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Vitamin D Levels as an Important Predictor for Type 2 Diabetes Mellitus and Weight Regain Post-Sleeve Gastrectomy. Nutrients 2022; 14:nu14102052. [PMID: 35631192 PMCID: PMC9143791 DOI: 10.3390/nu14102052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/06/2023] Open
Abstract
Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m2). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits.
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Heo JC, Kim D, An H, Son CS, Cho S, Lee JH. A Novel Biosensor and Algorithm to Predict Vitamin D Status by Measuring Skin Impedance. SENSORS (BASEL, SWITZERLAND) 2021; 21:8118. [PMID: 34884121 PMCID: PMC8662433 DOI: 10.3390/s21238118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
The deficiency and excess of vitamin D cause various diseases, necessitating continuous management; but it is not easy to accurately measure the serum vitamin D level in the body using a non-invasive method. The aim of this study is to investigate the correlation between vitamin D levels, body information obtained by an InBody scan, and blood parameters obtained during health checkups, to determine the optimum frequency of vitamin D quantification in the skin and to propose a vitamin D measurement method based on impedance. We assessed body composition, arm impedance, and blood vitamin D concentrations to determine the correlation between each element using multiple machine learning analyses and an algorithm which predicted the concentration of vitamin D in the body using the impedance value developed. Body fat percentage obtained from the InBody device and blood parameters albumin and lactate dehydrogenase correlated with vitamin D level. An impedance measurement frequency of 21.1 Hz was reflected in the blood vitamin D concentration at optimum levels, and a confidence level of about 75% for vitamin D in the body was confirmed. These data demonstrate that the concentration of vitamin D in the body can be predicted using impedance measurement values. This method can be used for predicting and monitoring vitamin D-related diseases and may be incorporated in wearable health measurement devices.
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Affiliation(s)
- Jin-Chul Heo
- Department of Biomedical Engineering, School of Medicine, Keimyung University, Daegu 42601, Korea;
| | - Doyoon Kim
- Samsung Research, Samsung Electronics, Suwon 16677, Korea; (D.K.); (H.A.)
| | - Hyunsoo An
- Samsung Research, Samsung Electronics, Suwon 16677, Korea; (D.K.); (H.A.)
| | - Chang-Sik Son
- Division of Intelligent Robot, Daegu Gyeongbuk Institute of Science and Technology, Daegu 42988, Korea;
| | - Sangwoo Cho
- The Center for Advanced Technology in Testing Human Factors, Keimyung University, Daegu 42601, Korea;
| | - Jong-Ha Lee
- Department of Biomedical Engineering, School of Medicine, Keimyung University, Daegu 42601, Korea;
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3
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Schleu MF, Barreto-Duarte B, Arriaga MB, Araujo-Pereira M, Ladeia AM, Andrade BB, Lima ML. Lower Levels of Vitamin D Are Associated with an Increase in Insulin Resistance in Obese Brazilian Women. Nutrients 2021; 13:2979. [PMID: 34578857 PMCID: PMC8471993 DOI: 10.3390/nu13092979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 12/12/2022] Open
Abstract
Adult women are more likely to be obese than men. Moreover, there is evidence that obesity is a risk factor for increased insulin resistance (IR) and hypovitaminosis D (VITD), conditions related to metabolic and endocrinologic disturbance. We performed a cross-sectional study with 103 women diagnosed with obesity, recruited between 2009 and 2013, in an obesity referral outpatient clinic in Bahia, Brazil. Laboratory and clinical characteristics were compared between the groups according to the degree of obesity (I, II and III), and levels of 25-hydroxyvitamin D [25(OH)D] were used to define the VITD status (insufficiency and no insufficiency). We calculated the homeostatic model assessment-IR (HOMA-IR) index to assess insulin resistance in the groups. Our analyses revealed that HOMA-IR values and VITD levels were inversely correlated. Furthermore, we observed a distinct expression profile of values of laboratory markers according to 25(OH)D levels. Negative correlations were found between HOMA-IR and body mass index (BMI) in VITD insufficient participants but not in those with the sufficiency. Furthermore, multivariate regression demonstrated independent associations between lower levels of 25(OH)D and increased values of HOMA-IR. These findings suggests that lower levels of VITD are strongly associated with the increased IR in obese women.
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Affiliation(s)
- Minna F. Schleu
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador 40290-000, Brazil; (M.F.S.); (A.M.L.); (M.L.L.)
| | - Beatriz Barreto-Duarte
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (B.B.-D.); (M.B.A.); (M.A.-P.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador 41720-200, Brazil
- Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-617, Brazil
| | - Maria B. Arriaga
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (B.B.-D.); (M.B.A.); (M.A.-P.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40110-100, Brazil
| | - Mariana Araujo-Pereira
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (B.B.-D.); (M.B.A.); (M.A.-P.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40110-100, Brazil
| | - Ana Marice Ladeia
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador 40290-000, Brazil; (M.F.S.); (A.M.L.); (M.L.L.)
| | - Bruno B. Andrade
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador 40290-000, Brazil; (M.F.S.); (A.M.L.); (M.L.L.)
- Laboratório de Inflamação e Biomarcadores, Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Salvador 40296-710, Brazil; (B.B.-D.); (M.B.A.); (M.A.-P.)
- Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative, Salvador 41810-710, Brazil
- Curso de Medicina, Universidade Salvador (UNIFACS), Laureate Universities, Salvador 41720-200, Brazil
- Programa de Pós-Graduação em Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-617, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador 40110-100, Brazil
| | - Maria L. Lima
- Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública (EBMSP), Salvador 40290-000, Brazil; (M.F.S.); (A.M.L.); (M.L.L.)
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4
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Garcia Carretero R, Vigil-Medina L, Barquero-Perez O, Mora-Jimenez I, Soguero-Ruiz C, Ramos-Lopez J. Machine learning approaches to constructing predictive models of vitamin D deficiency in a hypertensive population: a comparative study. Inform Health Soc Care 2021; 46:355-369. [PMID: 33792475 DOI: 10.1080/17538157.2021.1896524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: Given the association between vitamin D deficiency and risk for cardiovascular disease, we used machine learning approaches to establish a model to predict the probability of deficiency. Determination of serum levels of 25-hydroxy vitamin D (25(OH)D) provided the best assessment of vitamin D status, but such tests are not always widely available or feasible. Thus, our study established predictive models with high sensitivity to identify patients either unlikely to have vitamin D deficiency or who should undergo 25(OH)D testing.Methods: We collected data from 1002 hypertensive patients from a Spanish university hospital. The elastic net regularization approach was applied to reduce the dimensionality of the dataset. The issue of determining vitamin D status was addressed as a classification problem; thus, the following classifiers were applied: logistic regression, support vector machine (SVM), random forest, naive Bayes, and Extreme Gradient Boost methods. Classification accuracy, sensitivity, specificity, and predictive values were computed to assess the performance of each method.Results: The SVM-based method with radial kernel performed better than the other algorithms in terms of sensitivity (98%), negative predictive value (71%), and classification accuracy (73%).Conclusion: The combination of a feature-selection method such as elastic net regularization and a classification approach produced well-fitted models. The SVM approach yielded better predictions than the other algorithms. This combination approach allowed us to develop a predictive model with high sensitivity but low specificity, to identify the population that could benefit from laboratory determination of serum levels of 25(OH)D.
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Affiliation(s)
- Rafael Garcia Carretero
- Department of Internal Medicine, Mostoles University Hospital, Rey Juan Carlos University, Madrid, Spain
| | - Luis Vigil-Medina
- Department of Internal Medicine, Mostoles University Hospital, Fuenlabrada, Spain
| | - Oscar Barquero-Perez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Inmaculada Mora-Jimenez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Cristina Soguero-Ruiz
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
| | - Javier Ramos-Lopez
- Department of Signal Theory and Communications and Telematics Systems and Computing, Rey Juan Carlos University, Spain
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Melguizo-Rodríguez L, Costela-Ruiz VJ, García-Recio E, De Luna-Bertos E, Ruiz C, Illescas-Montes R. Role of Vitamin D in the Metabolic Syndrome. Nutrients 2021; 13:830. [PMID: 33802330 PMCID: PMC7999005 DOI: 10.3390/nu13030830] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of hypovitaminosis D has risen in developed countries over the past few years in association with lifestyle changes and an increase in unhealthy habits. Vitamin D deficiency has been implicated in various diseases, including metabolic syndrome (MetS), which is clinically defined by a set of metabolic and vascular disorders. The objective of this study was to review scientific evidence on the relationship between MetS and vitamin D deficiency to support the development of prevention strategies and health education programs. An inverse relationship has been reported between plasma vitamin D concentrations and the features that define MetS, i.e., elevated serum concentrations of glucose, total cholesterol, low-density lipoproteins, triglycerides, glycosylated hemoglobin, and a high body mass index. Numerous studies have described the benefits of vitamin D supplementation to improve outcomes in individuals with MetS. Interventions to maintain optimal vitamin D concentrations are proposed as a preventive strategy against MetS.
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Affiliation(s)
- Lucía Melguizo-Rodríguez
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
| | - Víctor J. Costela-Ruiz
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
| | - Enrique García-Recio
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
| | - Elvira De Luna-Bertos
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
| | - Concepción Ruiz
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
- Institute of Neuroscience, University of Granada, 18016 Granada, Spain
| | - Rebeca Illescas-Montes
- Biomedical Group (BIO277), Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain; (L.M.-R.); (V.J.C.-R.); (E.G.-R.); (E.D.L.-B.); (R.I.-M.)
- Instituto Investigación Biosanitaria, ibs.Granada, 18012 Granada, Spain
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Rodríguez-Martín S, González-Bermejo D, Rodríguez-Miguel A, Barreira D, García-Lledó A, Gil M, de Abajo FJ. Risk of Myocardial Infarction Among New Users of Calcium Supplements Alone or Combined With Vitamin D: A Population-Based Case-Control Study. Clin Pharmacol Ther 2019; 107:359-368. [PMID: 31560413 PMCID: PMC7006888 DOI: 10.1002/cpt.1636] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 09/12/2019] [Indexed: 12/13/2022]
Abstract
A population‐based case‐control study was conducted to evaluate the risk of acute myocardial infarction among new users of calcium supplements either in monotherapy (CaM) or in combination with vitamin D (CaD). A total of 23,025 cases and 114,851 controls randomly sampled from the underlying cohort and matched with cases by age, sex, and index date were included. New users of CaM and CaD were categorized as current users, recent users, past users, and nonusers. We computed adjusted odds ratios (AORs) and their 95% confidence intervals (CIs) among current users as compared with nonusers through a conditional logistic regression. No increased risk was associated with CaM overall (59 cases (0.26%) and 273 controls (0.24%); AOR = 0.80; 95% CI 0.59–1.09), nor was it found in any of the conditions examined. Instead, the use of CaD was associated with a decreased risk (275 cases (1.19%) and 1,160 controls (1.45%); AOR = 0.78; 95% CI 0.67–0.90), dose and duration‐dependent, and particularly evident in patients with a high cardiovascular risk (AOR = 0.59; 95% CI 0.43–0.81).
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Affiliation(s)
- Sara Rodríguez-Martín
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Department of Biomedical Sciences (Pharmacology Sector), University of Alcalá, Alcalá de Henares, Madrid, Spain.,Pharmacoepidemiology Research Group, Institute for Health Research IRYCIS, Madrid, Spain
| | - Diana González-Bermejo
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain
| | - Antonio Rodríguez-Miguel
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Department of Biomedical Sciences (Pharmacology Sector), University of Alcalá, Alcalá de Henares, Madrid, Spain.,Pharmacoepidemiology Research Group, Institute for Health Research IRYCIS, Madrid, Spain
| | - Diana Barreira
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Department of Biomedical Sciences (Pharmacology Sector), University of Alcalá, Alcalá de Henares, Madrid, Spain.,Pharmacoepidemiology Research Group, Institute for Health Research IRYCIS, Madrid, Spain
| | - Alberto García-Lledó
- Cardiology Department, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Department of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Miguel Gil
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain
| | - Francisco J de Abajo
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.,Department of Biomedical Sciences (Pharmacology Sector), University of Alcalá, Alcalá de Henares, Madrid, Spain.,Pharmacoepidemiology Research Group, Institute for Health Research IRYCIS, Madrid, Spain
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Fajardo VC, de Oliveira FLP, Machado-Coelho GLL, Pimenta FAP, de Freitas SN, Ribeiro ALP, Soares MMS, Lauria MW, Farias RDC, França IB, do Nascimento Neto RM. Effects of vitamin D supplementation on cardiovascular risk factors in shift workers: Study protocol for randomized, double-blind, placebo-controlled clinical trial. Medicine (Baltimore) 2019; 98:e15417. [PMID: 31045798 PMCID: PMC6504534 DOI: 10.1097/md.0000000000015417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The present clinical study aims to describe protocol to evaluate the effects of vitamin D3 supplementation on the cardiovascular risk factors in a population of rotating shift workers. DESIGN A randomized, double-blind, placebo-controlled, parallel group clinical trial testing 2 oral dosages of cholecalciferol (14,000 IU and 28,000 IU per week) for 12 months. SETTING The primary outcome for evaluation is an 18% reduction in hypertriglyceridemia (≥150 mg/dL) between pre and postintervention measurements. Baseline characteristics of the study population will be summarized separately within each randomized group, and will use tests for continuous and categorical variables. For all tests, a P < .05 will be considered significant. The analysis of primary and secondary outcomes will use an intention-to-treat population and a per-protocol population. The primary and secondary outcomes will be compared separately between each treatment group and placebo, using binary logistic regression or regressão de Poisson for proportions (for binary outcomes) and using linear regression for differences in means (for continuous endpoints), with 95% confidence intervals. PARTICIPANTS Rotating shift workers, adults aged between 18 and 60 years, with hypovitaminosis D and alterations in at least 1 of the following parameters: fasting glucose, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, blood pressure, and waist circumference. CONCLUSION This clinical trial aims to contribute to the gap in knowledge about the potential, dose, and time of vitamin D supplementation to generate beneficial effects on triglycerides in a population at increased risk for hypertriglyceridemia and vitamin D deficiency.
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Affiliation(s)
- Virginia Capistrano Fajardo
- Applied Science to Adult Health Postgraduate Program, School of Medicine, Federal University of Minas Gerais, Belo Horizonte
| | | | | | | | | | | | | | - Marcio Weissheimer Lauria
- Department of Clinical Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte
| | - Rosielle da Costa Farias
- Applied Statistics and Biometrics Postgraduate Program, Department of Statistics, Federal University of Viçosa, Viçosa, MG
| | - Ive Bahia França
- School of Medicine, University Center of Espirito Santo. Colatina, ES, Brazil
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de Abajo FJ, Rodríguez-Martín S, Rodríguez-Miguel A, Gil MJ. Risk of Ischemic Stroke Associated With Calcium Supplements With or Without Vitamin D: A Nested Case-Control Study. J Am Heart Assoc 2017; 6:e005795. [PMID: 28522672 PMCID: PMC5524112 DOI: 10.1161/jaha.117.005795] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/05/2017] [Indexed: 01/28/2023]
Abstract
BACKGROUND There is controversy surrounding the risk of ischemic stroke associated with the use of calcium supplements either in monotherapy or in combination with vitamin D. METHODS AND RESULTS A nested case-control study was performed with patients aged 40 to 89 years old, among whom a total of 2690 patients had a first episode of nonfatal ischemic stroke and for which 19 538 controls were randomly selected from the source population and frequency-matched with cases for age, sex, and calendar year. Logistic regression provided the odds ratios while adjusting for confounding factors. A sensitivity analysis was performed by restricting to patients who were new users of calcium supplements as either monotherapy or with vitamin D. Calcium supplementation with vitamin D was not associated with an increased risk of ischemic stroke (odds ratio 0.85; 95% confidence interval, 0.67-1.08) in the population as a whole or under any of the conditions examined (dose, duration, background cardiovascular risk, sex, or age). Calcium supplement monotherapy was not associated with an increased risk in the population as a whole (odds ratio 1.18; 95% confidence interval, 0.86-1.61), although a significant increased risk at high doses (≥1000 mg/day: odds ratio 2.09; 95% confidence interval, 1.25-3.49; <1000 mg: odds ratio 0.76; 95% confidence interval, 0.45-1.26) compared with nonuse was observed. The sensitivity analysis did not affect the inferences, with similar results observed among new users as to the overall study population. CONCLUSIONS This study suggests that calcium supplements given as monotherapy at high doses may increase the risk of ischemic stroke, whereas their combination with vitamin D seems to offset this hazard.
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Affiliation(s)
- Francisco J de Abajo
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares Madrid, Spain
- Departament of Biomedical Sciences (Pharmacology Sector), University of Alcalá, Alcalá de Henares Madrid, Spain
| | - Sara Rodríguez-Martín
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares Madrid, Spain
| | - Antonio Rodríguez-Miguel
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares Madrid, Spain
| | - Miguel J Gil
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain
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9
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The associations of vitamin D status and dietary calcium with the metabolic syndrome: an analysis of the Victorian Health Monitor survey. Public Health Nutr 2016; 20:1785-1796. [PMID: 27339376 DOI: 10.1017/s1368980016001609] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To examine the associations between serum 25-hydroxyvitamin D (25(OH)D), dietary Ca intake and presence of the metabolic syndrome (MetS). DESIGN A stratified cluster sample of a population aged 18-75 years from the Victorian Health Monitor survey. SETTING Non-institutionalized adults living in private dwellings in Victoria, Australia. SUBJECTS Adults (n 3404) with complete data and without type 1 or type 2 diabetes. RESULTS Adjusted for sociodemographic factors, physical characteristics and dietary covariates including Ca intake, every 10 nmol/l increase in serum 25(OH)D was significantly associated with decreased odds of MetS (adjusted odds ratio (AOR)=0·85, 95 % CI 0·80, 0·89; P<0·001). Relative to the low 25(OH)D tertile (median 33 nmol/l), there was a progressive decrease in odds of MetS that reached significance with the high 25(OH)D tertile (median 77 nmol/l; AOR=0·35, 95 % CI 0·26, 0·48; P<0·001). Every 500 mg/d increase in Ca intake adjusted for 25(OH)D did not reduce odds of MetS (AOR=0·81, 95 % CI 0·66, 1·06; P=0·141) but approached significance if unadjusted for 25(OH)D in the final model (AOR=0·81, 95 % CI 0·64, 1·02; P=0·073). No significant effect was obtained for tertiles of Ca intake. However, Ca and vitamin D tertile combinations suggested a beneficial effect of high Ca (median 1233 mg/d) only at low and medium 25(OH)D. The high 25(OH)D tertile was associated with significantly decreased odds of MetS regardless of Ca intake. CONCLUSIONS A high vitamin D status significantly reduced the odds of MetS. A high Ca intake may have a similar favourable outcome but only at lower circulating concentrations of 25(OH)D.
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