). In conclusion, a negative association between 25[OH]D with BP was observed and a positive association with lipids is suggested. Due to the small sample size, most associations did not reach statistical significance.
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Affiliation(s)
- Ramon A Durazo-Arvizu
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA.
| | - Reyna L Pacheco-Dominguez
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, México City 04510, Mexico
| | - Christopher T Sempos
- Vitamin D Standardization Program (VDSP), 520 Ferdinand Dr, Havre de Grace, MD 21078, USA
| | - Holly Kramer
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, Washington University School of Medicine, Seattle, WA 98185, USA
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Richard S Cooper
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL 60153, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL 60612, USA
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9
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Hong K, Florkowski CM, Doogue MP, Elder PA, Lewis JG. A monoclonal antibody sandwich ELISA for vitamin D-binding protein (VDBP) is unaffected by Gc-globulin phenotype peptides and actin and demonstrates reduced levels in sepsis and non-sepsis intensive care patients. Clin Chim Acta 2018; 484:7-13. [PMID: 29775620 DOI: 10.1016/j.cca.2018.05.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 11/29/2022]
Abstract
The measurement of vitamin D-binding protein (VDBP) by immunoassay has been confounded by variable antibody recognition of the Gc1s, Gc1F and Gc2 phenotypes. This has led to spurious conclusions regarding vitamin D status in different ethnic groups. In order to overcome these problems there is a requirement for VDBP antibodies that are unaffected by phenotype status. Here we report the generation and testing of three monoclonal antibodies to VDBP which recognise linear epitopes and are unaffected by vast molar excesses of synthetic peptides spanning these phenotypic domains. These IgG1 kappa antibodies were purified and biotinylated to allow suitable pairings to develop a sandwich ELISA for circulating VDBP. The VDBP ELISA is unaffected by actin and confirms that VDBP levels are significantly reduced in sepsis patients and non-sepsis intensive care patients compared to normal healthy subjects. Levels of VDBP along with total 25OH vitamin D3 can be used to calculate free 25OH vitamin D3 levels and these compare well with consensus values determined independently. The VDBP ELISA meets acceptable performance criteria and as such can be used in conjunction with total 25OH vitamin D3 to determine the free 25OH vitamin D3 status in various cohorts.
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Affiliation(s)
- Katrina Hong
- Endocrinology and Steroid Laboratory, Canterbury Health Laboratories, New Zealand
| | | | - Matthew P Doogue
- Department of Pharmacology, Christchurch Hospital, Christchurch, New Zealand
| | - Peter A Elder
- Endocrinology and Steroid Laboratory, Canterbury Health Laboratories, New Zealand
| | - John G Lewis
- Endocrinology and Steroid Laboratory, Canterbury Health Laboratories, New Zealand.
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10
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Mansouri M, Abasi R, Nasiri M, Sharifi F, Vesaly S, Sadeghi O, Rahimi N, Sharif NA. Association of vitamin D status with metabolic syndrome and its components: A cross-sectional study in a population of high educated Iranian adults. Diabetes Metab Syndr 2018; 12:393-398. [PMID: 29398635 DOI: 10.1016/j.dsx.2018.01.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Accepted: 01/24/2018] [Indexed: 12/15/2022]
Abstract
AIM We aimed to assess the association of vitamin D status with metabolic syndrome and its components among high educated Iranian adults. METHOD In this cross-sectional study, 352 faculty members with age of 35 years or more, belong to Tarbiat Modares University, Tehran, Islamic Republic of Iran, were recruited during 2016 and 2017. Fasting blood samples were obtained to quantify serum 25(OH)D concentrations, glycemic indicators and lipid profile. Metabolic syndrome was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (ATP III). Multivariate logistic regression adjusted for potential confounders was used to evaluate the association between vitamin D status and metabolic syndrome. RESULT Metabolic syndrome and vitamin D insufficiency were prevalent among 26% and 60.2% of subjects, respectively. There was no statistically significant difference in the prevalence of metabolic syndrome across quartiles of 25(OH)D levels either before or after adjusting for potential confounders (OR: 0.94, 95% CI: 0.43-1.95). In terms of metabolic syndrome components, subjects in the highest quartile of vitamin D levels had 59% decreased risk of abdominal obesity compared with those in the lowest quartile (OR: 0.41, 95% CI: 0.17-0.99), after adjusting for potential confounders. Such inverse relationship was also seen for elevated blood pressure (OR: 0.37, 95% CI: 0.14-0.99), and abnormal glucose homeostasis (OR: 0.40, 95% CI: 0.19-0.85). CONCLUSION Serum levels of 25(OH)D was inversely associated with the risk of abdominal obesity, hypertension, and abnormal glucose homeostasis. However, no significant relationship was seen for metabolic syndrome.
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Affiliation(s)
- Masoume Mansouri
- Student Health Services, Health Center of Tarbiat Modares University, Tehran, Iran.
| | - Roshanak Abasi
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology & Metabolism, Iran University of Medical Sciences, Tehran, Iran.
| | - Morteza Nasiri
- Department of Operating Room Technology, School of Paramedicine, Qom University of Medical Sciences, Qom, Iran.
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sedyghe Vesaly
- Student Health Services, Health Center of Tarbiat Modares University, Tehran, Iran.
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nayere Rahimi
- Student Health Services, Health Center of Tarbiat Modares University, Tehran, Iran.
| | - Nasrin Akbary Sharif
- Student Health Services, Health Center of Tarbiat Modares University, Tehran, Iran.
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11
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Sorriento D, De Luca N, Trimarco B, Iaccarino G. The Antioxidant Therapy: New Insights in the Treatment of Hypertension. Front Physiol 2018; 9:258. [PMID: 29618986 PMCID: PMC5871811 DOI: 10.3389/fphys.2018.00258] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/06/2018] [Indexed: 12/12/2022] Open
Abstract
Reactive oxygen species (ROS) and reactive nitrogen species (RNS) play a key role in the regulation of the physiological and pathological signaling within the vasculature. In physiological conditions, a delicate balance between oxidants and antioxidants protects cells from the detrimental effects of ROS/RNS. Indeed, the imbalance between ROS/RNS production and antioxidant defense mechanisms leads to oxidative and nitrosative stress within the cell. These processes promote the vascular damage observed in chronic conditions, such as hypertension. The strong implication of ROS/RNS in the etiology of hypertension suggest that antioxidants could be effective in the treatment of this pathology. Indeed, in animal models of hypertension, the overexpression of antioxidants and the genetic modulation of oxidant systems have provided an encouraging proof of concept. Nevertheless, the translation of these strategies to human disease did not reach the expected success. This could be due to the complexity of this condition, whose etiology depends on multiple factors (smoking, diet, life styles, genetics, family history, comorbidities). Indeed, 95% of reported high blood pressure cases are deemed "essential hypertension," and at the molecular level, oxidative stress seems to be a common feature of hypertensive states. In this scenario, new therapies are emerging that could be useful to reduce oxidative stress in hypertension. It is now ascertained the role of Vitamin D deficiency in the development of essential hypertension and it has been shown that an appropriate high dose of Vitamin D significantly reduces blood pressure in hypertensive cohorts with vitamin D deficiency. Moreover, new drugs are emerging which have both antihypertensive action and antioxidant properties, such as celiprolol, carvedilol, nebivolol. Indeed, besides adrenergic desensitization, these kind of drugs are able to interfere with ROS/RNS generation and/or signaling, and are therefore considered promising therapeutics in the management of hypertension. In the present review we have dealt with the effectiveness of the antioxidant therapy in the management of hypertension. In particular, we discuss about Vitamin D and anti-hypertensive drugs with antioxidant properties.
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Affiliation(s)
- Daniela Sorriento
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Nicola De Luca
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Bruno Trimarco
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Guido Iaccarino
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Salerno, Baronissi, Italy
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