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Süli A, Magyar P, Vezér M, Bányai B, Szekeres M, Sipos M, Mátrai M, Hetthéssy JR, Dörnyei G, Ács N, Horváth EM, Nádasy GL, Várbíró S, Török M. Effects of Gender and Vitamin D on Vascular Reactivity of the Carotid Artery on a Testosterone-Induced PCOS Model. Int J Mol Sci 2023; 24:16577. [PMID: 38068901 PMCID: PMC10706740 DOI: 10.3390/ijms242316577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 11/15/2023] [Accepted: 11/19/2023] [Indexed: 12/18/2023] Open
Abstract
The negative cardiovascular effects of polycystic ovary syndrome (PCOS) and vitamin D deficiency (VDD) have been discussed previously; however, the sex differences between PCOS females and males are not yet known. Our aim was to investigate the effect of PCOS and VDD in the carotid artery of male and female Wistar rats. Females were treated with transdermal testosterone (Androgel) for 8 weeks, which caused PCOS. VDD and vitamin D supplementation were accomplished via diet. The carotid arteries' contraction and relaxation were examined using myography. Receptor density was investigated using immunohistochemistry. In PCOS females, angiotensin receptor density, angiotensin II-induced contraction, androgen receptor optical density, and testosterone-induced relaxation increased. The increased contractile response may increase cardiovascular vulnerability in women with PCOS. As an effect of VDD, estrogen receptor density increased in all our groups, which probably compensated for the reduced relaxation caused by VDD. Testosterone-induced relaxation was decreased as a result of VDD in males and non-PCOS females, whereas this reduction was absent in PCOS females. Male sex is associated with increased contraction ability compared with non-PCOS and PCOS females. VDD and Androgel treatment show significant gender differences in their effects on carotid artery reactivity. Both VDD and PCOS result in a dysfunctional vascular response, which can contribute to cardiovascular diseases.
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Affiliation(s)
- Anita Süli
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
| | - Péter Magyar
- Medical Imaging Centre, Faculty of Medicine, Semmelweis University, 1082 Budapest, Hungary;
| | - Márton Vezér
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
| | - Bálint Bányai
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1094 Budapest, Hungary; (B.B.); (M.S.); (E.M.H.); (G.L.N.)
| | - Mária Szekeres
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1094 Budapest, Hungary; (B.B.); (M.S.); (E.M.H.); (G.L.N.)
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary;
| | - Miklós Sipos
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
| | - Máté Mátrai
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary;
| | - Judit Réka Hetthéssy
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary;
| | - Gabriella Dörnyei
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary;
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
| | - Eszter Mária Horváth
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1094 Budapest, Hungary; (B.B.); (M.S.); (E.M.H.); (G.L.N.)
| | - György L. Nádasy
- Department of Physiology, Faculty of Medicine, Semmelweis University, 1094 Budapest, Hungary; (B.B.); (M.S.); (E.M.H.); (G.L.N.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary;
- Department of Obstetrics and Gynecology, University of Szeged, 6725 Szeged, Hungary
| | - Marianna Török
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary; (A.S.); (M.S.); (N.Á.); (S.V.)
- Workgroup of Research Management, Doctoral School, Semmelweis University, 1085 Budapest, Hungary;
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Rossi R, Talarico M, Pascale A, Pascale V, Minici R, Boriani G. Low Levels of Vitamin D and Silent Myocardial Ischemia in Type 2 Diabetes: Clinical Correlations and Prognostic Significance. Diagnostics (Basel) 2022; 12:2572. [PMID: 36359415 PMCID: PMC9689411 DOI: 10.3390/diagnostics12112572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 07/30/2023] Open
Abstract
Vitamin D deficiency has a pathogenetic and prognostic role in coronary artery disease and a key role in pain transmission. Diabetic patients have a higher risk of silent myocardial ischemia (SMI) due to diabetic neuropathy. We evaluated the correlation between SMI and Vitamin D serum levels in type 2 diabetic patients and assessed whether SMI patients had a worse survival rate than their symptomatic counterpart. We enrolled 253 patients admitted in our Cardiology Unit and compared them with 50 healthy volunteers. We created three sub-groups: symptomatic MI group (125, 32.4%); SMI group (78, 25.7%), and no-MI group (50, 41.9%). 25(OH)D levels (nmol/L) were lower in the SMI group (34.9 ± 5.8) compared to those in the symptomatic MI (49.6 ± 6.1; p = 0.01), no MI (53.1 ± 6.2; p = 0.001), and control groups (62.1 ± 6.7; p = 0.0001). 25(OH)D levels predicted SMI in diabetic patients, with an inverted odds ratio of 1.11 (p = 0.01). Symptomatic MI group survival was higher than the SMI one (6-year survival rate: 83 vs. 69%; p = 0.01). Diabetic patients with SMI had a higher mortality risk and showed lower 25(OH)D levels than the symptomatic group. This suggests the crucial role that vitamin D has in the pathogenesis of SMI.
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Affiliation(s)
- Rosario Rossi
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Policlinico di Modena Hospital, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, MO, Italy
| | - Marisa Talarico
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Alessandra Pascale
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Vittorio Pascale
- Cardiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Roberto Minici
- Radiology Unit, Azienda Ospedaliera Pugliese-Ciaccio Hospital, Via Pio X 83, 88100 Catanzaro, CZ, Italy
| | - Giuseppe Boriani
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, Policlinico di Modena Hospital, University of Modena and Reggio Emilia, Via del Pozzo, 71, 41124 Modena, MO, Italy
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Xu J, Xu G, Fang J. Association between iron exposures and stroke in adults: Results from National Health and Nutrition Examination Survey during 2007-2016 in United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1925-1934. [PMID: 34003723 DOI: 10.1080/09603123.2021.1926440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/01/2021] [Indexed: 06/12/2023]
Abstract
The available findings on the association between iron status and risk of stroke remain controversial. We used multivariable logistic regression and restricted cubic spline models to explore the association between iron exposures and risk of stroke in the US National Health and Nutrition Examination Survey (NHANES 2007-2016, n = 24,627). A total of 941 (3.82%) stroke cases were identified in this study. In women, the ORs with 95% CIs of prevalence of stroke were 0.92 (0.65-1.28), 0.66 (0.44-0.98) and 0.72 (0.49-1.08) across quartiles 2-4 compared with quartile 1 of iron intake, respectively. An inverse and L-shaped association between iron intake and risk of stroke in women was observed, and the curve plateaued at 20 mg/day. However, neither serum iron concentrations nor iron intake were significantly associated with riskof stroke in men. Our study found that iron intake was inversely associated with risk of stroke in a sex-dependent fashion.
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Affiliation(s)
- Jingang Xu
- Department of Neurosurgery, Dongyang People's Hospital, Zhejiang, China
| | - Guofeng Xu
- Department of Neurosurgery, Dongyang People's Hospital, Zhejiang, China
| | - Junkang Fang
- Department of Neurosurgery, Dongyang People's Hospital, Zhejiang, China
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Plasma 25-hydroxyvitamin D3 concentrations and incident risk of ischemic stroke among rural Chinese adults: New insight on ceiling effect. Nutrition 2022; 99-100:111627. [DOI: 10.1016/j.nut.2022.111627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 01/26/2022] [Accepted: 02/01/2022] [Indexed: 11/20/2022]
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Su C, Jin B, Xia H, Zhao K. Association between Vitamin D and Risk of Stroke: A PRISMA-Compliant Systematic Review and Meta-Analysis. Eur Neurol 2021; 84:399-408. [PMID: 34325429 DOI: 10.1159/000517584] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 05/31/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies have shown inconsistent results for associations between vitamin D and risk of stroke. We gathered the existing published articles and conducted this meta-analysis with the aim to explore the association between vitamin D and risk of stroke. METHODS We searched for articles exploring the association between vitamin D and risk of stroke and published before April 2021 in the following databases: PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. All statistical analyses were made using STATA 12.0 software. Q test and I2 were applied to examine heterogeneities between studies. RESULTS For the association between serum levels of 25(OH) vitamin D and risks of stroke, the present analysis included 20 cohort studies (including 213,276 participants) and a case-control analysis (including 13,642 participants). Additionally, the analysis included 15 studies (including 41,146 participants given vitamin D supplementation and 41,163 participants given placebo) to evaluate the influence of vitamin D supplementation on risk of stroke. Higher circulating levels of 25(OH) vitamin D were associated with a reduced risk of stroke (odds ratio/relative risk = 0.78, 95% confidence interval [CI]: 0.70-0.86, I2 = 41.5%, p = 0.025). However, the present analysis showed that vitamin D supplementation did not influence the risk of stroke (hazard ratio = 1.05, 95% CI: 0.96-1.14, I2 = 2.3%, p = 0.425). CONCLUSIONS Our analysis indicated that lower circulating level of vitamin D was associated with an elevated risk of stroke, but extra supplement of vitamin D failed to show benefit in decreasing the risk of stroke. Further research and study are also needed to show the role of vitamin D in relation to stroke.
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Affiliation(s)
- Cen Su
- Department of Neurology, Fourth People's Hospital of Zhenjiang, Zhenjiang, China
| | - Biao Jin
- Department of Neurology, Fourth People's Hospital of Zhenjiang, Zhenjiang, China
| | - Haiping Xia
- Department of Neurology, Fourth People's Hospital of Zhenjiang, Zhenjiang, China
| | - Kangren Zhao
- Department of Neurology, Fourth People's Hospital of Zhenjiang, Zhenjiang, China
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Sipos M, Gerszi D, Dalloul H, Bányai B, Sziva RE, Kollarics R, Magyar P, Török M, Ács N, Szekeres M, Nádasy GL, Hadjadj L, Horváth EM, Várbíró S. Vitamin D Deficiency and Gender Alter Vasoconstrictor and Vasodilator Reactivity in Rat Carotid Artery. Int J Mol Sci 2021; 22:ijms22158029. [PMID: 34360792 PMCID: PMC8347553 DOI: 10.3390/ijms22158029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 01/07/2023] Open
Abstract
The vitamin-D-sensitivity of the cardiovascular system may show gender differences. The prevalence of vitamin D (VD) deficiency (VDD) is high, and it alters cardiovascular function and increases the risk of stroke. Our aim was to investigate the vascular reactivity and histological changes of isolated carotid artery of female and male rats in response to different VD supplies. A total of 48 male and female Wistar rats were divided into four groups: female VD supplemented, female VDD, male VD supplemented, male VDD. The vascular function of isolated carotid artery segments was examined by wire myography. Both vitamin D deficiency and male gender resulted in increased phenylephrine-induced contraction. Acetylcholine-induced relaxation decreased in male rats independently from VD status. Inhibition of prostanoid signaling by indomethacin reduced contraction in females, but increased relaxation ability in male rats. Functional changes were accompanied by VDD and gender-specific histological alterations. Elastic fiber density was significantly decreased by VDD in female rats, but not in males. Smooth muscle actin and endothelial nitric oxide synthase levels were significantly lowered, but the thromboxane receptor was elevated in VDD males. Decreased nitrative stress was detected in both male groups independently from VD supply. The observed interactions between vitamin D deficiency and sex may play a role in the gender difference of cardiovascular risk.
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Affiliation(s)
- Miklós Sipos
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
| | - Dóra Gerszi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
| | - Hicham Dalloul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
| | - Bálint Bányai
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
| | - Réka Eszter Sziva
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
- Workgroup for Science Management, Doctoral School, Semmelweis University, Üllői Street 22, 1085 Budapest, Hungary
- Correspondence:
| | - Réka Kollarics
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
| | - Péter Magyar
- Medical Imaging Centre, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary;
| | - Marianna Török
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
- Workgroup for Science Management, Doctoral School, Semmelweis University, Üllői Street 22, 1085 Budapest, Hungary
| | - Nándor Ács
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
| | - Mária Szekeres
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
- Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Vas Street 17, 1088, Budapest, Hungary
| | - György L. Nádasy
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
| | - Leila Hadjadj
- Department of Translational Medicine, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary;
| | - Eszter Mária Horváth
- Department of Physiology, Faculty of Medicine, Semmelweis University, Tűzoltó Street 37-47, 1094 Budapest, Hungary; (B.B.); (M.S.); (G.L.N.); (E.M.H.)
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Faculty of Medicine, Semmelweis University, Üllői Street 78/a, 1083 Budapest, Hungary; (M.S.); (D.G.); (H.D.); (R.K.); (M.T.); (N.Á.); (S.V.)
- Workgroup for Science Management, Doctoral School, Semmelweis University, Üllői Street 22, 1085 Budapest, Hungary
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Yarlagadda K, Ma N, Doré S. Vitamin D and Stroke: Effects on Incidence, Severity, and Outcome and the Potential Benefits of Supplementation. Front Neurol 2020; 11:384. [PMID: 32587562 PMCID: PMC7298071 DOI: 10.3389/fneur.2020.00384] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 04/16/2020] [Indexed: 12/12/2022] Open
Abstract
Vitamin D serum level has been positively associated with improved cardiovascular health, especially with reduction of stroke risk. This systemic review summarizes and synthesizes findings from studies relevant to the relationship between vitamin D and stroke risk, severity, and outcome; potential mechanisms explaining such a relationship; and outcomes from vitamin D supplementation. The literature shows that vitamin D deficiency is a significant risk factor for ischemic stroke, with sun exposure, sex, age, race, diabetes, and genetics playing a role as well. Stroke severity and short- and long-term outcomes also worsen with vitamin D deficiency. The neuroprotective mechanisms by which vitamin D operates to mitigate stroke onset and outcomes have yet to be fully studied, but researchers have proposed several pathways, including promotion of certain neuroprotective growth factors, reduction of arterial pressure through vasodilation, and inhibition of reactive oxygen species. There is some evidence that vitamin D supplementation could lower stroke risk and improve recovery, though outcomes can also be negligible or negative. Although results are mixed and the limitations of vitamin D supplementation merit some caution, vitamin D overall plays a significant role in stroke health. Future research should further develop understanding of the neuroprotective mechanisms of vitamin D and study how supplementation could be administered effectively in stroke treatment.
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Affiliation(s)
- Keerthi Yarlagadda
- Doré Lab, Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
| | - Nicholas Ma
- Doré Lab, Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
| | - Sylvain Doré
- Doré Lab, Department of Anesthesiology, Center for Translational Research in Neurodegenerative Disease, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
- Doré Lab, Departments of Neurology, Psychiatry, Pharmaceutics, Psychology, and Neuroscience, McKnight Brain Institute, University of Florida College of Medicine, Gainesville, FL, United States
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25-Hydroxyvitamin D level, vitamin D intake, and risk of stroke: A dose-response meta-analysis. Clin Nutr 2019; 39:2025-2034. [PMID: 31530422 DOI: 10.1016/j.clnu.2019.08.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 08/12/2019] [Accepted: 08/27/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND & AIMS A growing number of studies have shown that vitamin D are related to the risk of stroke, however, the dose-response association between vitamin D and the risk of stroke is still unclear. Accordingly, we conducted a dose-response meta-analysis to evaluate the relationships between 25-hydroxyvitamin D [25(OH)D] level, vitamin D intake, and the risk of stroke by summarizing cohort studies. METHODS PubMed, Embase, Cochrane and the Web of Science database were searched for related studies. Cohort studies examining the influence of 25(OH)D level and vitamin D intake on stroke risk were summarized. Dose-response relationships were determined using a random-effect model. RESULTS Twenty cohort studies involving 217,235 participants were included. The pooled relative risk for the high-versus-low categories was 0.74 (95% CI: 0.66-0.83) for 25(OH)D level, and 0.75 (95% CI: 0.57-0.98) for vitamin D intake. In addition, there were non-linear relationships between 25(OH)D level, vitamin D intake, and stroke risk. The incidence of stroke was reduced to its lowest point, with a reduction of about 20%, when 25(OH)D level was about 50 nmol/L or vitamin D intake was about 12 μg/day. CONCLUSION 25(OH)D level and vitamin D intake were both inversely related to stroke risk, with a non-linear dose-response relationship.
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Association between vitamin D level and hematuria from a dipstick test in a large scale population based study: Korean National Health and nutrition examination survey. BMC Nephrol 2019; 20:187. [PMID: 31126256 PMCID: PMC6534857 DOI: 10.1186/s12882-019-1369-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 05/02/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is an important health concern because it is related to several comorbidities and mortality. However, its relationship with the risk of hematuria remains undetermined in the general population. In this study, we analyzed the association between vitamin D deficiency and hematuria. METHODS We conducted cross-sectional analysis using data of participants from the Korean National Health and Nutrition Examination Survey (KNHANES) 2010-2014. A total of 20,240 participants, aged ≥18 years old, were analyzed. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured in a central laboratory and hematuria was defined as ≥1+ on a dipstick test. Multivariate logistic regression was conducted to calculate the odds ratio (OR) of hematuria risk according to serum 25(OH)D quartiles, after adjusting several covariates. RESULTS A total 3144 (15.5%) participants had hematuria. The mean 25(OH)D level was 17.4 ± 6.2 ng/mL (median, 16.6 ng/mL (interquartile range, 13.1-20.8 ng/mL)). The 3rd and 4th quartiles had a higher risk of hematuria than the 1st quartile, with adjusted ORs 1.26 (1.114-1.415) and 1.40 (1.240-1.572) in the 3rd and 4th quartiles, respectively. However, this relationship was only significant in women, not in men. When stratified analyses were conducted according to menopausal status, there was a significant increase of hematuria risk according to quartiles in postmenopausal but not in premenopausal women. CONCLUSION We found that vitamin D deficiency is correlated with hematuria in women, particularly after menopause. Further interventional studies are warranted to address whether correcting vitamin D deficiency can lower the risk of hematuria.
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Crotti C, Becciolini A, Biggioggero M, Favalli EG. Vitamin D and Spondyloarthritis: Review of the Literature. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Background:
Spondyloarthritides (SpAs) encompass heterogeneous diseases sharing similar genetic background, pathogenic mechanisms, and phenotypic features. Vitamin D is essential for calcium metabolism and skeletal homeostasis. Some recent evidences reported supplemental functions of vitamin D, such as modulation of inflammatory reactions.
Objective:
To analyze published data about a possible association between vitamin D and SpAs.
Results:
Vitamin D could play a role in immune reactions, influencing both immune and adaptive response. Vitamin D deficiency is more frequent in SpAs than in general population: an active and more severe disease infers patients’ mobility and reduces sunlight exposure. Quiescent inflammatory bowel disease, frequently associated with SpAs, could worsen vitamin D deficiency. All the parameters related to UVB exposure are the most important determinants for vitamin D status and need to be considered evaluating the vitamin D levels in SpAs.
Apart from musculoskeletal problems, patients affected by SpAs frequently suffer from other comorbidities, especially cardiovascular diseases and osteoporosis, and vitamin D status could have a relevance in this field. Bone is involved in SpAs with a dualistic role, coexisting trabecular bone resorption and new bone formation.
It seems rational to monitor vitamin D levels in SpA subjects and to target it to global health threshold.
Conclusion:
Literature data were not completely in agreement about a possible relation between poor vitamin D status and onset or worse disease course of SpAs. In fact, these results come from cross-sectional studies, which affect our ability to infer causality. Therefore, large, randomized controlled trials are needed.
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