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Hajhashemy Z, Ziaei R, Askari G, Saneei P. Serum 25-Hydroxyvitamin D Is Associated With Prediabetes, Type 2 Diabetes Mellitus, and Insulin Resistance in Children: A Systematic Review and Dose-Response Meta-analysis of Epidemiologic Studies. Nutr Rev 2024:nuae060. [PMID: 38894627 DOI: 10.1093/nutrit/nuae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CONTEXT Although several investigations have been conducted on the association between serum vitamin D levels and prediabetes and type 2 diabetes mellitus (T2DM) in children and adolescents, their findings are inconsistent. OBJECTIVE We conducted a systematic review and dose-response meta-analysis to summarize this subject. DATA SOURCES The electronic databases of ISI Web of Science, Scopus, PubMed, and motor engineering of Google Scholar were comprehensively searched up to May 2023. DATA EXTRACTION Epidemiologic studies that investigated the risk of hyperglycemia and insulin resistance in relation to serum 25-hydroxy vitamin D levels in children and adolescents were included. DATA ANALYSIS Twenty-two investigations, with a total of 38 622 participants, were systematically reviewed. Meta-analysis of 15 studies (n = 32 720 participants) showed that participants with the highest serum vitamin D levels had 42% lower risk of hyperglycemia, compared with those in the lowest category of serum vitamin D levels (relative risk [RR] = 0.58; 95%CI, 0.48, 0.71). Moreover, pooling 8 studies (n = 10 465 participants) illustrated that highest serum vitamin D level was associated with a 44% lower risk of insulin resistance compared with the lowest serum vitamin D level (RR = 0.56; 95%CI, 0.37, 0.83). Based on linear dose-response analysis, each 10 nmol/L increment in serum 25-hydroxy vitamin D was associated with a 6% decreased risk of hyperglycemia and insulin resistance in children. Furthermore, nonlinear dose-response analysis revealed that increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in risk of hyperglycemia and insulin resistance. CONCLUSION This meta-analysis revealed inverse associations between serum vitamin D levels and hyperglycemia and insulin resistance in children and adolescents, in a dose-response manner. Increasing serum vitamin D concentration from 40 nmol/L to sufficient values (>50 nmol/L) was associated with a decreasing trend in hyperglycemia and insulin resistance risk. Systematic Review Registration: PROSPERO registration no. CRD42023458155.
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Affiliation(s)
- Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Rahele Ziaei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, Iran
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Hajhashemy Z, Tirani SA, Askari G, Saneei P. The association between serum vitamin D levels and abnormal lipid profile in pediatrics: A GRADE-assessed systematic review and dose-response meta-analysis of epidemiologic studies. Nutr Rev 2024:nuae020. [PMID: 38568958 DOI: 10.1093/nutrit/nuae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
CONTEXT Several studies have investigated the relationship between serum vitamin D and dyslipidemia in children and adolescents, but the findings have been contradictory. OBJECTIVE The current systematic review and dose-response meta-analysis investigated the serum vitamin D - dyslipidemia relationship in children and adolescents. DATA SOURCES ISI Web of Science, Scopus, MEDLINE (PubMed), EMBASE databases, and Google Scholar, were searched up to December 2022. DATA EXTRACTION Observational studies that investigated the odds of dyslipidemia in categories of serum vitamin D levels in children were included, and their data were extracted. DATA ANALYSIS Pooling of 17 effect sizes from 15 studies (39 342 participants) showed that subjects with higher serum vitamin D had 27% lower odds of hypertriglyceridemia (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.60, 0.88). A meta-analysis of 18 effect sizes from 16 studies (39 718 participants) illustrated that highest vs lowest serum vitamin D was related to 22% lower odds of low high-density lipoprotein cholesterol (HDL-c) (OR = 0.78; 95% CI: 0.66, 0.91). Also, a nonlinear association between serum vitamin D and odds of abnormal lipid profile was found: elevating values of 25-hydroxyvitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in odds of hypertriglyceridemia, hyper low-density lipoprotein cholesterolemia, hypercholesterolemia, and hypo HDL-cholesterolemia. However, no significant linear association was observed. Based on the Grading of Recommendations, Assessment, Development and Evaluations (GRADE), the certainty of all evidence was rated as high. CONCLUSION This meta-analysis revealed that the level of 25-hydroxyvitamin D was inversely related to odds of abnormal serum triglycerides and HDL-c in children and adolescents. Increasing serum vitamin D from 35 nmol/L to 55 nmol/L was associated with a decreasing trend in the odds of abnormal serum triglycerides, HDL-c, low-density lipoprotein cholesterol, and total cholesterol in children. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. 42023400787.
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Affiliation(s)
- Zahra Hajhashemy
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Amani Tirani
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Daniel JB, de Farias Costa PR, Pereira M, Oliveira AM. Vitamin D deficiency and cardiometabolic risk factors in adolescents: systematic review and meta-analysis. Rev Endocr Metab Disord 2022; 23:995-1010. [PMID: 35713809 DOI: 10.1007/s11154-022-09736-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 10/18/2022]
Abstract
Vitamin D deficiency is associated with an increase in the occurrence of cardiometabolic events, but the evidence of this relationship in adolescence is still limited. Thus, we analyzed the association between vitamin D deficiency and cardiometabolic risk factors in adolescents. Observational studies were searching in PubMed/Medline, Embase, Scopus, Web of Science, Science Direct, Lilacs, and Google Scholar database. Random effects models were used to summarize standardized mean differences for as a summary measure. The certainty of the evidence was verified using the Cochrane recommendations. A total of 7537 studies were identified, of which 32 were included in the systematic review and 24 in the meta-analysis.Vitamin D deficiency was associated with increased systolic pressure (SMD = 0.22; 95%CI = 0.10; 0.34), diastolic pressure (SMD = 0.23; 95%CI = 0.10; 0.35), glycemia (SMD = 0.13; 95%CI = 0.05; 0.12), and insulin (SMD = 0.50; 95%CI = 0.15; 0.84), an increase in the HOMA index (SMD = 0.48; 95%CI = 0.36; 0.60), high triglyceride values (SMD = 0.30; 95%CI = 0.11; 0.49), and reduced HDL concentrations (SMD= -0.25; 95%CI = -0.46; -0.04). No statistically significant association was observed for glycated hemoglobin, LDL cholesterol, and total cholesterol. Most of the studies presented low and moderate risks of bias, respectively. The certainty of the evidence was very low for all the outcomes analyzed. Vitamin D deficiency was associated with increased exposure to the factors linked to the occurrence of cardiometabolic diseases in adolescents. Systematic Review Registration: PROSPERO (record number 42,018,086,298).
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Affiliation(s)
- Jonas Baltazar Daniel
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil
| | | | - Marcos Pereira
- Institute of Collective Health, Federal University of Bahia, Rua Basílio da Gama, s/n, 40110-040, Salvador, Bahia, Brazil.
- Institute of Collective Health, Federal University of Bahia, R. Basílio da Gama, s/n - Canela, 40110-040, Salvador, Bahia, Brazil.
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Hajhashemy Z, Lotfi K, Heidari Z, Saneei P. Serum Vitamin D Levels in Relation to Abdominal Obesity in Children and Adolescents: A Systematic Review and Dose-Response Meta-Analysis. Front Nutr 2022; 9:806459. [PMID: 35252295 PMCID: PMC8888413 DOI: 10.3389/fnut.2022.806459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 01/12/2022] [Indexed: 11/28/2022] Open
Abstract
Background Findings of epidemiological studies that investigated the relationship between serum vitamin D levels and abdominal obesity were inconsistent. To evaluate the relationship between blood vitamin D levels and abdominal obesity in children and adolescents, we did a comprehensive review and dose-response meta-analysis. Methods A comprehensive search in electronic databases including Scopus, Web of Science (ISI), MEDLINE (Pubmed), EMBASE, and Google Scholar was conducted, up to May 2021, for epidemiological studies that investigated the linkage between serum vitamin D levels (as the exposure) and abdominal obesity (as the outcome) in children and adolescents. Results Combining 19 effect sizes from 14 cross-sectional studies that included 29,353 apparently healthy children illustrated that the highest vs. lowest level of serum vitamin D was related to a 35% reduced odds of abdominal obesity [odds ratio (OR): 0.65; 95% CI: 0.50, 0.84]. Linear dose-response analysis revealed that each 10 ng/ml increase in serum vitamin D levels was related to a 7% decrease in odds of abdominal obesity (OR: 0.93; 95% CI: 0.90, 0.95), only among investigations that used percentiles of waist circumference (>75th or 90th) to define the disorder (including 6,868 total subjects and 1,075 cases with abdominal obesity). Increasing serum vitamin D levels from 20 to 40 ng/ml was related to reduce odds of abdominal obesity in children. Conclusion A negative relationship between blood vitamin D levels and abdominal obesity in children and adolescents was discovered in this meta-analysis of epidemiologic studies. Among investigations that used waist circumference percentiles to define the disorder, the relationship was in a dose-response manner. To affirm this relationship, more research studies are needed, particularly using a prospective design. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021261319, PROSPERO 2021, identifier: CRD42021261319.
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Affiliation(s)
- Zahra Hajhashemy
- Students' Scientific Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Heidari
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- *Correspondence: Parvane Saneei ;
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Rouhani P, Hajhashemy Z, Saneei P. Circulating serum vitamin D levels in relation to metabolic syndrome in children: A systematic review and dose-response meta-analysis of epidemiologic studies. Obes Rev 2021; 22:e13314. [PMID: 34231300 DOI: 10.1111/obr.13314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/28/2021] [Accepted: 06/07/2021] [Indexed: 01/08/2023]
Abstract
Findings from epidemiologic studies that evaluated the relationship between serum vitamin D levels and metabolic syndrome (MetS) in children were contradictory. We conducted a systematic review and meta-analysis on the relation of serum 25(OH)D levels and MetS in children. A comprehensive search was conducted in electronic databases, up to November 2020. Eleven cross-sectional studies that reported the link between circulating vitamin D levels and MetS in children were included in the analysis. Combining 11 effect sizes from 11 cross-sectional studies with 22,196 participants revealed that highest versus lowest serum vitamin D concentration was significantly associated with a 50% reduced odds of MetS in children (OR: 0.50; 95%CI: 0.39, 0.64). Subgroup analysis by study location revealed decreased odds of MetS in both non-Asian (OR: 0.45; 95%CI: 0.33, 0.63) and Asian countries (OR: 0.54; 95%CI: 0.39, 0.76) with no heterogeneity in these subgroups. When we confined the studies to those with representative populations (n = 21,611), a significant inverse association was found between highest versus lowest circulating vitamin D level and MetS (OR: 0.55; 95%CI: 0.42, 0.71). Dose-response analysis showed that each 10 ng/ml (or 25 nmol/L) in serum vitamin D was linearly related to a 12% reduced odds of MetS (OR: 0.88; 95%CI: 0.78, 0.99) in children. A nonlinear association was also detected between serum 25(OH)D and MetS. This meta-analysis revealed that circulating vitamin D concentration was inversely associated with odds of MetS in children, in a dose-response fashion. The same finding was found in the studies with representative populations.
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Affiliation(s)
- Parisa Rouhani
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Abboud M, Al Anouti F, Papandreou D, Rizk R, Mahboub N, Haidar S. Vitamin D status and blood pressure in children and adolescents: a systematic review of observational studies. Syst Rev 2021; 10:60. [PMID: 33618764 PMCID: PMC7898425 DOI: 10.1186/s13643-021-01584-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Childhood hypertension is a growing public health problem. Simultaneously, hypovitaminosis D is widespread in this population and could be associated with hypertension. This study systematically reviewed the literature on the relationship between vitamin D status and blood pressure (BP) in children and adolescents. METHODS Following the PRISMA guidelines, PUBMED, MEDLINE, CINAHL, EMBASE, Cochrane Library, and ClinicalTrials.gov and the gray literature without language or time restrictions were searched. We included observational studies, assessed their risk of bias, and extracted data on population characteristics, vitamin D status and BP measurements, and the association between the two variables. A narrative analysis of the studies was performed. RESULTS In total, 85 studies were included. Prospective cohort studies showed no association between vitamin D and BP, and generally, they were flawed. Also, the majority of non-prospective cohort studies (cross-sectional, retrospective, case-control) did not report an association between vitamin D and BP. They were mostly flawed regarding BP measurement and adjusting to potential confounders. CONCLUSION The results on the relationship between vitamin D status and BP in children and adolescents varied between the studies, and mainly pointed towards lack of association.
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Affiliation(s)
- Myriam Abboud
- Department of Health, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Fatme Al Anouti
- Department of Health, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Dimitrios Papandreou
- Department of Health, College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | - Rana Rizk
- Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie (INSPECT-Lb), Beirut, Lebanon
| | - Nadine Mahboub
- Lebanese International University, Beirut, Lebanon
- Maastricht University, Maastricht, The Netherlands
| | - Suzan Haidar
- Lebanese International University, Beirut, Lebanon
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Meng H, Matthan NR, Angellotti E, Pittas AG, Lichtenstein AH. Exploring the effect of vitamin D3 supplementation on surrogate biomarkers of cholesterol absorption and endogenous synthesis in patients with type 2 diabetes-randomized controlled trial. Am J Clin Nutr 2020; 112:538-547. [PMID: 32559272 PMCID: PMC7458767 DOI: 10.1093/ajcn/nqaa149] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 05/20/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Inverse associations have been reported between serum 25-hydroxyvitamin D [25(OH)D] and circulating cholesterol concentrations in observational studies. Postulated mechanisms include reduced bioavailability of intestinal cholesterol and alterations in endogenous cholesterol synthesis. OBJECTIVE To explore the effect of daily supplementation with 4000 IU/d vitamin D3 for 24 wk on surrogate biomarkers of cholesterol absorption (campesterol and β-sitosterol) and endogenous synthesis (lathosterol and desmosterol). METHODS Ancillary study of The Vitamin D for Established Type 2 Diabetes (DDM2) trial. Patients with established type 2 diabetes (N = 127, 25-75 y, BMI 23-42 kg/m2) were randomly assigned to receive either 4000 IU vitamin D3 or placebo daily for 24 wk. Of participants without changes in cholesterol-lowering medications (n = 114), plasma surrogate cholesterol absorption and endogenous synthesis biomarker concentrations were measured and merged with available measures of serum LDL cholesterol and HDL cholesterol concentrations. RESULTS At week 24, vitamin D3 supplementation significantly increased 25(OH)D concentrations (+21.5 ± 13.4 ng/mL) but not insulin secretion rates (primary outcome of the parent study) as reported previously. In this ancillary study there was no significant effect of vitamin D3 supplementation on serum cholesterol profile or surrogate biomarkers of cholesterol absorption and endogenous synthesis. Compared with participants not treated with cholesterol-lowering medications, those who were treated exhibited a greater reduction in plasma campesterol concentrations in the vitamin D3 but not placebo group (P-interaction = 0.011). Analyzing the data on the basis of cholesterol absorption status (hypo- versus hyperabsorbers) or cholesterol synthesis status (hypo- versus hypersynthesizers) did not alter these results. CONCLUSIONS Vitamin D3 supplementation for 24 wk had no significant effect on surrogate biomarkers of cholesterol absorption or endogenous synthesis, consistent with the lack of effect on serum cholesterol profile. Vitamin D3 supplementation resulted in greater reduction in campesterol concentrations in participants not using compared with those using cholesterol-lowering medications. Further studies are required.This trial was registered at clinicaltrials.gov as NCT01736865.
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Affiliation(s)
- Huicui Meng
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nirupa R Matthan
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Edith Angellotti
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Tang Z, Huang S, Ma R, Zheng H, Zhu Y. Low vitamin D status is associated with obesity but no other cardiovascular risk factors in Chinese children and adolescents. Nutr Metab Cardiovasc Dis 2020; 30:1573-1581. [PMID: 32605882 DOI: 10.1016/j.numecd.2020.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 05/14/2020] [Accepted: 05/20/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Evidence on relationship between vitamin D status and cardiovascular health in childhood remains inconsistent. This study aimed to investigate vitamin D status and its relationship with cardiovascular risk factors in Chinese children and adolescents. METHODS AND RESULTS Cross-sectional data were obtained from 2680 children and adolescents aged 7-18 y in Guangzhou, South China. Anthropometric and socioeconomic characters, concentration of serum 25-hydroxyvitamin D [25(OH)D], fasting blood glucose and lipids, as well as information about diet and physical activity were measured and collected. Logistic regression model was adopted to analyze the associations between 25(OH)D levels and cardiovascular risk factors including obesity, high blood pressure, dyslipidemia, hyperglycemia, and metabolic syndrome. Overall, median level of 25(OH)D was 19.74 ng/mL. The prevalence rates of vitamin D deficiency and inadequacy were 7.5% and 44.4%, both of which were highest among adolescents aged 14-18 y (14.5% and 51.6%, respectively). As vitamin D level increased, an upward trend in fasting glucose concentrations was observed in subjects with normal fasting glucose level, but not in subjects with hyperglycemia. Among the assessed cardiovascular risk factors, vitamin D status was only inversely associated with general obesity, and the adjusted odds ratio was 1.95 (95% CI: 1.08-3.49), comparing the lowest 25(OH)D quartile with the highest one. CONCLUSIONS Vitamin D deficiency and inadequacy remain a concern among school-aged children and adolescents in Guangzhou, South China, particularly in adolescents aged 14-18 y. However, low vitamin D status was found only associated with general obesity but no other cardiovascular risk factors.
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Affiliation(s)
- Zhaoxie Tang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Saijun Huang
- Department of Child Health, Foshan Maternal and Child Health Hospital, Foshan, 528000, Guangdong Province, China
| | - Rui Ma
- Department of Child Health, Shenzhen Nanshan Maternal and Child Health Care Hospital, Shenzhen, 518067, Guangdong Province, China
| | - Hao Zheng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China
| | - Yanna Zhu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, Guangdong Province, China; Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
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Craveiro V, Cabral M, Araújo J, Falcão H, Guimarães JT, Ramos E. Association of Serum 25-Hydroxyvitamin D Concentration with Pulmonary Function in Young Adults. Nutrients 2018; 10:nu10111728. [PMID: 30423859 PMCID: PMC6266201 DOI: 10.3390/nu10111728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/06/2018] [Accepted: 11/09/2018] [Indexed: 02/06/2023] Open
Abstract
The role of vitamin D on pulmonary function is unclear and is mostly studied in patients, smokers and elderly people. The aim of this paper was to evaluate the association between serum 25-hydroxyvitamin D [25(OH)D] concentration and pulmonary function in young adults. Cross-sectional analysis of 499 individuals that were evaluated at 21 years of age as part of the population-based cohort Epidemiological Health Investigation of Teenagers in Porto (EPITeen). Serum 25(OH)D was categorized according to the Institute of Medicine. Pulmonary function was evaluated using spirometry. Linear regression models were used to estimate the regression coefficients (β) and its 95% confidence intervals (95% CI), and were adjusted for confounders. Education, smoking, body mass index, and season of evaluation were determinants of serum 25(OH)D concentration. Prevalence of serum 25(OH)D concentration <50 nmol/L was 48.9%. A decrease in all pulmonary function parameters, with the decrease of serum 25(OH)D, was observed. The higher effect was found for peak expiratory flow (PEF). Having as reference participants with serum 25(OH)D concentration ≥50 nmol/L, PEF was significantly lower for those with a concentration of 30 to <50 nmol/L (β= −0.576; 95% CI: −0.943, −0.210), and for those with a concentration of <30 nmol/L (β= −0.650; 95% CI: −1.155, −0.146). Although only PEF attained statistical significance, the consistent results with the other parameters support the role of serum 25(OH)D to promote better pulmonary function in young adults.
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Affiliation(s)
- Vanda Craveiro
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
| | - Maria Cabral
- Unidade de Epidemiologia-Departamento de Ciências da Saúde Pública e Forenses e Educação Médica da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
| | - Joana Araújo
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
| | - Helena Falcão
- Serviço de Imunoalergologia do Centro Hospitalar do Porto, E.P.E., 4099-001 Porto, Portugal.
| | - João Tiago Guimarães
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
- Serviço de Patologia Clínica do Centro Hospitalar de São João, E.P.E., 4200-319 Porto, Portugal.
- Departamento de Biomedicina da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
| | - Elisabete Ramos
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, nº 135, 4050-600 Porto, Portugal.
- Unidade de Epidemiologia-Departamento de Ciências da Saúde Pública e Forenses e Educação Médica da Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal.
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Smith TJ, Tripkovic L, Hauger H, Damsgaard CT, Mølgaard C, Lanham-New SA, Hart KH. Winter Cholecalciferol Supplementation at 51°N Has No Effect on Markers of Cardiometabolic Risk in Healthy Adolescents Aged 14-18 Years. J Nutr 2018; 148:1269-1275. [PMID: 29920594 DOI: 10.1093/jn/nxy079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/26/2018] [Indexed: 12/29/2022] Open
Abstract
Background Epidemiologic studies have supported inverse associations between low serum 25-hydroxyvitamin D [25(OH)D] and cardiometabolic risk markers, but few randomized trials have investigated the effect of vitamin D supplementation on these markers in adolescents. Objective The objective of this study was to investigate the effect of winter-time cholecalciferol (vitamin D3) supplementation on cardiometabolic risk markers in white, healthy 14- to 18-y-old adolescents in the UK (51°N) as part of the ODIN Project. Methods In a dose-response trial, 110 adolescents (mean ± SD age: 15.9 ± 1.4 y; 43% male; 81% normal weight) were randomly assigned to receive 0, 10 or 20 μg/d vitamin D3 for 20 wk (October-March). Cardiometabolic risk markers including BMI-for-age z score (BMIz), waist circumference, systolic and diastolic blood pressure, fasting plasma triglycerides, cholesterol (total, HDL, LDL, and total:HDL), and glucose were measured at baseline and endpoint as secondary outcomes, together with serum 25(OH)D. Intervention effects were evaluated in linear regression models as between-group differences at endpoint, adjusted for the baseline value of the outcome variable and additionally for age, sex, Tanner stage, BMIz, and baseline serum 25(OH)D. Results Mean ± SD baseline serum 25(OH)D was 49.1 ± 12.3 nmol/L and differed between groups at endpoint with concentrations of 30.7 ± 8.6, 56.6 ± 12.4, and 63.9 ± 10.6 nmol/L in the 0, 10, and 20 μg/d groups, respectively (P ≤ 0.001). Vitamin D3 supplementation had no effect on any of the cardiometabolic risk markers (all P > 0.05), except for lower HDL (-0.12 mmol/L; 95% CI: -0.21, 0.04 mmol/L; P = 0.003) and total cholesterol (-0.21 mmol/L; 95% CI: -0.42, 0.00 mmol/L; P = 0.05) in the 20 μg/d than in the 10 μg/d group, which disappeared in the fully adjusted analysis (P = 0.27 and P = 0.30, respectively). Conclusions Supplementation with vitamin D3 at 10 and 20 μg/d, which increased serum 25(OH)D concentrations during the winter-time, had no effect on markers of cardiometabolic risk in healthy 14- to 18-y-old adolescents. This trial was registered at clinicaltrials.gov as NCT02150122.
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Affiliation(s)
- Taryn J Smith
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Laura Tripkovic
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Hanne Hauger
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Denmark
| | - Susan A Lanham-New
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
| | - Kathryn H Hart
- Department of Nutritional Sciences, Faculty of Health and Medical Sciences, University of Surrey, Surrey, United Kingdom
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11
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Vitamin D in adolescence: evidence-based dietary requirements and implications for public health policy. Proc Nutr Soc 2017; 77:292-301. [PMID: 29198201 DOI: 10.1017/s0029665117004104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Vitamin D is a unique nutrient. First, it acts as a pro-hormone and secondly, the requirement for vitamin D can be met by both endogenous synthesis from sunlight and by dietary sources. This complicates the determination of dietary requirements for vitamin D, which along with the definition of optimal vitamin D status, have been highly controversial and much debated over recent years. Adolescents are a population group at high risk of low vitamin D status, which is concerning given the important role of vitamin D, and calcium, in promoting normal bone mineralisation and attainment of peak bone mass during this rapid growth phase. Dietary vitamin D recommendations are important from a public health perspective in helping to avoid deficiency and optimise vitamin D status for health. However limited experimental data from winter-based dose-response randomised trials in adolescents has hindered the development of evidence-based dietary requirements for vitamin D in this population group. This review will highlight how specifically designed randomised trials and the approach adopted for estimating such requirements can lead to improved recommendations. Such data indicate that vitamin D intakes of between 10 and about 30 µg/d may be required to avoid deficiency and ensure adequacy in adolescents, considerably greater than the current recommendations of 10-15 µg/d. Finally this review will consider the implications of this on public health policy, in terms of future refinements of vitamin D requirement recommendations and prioritisation of public health strategies to help prevent vitamin D deficiency.
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12
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Manios Y, Moschonis G, Lambrinou CP, Tsoutsoulopoulou K, Binou P, Karachaliou A, Breidenassel C, Gonzalez-Gross M, Kiely M, Cashman KD. A systematic review of vitamin D status in southern European countries. Eur J Nutr 2017; 57:2001-2036. [PMID: 29090332 DOI: 10.1007/s00394-017-1564-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 10/07/2017] [Indexed: 12/16/2022]
Abstract
PURPOSE Despite an acknowledged dearth of data on serum 25-hydroxyvitamin D (25(OH)D) concentrations from Southern European countries, inter-country comparison is hampered by inconsistent data reporting. The purpose of the current study was to conduct a systematic literature review of available data on serum 25(OH)D concentrations and estimate vitamin D status in Southern European and Eastern Mediterranean countries, both at a population level and within key population subgroups, stratified by age, sex, season and country. METHODS A systematic review of the literature was conducted to identify and retrieve scientific articles reporting data on serum 25(OH)D concentration and/or vitamin D status following standard procedures. RESULTS Data were extracted from 107 studies, stratified by sex and age group, representing 630,093 individuals. More than one-third of the studies reported mean 25(OH)D concentrations below 50 nmol/L and ~ 10% reported mean serum 25(OH)D concentrations below 25 nmol/L. Overall, females, neonates/ infants and adolescents had the higher prevalence of poor vitamin D status. As expected, there was considerable variability between studies. Specifically, mean 25(OH)D ranged from 6.0 (in Italian centenarians) to 158 nmol/L (in elderly Turkish men); the prevalence of serum 25(OH)D < 50 nmol/L ranged from 6.8 to 97.9% (in Italian neonates). CONCLUSIONS Contrary to expectations, there was a high prevalence of low vitamin D status in the Southern Europe and the Eastern Mediterranean regions, despite abundant sunshine. These data further emphasize the need for strategies, such as fortification of foods with vitamin D and/or vitamin D supplementation, which will be tailored to the needs of specific population groups with higher risk of insufficiency or deficiency, to efficiently tackle the pandemic of hypovitaminosis D in Europe.
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Affiliation(s)
- Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece.
| | - George Moschonis
- Department of Rehabilitation, Nutrition and Sport, College of Science, Health and Engineering, La Trobe University, Bundoora, 3086, Melbourne, Australia
| | - Christina-Paulina Lambrinou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece
| | - Konstantina Tsoutsoulopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece
| | - Panagiota Binou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece
| | - Alexandra Karachaliou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El Venizelou Avenue, Kallithea, 17671, Athens, Greece
| | - Christina Breidenassel
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Marcela Gonzalez-Gross
- ImFINE Research Group, Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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13
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Relationship between dietary vitamin D and serum 25-hydroxyvitamin D levels in Portuguese adolescents. Public Health Nutr 2017; 21:325-332. [PMID: 29081320 DOI: 10.1017/s1368980017002804] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To understand the relationship between vitamin D intake and serum 25-hydroxyvitamin D (25(OH)D) levels in a sample of Portuguese adolescents. DESIGN Cross-sectional evaluation carried out in the 2003/2004 school year. Vitamin D intake was assessed by an FFQ and 25(OH)D was measured in a fasting blood sample. SETTING Public and private schools in Porto, Portugal. SUBJECTS Adolescents aged 13 years (n 521) enrolled at school (EPITeen cohort). RESULTS Both mean (sd) intake and serum 25(OH)D level were far below the recommended, 4·47 (2·49) µg/d and 16·5 (5·7) ng/ml, respectively. A significant difference in serum level was found according to season, with lower values in winter than summer (14·8 (4·6) v. 17·3 (5·9) ng/ml, P<0·001). Vitamin D intake was weakly correlated with serum 25(OH)D (r=0·056, P=0·203). CONCLUSIONS Dietary vitamin D and serum 25(OH)D levels were positively but weakly correlated and the error was higher among those with higher serum 25(OH)D concentration. Our results support the need for strategies that promote increase of the most important food sources of vitamin D to reduce the high prevalence of low vitamin D status.
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14
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Nikooyeh B, Abdollahi Z, Hajifaraji M, Alavi-Majd H, Salehi F, Yarparvar AH, Neyestani TR. Vitamin D status and cardiometabolic risk factors across latitudinal gradient in Iranian adults: National food and nutrition surveillance. Nutr Health 2017; 23:87-94. [PMID: 28397539 DOI: 10.1177/0260106017702918] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study aimed to evaluate the vitamin D status in an adult population across latitudinal gradient and to investigate its possible associations with certain cardiometabolic risk factors. METHODS A total of 1406 healthy subjects aged 19-60 years were randomly selected from six regions of Iran across latitudinal gradient from 29° N to 37.5° N. Anthropometric and biochemical assessments were performed. The combination of high body mass index (>25 kg/m2), low high-density lipoprotein cholesterol (< 40 mg/dl in males and < 50 mg/dl in females) and high triglycerides (> 150 mg/dl) was defined as cardiometabolic risk factors. RESULTS The mean concentration of serum 25-hydroxycalciferol (25(OH)D) was 26.8±17.7 nmol/l. There were no significant differences in the mean serum 25(OH)D levels among different latitudes. Undesirable vitamin D status (deficiency and insufficiency) was found in 90.7% of the subjects. After adjustment for age and gender, the association between weight status and serum 25(OH)D was significant ( p< 0.04, odds ratio:1.49; confidence interval: 1.01-2.19). The prevalence of cardiometabolic risk factors among the subjects with serum 25(OH)D less than 27.5 nmol/l was significantly higher than those with serum calcidiol concentrations above 27.5 nmol/l (13.3% vs. 10.0%, p = 0.033). CONCLUSION Undesirable vitamin D status is highly prevalent among Iranian adults of both sexes irrespective of latitude and even in sunny regions. The occurrence of cardiometabolic risk factors was significantly higher in those subjects with circulating calcidiol concentrations below 27.5 nmol/l.
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Affiliation(s)
- Bahareh Nikooyeh
- 1 Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Abdollahi
- 2 Nutrition Office, Iran Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | - Majid Hajifaraji
- 3 Department of Nutritional Policy-Making Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi-Majd
- 4 Department of Biostatistics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Forouzan Salehi
- 2 Nutrition Office, Iran Ministry of Health, Treatment and Medical Education, Tehran, Iran
| | | | - Tirang R Neyestani
- 1 Laboratory of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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