1
|
Zhang C, Cui J, Li S, Shen J, Luo X, Yao Y, Shi H. Combined effects of vitamin D deficiency and systemic inflammation on all-cause mortality and cause-specific mortality in older adults. BMC Geriatr 2024; 24:122. [PMID: 38302956 PMCID: PMC10836043 DOI: 10.1186/s12877-024-04706-x] [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: 07/31/2023] [Accepted: 01/12/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Vitamin D deficiency and systemic inflammation share common pathological mechanisms in muscle loss, cardio-pulmonary function decline, and abnormal metabolism, which are linked to chronic conditions, senescence, and early mortality. However, their combined effect on mortality in older adults has not been well established. This study longitudinal aimed to explore the independent and combined associations of serum 25-hydroxyvitamin D [25(OH)D] and high sensitivity C-reactive protein (hs-CRP) with mortality risk in Chinese community-based older people. METHODS 3072 older adults (86.07 ± 11.87 years, 54.52% female) from the Chinese Longitudinal Healthy Longevity Survey (2012-2018) were enrolled. Baseline 25(OH)D and hs-CRP levels were collected, and survival information was recorded in the 2014 and 2018 follow-up waves. Cox proportional hazard regressions were conducted to explore the associations between 25(OH)D, hs-CRP, and mortality. Demographic characteristics, health behaviors, and chronic disease biomarkers were adjusted. RESULTS During 10,622.3 person-years of follow-up (median: 3.51 years), 1321 older adults died, including 448 deaths due to cardiovascular disease (CVD). Increased mortality risk was associated with lower 25(OH)D and higher hs-CRP quantiles, even after adjusting for each other and multiple covariates (all P-trend < 0.05). In combined analyses, the highest all-cause mortality (HR: 2.18, 95% CI: 1.73 ~ 2.56), CVD mortality (HR: 2.30, 95% CI: 1.64 ~ 3.21), and non-CVD mortality (HR: 2.19, 95% CI: 1.79 ~ 2.49) were obtained in participants with both 25(OH)D deficiency (< 50 nmol/L) and high hs-CRP (≥ 3.0 mg/L), respectively. We observed significant additive interactions of 25(OH)D and hs-CRP on all-cause mortality and non-CVD mortality (RERIS>0). CONCLUSIONS Low 25(OH)D and high hs-CRP, both independently and jointly, increase mortality risk in Chinese community-dwelling older adults. Thus, priority should be given to early detection and appropriate intervention in older individuals with combined vitamin D deficiency and systemic inflammation. Molecular mechanisms of related adverse health effect are worthy of further investigation.
Collapse
Affiliation(s)
- Chi Zhang
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Ju Cui
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Shaojie Li
- China Center for Health Development Studies, National School of Development, Peking University, Haidian District, 100191, Beijing, China
| | - Ji Shen
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dongcheng District, 100730, Beijing, China
| | - Xuanmei Luo
- The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, National Center of Gerontology of National Health Commission, 100730, Beijing, China
| | - Yao Yao
- China Center for Health Development Studies, National School of Development, Peking University, Haidian District, 100191, Beijing, China.
| | - Hong Shi
- Department of Geriatrics, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Dongcheng District, 100730, Beijing, China.
| |
Collapse
|
2
|
Sha S, Gwenzi T, Chen LJ, Brenner H, Schöttker B. About the associations of vitamin D deficiency and biomarkers of systemic inflammatory response with all-cause and cause-specific mortality in a general population sample of almost 400,000 UK Biobank participants. Eur J Epidemiol 2023; 38:957-971. [PMID: 37340242 PMCID: PMC10501954 DOI: 10.1007/s10654-023-01023-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/03/2023] [Indexed: 06/22/2023]
Abstract
It is unknown whether the well-known association between vitamin D deficiency and mortality could be explained by the immune system modulating effects of vitamin D, which may protect from a systemic inflammatory response (SIR) to adverse health conditions. This study aims to investigate the interrelationships of vitamin D deficiency, biomarkers of SIR, and mortality. We used multivariate logistic regression with adjustment for 51 covariates to assess the associations of vitamin D deficiency with disadvantageous levels of nine biomarkers of SIR in the UK Biobank cohort. Furthermore, we tested with Cox regression and mediation analysis whether biomarkers of SIR and vitamin D deficiency were independently associated with mortality. We included 397,737 participants aged 37-73 years. Vitamin D deficiency was associated with disadvantageous levels of all blood cell count-based biomarkers, but not with C-reactive protein (CRP)-based biomarkers after adjustment for body weight. Vitamin D deficiency and all biomarkers of SIR were significantly associated with all-cause mortality and mortality from cancer, cardiovascular and respiratory disease. The strength of these associations was unaltered if vitamin D deficiency and biomarkers of SIR were put in the same model. This finding was further supported by the mediation analyses. This study showed that vitamin D deficiency is associated with disadvantageous levels of blood cell count-based but not CRP-based biomarkers of SIR. Vitamin D deficiency and systemic inflammation were independently and strongly associated with mortality. The potential of clinical interventions against both vitamin D deficiency and underlying causes of systemic inflammation should be explored.
Collapse
Affiliation(s)
- Sha Sha
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Faculty of Medicine, University of Heidelberg, 69115, Heidelberg, Germany
| | - Tafirenyika Gwenzi
- Faculty of Medicine, University of Heidelberg, 69115, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
| | - Li-Ju Chen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ), National Center for Tumor Diseases (NCT), 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
| |
Collapse
|
3
|
Lauretani F, Salvi M, Zucchini I, Testa C, Cattabiani C, Arisi A, Maggio M. Relationship between Vitamin D and Immunity in Older People with COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085432. [PMID: 37107714 PMCID: PMC10138672 DOI: 10.3390/ijerph20085432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 05/11/2023]
Abstract
Vitamin D is a group of lipophilic hormones with pleiotropic actions. It has been traditionally related to bone metabolism, although several studies in the last decade have suggested its role in sarcopenia, cardiovascular and neurological diseases, insulin-resistance and diabetes, malignancies, and autoimmune diseases and infections. In the pandemic era, by considering the response of the different branches of the immune system to SARS-CoV-2 infection, our aims are both to analyse, among the pleiotropic effects of vitamin D, how its strong multimodal modulatory effect on the immune system is able to affect the pathophysiology of COVID-19 disease and to emphasise a possible relationship between the well-known circannual fluctuations in blood levels of this hormone and the epidemiological trend of this infection, particularly in the elderly population. The biologically active form of vitamin D, or calcitriol, can influence both the innate and the adaptive arm of the immune response. Calcifediol levels have been found to be inversely correlated with upper respiratory tract infections in several studies, and this activity seems to be related to its role in the innate immunity. Cathelicidin is one of the main underlying mechanisms since this peptide increases the phagocytic and germicidal activity acting as chemoattractant for neutrophils and monocytes, and representing the first barrier in the respiratory epithelium to pathogenic invasion. Furthermore, vitamin D exerts a predominantly inhibitory action on the adaptive immune response, and it influences either cell-mediated or humoral immunity through suppression of B cells proliferation, immunoglobulins production or plasma cells differentiation. This role is played by promoting the shift from a type 1 to a type 2 immune response. In particular, the suppression of Th1 response is due to the inhibition of T cells proliferation, pro-inflammatory cytokines production (e.g., INF-γ, TNF-α, IL-2, IL-17) and macrophage activation. Finally, T cells also play a fundamental role in viral infectious diseases. CD4 T cells provide support to B cells antibodies production and coordinate the activity of the other immunological cells; moreover, CD8 T lymphocytes remove infected cells and reduce viral load. For all these reasons, calcifediol could have a protective role in the lung damage produced by COVID-19 by both modulating the sensitivity of tissue to angiotensin II and promoting overexpression of ACE-2. Promising results for the potential effectiveness of vitamin D supplementation in reducing the severity of COVID-19 disease was demonstrated in a pilot clinical trial of 76 hospitalised patients with SARS-CoV-2 infection where oral calcifediol administration reduced the need for ICU treatment. These interesting results need to be confirmed in larger studies with available information on vitamin D serum levels.
Collapse
Affiliation(s)
- Fulvio Lauretani
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
- Correspondence: ; Tel.: +39-0521-703325
| | - Marco Salvi
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| | - Irene Zucchini
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| | - Crescenzo Testa
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| | - Chiara Cattabiani
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| | - Arianna Arisi
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Marcello Maggio
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
- Cognitive and Motor Center, Medicine and Geriatric-Rehabilitation Department of Parma, University-Hospital of Parma, 43126 Parma, Italy
| |
Collapse
|
4
|
Jaffey JA, Kreisler R, Shubitz LF, Backus RC, Hostnik ET, Wycislo KL, Monasky R, Schaffer M, Holland C. Serum 25-hydroxyvitamin D concentrations in dogs with coccidioidomycosis and variables associated with extent of clinically evident disease. Vet Med (Auckl) 2023; 37:150-160. [PMID: 36629803 PMCID: PMC9889719 DOI: 10.1111/jvim.16629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Clinicopathologic variables predictive of disseminated coccidioidomycosis are known in humans but have not been explored in dogs. Serum 25-hydroxyvitamin (OH)D correlates with severity of disease of various etiologies in dogs but its role in coccidioidomycosis is unknown. OBJECTIVE Determine whether serum 25(OH)D concentrations are different in dogs with coccidioidomycosis compared with healthy controls and if clinicopathologic variables are associated with extent of disease. ANIMALS Thirty-five dogs with coccidioidomycosis (pulmonary, n = 13; disseminated, n = 15; uncharacterized, n = 7), and 25 healthy control dogs. METHODS Prospective cohort study. Serum 25(OH)D and C-reactive protein (CRP) concentrations were measured with modified-HPLC and a commercial ELISA kit, respectively. RESULTS There was no difference in 25(OH)D concentrations between dogs with coccidioidomycosis (median, interquartile range [IQR]; 31.9 ng/mL, 23.3-49.2) and controls (29.5 ng/mL, 25.6-40.8, P = .73). Serum 25(OH)D concentration was lower in dogs with coccidioidomycosis and IgG titers ≥1:32 than dogs with titers below this cut-off (P = .02). Dogs with IgG titers ≥1:32 were more likely to have disseminated disease (OR, 7.5; 95% CI: 1.1-68; P = .03). Serum CRP concentrations were higher in dogs with IgG titers ≥1:16 (median, IQR; 4474.8 ng/mL, 2885.8-8236.1) than in those below this cut-off (151.2 ng/mL, 30.4-2907.3; P = .02). There was a significant inverse association between serum 25(OH)D and CRP at 25(OH)D concentrations ≤33 ng/mL. CONCLUSION AND CLINICAL IMPORTANCE Serum 25(OH)D concentration was lower for dogs with IgG titers ≥1:32, indicating a potential association between semi-quantitative titers and 25(OH)D concentrations in dogs with coccidioidomycosis. IgG titers ≥1:32 yielded higher odds of disseminated disease, but was inadequate as a standalone test to determine form of disease.
Collapse
Affiliation(s)
- Jared A. Jaffey
- Department of Specialty MedicineMidwestern University College of Veterinary MedicineGlendaleArizonaUSA
| | - Rachael Kreisler
- Department of Primary Care, Shelter, and Community MedicineMidwestern University College of Veterinary MedicineGlendaleArizonaUSA
| | - Lisa F. Shubitz
- Valley Fever Center for ExcellenceUniversity of Arizona College of Medicine‐TucsonTucsonArizonaUSA
| | - Robert C. Backus
- Department of Veterinary Medicine and Surgery, Veterinary Health CenterUniversity of MissouriColumbiaMissouriUSA
| | - Eric T. Hostnik
- Department of Veterinary Clinical Sciences, College of Veterinary MedicineThe Ohio State UniversityColumbusOhioUSA
| | - Kathryn L. Wycislo
- Department of PathologyMidwestern University College of Veterinary MedicineGlendaleArizonaUSA
| | - Ross Monasky
- Department of Specialty MedicineMidwestern University College of Veterinary MedicineGlendaleArizonaUSA
| | - Magen Schaffer
- Department of Specialty MedicineMidwestern University College of Veterinary MedicineGlendaleArizonaUSA
| | | |
Collapse
|
5
|
Asghari A, Jafari F, Jameshorani M, Chiti H, Naseri M, Ghafourirankouhi A, Kooshkaki O, Abdshah A, Parsamanesh N. Vitamin D role in hepatitis B: focus on immune system and genetics mechanism. Heliyon 2022; 8:e11569. [DOI: 10.1016/j.heliyon.2022.e11569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/01/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
|
6
|
van Oostrom EC, Mulder KEW, Verheul MCE, Hendriksen PA, Thijssen S, Kraneveld AD, Vlieg-Boerstra B, Garssen J, Verster JC. A healthier daily diet is associated with greater immune fitness. PHARMANUTRITION 2022. [DOI: 10.1016/j.phanu.2022.100306] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
7
|
Temporal Association of Reduced Serum Vitamin D with COVID-19 Infection: Two Single-Institution Case–Control Studies. Nutrients 2022; 14:nu14132757. [PMID: 35807937 PMCID: PMC9268980 DOI: 10.3390/nu14132757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 06/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Vitamin D supplementation has been proposed for the prevention and treatment of COVID-19, but it is not clear if reduced serum vitamin D predisposes individuals to COVID-19 and/or is a secondary consequence of infection. This study assessed the temporal association between serum vitamin D and COVID-19 with two single-institution case–control studies through the University of California San Diego (UCSD) Health System. (2) Methods: This study included patients who tested positive for COVID-19 from 1 January to 30 September 2020 with serum 25-hydroxy-vitamin D (25(OH)D) measured within 180 days of diagnosis. Patients were separated based on whether 25(OH)D was measured before (n = 107 cases, 214 controls) or after (n = 203 cases, 406 controls) COVID-19 diagnosis. COVID-19 infection status was the outcome variable in the pre-diagnosis study, whereas serum 25(OH)D level was the outcome variable in the post-diagnosis study. (3) Results: Serum 25(OH)D levels were not associated with the odds of subsequent COVID-19 infection (OR 1.0, 95% CI: 1.0 to 1.0, p = 0.98). However, COVID-19-positive individuals had serum 25(OH)D measurements that were 2.7 ng/mL lower than the controls (95% CI: −5.2 to −0.2, p = 0.03). (4) Conclusions: In our study population, serum 25(OH)D levels were not associated with the risk of acquiring COVID-19 infection but were reduced in subjects after COVID-19 infection. These results support the possibility that reduced serum 25(OH)D is a consequence and not a cause of COVID-19 infection.
Collapse
|
8
|
Talasaz AH, Salehiomran A, Heidary Z, Gholami K, Aryannejad H, Jalali A, Daei M. The effects of vitamin D supplementation on postoperative atrial fibrillation after coronary artery bypass grafting in patients with vitamin D deficiency. J Card Surg 2022; 37:2219-2224. [PMID: 35470909 DOI: 10.1111/jocs.16550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/17/2022] [Accepted: 03/28/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Postoperative atrial fibrillation (POAF) as a common complication of coronary artery bypass grafting (CABG) surgery is associated with increased mortality and morbidity rates. Vitamin D deficiency increases the prevalence of POAF; however, the effects of vitamin D supplementation on the incidence of POAF have not yet been completely elucidated. METHODS In this prospective, open-label, randomized clinical trial the level of 25-hydroxy vitamin D (25(OH) D) was measured in patients undergoing CABG surgery. Patients with vitamin D insufficiency (defined as 25(OH) D level < 30 ng/ml) were included and randomly assigned to control group to receive either the general standard of care (Group A) or to study group to receive the general standard of care plus oral vitamin D3 , 600,000 IU 5 days before surgery (Group B). The primary outcome of our study was the occurrence of POAF during the first 5 days after CABG surgery. RESULTS Totally, 93 patients in group B and 103 patients in group A completed the study. The occurrence of POAF was significantly lower in group B as compared to group A (9.68% vs. 20.39%, p = .038). The length of intensive care unit (ICU) stay and hospital stay were reduced in group B patients (2.21 vs. 3.86 days, p < .001 and 7.40 vs. 9.58 days, p = .022, respectively). CONCLUSION Our study demonstrated that vitamin D supplementation reduces the incidence of POAF, duration of ICU, and hospital stay following CABG surgery.
Collapse
Affiliation(s)
- Azita H Talasaz
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Salehiomran
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zinat Heidary
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kheirollah Gholami
- Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Aryannejad
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Jalali
- Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daei
- Department of Clinical Pharmacy, Faculty of Pharmacy, Alborz University of Medical Sciences, Alborz, Iran
| |
Collapse
|
9
|
Wijayabahu AT, Mickle AM, Mai V, Garvan C, Glover TL, Cook RL, Zhao J, Baum MK, Fillingim RB, Sibille KT. Associations between Vitamin D, Omega 6:Omega 3 Ratio, and Biomarkers of Aging in Individuals Living with and without Chronic Pain. Nutrients 2022; 14:266. [PMID: 35057447 PMCID: PMC8779718 DOI: 10.3390/nu14020266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 02/01/2023] Open
Abstract
Elevated inflammatory cytokines and chronic pain are associated with shorter leukocyte telomere length (LTL), a measure of cellular aging. Micronutrients, such as 25-hydroxyvitamin D (vitamin D) and omega 3, have anti-inflammatory properties. Little is known regarding the relationships between vitamin D, omega 6:3 ratio, LTL, inflammation, and chronic pain. We investigate associations between vitamin D, omega 6:3 ratio, LTL, and C-reactive protein (CRP) in people living with/without chronic pain overall and stratified by chronic pain status. A cross-sectional analysis of 402 individuals (63% women, 79.5% with chronic pain) was completed. Demographic and health information was collected. Chronic pain was assessed as pain experienced for at least three months. LTL was measured in genomic DNA isolated from blood leukocytes, and micronutrients and CRP were measured in serum samples. Data were analyzed with general linear regression. Although an association between the continuous micronutrients and LTL was not observed, a positive association between omega 6:3 ratio and CRP was detected. In individuals with chronic pain, based on clinical categories, significant associations between vitamin D, omega 6:3 ratio, and CRP were observed. Findings highlight the complex relationships between anti-inflammatory micronutrients, inflammation, cellular aging, and chronic pain.
Collapse
Affiliation(s)
- Akemi T. Wijayabahu
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Angela M. Mickle
- Department of Physical Medicine & Rehabilitation and Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA;
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
| | - Volker Mai
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Cynthia Garvan
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| | - Toni L. Glover
- School of Nursing, Oakland University, Rochester, MI 48309, USA;
| | - Robert L. Cook
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610, USA
| | - Jinying Zhao
- Department of Epidemiology, College of Public Health and Health Professions, and College of Medicine, University of Florida, Gainesville, FL 32610, USA; (A.T.W.); (V.M.); (R.L.C.); (J.Z.)
| | - Marianna K. Baum
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33174, USA;
| | - Roger B. Fillingim
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
| | - Kimberly T. Sibille
- Department of Physical Medicine & Rehabilitation and Aging & Geriatric Research, University of Florida, Gainesville, FL 32610, USA;
- Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, FL 32610, USA;
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL 32610, USA;
| |
Collapse
|
10
|
AlKhafaji D, Al Argan R, Albaker W, Al Elq A, Al-Hariri M, AlSaid A, Alwaheed A, Alqatari S, Alzaki A, Alwarthan S, AlRubaish F, AlGuaimi H, Ismaeel F, Alsaeed N, AlElq Z, Zainuddin F. The Impact of Vitamin D Level on the Severity and Outcome of Hospitalized Patients with COVID-19 Disease. Int J Gen Med 2022; 15:343-352. [PMID: 35027842 PMCID: PMC8752578 DOI: 10.2147/ijgm.s346169] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/15/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The world is experiencing a life-altering and extraordinary situation in response to the COVID-19 pandemic. There are limited data and controversies regarding the relationship between vitamin D (Vit D) status and COVID-19 disease. Thus, this study was designed to investigate the association between Vit D levels and the severity or outcomes of COVID-19 disease. METHODS A cross-sectional observational study was conducted in the Eastern province of Saudi Arabia from January to August 2021. All the admitted patients who were diagnosed with COVID-19 infection were distributed into three groups depending on their Vit D levels: normal, insufficiency, and deficiency. For the three groups, demographic data, and laboratory investigations as well as data regarding the severity of COVID-19 were collected and analysed. RESULTS A total of 203 diagnosed cases of COVID-19 were included in this study. The Vit D level was normal (>30) in 31 (15.3%) cases, insufficient in 45 (22.2%) cases and deficient in 127 (62.6%) cases. Among the included cases, 58 (28.6%) were critical cases, 109 (53.7%) were severe and 36 (17.7%) had a mild-moderate COVID-19 infection. The most prevalent comorbidity of patients was diabetes mellitus 117 (57.6%), followed by hypertension 70 (34.5%), cardiac disease 24 (11.8%), chronic kidney disease 19 (9.4%) and chronic respiratory disease in 17 (8.4%) cases. Importantly, the current study did not detect any significant association between Vit D status and COVID-19 severity (p-value=0.371) or outcomes (hospital stay, intensive care units admission, ventilation, and mortality rate) (p-value > 0.05), even after adjusting the statistical model for the confounders. CONCLUSION In hospital settings, Vit D levels are not associated with the severity or outcomes of COVID-19 disease. Further, well-designed studies are required to determine whether Vit D status provides protective effects against worse COVID-19 outcomes.
Collapse
Affiliation(s)
- Dania AlKhafaji
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Reem Al Argan
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Waleed Albaker
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abdulmohsen Al Elq
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Mohammed Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Abir AlSaid
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Abrar Alwaheed
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Safi Alqatari
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Alaa Alzaki
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Sara Alwarthan
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Fatimah AlRubaish
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Haya AlGuaimi
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Fatema Ismaeel
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Nidaa Alsaeed
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Zainab AlElq
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| | - Fatma Zainuddin
- Department of Medical Allied Services, Imam Abdulrahman Bin Faisal University, King Fahd Hospital of the University, Khobar, Eastern Province, Saudi Arabia
| |
Collapse
|
11
|
The Role of Vitamin D Supplementation in Children with Autism Spectrum Disorder: A Narrative Review. Nutrients 2021; 14:nu14010026. [PMID: 35010901 PMCID: PMC8746934 DOI: 10.3390/nu14010026] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 12/18/2022] Open
Abstract
Children with autism spectrum disorder (ASD) present with persistent deficits in both social communication and interactions, along with the presence of restricted and repetitive behaviors, resulting in significant impairment in significant areas of functioning. Children with ASD consistently reported significantly lower vitamin D levels than typically developing children. Moreover, vitamin D deficiency was found to be strongly correlated with ASD severity. Theoretically, vitamin D can affect neurodevelopment in children with ASD through its anti-inflammatory properties, stimulating the production of neurotrophins, decreasing the risk of seizures, and regulating glutathione and serotonin levels. A Title/Abstract specific search for publications on Vitamin D supplementation trials up to June 2021 was performed using two databases: PubMed and Cochrane Library. Twelve experimental studies were included in the synthesis of this review. Children with ASD reported a high prevalence of vitamin D deficiency or insufficiency. In general, it was observed that improved vitamin D status significantly reduced the ASD severity, however, this effect was not consistently different between the treatment and control groups. The variations in vitamin D dose protocols and the presence of concurrent interventions might provide an explanation for the variability of results. The age of the child for introducing vitamin D intervention was identified as a possible factor determining the effectiveness of the treatment. Common limitations included a small number of participants and a short duration of follow-ups in the selected studies. Long-term, well-designed randomized controlled trials are warranted to confirm the effect of vitamin D on severity in children with ASD.
Collapse
|
12
|
Hagag AA, El Frargy MS, Houdeeb HA. Therapeutic Value of Vitamin D as an Adjuvant Therapy in Neonates with Sepsis. Infect Disord Drug Targets 2021; 20:440-447. [PMID: 31241441 DOI: 10.2174/1871526519666190626141859] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 01/25/2023]
Abstract
Sepsis is unusual systemic reaction to an ordinary infection, and it probably represents a pattern of response by the immune system to the injury. Vitamin D is a fat-soluble steroid hormone that contributes to the maintenance of normal calcium homeostasis and skeletal mineralization. Vitamin D has an important role in the regulation of both innate and adaptive immune systems. AIM OF THE WORK The current study aimed to evaluate the therapeutic value of vitamin D supplementation as an adjuvant therapy in neonates with sepsis. SUBJECTS AND METHOD This study included 60 neonates with sepsis who were randomly divided into 2 equal groups; group I: 30 neonates with sepsis who received antibiotic only, Group II: 30 neonates with sepsis who received antibiotic therapy and vitamin D. This study also included 30 healthy neonates as a control group. For all patients and controls, serum level of 25 (OH) vitamin D and highly sensitive C reactive protein (hs-CRP) were immunoassayed. RESULTS There is no significant difference between groups I, II and controls regarding weight, gestational age, sex and mode of delivery. There were significant differences between groups I and II in sepsis score and hs-CRP after 3, 7, 10 days of treatment (p values for sepsis score were 0.009, 0.006, 0.004 respectively and for hs-CRP were 0.015, 0.001, 0.001 respectively). There was a significant difference in immature /total (I/T) ratio after 7, and 10 days of treatment (p value= 0.045, 0.025, respectively,) while there was no significant difference in immature /total (I/T) ratio after 3 days of treatment (p value = 0.624).Serum 25(OH) vitamin D levels were significantly lower in neonates with sepsis (group I and II) than the controls (p value < 0.05, while there were no significant differences between the three groups considering serum calcium and phosphorus levels (P =1.000, 1.000, respectively). Isolated organisms from blood culture in neonates with sepsis (group I and group II) were most commonly B- hemolytic streptococci, E-coli, hemophilus influenza and staphylococcus aurous. There was a significant negative correlation between hs-CRP and serum 25 (OH) vitamin in group II on entry (r = - 0.832 and P value = 0.001) and after 2 weeks (r = - 0.590 and P value = 0.021). ROC curve of specificity and sensitivity of 25 (OH) vitamin D level in prediction of early-onset neonatal sepsis showed that cutoff value of vitamin D was ≤20 ng/ml, sensitivity was 100%, specificity was 73%, positive predictive value was 73%, negative predictive value was 100% and accuracy was 87. CONCLUSION AND RECOMMENDATION Serum 25 (OH) vitamin D levels of neonates with the early onset neonatal sepsis were significantly lower than the healthy controls. Vitamin D supplementation improved sepsis score and decrease high levels of hs-CRP; this reflects the role of vitamin D as a target therapy for neonatal sepsis. Further studies are warranted to confirm the therapeutic value of vitamin D in neonatal sepsis.
Collapse
Affiliation(s)
- Adel A Hagag
- Pediatric Department, Faculty of Medicine, Tanta University, Egypt
| | | | - Hoassam A Houdeeb
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Egypt
| |
Collapse
|
13
|
Fassula AS, Gonzalez-Chica D, Giehl MC, Silva DAS, Cembranel F, Moreno YMF. Moderator role of vitamin D concentrations on the association between metabolic syndrome and C-reactive protein among adults. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2021; 64:695-703. [PMID: 34033278 PMCID: PMC10528610 DOI: 10.20945/2359-3997000000272] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/05/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To evaluate the association between MetS, its components and insulin resistance (IR) with 25(OH)D and hsCRP. The moderator role of 25(OH)D in the association of MetS, its diagnostic components and IR with hsCRP were also explored. METHODS A cross-sectional study (2014/2015) with a population-based cohort in Southern Brazil (n = 605). Metabolic syndrome (MetS) diagnosis was defined based on the Joint Interim Statement, while the Homeostasis Model Assessment of insulin resistance (IR) (HOMA-IR) was used for determining IR. Serum concentrations of 25-hydroxy vitamin D [25(OH)D] (ng/mL) and high sensitivity C-reactive protein (hsCRP) (mg/L) were evaluated following standard protocols. 25(OH)D was categorized as sufficiency (>30 ng/mL), insufficiency (20-30 ng/mL) or deficiency (<20 ng/mL) to test its moderator role. Multiple linear regression was used to test the associations. The results were adjusted for possible confounders. RESULTS Hypertriglyceridemia and IR were associated with lower 25(OH)D concentrations. However, except for systolic blood pressure, other MetS components and IR were associated with higher hsCRP. The association between elevated waist circumference (WC) and hsCRP was moderated by the 25(OH)D concentrations. The hsCRP median concentrations were more than two times higher among those with elevated WC and 25(OH)D insufficiency or deficiency. In this study, inadequate concentrations of 25(OH)D increased the adverse relationship between elevated WC and inflammation. 25(OH)D concentrations could be incorporated into the clinical protocols for monitoring individuals with abdominal obesity to identify those at a higher risk of complications.
Collapse
Affiliation(s)
| | - David Gonzalez-Chica
- Disciplina de Clínica Geral, Faculdade de Medicina de Adelaide, Universidade de Adelaide, Adelaide, Austrália
- Escola Clínica Rural de Adelaide, Universidade de Adelaide, Adelaide, Austrália
| | - Marui Corseuil Giehl
- Departamento de Ciências da Saúde, Universidade Federal de Santa Catarina, Araranguá, SC, Brasil
| | | | - Francieli Cembranel
- Departamento de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
| | - Yara Maria Franco Moreno
- Programa de Pós-Graduação em Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil
- Departamento de Nutrição, Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil,
| |
Collapse
|
14
|
Grant WB, Lahore H, Rockwell MS. The Benefits of Vitamin D Supplementation for Athletes: Better Performance and Reduced Risk of COVID-19. Nutrients 2020; 12:E3741. [PMID: 33291720 PMCID: PMC7761895 DOI: 10.3390/nu12123741] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic is having major economic and personal consequences for collegiate and professional sports. Sporting events have been canceled or postponed, and even when baseball and basketball seasons resumed in the United States recently, no fans were in attendance. As play resumed, several players developed COVID-19, disrupting some of the schedules. A hypothesis now under scientific consideration is that taking vitamin supplements to raise serum 25-hydroxyvitamin D [25(OH)D] concentrations could quickly reduce the risk and/or severity of COVID-19. Several mechanisms have been identified through which vitamin D could reduce the risks of infection and severity, death, and long-haul effects of COVID-19: (1) inducing production of cathelicidin and defensins to reduce the survival and replication of the SARS-CoV-2 virus; (2) reducing inflammation and the production of proinflammatory cytokines and risk of the "cytokine storm" that damages the epithelial layer of the lungs, heart, vascular system, and other organs; and (3) increasing production of angiotensin-converting enzyme 2, thus limiting the amount of angiotensin II available to the virus to cause damage. Clinical trials have confirmed that vitamin D supplementation reduces risk of acute respiratory tract infections, and approximately 30 observational studies have shown that incidence, severity, and death from COVID-19 are inversely correlated with serum 25(OH)D concentrations. Vitamin D supplementation is already familiar to many athletes and sports teams because it improves athletic performance and increases playing longevity. Thus, athletes should consider vitamin D supplementation to serve as an additional means by which to reduce risk of COVID-19 and its consequences.
Collapse
Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | - Henry Lahore
- VitaminDWiki, 2289 Highland Loop, Port Townsend, WA 98368, USA;
| | - Michelle S. Rockwell
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061, USA;
- Center for Transformative Research on Health Behaviors, Fralin Biomedical Research Institute at Virginia Tech Carilion, Roanoke, VA 24016, USA
| |
Collapse
|
15
|
Clements DN, Bruce G, Ryan JM, Handel IG, Oikonomidis IL, Gow AG, Evans H, Campbell S, Hurst E, Mellanby RJ. Effects of surgery on free and total 25 hydroxyvitamin D concentrations in dogs. J Vet Intern Med 2020; 34:2617-2621. [PMID: 33179819 PMCID: PMC7694799 DOI: 10.1111/jvim.15933] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background It is unclear whether a low total 25(OH)D concentration is a cause or consequence of illnesses. To address this knowledge gap, studies measuring free and total 25(OH)D during the evolution and resolution of an inflammatory process are required. Objectives Serum total and free 25(OH)D concentrations would transiently decline after cruciate surgery in dogs. Animals Seventeen client‐owned dogs with a spontaneous cranial cruciate ligament rupture (CCLR). Methods A longitudinal cohort study involving the measurement of serum concentrations of total and free 25(OH)D, total calcium, creatinine, albumin, phosphate, C‐reactive protein and plasma ionized calcium, at 1 day before and a median time of 1 and 60 days after surgical treatment of CCLR. Results Median serum concentrations of total 25(OH)D before surgery (80.3 nmoL/L [range, 43.5‐137.3]) significantly declined immediately after surgery; (64.8 nmoL/L [range, 36.3‐116.5] 1 day after surgery, P < .005) before increasing to become nonsignificantly different from concentrations before surgery at day 60 after surgery (median 78.0 nmoL/L [range, 24.2‐115.8], P = .14). In contrast, median free 25(OH)D concentrations before surgery (7.6 pg/mL [range, 3.8‐12.2]) significantly increased immediately after surgery (9.2 pg/mL [range, 5.2‐15.7], P < .05) before declining to become nonsignificantly different from before surgery concentrations at day 60 after surgery (median 6.2 pg/mL [range, 4.0‐15.8], P = .37). Conclusion and Clinical Importance This study reveals the difficulties of assessing vitamin D status in dogs following elective surgery.
Collapse
Affiliation(s)
- Dylan N Clements
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Gemma Bruce
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - John M Ryan
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Ian G Handel
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Ioannis L Oikonomidis
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Adam G Gow
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Helen Evans
- Nationwide Specialist Laboratories, Unit 2 Sawston Park, Cambridge, Cambridgeshire, UK
| | - Susan Campbell
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Emma Hurst
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| | - Richard J Mellanby
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Hospital for Small Animals, Roslin, Midlothian, UK
| |
Collapse
|
16
|
Correr CJ, Coura-Vital W, Frade JCQP, Nascimento RCRM, Nascimento LG, Pinheiro EB, Ferreira WM, Reis JS, Melo KFS, Pontarolo R, Lenzi MSA, Almeida JV, Pedrosa HC, João WSJ. Prevalence of people at risk of developing type 2 diabetes mellitus and the involvement of community pharmacies in a national screening campaign: a pioneer action in Brazil. Diabetol Metab Syndr 2020; 12:89. [PMID: 33062060 PMCID: PMC7545923 DOI: 10.1186/s13098-020-00593-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Brazil is one of top 10 countries with the highest number of people with diabetes mellitus (DM), affecting 16.8 million peoples. It is estimated that 7.7 million people (20-79 years) in the country have not yet been diagnosed, representing an under-diagnosis rate of 46.0%. Herein we aimed to screen people for high blood glucose or risk for developing type 2 DM (T2DM) through community pharmacies in Brazil. METHODS A cross-sectional study was carried out in November 2018, involving 977 pharmacists from 345 municipalities in Brazil. The study evaluated people between 20 and 79 years old without a previous diagnosis of DM. Glycemia was considered high when its value was ≥ 100 mg/dL fasting and ≥ 140 mg/dL in a casual feeding state. The FINDRISC (Finnish Diabetes Risk Score) was used to estimate the risk for developing T2DM. The prevalence of high blood glucose was estimated and the associated factors were obtained using Poisson's multivariate analysis with robust variance. RESULTS During the national screening campaign, 17,580 people were tested with the majority of the consultations (78.2%) being carried out in private pharmacies. The population was composed mainly of women (59.5%) and people aged between 20 and 45 years (47.9%). The frequency of participants with high blood glucose was 18.4% (95% CI 17.9-19.0). Considering the FINDRISC, 22.7% of people had a high or very high risk for T2DM. The risk factors associated with high blood glucose were: Body Mass Index > 25 kg/m2, abdominal circumference > 94 cm for men and > 80 cm for women; education level below 15 years of study, no daily intake of vegetables and fruits; previous diagnosis of arterial hypertension; history of high blood glucose and family history of DM. CONCLUSIONS This is the largest screening study that evaluated the frequency of high blood glucose and its associated factors in a population without a previous diagnosis ever performed in community pharmacies in Brazil. These results may help to improve public health policies and reinforce the role of pharmacists in screening and education actions aimed at this undiagnosed population in a continent-size country such as Brazil.
Collapse
Affiliation(s)
- Cassyano J. Correr
- Departamento de Farmácia, Universidade Federal do Paraná, Curitiba, Paraná Brazil
| | - Wendel Coura-Vital
- Programa de Pós Graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais Brazil
| | | | - Renata C. R. M. Nascimento
- Programa de Pós Graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais Brazil
| | - Lúbia G. Nascimento
- Programa de Pós Graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais Brazil
| | | | | | - Janice S. Reis
- Sociedade Brasileira de Diabetes, Ensino e Pesquisa da Santa Casa de Belo Horizonte, Belo Horizonte, Minas Gerais Brazil
| | - Karla F. S. Melo
- Sociedade Brasileira de Diabetes, Equipe de Diabetes do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Roberto Pontarolo
- Departamento de Farmácia, Universidade Federal do Paraná, Curitiba, Paraná Brazil
| | | | - José V. Almeida
- Conselho Federal de Farmácia, Brasília, Distrito Federal Brazil
| | - Hermelinda C. Pedrosa
- Sociedade Brasileira de Diabetes, São Paulo, Brazil
- Secretaria de Estado da Saúde, Polo de Pesquisa da Unidade de Endocrinologia FEPECS-HRT, Brasília, Distrito Federal Brazil
| | | |
Collapse
|
17
|
Postolache TT, Akram F, Lee EE, Lowry CA, Stiller JW, Brenner LA, Streeten EA, Turecki G, Dwivedi Y. Increased brain vitamin D receptor expression and decreased expression of cathelicidin antimicrobial peptide in individuals who died by suicide. J Psychiatr Res 2020; 125:75-84. [PMID: 32213352 DOI: 10.1016/j.jpsychires.2020.02.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 01/01/2020] [Accepted: 02/24/2020] [Indexed: 01/22/2023]
Abstract
Vitamin D deficiency is associated with immune dysregulation, increased vulnerability to infections, depression, and suicidal behavior. One mediator of vitamin D-dependent immune regulation and antimicrobial defense is the cathelicidin antimicrobial peptide (LL-37), encoded by the cathelicidin-related antimicrobial peptide (CRAMP) gene. We compared the mRNA expression of the CRAMP gene, the vitamin D receptor (VDR) gene, as well as the CYP27B1 and CYP24A1 genes (involved in vitamin D metabolism) in the dorsolateral prefrontal cortex (dlPFC) and anterior cingulate cortex (ACC) between depressed individuals who died by suicide (n = 15) and matched (age, gender, and post-mortem interval) non-psychiatric controls (n = 15). Gene expression was measured through qRT-PCR with TaqMan® primers and probes, with GAPDH and β-actin genes as endogenous controls. Statistical analyses included t-tests and Pearson correlations. CRAMP mRNA expression was downregulated and VDR mRNA expression was upregulated in both dlPFC and ACC in suicides relative to controls, with no significant differences in expression of CYP24A1 and CYP27B1. To our knowledge, this is the first study on brain cathelicidin expression in the human brain in relationship to suicide. Increased VDR and decreased CRAMP expression are consistent with previously reported associations between vitamin D deficiency, immune dysregulation, and suicidal behavior, and should lead to future studies uncovering novel interactive targets for suicide prevention.
Collapse
Affiliation(s)
- Teodor T Postolache
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Veterans Health Administration, Capitol MIRECC, Baltimore VA Medical Center, Baltimore MD, USA.
| | - Faisal Akram
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital, DC Department of Behavioral Health, Washington, DC, USA
| | - Ellen E Lee
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA; Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, CA, USA; Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Christopher A Lowry
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Department of Integrative Physiology, Center for Neuroscience, And Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John W Stiller
- Mood and Anxiety Program, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeths Hospital, DC Department of Behavioral Health, Washington, DC, USA; Maryland State Athletic Commission, Baltimore, MD, USA
| | - Lisa A Brenner
- Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO, USA; Department of Physical Medicine & Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth A Streeten
- Program for Personalized and Genomic Medicine, Department of Medicine, Endocrinology, Diabetes & Metabolism, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
18
|
Ebert T, Pawelzik SC, Witasp A, Arefin S, Hobson S, Kublickiene K, Shiels PG, Bäck M, Stenvinkel P. Inflammation and Premature Ageing in Chronic Kidney Disease. Toxins (Basel) 2020; 12:E227. [PMID: 32260373 PMCID: PMC7232447 DOI: 10.3390/toxins12040227] [Citation(s) in RCA: 117] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/20/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023] Open
Abstract
Persistent low-grade inflammation and premature ageing are hallmarks of the uremic phenotype and contribute to impaired health status, reduced quality of life, and premature mortality in chronic kidney disease (CKD). Because there is a huge global burden of disease due to CKD, treatment strategies targeting inflammation and premature ageing in CKD are of particular interest. Several distinct features of the uremic phenotype may represent potential treatment options to attenuate the risk of progression and poor outcome in CKD. The nuclear factor erythroid 2-related factor 2 (NRF2)-kelch-like erythroid cell-derived protein with CNC homology [ECH]-associated protein 1 (KEAP1) signaling pathway, the endocrine phosphate-fibroblast growth factor-23-klotho axis, increased cellular senescence, and impaired mitochondrial biogenesis are currently the most promising candidates, and different pharmaceutical compounds are already under evaluation. If studies in humans show beneficial effects, carefully phenotyped patients with CKD can benefit from them.
Collapse
Affiliation(s)
- Thomas Ebert
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| | - Sven-Christian Pawelzik
- Karolinska Institutet, Department of Medicine Solna, Cardiovascular Medicine Unit, SE-171 76 Stockholm, Sweden; (S.-C.P.); (M.B.)
- Karolinska University Hospital, Theme Heart and Vessels, Division of Valvular and Coronary Disease, SE-171 76 Stockholm, Sweden
| | - Anna Witasp
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| | - Samsul Arefin
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| | - Sam Hobson
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| | - Karolina Kublickiene
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| | - Paul G. Shiels
- University of Glasgow, Wolfson Wohl Cancer Research Centre, College of Medical, Veterinary & Life Sciences, Institute of Cancer Sciences, Glasgow G61 1QH, UK;
| | - Magnus Bäck
- Karolinska Institutet, Department of Medicine Solna, Cardiovascular Medicine Unit, SE-171 76 Stockholm, Sweden; (S.-C.P.); (M.B.)
- Karolinska University Hospital, Theme Heart and Vessels, Division of Valvular and Coronary Disease, SE-171 76 Stockholm, Sweden
| | - Peter Stenvinkel
- Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Renal Medicine, SE-141 86 Stockholm, Sweden; (A.W.); (S.A.); (S.H.); (K.K.)
| |
Collapse
|
19
|
Yang F, Sun M, Sun C, Li J, Yang X, Bi C, Wang M, Pu L, Wang J, Wang C, Xie M, Yao Y, Jin L. Associations of C-reactive Protein with 25-hydroxyvitamin D in 24 Specific Diseases: A Cross-sectional Study from NHANES. Sci Rep 2020; 10:5883. [PMID: 32246038 PMCID: PMC7125216 DOI: 10.1038/s41598-020-62754-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/16/2020] [Indexed: 11/22/2022] Open
Abstract
Most diseases might be associated with acute or chronic inflammation, and the role of vitamin D in diseases has been extensively explored in recent years. Thus, we examined the associations of one of the best markers for inflammation ― C-reactive protein (CRP) with 25-hydroxyvitamin D [25(OH)D] in 24 specific diseases. We performed cross-sectional analyses among 9,809 subjects aged ≥18 years who participated in the U.S. National Health and Nutrition Examination Survey (NHANES) in 2007~2010. The generalized additive model (GAM) was used to explore the associations of CRP with 25(OH)D in different diseases, adjusted for the age, gender, examination period and race. Distributions of CRP were significantly different (P < 0.05) in gender, examination period and race, and distributions of 25(OH)D were different (P < 0.05) in the examination period and race. Generally, CRP was negatively associated with 25(OH)D for majority diseases. 25(OH)D was negatively associated with CRP generally, and the associations were disease-specific and disease category-specific. In respiratory, gastrointestinal and mental diseases, the associations tended to be approximately linear. While in metabolic diseases, the associations were nonlinear, and the slope of the nonlinear curve decreased with 25(OH)D, especially when 25(OH)D < 30 μg/L.
Collapse
Affiliation(s)
- Fang Yang
- Department of Health Management Center, the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Mengzi Sun
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Chong Sun
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Jiagen Li
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Xiuning Yang
- Department of Hepatobiliary Surgery, Affiliated hospital of Beihua University, Jilin, Jilin, 132011, China
| | - Chunli Bi
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Min Wang
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Liyuan Pu
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China
| | - Jianmeng Wang
- Department of Geriatrics, the First Hospital of Jilin University, Changchun, Jilin, 130021, China
| | - Chunxiao Wang
- Department of Clinical Medicine, School of Clinical Medicine, Changchun, Jilin, 130021, China
| | - Meizhen Xie
- Department of Clinical Medicine, School of Clinical Medicine, Changchun, Jilin, 130021, China
| | - Yan Yao
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China.
| | - Lina Jin
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, School of Public Health, Jilin University, Changchun, Jilin, 130021, China.
| |
Collapse
|
20
|
Nejm MB, Guimarães-Marques MJ, Oliveira LF, Damasceno L, Andersen ML, Tufik S, Fonseca F, Olszewer E, Leça R, de Almeida ACG, Scorza FA, Scorza CA. Assessment of vitamin D and inflammatory markers profile in cardiac tissue on Parkinson disease animal model. Pharmacol Rep 2020; 72:296-304. [PMID: 32124387 DOI: 10.1007/s43440-020-00074-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/13/2019] [Accepted: 12/30/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cardiovascular dysfunctions are common non-motor symptoms in patients with Parkinson's disease (PD) that can result in reduced quality of life and even death. Research in animal models designed to characterize the pathological association between PD and cardiovascular abnormalities is still in its infancy. This study assessed the early impact of the nigrostriatal dopaminergic damage on cardiological features in the unilateral 6-OHDA rat model of PD. METHODS Male Wistar rats received unilateral intrastriatal injections of 6-OHDA and sham rats were injected with saline. Animals were studied 15 days later. Immunohistochemistry was used for visualization of tyrosine hydroxylase (TH)-positive neurons in the nigrostriatal system. Electrocardiogram recordings of heart rate were performed in conscious rats. Heart levels of vitamin D, inflammatory cytokines and C-reactive protein were assessed through electrochemiluminescence immunoassay, quantitative reverse transcription PCR and turbidimetric method, respectively. RESULTS We found a post-injury reduction of TH-immunoreactivity of approximately 45% in the substantia nigra pars compacta and 20% in the striatum. Heart rate reduction was found in 6-OHDA-lesioned rats as compared with sham counterparts. Reduced levels of vitamin D and increased levels of inflammatory factors (C-reactive protein, IL-6, TNF-α and TGF-β) were detected in the heart tissue of PD rats in comparison with sham. CONCLUSION Our findings suggest a link between cardiac tissue changes and cardiac functional changes early after the central dopaminergic damage induced by 6-OHDA. Knowledge of the cardiac abnormalities in the 6-OHDA model is critical in identifying future therapeutic targets and disease-modifying approaches for PD non-motor features.
Collapse
Affiliation(s)
- Mariana Bocca Nejm
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil
| | - Marcia Jonathas Guimarães-Marques
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil
| | - Leandro Freitas Oliveira
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil
| | - Laís Damasceno
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), São Paulo, SP, Brazil
| | - Fernando Fonseca
- Laboratório de Análises Clínicas da Faculdade de Medicina do ABC, Santo André, SP, Brazil
- Departamento de Ciências Farmacêuticas da, Universidade Federal de São Paulo (UNIFESP), Diadema, SP, Brazil
| | - Efrain Olszewer
- Fundação de Apoio à Pesquisa e Estudo na Área de Saúde (FAPES), São Paulo, SP, Brazil
| | - Renato Leça
- Departamento de Cirurgia II, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Antonio Carlo G de Almeida
- Departamento de Engenharia de Biossistemas, Universidade Federal de São João Del Rei (UFSJ), São João Del Rei, MG, Brazil
| | - Fulvio Alexandre Scorza
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil
| | - Carla Alessandra Scorza
- Departamento de Neurologia/Neurociência, Universidade Federal de São Paulo-Escola Paulista de Medicina (UNIFESP/EPM), Av. Pedro de Toledo, 699, 1º andar, São Paulo, SP, Brazil.
| |
Collapse
|
21
|
Association of Fibroblast Growth Factor-23 (FGF-23) With Incident Frailty in HIV-Infected and HIV-Uninfected Individuals. J Acquir Immune Defic Syndr 2019; 80:118-125. [PMID: 30299347 DOI: 10.1097/qai.0000000000001868] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the Multicenter AIDS Cohort Study, we examined whether fibroblast growth factor-23 (FGF-23), a bone-derived phosphaturic hormone involved in bone metabolism, is associated with incident frailty. Furthermore, we examined whether this association differs by HIV serostatus and race. METHODS Of 715 men assessed for frailty and selected for FGF-23 measurements using stored blood samples (2007-2011), 512 men were nonfrail at/before the baseline visit. Frailty was defined by the presence of ≥3 of the following on 2 consecutive 6-month visits within 1 year: unintentional weight loss ≥10 pounds, weakness, slowness, low energy, and low physical activity. We determined the association of FGF-23 levels with incident frailty using proportional hazards models adjusting for sociodemographics, comorbidities, and kidney function. RESULTS Sixty-five percent were HIV-infected; 29% were black. Median baseline FGF-23 levels were lower in HIV-infected vs. HIV-uninfected men (33.7 vs. 39.9 rU/mL, P = 0.006) but similar by race. During a median follow-up of 6.6 years, 32 men developed frailty; they had higher baseline FGF-23 levels vs. men who remained nonfrail (45 vs. 36 rU/mL, P = 0.02). FGF-23 (per doubling) was associated with a 1.63-fold risk of frailty [95% confidence interval (CI): 1.19 to 2.23]; results did not differ by HIV serostatus. Conversely, FGF-23 was associated with a 2.72-fold risk of frailty among blacks (95% CI: 1.51 to 4.91) but had minimal association among nonblacks (hazard ratio = 1.26, 95% CI: 0.77 to 2.05; p-interaction = 0.024). CONCLUSIONS Among men with or at-risk of HIV infection, higher FGF-23 was associated with greater risk of frailty, particularly in blacks. The mechanisms by which FGF-23 may contribute to frailty warrant further study.
Collapse
|
22
|
Krasowska K, Skrobot W, Liedtke E, Sawicki P, Flis DJ, Dzik KP, Libionka W, Kloc W, Kaczor JJ. The Preoperative Supplementation With Vitamin D Attenuated Pain Intensity and Reduced the Level of Pro-inflammatory Markers in Patients After Posterior Lumbar Interbody Fusion. Front Pharmacol 2019; 10:527. [PMID: 31191300 PMCID: PMC6539202 DOI: 10.3389/fphar.2019.00527] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/26/2019] [Indexed: 12/17/2022] Open
Abstract
The aim of this experimental study was to assess whether 5 weeks of preoperative supplementation with vitamin D affects the intensity of pain and the level of inflammatory markers in patients undergoing posterior lumbar interbody fusion (PLIF) followed by rehabilitation. 42 patients were divided, by double-blind randomization, into two groups: supplemented (SUPL) vitamin D (3200 IU dose of vitamin D/day for 5 weeks) and placebo group (PL) treated with vegetable oil. The 10-week program of early rehabilitation (3 times a week) was initiated 4 weeks following PLIF. Measurements of serum 25(OH)D3 and CRP, IL-6, TNF-α, and IL-10 were performed. Pain intensity was measured using VAS. After supplementation with vitamin D serum, the concentration of 25(OH)D3 significantly increased in the SUPL group (∗ p < 0.005) and was significantly higher as compared to the PL group (∗ p < 0.001). A significant reduction in pain intensity was observed 4 weeks after surgery and after rehabilitation in both groups. In the SUPL group, serum CRP and IL-6 concentration significantly decreased after rehabilitation, compared with the postsurgical level (a p < 0.04). The level of TNF-α was significantly lower after rehabilitation only in the supplemented group (∗ p < 0.02). There were no significant changes in the IL-10 level in both groups during the study. Our data indicate that supplementation with vitamin D may reduce systemic inflammation and when combined with surgery and early postsurgical rehabilitation, it may decrease the intensity of pain in LBP patients undergoing PLIF. Data indicate that LBP patients undergoing spine surgery should use vitamin D perioperatively as a supplement.
Collapse
Affiliation(s)
- Katarzyna Krasowska
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Wojciech Skrobot
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Ewelina Liedtke
- Department of Kinesiology, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Piotr Sawicki
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Damian Jozef Flis
- Department of Bioenergetics and Nutrition, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Katarzyna Patrycja Dzik
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Witold Libionka
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
- Department of Neurosurgery, Copernicus Hospital Gdansk, Gdańsk, Poland
| | - Wojciech Kloc
- Department of Neurosurgery, Copernicus Hospital Gdansk, Gdańsk, Poland
- Department of Neurology and Neurosurgery, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Jan Jacek Kaczor
- Department of Neurobiology of Muscle, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| |
Collapse
|
23
|
Intiso D, Fontana A, Copetti M, Di Rienzo F. Serum vitamin D deficiency in subjects with severe acquired brain injury and relationship with functional severity. Brain Inj 2018; 32:1817-1823. [PMID: 30339483 DOI: 10.1080/02699052.2018.1537512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Vitamin D may be important for the development and function of the nervous system. Low serum vitamin D levels have been detected in several neurological diseases. OBJECTIVE To ascertain the relationship between 25(OH)D serum level and disability in subjects with severe acquired brain injury (sABI). DESIGN Prospective cross-sectional study Methods: Consecutive subjects with sABI admitted to neuro-rehabilitation were enrolled. A sample of subjects from the neurological ward was considered the control group. Vitamin D serum levels and blood parameters were measured at admission. Disability Rating Scale (DRS), Glasgow Outcome Scale (GOS), and Level of Cognitive Functioning (LCF) were used in assessing disability. RESULTS A total of 104 subjects (34 F, 70 M; mean age 53.9 ± 15.2 years) were enrolled: 54 (19 F, 35 M) with sABI and 50 (15 F, 35 M) subjects as control group. Deficient mean serum levels of vitamin D (19.2 ± 9.4 ng/mL) were detected in the subjects with sABI and a significant inverse correlation between vitamin D serum levels and DRS score was detected (p = 0.04). CONCLUSION Subjects with sABI showed vitamin D deficiency that might correlate to disability severity. The reason is unclear and might represent a secondary phenomenon resulting from the inflammatory process.
Collapse
Affiliation(s)
- D Intiso
- a Unit of Neuro-rehabilitation, and Rehabilitation Medicine , IRCCS "Casa Sollievo della Sofferenza" , San Giovanni Rotondo , Foggia , Italy
| | - A Fontana
- b Unit of Biostatistics , IRCCS "Casa Sollievo della Sofferenza" , San Giovanni Rotondo , Foggia , Italy
| | - M Copetti
- b Unit of Biostatistics , IRCCS "Casa Sollievo della Sofferenza" , San Giovanni Rotondo , Foggia , Italy
| | - F Di Rienzo
- a Unit of Neuro-rehabilitation, and Rehabilitation Medicine , IRCCS "Casa Sollievo della Sofferenza" , San Giovanni Rotondo , Foggia , Italy
| |
Collapse
|
24
|
Giordano S, Proietti A, Bisaccia T, Caso P, Martocchia A, Falaschi P, Tafaro L. Hypovitaminosis D: comparison between patients with hip fracture and patients with vertebral fractures. Osteoporos Int 2018; 29:2087-2091. [PMID: 29934647 DOI: 10.1007/s00198-018-4582-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/16/2018] [Indexed: 01/04/2023]
Abstract
UNLABELLED This study analyses the difference in 25OH-vitamin D values between two groups of patients both affected by severe osteoporosis with fragility fractures, but one group has vertebral fractures and the other one has hip fractures. Patients with hip fractures have vitamin D values lower than patients with vertebral fractures. INTRODUCTION The purpose of this study was to evaluate 25OHD levels in patients with fragility vertebral fractures (VF) and hip fractures (HF) and make a comparison between the groups. METHODS In the first group were enrolled ambulatory patients with 3 or more moderate to severe VF; in the second group were enrolled patients hospitalized in the Department of Orthogeriatrics undergoing surgery for HF. For all patients, we collected values of 25OHD and PTH. The group of patients with VF was further subdivided into pre-existing VF or recent VF treated within 30 days with vertebroplasty. RESULTS The sample consists of 180 subjects divided into two groups: 90 with VF and 90 with HF. The average value of 25OHD in the total sample was 13.2 ± 9.6 ng/ml, Vitamin D was significantly lower in the HF group than the VF group (p < 0.001)(VF 18.6 ± 9.7 ng/ml, HF 7.9 ± 5.7 ng/ml). The mean PTH value in the total sample was 67.5 ± 54.9 pg/ml and PTH was significantly higher in the HF group compared to the group with VF (p < 0.001) (VF 55.6 ± 27.2 pg/ml, HF 78.7 ± 70.2 pg/ml). The mean 25OHD value in the recent VF group is 16.0 ± 6.6 ng/ml while in the pre-existing VF group is 19.5 ± 10.4 ng/ml with a statistically significant difference (p < 0.001). CONCLUSIONS Patients of the same age with severe osteoporosis have a lower 25OHD value when the fracture occur at the hip and is recent, probably this is due to the inflammation caused by fracture and/or surgical intervention.
Collapse
Affiliation(s)
- S Giordano
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy.
| | - A Proietti
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| | - T Bisaccia
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| | - P Caso
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| | - A Martocchia
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| | - P Falaschi
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| | - L Tafaro
- Sant'Andrea Hospital, Sapienza University of Rome, Via di Grottarossa, 1035, Rome, Italy
| |
Collapse
|
25
|
Autier P, Mullie P, Macacu A, Dragomir M, Boniol M, Coppens K, Pizot C, Boniol M. Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials. Lancet Diabetes Endocrinol 2017; 5:986-1004. [PMID: 29102433 DOI: 10.1016/s2213-8587(17)30357-1] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/13/2017] [Accepted: 07/18/2017] [Indexed: 02/06/2023]
Abstract
Randomised trials reported up to Dec 31, 2012, did not confirm that vitamin D supplementation could protect from non-skeletal health conditions affecting adults, as was expected on the basis of data from observational studies. To examine whether the more recently published meta-analyses and trials would change past conclusions, we systematically reviewed meta-analyses of vitamin D supplementation and non-skeletal disorders published between Jan 1, 2013, and May 31, 2017, that included study participants of all ages, including pregnant women. We also searched for randomised trials not included in meta-analyses. We identified 87 meta-analyses, of which 52 were excluded because they contained less recent literature or were of suboptimal quality. We retrieved 202 articles on trials that were not included in meta-analyses. Recent meta-analyses reinforce the finding that 10-20 μg per day of vitamin D can reduce all-cause mortality and cancer mortality in middle-aged and older people. Although vitamin D doses were greater than those assessed in the past, we found no new evidence that supplementation could have an effect on most non-skeletal conditions, including cardiovascular disease, adiposity, glucose metabolism, mood disorders, muscular function, tuberculosis, and colorectal adenomas, or on maternal and perinatal conditions. New data on cancer outcomes were scarce. The compilation of results from 83 trials showed that vitamin D supplementation had no significant effect on biomarkers of systemic inflammation. The main new finding highlighted by this systematic review is that vitamin D supplementation might help to prevent common upper respiratory tract infections and asthma exacerbations. There remains little evidence to suggest that vitamin D supplementation has an effect on most conditions, including chronic inflammation, despite use of increased doses of vitamin D, strengthening the hypothesis that low vitamin D status is a consequence of ill health, rather than its cause. We further hypothesise that vitamin D supplementation could exert immunomodulatory effects that strengthen resistance to acute infections, which would reduce the risk of death in debilitated individuals. We identified many meta-analyses of suboptimal quality, which is of concern. Future systematic reviews on vitamin D should be based on data sharing so that data for participants with the same outcomes measured in the same way can be pooled to generate stronger evidence.
Collapse
Affiliation(s)
- Philippe Autier
- International Prevention Research Institute, Lyon, France; University of Strathclyde Institute of Global Public Health at the International Prevention Research Institute, Lyon, France.
| | - Patrick Mullie
- Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Alina Macacu
- International Prevention Research Institute, Lyon, France
| | | | - Magali Boniol
- International Prevention Research Institute, Lyon, France
| | - Kim Coppens
- International Prevention Research Institute, Lyon, France
| | - Cécile Pizot
- International Prevention Research Institute, Lyon, France
| | - Mathieu Boniol
- International Prevention Research Institute, Lyon, France; University of Strathclyde Institute of Global Public Health at the International Prevention Research Institute, Lyon, France
| |
Collapse
|
26
|
VONDRA K, BÍLEK R, MATUCHA P, SALÁTOVÁ M, VOSÁTKOVÁ M, STÁRKA L, HAMPL R. Vitamin D Supplementation Changed Relationships, Not Levels of Metabolic-Hormonal Parameters in Autoimmune Thyroiditis. Physiol Res 2017; 66:S409-S417. [DOI: 10.33549/physiolres.933727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In women with chronic autoimmune thyroiditis and vitamin D deficiency we have found reference levels of relevant metabolic-hormonal parameters except for parathormone and total calcium. Three months supplementation with vitamin D (4300 IU/day, cholekalciferol) did not lead to significant changes of investigated hormonal parameters, while the levels of parathormone and calcium reached normal levels. However, a correlation analysis revealed marked changes in mutual relations. First, an inverse correlation of vitamin D with parathormone, insulin secretion (C peptide, insulin) and its efficiency (HOMA IR) disappeared. Relationships of vitamin D to hepatic insulin resistance (insulin/C peptide), to DHEA (both negative), and to DHEAS/DHEA ratio (positive) were newly found. Second, a positive correlation of CRP with insulin secretion remained, while its relation to insulin efficiency (HOMA IR, insulin/ C peptide) was newly observed. Analogical positive correlations appeared also among anti TPO and insulinemia, insulin/C peptide, HOMA IR, and anti Tg to C peptide. A relationship of the CRP with anti TPO became significant (+). Third, out of glucose metabolism parameters only insulin/C peptide and glycemia did not correlate with vitamin D during its deficiency, while after supplementation insulin/ C peptide alone correlated positively with both DHEAS and DHEA, and negatively with vitamin D.
Collapse
Affiliation(s)
- K. VONDRA
- Institute of Endocrinology, Prague, Czech Republic
| | | | | | | | | | | | | |
Collapse
|
27
|
Rosendahl J, Holmlund-Suila E, Helve O, Viljakainen H, Hauta-Alus H, Valkama S, Enlund-Cerullo M, Hytinantti T, Tervahartiala T, Sorsa T, Mäkitie O, Andersson S. 25-hydroxyvitamin D correlates with inflammatory markers in cord blood of healthy newborns. Pediatr Res 2017; 81:731-735. [PMID: 28085793 DOI: 10.1038/pr.2017.9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 12/23/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D is a potent immunomodulator and may play a role in the development of the fetal innate immune functions. The aim of our study was to evaluate inflammatory markers in cord blood of healthy newborns in relation to vitamin D status at birth. METHODS We studied the concentrations of inflammatory markers, matrix metalloproteinase 8 (MMP-8) and high sensitivity CRP (hs-CRP), and 25-hydroxyvitamin D (25(OH)D) in cord blood of 939 healthy term infants born to mothers of Caucasian origin. We evaluated perinatal factors that affect the concentrations of MMP-8 and hs-CRP, and further explored associations between cord blood 25(OH)D and these inflammatory biomarkers. RESULTS Majority (99%) of the cohort was vitamin D sufficient (>50 nmol/l or 20 ng/ml). We observed a positive correlation between cord blood 25(OH)D and MMP-8 concentrations, and between 25(OH)D and hs-CRP concentrations. After adjustment for potential confounders (parity, antenatal antibiotic treatment, gestational age, mode of delivery, and maternal prepregnancy BMI), the association of 25(OH)D with MMP-8 and hs-CRP remained significant. CONCLUSION Cord blood 25(OH)D correlates with inflammatory markers MMP-8 and hs-CRP. The findings may reflect the diverse immunomodulatory functions of vitamin D in the innate immune response of the newborn.
Collapse
Affiliation(s)
- Jenni Rosendahl
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Elisa Holmlund-Suila
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Otto Helve
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Helena Hauta-Alus
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saara Valkama
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Maria Enlund-Cerullo
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Hytinantti
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Taina Tervahartiala
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Sorsa
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Center for Molecular Medicine, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden.,Folkhälsan Research Center, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| |
Collapse
|
28
|
Vitamin D and inflammatory markers: cross-sectional analyses using data from the English Longitudinal Study of Ageing (ELSA). J Nutr Sci 2017; 6:e1. [PMID: 28620476 PMCID: PMC5465858 DOI: 10.1017/jns.2016.37] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 08/30/2016] [Indexed: 12/16/2022] Open
Abstract
Recent evidence suggests that low vitamin D concentrations are associated with increased levels of inflammatory markers. However, there are limited studies investigating associations between vitamin D levels and inflammatory markers in the general population and much of this evidence in older adults is inconclusive. Therefore, this study investigates the cross-sectional association of serum 25-hydroxyvitamin D (25(OH)D) levels with inflammatory markers in 5870 older English adults from wave 6 (2012–2013) of the English Longitudinal Study of Ageing (ELSA). ELSA is a large prospective observational study of community-dwelling people aged 50 years and over in England. Serum 25(OH)D levels, C-reactive protein (CRP) levels, plasma fibrinogen levels, white blood cell count (WBC), age, season of blood collection, waist circumference, total non-pension household wealth, measures of health and health behaviours that included depression, number of cardiovascular, non-cardiovascular conditions and difficulties in activities of daily living, smoking, and physical activity were measured. There was a significant negative association between low 25(OH)D levels (≤30 nmol/l) and CRP (OR 1·23, 95 % CI 1·00, 1·51) and WBC (OR 1·35, 95 % CI 1·13, 1·60) that remained after adjustment for a wide range of covariates of clinical significance. However, for fibrinogen, the association did not remain significant when waist circumference was entered in the final model. Our findings showed that 25(OH)D levels were associated with two out the three inflammatory markers investigated. The independent and inverse association between serum 25(OH)D levels and inflammation suggests a potential anti-inflammatory role for vitamin D in older English individuals from the general population.
Collapse
|
29
|
Anti-Inflammatory Effects of Vitamin D on Human Immune Cells in the Context of Bacterial Infection. Nutrients 2016; 8:nu8120806. [PMID: 27973447 PMCID: PMC5188461 DOI: 10.3390/nu8120806] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 11/24/2016] [Accepted: 12/07/2016] [Indexed: 12/31/2022] Open
Abstract
Vitamin D induces a diverse range of biological effects, including important functions in bone health, calcium homeostasis and, more recently, on immune function. The role of vitamin D during infection is of particular interest given data from epidemiological studies suggesting that vitamin D deficiency is associated with an increased risk of infection. Vitamin D has diverse immunomodulatory functions, although its role during bacterial infection remains unclear. In this study, we examined the effects of 1,25(OH)₂D₃, the active metabolite of vitamin D, on peripheral blood mononuclear cells (PBMCs) and purified immune cell subsets isolated from healthy adults following stimulation with the bacterial ligands heat-killed pneumococcal serotype 19F (HK19F) and lipopolysaccharide (LPS). We found that 1,25(OH)₂D₃ significantly reduced pro-inflammatory cytokines TNF-α, IFN-γ, and IL-1β as well as the chemokine IL-8 for both ligands (three- to 53-fold), while anti-inflammatory IL-10 was increased (two-fold, p = 0.016) in HK19F-stimulated monocytes. Levels of HK19F-specific IFN-γ were significantly higher (11.7-fold, p = 0.038) in vitamin D-insufficient adults (<50 nmol/L) compared to sufficient adults (>50 nmol/L). Vitamin D also shifted the pro-inflammatory/anti-inflammatory balance towards an anti-inflammatory phenotype and increased the CD14 expression on monocytes (p = 0.008) in response to LPS but not HK19F stimulation. These results suggest that 1,25(OH)₂D₃ may be an important regulator of the inflammatory response and supports further in vivo and clinical studies to confirm the potential benefits of vitamin D in this context.
Collapse
|
30
|
Aging, low-grade systemic inflammation and vitamin D: a mini-review. Eur J Clin Nutr 2016; 71:434-440. [PMID: 27677370 DOI: 10.1038/ejcn.2016.177] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 08/08/2016] [Accepted: 08/17/2016] [Indexed: 12/20/2022]
Abstract
We conducted a mini-review of the literature, focusing on aging-related systemic inflammation and its association with vitamin D (VitD). As main findings, data indicate that inflammation in aging seems to have multiple origins, including immunosenescence, and from intestinal and adipose tissue, where VitD may modulate these three factors, through mechanisms not totally known. From the selected studies, three randomized clinical trials of VitD supplementation showed improvements in inflammatory status, whereas two studies did not. Ten epidemiological studies showed associations between VitD and inflammation, whereas two studies did not. One case study reinforced this association. As such, we can assume a reasonable association between VitD and inflammation in the elderly, and a promising role of supplementation in some situations. However, most studies did not take into account environmental and individual factors such as the season of the year, latitude, skin color or even the use of some medicines; in addition, the doses, time of intervention and the sample sizes differed between the studies. In conclusion, although more controlled VitD studies, both clinical and epidemiological, are necessary, it is important to remember the network of factors involved in systemic inflammation in the elderly; an understanding of the dietetic and non-dietetic factors is needed to offer a realistic approach.
Collapse
|