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Xiong J, Luo X, Liu L, Gong X. A bibliometric analysis and visualization of literature on the relationship between vitamin D and obesity over the last two decades. Complement Ther Med 2024; 86:103093. [PMID: 39362306 DOI: 10.1016/j.ctim.2024.103093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/15/2024] [Accepted: 09/25/2024] [Indexed: 10/05/2024] Open
Abstract
OBJECTIVE The purpose of this study was to employ bibliometric analysis to visualize hot spots and evolving trends in the studies on the relationship between vitamin D and obesity. METHODS From the Web of Science Core Collection database, articles on vitamin D and obesity from 2001 to 2021 were retrieved. For the bibliometric visualization analysis, CiteSpace was employed. Some of the figures were created using GraphPad software. RESULTS 4454 pieces of articles and reviews were found, with an average citation of 30.68 times. There are many more published papers in the area of "nutrition dietetics" (1166, 26.179%). The United States possesses the largest number of publications (1297, 29.12%) and demonstrates definitive leadership in this field. The League of European Research Universities generates a higher percentage of publications (256, 5.748%) than other institutions. Major studies are funded by the United States Department of Health and Human Services (531, 11.922%) and the National Institutes of Health, USA (528, 11.855%). The top five keywords with the highest co-occurrence frequency are "obesity" (1260), "vitamin d" (943), "insulin resistance" (651), "risk" (642), and "d deficiency" (636). The biggest keyword cluster was #0 "adolescent" among the 18 keyword clusters. The three latest keywords in the keyword burst were "mineral density"、"d insufficiency" and "25 hydroxyvitamin d concentration". CONCLUSION This bibliometric analysis shows an overview of the current status of the research on the association between vitamin D and obesity. The prevalence of vitamin D deficiency and the relationship between vitamin D and metabolic syndrome in obese individuals remains hot topics. We speculate that the effect of obesity on vitamin D levels and bone mineral density, and the influence of vitamin D insufficiency on various body systems in obese populations will be future trends.
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Affiliation(s)
- Jie Xiong
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Liqun Liu
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoxiang Gong
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China.
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Bucurica S, Nancoff AS, Dutu M, Mititelu MR, Gaman LE, Ioniță-Radu F, Jinga M, Maniu I, Ruța F. Exploring the Relationship between Lipid Profile, Inflammatory State and 25-OH Vitamin D Serum Levels in Hospitalized Patients. Biomedicines 2024; 12:1686. [PMID: 39200151 PMCID: PMC11351771 DOI: 10.3390/biomedicines12081686] [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] [Received: 05/28/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 09/01/2024] Open
Abstract
Anomalies in lipid metabolism involve multifactorial pathogenesis, among other factors, being associated with an inflammatory state and disturbances in vitamin D status. The literature has focused on the binary relationships between inflammation and dyslipidemia, vitamin D and dyslipidemia, or vitamin D and inflammation. Our study aimed to explore the link between all these three factors: 25-OH vitamin D serum levels, the presence of inflammation assessed through serum C-reactive protein (CRP), and serum lipid profile in 2747 hospitalized patients. Our results showed a positive correlation of HDL-C with 25 (OH) vitamin D and a negative correlation of HDL-C with CRP. This relationship had different patterns in the statistical network analysis. The network analysis patterns are preserved for males and females, except for the relationship between CRP and vitamin D, which is present in male cases and absent in females. The same triangular relationship between all three-CRP, vitamin D, and HDL-C was found with different strengths of partial correlation in obese and non-obese patients. This pattern was similar in patients with and without fatty liver. A shifted pattern was found in the network analysis of hypertensive patients. The CRP was negatively correlated with vitamin D and HDL-C, and vitamin D was positively correlated with HDL-C in non-hypertensive patients. Castelli's Risk indexes I and II were positively associated with CRP, suggesting that increased cardiovascular risk is proportional to an inflammatory state. The triad formed by altered serum lipid levels, inflammation, and vitamin D represents a complex relationship marked by specific dynamics between lipidic fractions such as HDL-C and C-reactive protein and vitamin D.
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Affiliation(s)
- Sandica Bucurica
- Department Gastroenterology, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania; (S.B.); (F.I.-R.); (M.J.)
- Department of Gastroenterology, University Emergency Central Military Hospital, 010825 Bucharest, Romania;
| | - Andreea Simona Nancoff
- Department of Gastroenterology, University Emergency Central Military Hospital, 010825 Bucharest, Romania;
| | - Madalina Dutu
- Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania
- Department of Anesthesiology and Intensive Care, Dr. Carol Davila Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Mihaela Raluca Mititelu
- Department of Nuclear Medicine, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania
- Department of Nuclear Medicine, University Emergency Central Military Hospital, 010825 Bucharest, Romania
| | - Laura Elena Gaman
- Department of Biochemistry, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania;
| | - Florentina Ioniță-Radu
- Department Gastroenterology, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania; (S.B.); (F.I.-R.); (M.J.)
- Department of Gastroenterology, University Emergency Central Military Hospital, 010825 Bucharest, Romania;
| | - Mariana Jinga
- Department Gastroenterology, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania; (S.B.); (F.I.-R.); (M.J.)
- Department of Gastroenterology, University Emergency Central Military Hospital, 010825 Bucharest, Romania;
| | - Ionela Maniu
- Research Team, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania;
- Department of Mathematics and Informatics, Faculty of Sciences, Lucian Blaga University Sibiu, 550012 Sibiu, Romania
| | - Florina Ruța
- Department of Community Nutrition and Food Safety, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania;
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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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Adeniyi OV, Masilela C, George JA. Prevalence of vitamin D deficiency and its association with cardiometabolic risk factors among healthcare workers in the Eastern Cape province, South Africa; cross-sectional study. Sci Rep 2024; 14:4756. [PMID: 38413628 PMCID: PMC10899187 DOI: 10.1038/s41598-024-54977-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
This study assesses the prevalence of Vitamin D deficiency and its potential association with cardiometabolic risk factors among South African adults residing in the Eastern Cape province. In this cross-sectional study, 1244 healthcare workers (HCWs) completed a self-administered questionnaire and venous blood samples were drawn at two academic hospitals in the Eastern Cape. History of hypertension and diabetes mellitus were self-reported. Participants were categorised as obese if their body mass index (BMI) ≥ 30 kg/m2. Participants were classified as having metabolic syndrome if they had hypertension, diabetes mellitus and obesity. Vitamin D [25(OH)D] deficiency was defined as venous blood concentrations < 50 nmol/L. Associations between vitamin D deficiency and participants' characteristics were assessed using multivariate logistic regression model analysis. The prevalence of vitamin D deficiency was 28.5% (n = 355), of whom 292 were female. Among the participants who were deficient in vitamin D, the prevalence of obesity, diabetes mellitus, hypertension, chronic kidney disease, and metabolic syndrome was 64.9% (n = 230), 9% (n = 32), 16.6% (n = 59), 2.3% (n = 8) and 18% (n = 64), respectively. In the adjusted multivariate logistic regression model, black Africans (AOR = 2.87; 95% CI 1.52-5.43) and individuals ≥ 42 years (AOR = 1.37; 95% CI 1.07-1.77) were more likely to exhibit vitamin D deficiency. However, there was no significant association by age, sex, and cardiometabolic markers. More than one in four healthcare workers was deficient in vitamin D among the study sample, especially the black Africans and older individuals. Further studies are needed at the population level to elucidate on the vitamin D status in the region.
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Affiliation(s)
| | - Charity Masilela
- Department of Biochemistry and Microbiology, University of Zululand, KwaDlangezwa, South Africa
| | - Jaya A George
- Department of Chemical Pathology, National Health Laboratory Service and University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Zhang B, Dong X. The unique association between serum 25-hydroxyvitamin D concentrations and blood lipid profiles in agriculture, forestry, and fishing occupations: Insights from NHANES 2001-2014. PLoS One 2024; 19:e0297873. [PMID: 38412162 PMCID: PMC10898752 DOI: 10.1371/journal.pone.0297873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/04/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The relationship of serum 25(OH)D levels and hyperlipidemia has not been explored in the Agriculture, Forestry, and Fishing (AFF) occupation. We aimed to explore the impact of serum 25(OH)D levels on lipid profiles in AFF workers, traffic drivers, and miners. METHODS Data from 3937 adults aged 18-65 years old with completed information were obtained from the National Health and Examination Survey from 2001 to 2014. Multivariate linear regression models were used to examine the associations between serum 25(OH)D concentrations and triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and HDL-C/LDL-C ratio. Subgroup analyses for AFF workers considered age, sex, BMI, work activity, months worked, and alcohol consumption. Non-linear relationships were explored using curve fitting. RESULTS Serum 25(OH)D levels differed between groups (AFF: 60.0 ± 21.3 nmol/L, drivers: 56.6 ± 22.2 nmol/L, miners: 62.8 ± 22.3 nmol/L). Subgroup analysis of the AFF group showed that participants with serum 25(OH)D ≥50 nmol/L, females, and BMI <30 kg/m2 demonstrated improved HDL-C levels correlating with higher serum 25(OH)D. Serum 25(OH)D in AFF workers had a reversed U-shaped relationship with TG and TC, and a U-shaped relationship with HDL-C, with HDL-C, with inflection points at 49.5 nmol/L for TG and TC, and 32.6 nmol/L for HDL-C. CONCLUSIONS Serum 25(OH)D levels are associated with lipid profiles, and the relationship varies among occupational groups. AFF workers, facing unique occupational challenges, may benefit from maintaining adequate serum 25(OH)D levels to mitigate adverse lipid profiles and reduce cardiovascular risk.
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Affiliation(s)
- Baoshan Zhang
- Key Laboratory of Sustainable Forest Management and Environmental Microorganism Engineering of Heilongjiang Province, Northeast Forestry University, Harbin, China
- Faculty of Forestry and Environmental Management, University of New Brunswick, Fredericton, Canada
| | - Xibin Dong
- Key Laboratory of Sustainable Forest Management and Environmental Microorganism Engineering of Heilongjiang Province, Northeast Forestry University, Harbin, China
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Min EJ, Jeong S, Park JB. Evaluation of the Association between Amount and Type of Milk Consumption and Periodontitis: Data from the Korea National Health and Nutrition Examination Survey (2016-2018). Nutrients 2023; 15:nu15040914. [PMID: 36839272 PMCID: PMC9961995 DOI: 10.3390/nu15040914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
This study evaluated the association between the consumption of milk and having severe periodontitis. It is based on the information from the 2016-2018 Korea National Health and Nutrition Examination Survey. Severe periodontitis was characterized as a community periodontal index of code 4. A total of 18,034 individual respondents (7835 men and 10,199 women) without missing values were included in this study. Adjusted odds ratios and a 95% confidence interval of periodontitis in a multivariate logistic regression model for the amount of milk consumption were 0.774 [0.633-0.945] after the adjustment of confounding factors. This trend was maintained in a subgroup analysis of males with adjusted odds ratios, with a 95% confidence interval of 0.705 [0.538-0.924]. Overall, the findings showed a negative association between Korean adults' milk consumption and the prevalence of severe periodontitis. Men with higher milk consumption were more likely to have a lower prevalence of severe periodontitis regardless of age, body mass index, smoking or drinking habits, education, income, region, and physical exercise, diabetes mellitus, hypertension, metabolic syndrome, white blood cell count and toothbrushing frequency. By contrast, in women, the amount of milk consumption was not significantly associated with severe periodontitis. The amount of milk consumed was discovered to be a potential risk indicator for severe periodontitis in men in this study.
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Affiliation(s)
- Eun Jeong Min
- Department of Medical Life Science, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Department of Biomedicine & Health Sciences, The Catholic University Graduate School, Seoul 06591, Republic of Korea
| | - Siseong Jeong
- Department of Biomedicine & Health Sciences, The Catholic University Graduate School, Seoul 06591, Republic of Korea
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Dental Implantology, Graduate School of Clinical Dental Science, The Catholic University of Korea, Seoul 06591, Republic of Korea
- Correspondence: ; Tel.: +82-2-2258-6290
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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: 2] [Impact Index Per Article: 1.0] [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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Lu J, Yu F, Huang J, Yu H, Li F, Le Z, Cheng Y, Zhang Q, Li G, Xie X, Tang H, Zhang J. Hypocholesterolemia and Inflammatory Biomarkers Act as Predictors of Severe Vitamin D Deficiency in Patients With Crohn’s Disease: A Clinical Analysis of 862 Patients in China. Front Nutr 2022; 9:806887. [PMID: 35495921 PMCID: PMC9043686 DOI: 10.3389/fnut.2022.806887] [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: 11/01/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background In this study, we enrolled 862 patients with Crohn’s disease (CD) in China to investigate the correlation between serum vitamin D (SVD) and serum lipids, inflammatory biomarkers, and important clinical parameters. Materials and Methods 25(OH)D was measured by LS/MS/MS. Correlation analysis, chi-square tests, and logistic regression analysis were performed to determine the correlations between vitamin D and potential risk factors when vitamin D levels were lower than 10 ng/mL or 20 ng/mL. Results The incidence of severe vitamin D deficiency (SVD < 10 ng/mL) in patients with CD was significantly higher than that in healthy controls (28.9 vs. 9.5%). Multinomial logistic regression analysis showed that penetrating disease [odds ratio (OR) = 2.18], low levels of high-density lipoprotein cholesterol (HDL) (OR = 1.91), high erythrocyte sedimentation rate (OR = 1.73), and platelet count (PLT) (OR = 2.71) were regarded as predictors of severe vitamin D deficiency, while only PLT (OR = 1.90) and HDL (OR = 1.76) were considered as predictors of mild vitamin D deficiency (SVD 10–20 ng/mL). Conclusion Our results confirm a higher incidence of severe vitamin D deficiency in patients with CD in China and show that vitamin D deficiency could result from the combined effects of penetrating disease, inflammation, and low levels of HDL.
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Affiliation(s)
- Jie Lu
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Fei Yu
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jun Huang
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Haitao Yu
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Fengying Li
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Zhi’an Le
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Yulan Cheng
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Qi Zhang
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Guiling Li
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Xinyou Xie
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
| | - Huifang Tang
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
- Department of Pharmacology and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- *Correspondence: Huifang Tang,
| | - Jun Zhang
- Clinical Laboratory, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
- Key Laboratory of Precision Medicine in Diagnosis and Monitoring Research of Zhejiang Province, Hangzhou, China
- Jun Zhang,
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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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11
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Hong J. A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems. Clin Exp Pediatr 2022; 65:65-72. [PMID: 34886593 PMCID: PMC8841974 DOI: 10.3345/cep.2020.00934] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 11/13/2021] [Indexed: 11/27/2022] Open
Abstract
Cholesterol, the main structural molecule of cell membranes, is involved in essential functions of the human body. Dyslipidemia is an established risk factor for cardiovascular diseases (CVDs) that is observed even in childhood. To reduce the risk of CVDs in children, several clinical guidelines have been published for the management of pediatric dyslipidemia. However, pediatric dyslipidemia is also associated with several health problems other than CVDs. This article reviews the current data on dyslipidemia-related pediatric health issues. There is strong evidence that low serum vitamin D levels, asthma, and mental health problems may be associated with dyslipidemia in the pediatric population regardless of body mass index. This review also highlights the need for further large-scale population-based studies in the Korean pediatric population to establish effective strategies for promoting children's health.
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Affiliation(s)
- Jeana Hong
- Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon, Korea
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12
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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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13
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Poopedi MA, Norris SA, Pettifor JM. Is vitamin D status associated with non-communicable disease risk in children? A cohort study. SOUTH AFRICAN JOURNAL OF CLINICAL NUTRITION 2021. [DOI: 10.1080/16070658.2021.1976608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Machuene A Poopedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
- current address: School of Medicine and Public Health Medicine, Pietersburg Hospital, University of Limpopo, Polokwane, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
| | - John M Pettifor
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, University of the Witwatersrand, Johannesburg, South Africa
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14
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Kang M, Choi SY, Jung M. Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data. Clin Exp Pediatr 2021; 64:443-458. [PMID: 33445834 PMCID: PMC8426097 DOI: 10.3345/cep.2020.01655] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/06/2020] [Accepted: 12/07/2020] [Indexed: 12/11/2022] Open
Abstract
In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk Behavior Web-based Survey and describes key nationwide survey findings published in the last 5 years on infant feeding practices and the dietary intake and nutritional status of Korean infants, children, and adolescents. There have been increasing trends in children, and teenagers who skip breakfast, eat fast food, consume sugary drinks, have vitamin D deficiency, and are obese. This review will inform pediatricians, nutritionists, and other health care practitioners who track children's growth and development. It may also help researchers and policymakers identify diet-related policies and strategies for chronic disease prevention in Korean infants, children, and adolescents.
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Affiliation(s)
- Minji Kang
- BK21 FOUR Education and Research Team for Sustainable Food & Nutrition, Department of Food and Nutrition, College of Human Ecology, Seoul National University, Seoul, Korea
| | - So Yoon Choi
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
| | - Minyoung Jung
- Department of Pediatrics, Kosin University Gospel Hospital, Kosin University School of Medicine, Busan, Korea
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15
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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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16
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Paik KY, Seok HE, Chung JH. The analysis of risk for peptic ulcer disease using Korean national health and nutrition examination survey: a cross-sectional analysis of a national survey sample. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:460. [PMID: 32395504 PMCID: PMC7210158 DOI: 10.21037/atm.2020.03.126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background To evaluate the risk factors associated with the incidence of peptic ulcer disease (PUD), study was conducted to assess the relationship between socioeconomic and environmental factors and PUD in a large scales data of the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES). Methods We conducted a cross sectional study of 12,095 enrollment in the Health Professionals Follow-Up Study. The data was collected from KNHANES between 2008 and 2009 by the Division of Chronic Disease Surveillance under the Korea Centers for Disease Control and Prevention and the Korean Ministry of Health and Welfare. Multiple logistic regression analyses were used to assess the associations of PUD with the multiple variables. Results An association between old age, mental and psychosocial factor and PUD could be seen in both genders under multivariate analysis. Additionally, PUD in male associated with lower BMI and lesser exercise in life. Conclusions These findings suggest that, in Korean, mental health is associated with increased prevalence of PUD.
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Affiliation(s)
- Kwang Yeol Paik
- Department of Surgery, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Eun Seok
- Department of Psychology, Ewha Womans University, Seoul, Republic of Korea
| | - Jae Hee Chung
- Department of Surgery, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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17
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The Association of Vitamin D Status with Lipid Profile and Inflammation Biomarkers in Healthy Adolescents. Nutrients 2020; 12:nu12020590. [PMID: 32102427 PMCID: PMC7071498 DOI: 10.3390/nu12020590] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/19/2023] Open
Abstract
Background: The association between vitamin D status and inflammatory biomarkers and lipid profile is not well known, especially in adolescents. Therefore, the aim of the current study is to investigate the association of vitamin D status with serum lipids and inflammatory biomarkers, including IL-10, IL-6, hsCRP, and TNFR-2, in male adolescents. Methods and materials: A sample of seventy-one high school male students, aged 17 years old, from a high school in Tehran were enrolled in the study. They were divided into four groups including group with serum vitamin D below 25 (ng/mL) (SVD < 25; n = 36), 25 and above (ng/mL) (SVD ≥ 25; n = 35), negative-hsCRP (n = 48), and positive-hsCRP (n = 23). Weight, height, body mass index, dietary intake, serum lipids, and inflammatory biomarkers, including IL-10, IL-6, hsCRP, and TNFR-2, were measured. Results: In the (SVD < 25) group, the serum level of TNFR-2 was significantly higher compared to that in the (SVD ≥ 25) group. There was a significant negative association between serum TNFR-2 and vitamin D levels in the whole sample. We found significant lower levels of IL-10 in positive-hsCRP group compared to the negative-hsCRP group. In addition, there was a significant negative correlation between the serum vitamin D level and hsCRP in both hsCRP groups. The HDL level was lower in the (SVD < 25) group compared to that in the (SVD ≥ 25) group. Finally, there was a negative correlation between the serum HDL and hsCRP levels in the positive-hsCRP subjects. Conclusion: Based on the findings it can be concluded that serum vitamin D affects HDL and inflammation status. Although serum levels of HDL and inflammation status are both predictors of metabolic syndrome and cardiovascular disease, further studies are needed to prove it, especially in adolescents.
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18
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Relationship between Vitamin D Level and Lipid Profile in Non-Obese Children. Metabolites 2019; 9:metabo9070125. [PMID: 31262034 PMCID: PMC6680594 DOI: 10.3390/metabo9070125] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/22/2019] [Accepted: 06/28/2019] [Indexed: 11/17/2022] Open
Abstract
Vitamin D deficiency is associated with not only cardiovascular disease itself but also cardiovascular risk factors, including obesity, hypertension, diabetes, hyperglycemia, and dyslipidemia. This study aimed to investigate the relationship between vitamin D level and lipid profile in non-obese children. A total of 243 non-obese healthy volunteers, aged 9-18 years, were enrolled from March to May 2017. Their height and weight were measured, and body mass index was calculated. Subjects underwent blood tests, including measurements of vitamin D (25(OH)D) level and lipid panels, and were divided into either the vitamin D-deficient group (<20 ng/mL) or normal group. The student's t-test and a simple linear regression analysis were used to estimate the association between vitamin D level and lipid profile. Overall, 69.5% of non-obese children (n = 169) had a 25(OH)D level of less than 20 ng/mL. The vitamin D-deficient group showed higher triglyceride (TG) level and TG/high-density lipoprotein cholesterol (HDL-C) ratio than the normal group (TG level: 90.27 vs. 74.74 mmol/L, p = 0.003; TG/HDL-C ratio: 1.753 vs. 1.358, p = 0.003). Vitamin D level seems to affect the lipid profile, even in non-obese children, and a low vitamin D level may progress to dyslipidemia or obesity in non-obese children.
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19
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Cho YH, Kim JW, Shim JO, Yang HR, Chang JY, Moon JS, Ko JS. Association Between Vitamin D Deficiency and Suspected Nonalcoholic Fatty Liver Disease in an Adolescent Population. Pediatr Gastroenterol Hepatol Nutr 2019; 22:233-241. [PMID: 31110956 PMCID: PMC6506433 DOI: 10.5223/pghn.2019.22.3.233] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Vitamin D deficiency is a condition widespread throughout the world. Recent studies have suggested that vitamin D deficiency was associated with obesity and metabolic syndrome. The purpose of the study was to examine the relationship between vitamin D deficiency and nonalcoholic fatty liver disease (NAFLD) in adolescents. METHODS The data were obtained from the Korean National Health and Nutrition Examination Survey from 2008-2014. A total of 3,878 adolescents were included in the study. Vitamin D deficiency was defined as a 25-hydroxyvitamin D concentration <20 ng/mL and suspected NAFLD was defined as an alanine transaminase concentration >30 U/L. RESULTS Vitamin D deficiency was noted in 78.9% of the studied population. Age, body mass index, waist circumference, and blood pressure, glucose, cholesterol, and triglyceride levels were significantly higher in adolescents with suspected NAFLD than in adolescents without suspected NAFLD, while the mean vitamin D level was significantly lower in adolescents with suspected NAFLD. The multivariate-adjusted odds of suspected NAFLD were higher with increased age, male gender, obesity, and metabolic syndrome. Individuals with vitamin D deficiency were at higher risk of suspected NAFLD (odds ratio, 1.77; 95% confidence interval, 1.07-2.95) after adjusting for age, gender, obesity, and metabolic syndrome. CONCLUSION Vitamin D deficiency was associated with suspected NAFLD, independent of obesity and metabolic syndrome, in adolescents.
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Affiliation(s)
- Young Hoon Cho
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Whi Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jung Ok Shim
- Department of Pediatrics, Korea University Medical Center, Seoul, Korea
| | - Hye Ran Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Young Chang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Soo Moon
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Ko
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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20
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Jeon Y, Shin J, Jhee JH, Cho Y, Park EC. Differential Association of Vitamin D Deficiency With Albuminuria by Sex in the Korean General Population: A Cross-sectional Study of the Korea National Health and Nutrition Examination Survey 2011-2012. J Prev Med Public Health 2018; 51:92-99. [PMID: 29631350 PMCID: PMC5897236 DOI: 10.3961/jpmph.17.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 01/23/2018] [Indexed: 11/09/2022] Open
Abstract
Objectives Albuminuria has emerged as a biomarker for several medical conditions, and vitamin D has received attention due to its associations with various disorders. We evaluated the association between low serum vitamin D levels and prevalent albuminuria by sex in the Korean general population. Methods We analyzed 9823 participants (4401 males, 5422 females) from the Korea National Health and Nutrition Examination Survey 2011-2012 (KNHANES V-2), and categorized them as having a normal range of vitamin D levels, vitamin D insufficiency, or vitamin D deficiency. A multivariable logistic regression model was used to compare the risk of albuminuria across these groups. Stratified analyses were conducted by smoking status, obesity, and renal function. Results Albuminuria was found in 325 of the 4401 male participants (7.4%) and in 455 of the 5422 female participants (8.4%). Among the males, vitamin D deficiency was associated with an odds ratio (OR) for albuminuria of 1.78 (95% confidence interval [CI], 1.07 to 2.97, p<0.05). However, such an association was not found in females. The association was stronger in male current smokers (OR, 3.54; 95% CI, 1.47 to 8.50; p=0.005). Conclusions The findings of this study suggest that sex differences exist in the association between serum vitamin D deficiency and albuminuria. Additionally, we observed that the association was stronger in current smokers than in the overall male population, but was not seen in non-smokers. Therefore, different approaches by sex and smoking status might be needed when considering using vitamin D as a biomarker for renal function.
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Affiliation(s)
- Yongwoo Jeon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jaeyong Shin
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hyun Jhee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Youngdae Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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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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22
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Ke L, Mason RS, Baur LA, Cowell CT, Liu X, Garnett SP, Brock KE. Vitamin D levels in childhood and adolescence and cardiovascular risk factors in a cohort of healthy Australian children. J Steroid Biochem Mol Biol 2018; 177:270-277. [PMID: 28716759 DOI: 10.1016/j.jsbmb.2017.07.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/07/2017] [Accepted: 07/12/2017] [Indexed: 01/01/2023]
Abstract
As the prevalence of obesity appears to be increasing in Australia's youth the overall objective of this study was to examine serum 25-hydroxyvitamin D (25OHD) concentrations in a cohort of 8-year-olds (n=249) followed up at age 15 (n=162) and explore associations between 25OHD with cardiovascular disease (CVD) risk factors in these populations. This was done in two stages: the first, two cross-sectional analyses (at ages 8 and 15); and the second, a prospective analysis from age 8 to 15. At both ages data on 25OHD, blood lipids, and anthropometry were measured. Date of blood draw was used as a surrogate of sunlight exposure. Results were then analysed by multivariate linear analyses taking into account interaction and confounding. Mean 25OHD concentrations decreased from 94±25nmol/L to 63±16nmol/L between age 8 and 15 years (p<0.001). On cross-sectional analysis of 8year olds, no CVD risk factor was found to be significantly associated with 25OHD concentrations. On cross-sectional analysis of 15year olds lower 25OHD levels were significantly associated with higher body fat (adjusted β=-0.24, p=0.003). Prospectively, lower 25OHD levels in 8-year-old boys, but not girls, were significantly associated with higher blood total cholesterol (adjusted β=-0.28, p=0.040) and triglyceride levels (adjusted β=-0.33, p=0.030) at age 15. The limitation of these data is the relatively small sample sizes, however these results suggest that low 25OHD in childhood needs to be further investigated in larger cohort studies as there may be later cardiovascular consequences in adolescence.
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Affiliation(s)
- Larry Ke
- Faculty of Health Sciences, The University of Sydney, Australia
| | - Rebecca S Mason
- Physiology, School of Medical Sciences Bosch Institute, The University of Sydney, Australia
| | - Louise A Baur
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Australia; The Children's Hospital at Westmead Clinical School, The University of Sydney, Australia
| | - Chris T Cowell
- The Children's Hospital at Westmead Clinical School, The University of Sydney, Australia
| | - Xiaoying Liu
- Physiology, School of Medical Sciences Bosch Institute, The University of Sydney, Australia
| | - Sarah P Garnett
- The Children's Hospital at Westmead Clinical School, The University of Sydney, Australia; Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead Sydney, Australia
| | - Kaye E Brock
- Physiology, School of Medical Sciences Bosch Institute, The University of Sydney, Australia.
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Kim YS, Hwang JH, Song MR. The Association Between Vitamin D Deficiency and Metabolic Syndrome in Korean Adolescents. J Pediatr Nurs 2018; 38:e7-e11. [PMID: 29212598 DOI: 10.1016/j.pedn.2017.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/05/2017] [Accepted: 11/05/2017] [Indexed: 01/29/2023]
Abstract
PURPOSE This study aimed to analyze the demographic characteristics associated with vitamin D deficiency, as well as the association between vitamin D deficiency and metabolic syndrome, among Korean adolescents. DESIGN AND METHODS This cross-sectional descriptive study involved 2314 adolescents aged 12-18years. Participant data were extracted from the Korean National Health and Nutrition Examination Survey conducted between January 2010 and December 2014. A logistic regression analysis was performed to analyze the association between vitamin D and metabolic syndrome. All analyses were performed using IBM SPSS Statistics 24. RESULTS Among the participants, 78% exhibited vitamin D deficiency and 7.8% had metabolic syndrome. The vitamin D deficient and sufficient groups differed significantly in terms of age, sex, household income, and self-perceived health status. Among the subcomponents of metabolic syndrome, vitamin D deficiency was associated with a 2.07-fold higher risk of elevated fasting blood glucose (≥100mg/dL). CONCLUSIONS The association of vitamin D deficiency with an increased risk of elevated fasting blood glucose levels suggests that adolescents in this population should receive interventions to prevent and manage diabetes. In the future, the effects of vitamin D deficiency on chronic health problems, including diabetes, should be investigated in adolescents. PRACTICE IMPLICATIONS Adolescents with vitamin D deficiency should be screened for prediabetes, and clinicians should be concerned about both the diagnosis and prevention of diabetes in this population.
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Affiliation(s)
- Yoon-Sook Kim
- Department of Quality Improvement, Konkuk University Medical Center, Seoul, South Korea
| | - Jeong Hae Hwang
- Department of Health Administration, Hanyang Cyber University, Seoul, South Korea
| | - Mi Ryeong Song
- College of Nursing, Gachon University, Incheon, South Korea.
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24
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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: 8] [Impact Index Per Article: 1.1] [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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Byun EJ, Heo J, Cho SH, Lee JD, Kim HS. Suboptimal vitamin D status in Korean adolescents: a nationwide study on its prevalence, risk factors including cotinine-verified smoking status and association with atopic dermatitis and asthma. BMJ Open 2017; 7:e016409. [PMID: 28698345 PMCID: PMC5541452 DOI: 10.1136/bmjopen-2017-016409] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine the prevalence and risk factors for suboptimal vitamin D status in Korean adolescents and to assess its relationship with atopic dermatitis (AD) and asthma at a national level. DESIGN This is a cross-sectional study with data from the Korean National Health and Nutrition Examination Survey. Information regarding socioeconomic characteristics, clinical data and environmental factors was collected. Blood and urine samples were taken for vitamin D and cotinine, respectively. Descriptive and multivariable logistic regression was performed on the data. SETTING South Korea (nationwide). PARTICIPANTS 2515 individuals aged 10-18 years who participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2011. MAIN OUTCOME MEASURES Vitamin D status was determined through measurement of serum 25-hydroxyvitamin D (25OHD). Smoking status was classified based on the urine cotinine level. Physician diagnosed with AD and asthma were assessed using a questionnaire. RESULTS Overall, 73.3% of the subjects were vitamin D deficient (25OHD <20 ng/mL) and 24.4% of the subjects were vitamin D insufficient (25OHD, 20-29.9 ng/mL). Older age (p<0.001), female gender (p<0.001), urban residence (p=0.019), higher body mass index (p=0.003) and sampling in winter months (November-March) (p<0.001) were independently associated with low serum 25OHD levels. With cotinine verification, 18.2% of the participants were classified as active smokers, and 43.4% were classified as passive smokers. After adjusting for potential confounders, serum 25OHD status showed no association with AD or asthma. CONCLUSION Vitamin D deficiency is highly prevalent in Korean adolescents. Cotinine-verified prevalence of smoking was also high, but its relationship with vitamin D deficiency was not confirmed in our study. Above all, our results provide epidemiological evidence against the association of vitamin D status with AD and asthma at the national level among Korean adolescents.
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Affiliation(s)
- Eun Jung Byun
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jinyoung Heo
- Department of Preventive Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Jeong Deuk Lee
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Republic of Korea
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Tavakoli F, Namakin K, Zardast M. Vitamin D Supplementation and High-Density Lipoprotein Cholesterol: A Study in Healthy School Children. IRANIAN JOURNAL OF PEDIATRICS 2016; 26:e3311. [PMID: 27713805 PMCID: PMC5045666 DOI: 10.5812/ijp.3311] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 02/20/2016] [Accepted: 03/12/2016] [Indexed: 02/07/2023]
Abstract
Background The high-density lipoprotein cholesterol (HDL-C) level has been shown to have a significant role in the prevention of cardiovascular diseases and atherosclerosis. Low vitamin D levels have been shown to be correlated with dyslipidemia, but limited data exist on indigenous children. Objectives We aimed to investigate the effect of vitamin D supplementation on HDL-C levels in school-aged Iranian children. Methods In this prospective controlled clinical trial, 47 healthy children (23 boys) aged 10 - 14 years, students of Birjand (Iran) elementary schools, were selected and randomly divided into two groups. The study group received a vitamin D supplement (1000 mg capsule) daily for one month, and placebo tablets were prescribed to the controls. Before and after the treatment course, the serum HDL-C and 25-hydroxy vitamin D levels of both groups were measured. The data were analyzed by SPSS, ver. 16, and Chi-square tests, Fisher’s exact test, paired-sample t-tests, and Pearson’s correlation were used, wherever appropriate. The significance level was set at P < 0.05. Results Forty children completed the study; their mean age was 11.5 ± 1.175 years. The mean serum levels of both HDL-C and vitamin D showed a significant rise following the treatment in the study group (P = 0.007 and P < 0.001, respectively), whereas both variables decreased slightly in the control group (P = 0.27). There was no statistically significant difference in the mean serum levels of HDL-C and vitamin D between the two groups after the intervention (P = 0.11 and P = 0.20, respectively). Conclusions Vitamin D supplements seem to have a positive impact on serum HDL-C levels and may be effective in reducing the risk of cardiovascular diseases in the long term.
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Affiliation(s)
- Fatemeh Tavakoli
- Department of Pediatrics, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
| | - Kokab Namakin
- Department of Pediatrics, Atherosclerosis and Coronary Artery Research Center, Birjand University of Medical Sciences, Birjand, IR Iran
- Corresponding author: Kokab Namakin, Department of Pediatrics, Atherosclerosis and Coronary Artery Research Centre, Birjand University of Medical Sciences, Birjand, IR Iran, E-mail:
| | - Mahmood Zardast
- Department of Pathology, School of Medicine, Birjand University of Medical Sciences, Birjand, IR Iran
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Serum 25-hydroxyvitamin D concentrations and cardiometabolic risk factors in adolescents and young adults. Br J Nutr 2016; 115:1994-2002. [DOI: 10.1017/s0007114516001185] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AbstractEvidence associating serum 25-hydroxyvitamin D (25(OH)D) concentrations and cardiometabolic risk factors is inconsistent and studies have largely been conducted in adult populations. We examined the prospective associations between serum 25(OH)D concentrations and cardiometabolic risk factors from adolescence to young adulthood in the West Australian Pregnancy Cohort (Raine) Study. Serum 25(OH)D concentrations, BMI, homoeostasis model assessment for insulin resistance (HOMA-IR), TAG, HDL-cholesterol and systolic blood pressure (SBP) were measured at the 17-year (n 1015) and 20-year (n 1117) follow-ups. Hierarchical linear mixed models with maximum likelihood estimation were used to investigate associations between serum 25(OH)D concentrations and cardiometabolic risk factors, accounting for potential confounders. In males and females, respectively, mean serum 25(OH)D concentrations were 73·6 (sd 28·2) and 75·4 (sd 25·9) nmol/l at 17 years and 70·0 (sd 24·2) and 74·3 (sd 26·2) nmol/l at 20 years. Deseasonalised serum 25(OH)D3 concentrations were inversely associated with BMI (coefficient −0·01; 95 % CI −0·03, −0·003; P=0·014). No change over time was detected in the association for males; for females, the inverse association was stronger at 20 years compared with 17 years. Serum 25(OH)D concentrations were inversely associated with log-HOMA-IR (coefficient −0·002; 95 % CI −0·003, −0·001; P<0·001) and positively associated with log-TAG in females (coefficient 0·002; 95 % CI 0·0008, 0·004; P=0·003). These associations did not vary over time. There were no significant associations between serum 25(OH)D concentrations and HDL-cholesterol or SBP. Clinical trials in those with insufficient vitamin D status may be warranted to determine any beneficial effect of vitamin D supplementation on insulin resistance, while monitoring for any deleterious effect on TAG.
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Bucak IH, Ozturk AB, Almis H, Cevik MÖ, Tekin M, Konca Ç, Turgut M, Bulbul M. Is there a relationship between low vitamin D and rotaviral diarrhea? Pediatr Int 2016; 58:270-3. [PMID: 26287796 DOI: 10.1111/ped.12809] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Revised: 08/05/2015] [Accepted: 08/12/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND For children under 5 years of age, 1700 000 000 episodes of diarrhea are seen worldwide, and death occurs in 700 000 of these cases due to diarrhea. Rotavirus is an important cause of diarrhea in this age group, and many studies have shown that vitamin D plays a pivotal role in the immune system, as well as in antimicrobial peptide gene expression. In addition, lower vitamin D has been correlated with higher rates of infectious diseases such as respiratory tract infection, tuberculosis, and viral infection. METHODS Seventy patients with rotaviral diarrhea and 67 healthy patients were enrolled in this study. Serum 25-hydroxy vitamin D(3) (25(OH)D(3)), parathormone, calcium, phosphate, alkaline phosphatase, complete blood count parameters, and C-reactive protein were compared between pre-school children hospitalized due to rotaviral diarrhea and healthy children. Additionally, birthweight, feeding habits in the first 6 months of life, vitamin D and multivitamin supplements, and rotaviral vaccinations were also evaluated in each group. RESULTS There were no differences between the groups with regard to gender and age, but 25(OH)D(3) was significantly different: 14.6 ± 8.7 ng/mL in the rotaviral diarrhea patients versus 29.06 ± 6.51 ng/mL in the health controls (P < 0.001), and serum 25(OH)D(3) <20 ng/mL (OR, 6.3; 95%CI: 3.638-10.909; P < 0.001) was associated with rotaviral diarrhea. CONCLUSIONS Low vitamin D is associated with rotaviral diarrhea. This is the first study in the literature to show this, and this result needs to be repeated in larger controlled clinical studies.
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Affiliation(s)
- Ibrahim Hakan Bucak
- Department of Pediatrics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Agah Bahadır Ozturk
- Department of Family Medicine, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Habip Almis
- Department of Pediatrics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Muhammer Özgür Cevik
- Department of Medical Genetics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Mehmet Tekin
- Department of Pediatrics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Çapan Konca
- Department of Pediatrics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Mehmet Turgut
- Department of Pediatrics, Adıyaman University School of Medicine, Adıyaman, Turkey
| | - Mehmet Bulbul
- Department of Obstetrics and Gynecology, Adıyaman University School of Medicine, Adıyaman, Turkey
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Wakayo T, Whiting SJ, Belachew T. Vitamin D Deficiency is Associated with Overweight and/or Obesity among Schoolchildren in Central Ethiopia: A Cross-Sectional Study. Nutrients 2016; 8:190. [PMID: 27043619 PMCID: PMC4848659 DOI: 10.3390/nu8040190] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/19/2016] [Accepted: 03/22/2016] [Indexed: 12/11/2022] Open
Abstract
Childhood and adolescent obesity is an international public health problem leading to an increased risk of adulthood obesity, mortality and morbidity. Its prevalence is increasing in low-income populations, and we hypothesized it may be associated with vitamin D deficiency. Low vitamin D status is a worldwide public health issue including in Ethiopia; however, no one has examined overweight/obesity in Ethiopian schoolchildren with regard to vitamin D status. The Analyses of a data set from a school-based cross-sectional study conducted in Adama Town (n = 89) and in rural Adama Woreda (n = 85) was carried out to determine vitamin D deficiency and its association with overweight and/or obesity. Data on a total of 174 schoolchildren aged 11-18 years was used for these analyses. The overall prevalence of overweight and/or obesity was 10.3%, with 8.5% overweight and 2.3% obese; the prevalence of underweight was 19%. In the multivariable logistic regression model, vitamin D deficiency, being in the higher age group, female sex and urban residence of students, their mothers' occupation of being employed and their households' high and middle socioeconomic status were significantly associated with overweight and/or obesity. We concluded that vitamin D deficiency is an independent predictor significantly associated with overweight and/or obesity among schoolchildren from rural and urban settings in Ethiopia. The results imply the need for behavior change communications on the importance of exposure to sunlight to produce adequate vitamin D to curb this emerging health problem of overweight/obesity following economic growth and globalization in Ethiopia. As this study only highlighted the association, prospective studies and randomized controlled trials are required to establish causality.
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Affiliation(s)
- Tolassa Wakayo
- College of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada.
| | - Tefera Belachew
- College of Health Sciences, Jimma University, Jimma, Ethiopia.
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Yoon SY, Bae SH, Shin YJ, Park SG, Hwang SH, Hyon JY, Wee WR. Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome. PLoS One 2016; 11:e0147847. [PMID: 26807908 PMCID: PMC4726745 DOI: 10.1371/journal.pone.0147847] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 01/08/2016] [Indexed: 01/07/2023] Open
Abstract
Background Dry eye syndrome (DES) is a common tear film and ocular surface disease that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Systemic diseases associated with DES include diabetes mellitus, rheumatoid arthritis, depression, anxiety, thyroid disease, allergic diseases, irritable bowel syndrome, chronic pain syndrome, and hyperlipidemia. Interestingly, it has been found that most of these are associated with low levels of serum 25-hydroxyvitamin D (25(OH)D) or inadequate sunlight exposure. Methods In this cross-sectional data analysis, noninstitutionalized adults aged ≥19 years (N = 17,542) who participated in Korean National Health and Nutrition Examination Survey 2010–2012 were included. Information regarding duration of sunlight exposure was collected from the survey participants. Serum 25(OH)D and zinc levels were measured. The confounding variables were age, gender, sunlight exposure time, region of residence, obesity, serum 25(OH)D level, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and walking exercise. Results Mean serum 25(OH)D levels of subjects with and without DES were 16.90 ± 6.0 and 17.52 ± 6.07 (p<0.001). Inadequate sunlight exposure time (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.307–1.848), urban residence (OR, 1.669; 95% CI, 1.456–1.913), indoor occupation (OR, 1.578; 95% CI, 1.389–1.814), and low serum 25(OH)D level (OR, 1.158; 95% CI, 1.026–1.308) were the risk factors for DES. After adjusting for age, sex, obesity, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and occupation, low serum 25(OH)D level (OR, 1.178; 95% CI, 1.010–1.372) and deficient sunlight exposure time (OR, 1.383; 95% CI, 1.094–1.749) were the risk factors for diagnosed DES. Conclusion Low serum 25(OH)D levels and inadequate sunlight exposure are associated with DES in Korean adults. These results suggest that sufficient sunlight exposure or vitamin D supplementation may be useful in DES treatment.
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Affiliation(s)
- Sam Young Yoon
- Department of Ophthalmology, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Seok Hyun Bae
- Department of Ophthalmology, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Young Joo Shin
- Department of Ophthalmology, Hallym University College of Medicine, Seoul, Republic of Korea
- * E-mail: ;
| | - Shin Goo Park
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - Sang-Hee Hwang
- Department of Dentistry, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Gyeonggi, Korea
| | - Won Ryang Wee
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Republic of Korea
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Foroughi M, Maghsoudi Z, Askari G. The effect of vitamin D supplementation on blood sugar and different indices of insulin resistance in patients with non-alcoholic fatty liver disease (NAFLD). IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2016; 21:100-4. [PMID: 26985230 PMCID: PMC4776554 DOI: 10.4103/1735-9066.174759] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2013] [Accepted: 02/18/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D supplementation has been shown to decrease insulin resistance through which it might cause fatty liver. Fatty liver increasingly results in type 2 diabetes mellitus (T2DM). Insulin resistance and fatty liver are particularly closely related. The aim of present study is to examine the effect of vitamin D supplementation on blood sugar and different indices of insulin resistance in patients with non-alcoholic fatty liver disease (NAFLD). MATERIALS AND METHODS This randomized placebo-controlled clinical trial was conducted on 60 patients with NAFLD, who were divided equally into intervention and control groups. Patients in the intervention group received vitamin D3 (50,000 IU) and patients in the control group received placebo capsules every week for 10 weeks. Blood sugar, homeostatic model assessment-insulin resistance (HOMA-IR), and homeostatic model assessment-beta cell (HOMA-B) were checked at baseline and after 10 weeks of the intervention. Adjustment for variables was performed by analysis of covariance (ANCOVA). RESULTS Vitamin D supplementation resulted in increased serum 25-hydroxy vitamin D [25(OH) D] concentration in the intervention group compared to the control group [+68 (12) vs. -1.9 (2.44); P = 0.001]. Intake of vitamin D supplements led to a marginally significant decrease in fasting blood glucose [FBS: -12 (4) in the intervention group compared to - 3 (2) in the control group; P = 0.055]. Also, HOMA-IR decreased in the intervention group compared to the control group [-1.75 (0.23) vs. 0.12 (0.41); P = 0.066]. CONCLUSIONS Vitamin D supplementation resulted in decreased HOMA-IR and FBS concentration in patients with NAFLD; however, it did not affect the insulin level and HOMA-B significantly.
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Affiliation(s)
- Mehdi Foroughi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Maghsoudi
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Beuzit C, L’Hour MC, Roudaut S, Gouillou M, Metz C, Moineau MP, Kerspern H, de Parscau L, Teissier R. Prévalence du déficit en vitamine D chez les enfants âgés de 5 à 10ans en Bretagne Occidentale. Arch Pediatr 2015; 22:1112-8. [PMID: 26482185 DOI: 10.1016/j.arcped.2015.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 06/29/2015] [Accepted: 08/23/2015] [Indexed: 12/20/2022]
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Park JB, Han K, Park YG, Ko Y. Association Between Alcohol Consumption and Periodontal Disease: The 2008 to 2010 Korea National Health and Nutrition Examination Survey. J Periodontol 2014; 85:1521-8. [DOI: 10.1902/jop.2014.130782] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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de Moraes ACF, Gracia-Marco L, Iglesia I, González-Gross M, Breidenassel C, Ferrari M, Molnar D, Gómez-Martínez S, Androutsos O, Kafatos A, Cuenca-García M, Sjöström M, Gottrand F, Widhalm K, Carvalho HB, Moreno LA. Vitamins and iron blood biomarkers are associated with blood pressure levels in European adolescents. The HELENA study. Nutrition 2014; 30:1294-300. [PMID: 25194965 DOI: 10.1016/j.nut.2014.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 02/08/2014] [Accepted: 03/12/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Previous research showed that low concentration of biomarkers in the blood during adolescence (i.e., iron status; retinol; and vitamins B6, B12, C, and D) may be involved in the early stages of development of many chronic diseases, such as hypertension. The aim was to evaluate if iron biomarkers and vitamins in the blood are associated with blood pressure in European adolescents. METHODS Participants from the Healthy Lifestyle in Europe by Nutrition in Adolescence cross-sectional study (N = 1089; 12.5-17.5 y; 580 girls) were selected by complex sampling. Multilevel linear regression models examined the associations between iron biomarkers and vitamins in the blood and blood pressure; the analyses were stratified by sex and adjusted for contextual and individual potential confounders. RESULTS A positive association was found in girls between RBC folate concentration and systolic blood pressure (SBP) (β = 3.19; 95% confidence interval [CI], 0.61-5.77), although no association between the vitamin serum biomarkers concentrations and diastolic blood pressure (DBP) was found. In boys, retinol was positively associated with DBP (β = 3.84; 95% CI, 0.51-7.17) and vitamin B6 was positively associated with SBP (β = 3.82; 95% CI, 1.46-6.18). In contrast, holotranscobalamin was inversely associated with SBP (β = -3.74; 95% CI, -7.28 to -0.21). CONCLUSIONS Levels of RBC folate and vitamin B6 in blood may affect BP in adolescents. In this context, programs aimed at avoiding high BP levels should promote healthy eating behavior by focusing on the promotion of vegetable proteins and foods rich in vitamin B12 (i.e., white meat and eggs), which may help to achieve BP blood control in adolescents.
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Affiliation(s)
- Augusto César Ferreira de Moraes
- Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil; GENUD-Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences of the University of Zaragoza, Zaragoza, Spain.
| | - Luis Gracia-Marco
- GENUD-Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; University of Exeter, Children's Health and Exercise Research Centre, Sport and Health Sciences, Exeter, United Kingdom
| | - Iris Iglesia
- GENUD-Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences of the University of Zaragoza, Zaragoza, Spain
| | - Marcela González-Gross
- Faculty of Physical Activity and Sport-INEF, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain; Universität Bonn, Institut für Ernährungs-und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms, Bonn, Germany
| | - Christina Breidenassel
- Faculty of Physical Activity and Sport-INEF, Department of Health and Human Performance, Technical University of Madrid, Madrid, Spain; Universität Bonn, Institut für Ernährungs-und Lebensmittelwissenschaften-Humanernährung, Rheinische Friedrich-Wilhelms, Bonn, Germany
| | - Marika Ferrari
- National Research Institute on Food and Nutrition, Rome, Italy
| | - Dénes Molnar
- Medical Faculty, University of Pécs, Department of Paediatrics, Pécs, Hungary
| | - Sonia Gómez-Martínez
- Food Science and Technology and Nutrition Institute, Spanish National Research Council Immunonutrition-Research Group Department of Metabolism and Nutrition, Madrid, Spain
| | | | - Anthony Kafatos
- University of Crete School of Medicine, Preventive Medicine & Nutrition Unit, Heraklion, Crete, Greece
| | - Magdalena Cuenca-García
- Department of Medical Physiology, School of Medicine of the University of Granada, Granada, Spain
| | - Michael Sjöström
- Department of Biosciences, Unit for Preventive Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Frederic Gottrand
- Unité Inserm U995 & Université Lille Nord de France, Lille, France; Centre d'Investigation Clinique, Lille, France
| | - Kurt Widhalm
- Department of Pediatrics, Private Medical University Salzburg, Salzburg, Austria
| | | | - Luis A Moreno
- Department of Preventive Medicine, School of Medicine of the University of São Paulo, São Paulo, Brazil; GENUD-Growth, Exercise, Nutrition and Development Research Group, University of Zaragoza, Zaragoza, Spain; Faculty of Health Sciences of the University of Zaragoza, Zaragoza, Spain
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Cheng HM, Kim S, Park GH, Chang SE, Bang S, Won CH, Lee MW, Choi JH, Moon KC. Low vitamin D levels are associated with atopic dermatitis, but not allergic rhinitis, asthma, or IgE sensitization, in the adult Korean population. J Allergy Clin Immunol 2013; 133:1048-55. [PMID: 24388009 DOI: 10.1016/j.jaci.2013.10.055] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/27/2013] [Accepted: 10/29/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND The effect of vitamin D on allergic conditions is unclear. In particular, large-scale, population-based studies examining this relationship in adult Asian populations are lacking. OBJECTIVE To evaluate the association between serum vitamin D levels and allergic conditions in the general adult Korean population. METHODS A cross-sectional study was performed by using data collected from 15,212 individuals 19 years or older who participated in the Korean National Health and Nutrition Examination Survey from 2008 to 2010. The confounder-adjusted mean serum 25-hydroxyvitamin D (25[OH]D) levels of participants with and without allergic conditions (including atopic dermatitis, asthma, allergic rhinitis, and increased total and allergen-specific serum IgE) were compared by using multiple linear regression analyses. Multiple logistic regression analyses with confounder adjustment estimated the odds ratios (ORs) for developing each condition according to adequate, inadequate, or deficient serum 25(OH)D levels. RESULTS After adjusting for potential confounders, mean serum 25(OH)D levels were significantly lower in participants diagnosed with atopic dermatitis than in those without this diagnosis (mean ± SE, 18.58 ± 0.29 ng/mL vs 19.20 ± 0.15 ng/mL; P = .02). Compared with participants with adequate vitamin D levels (≥20 ng/mL), confounder-adjusted ORs of atopic dermatitis were significantly higher in those with inadequate (12-19.99 ng/mL) or deficient (<12 ng/mL) levels (OR [95% CI], 1.50 [1.10-2.06] and 1.48 [1.04-2.12], respectively; P = .02). This relationship was not observed in participants with the other allergic conditions. CONCLUSION Vitamin D-insufficient adult individuals within the general Korean population have an increased likelihood of atopic dermatitis, but not asthma, allergic rhinitis, or IgE sensitization.
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Affiliation(s)
- Hui Mei Cheng
- Royal Perth Hospital, Perth, Western Australia, Australia
| | - Sunmi Kim
- Department of Family Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Gyeong-Hun Park
- Department of Dermatology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
| | - Sung Eun Chang
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | | | - Chong Hyun Won
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jee Ho Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kee Chan Moon
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Jiménez-Pavón D, Sesé MA, Valtueña J, Cuenca-García M, González-Gross M, Gottrand F, Kafatos A, Manios Y, Widhalm K, de Henauw S, Polito A, Pérez-López FR, Moreno LA. Leptin, vitamin D, and cardiorespiratory fitness as risk factors for insulin resistance in European adolescents: gender differences in the HELENA Study. Appl Physiol Nutr Metab 2013; 39:530-7. [PMID: 24766234 DOI: 10.1139/apnm-2013-0250] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The purpose of this study was to identify the relevance of a set of risk factors for insulin resistance in adolescents from Europe and to consider their possible gender-specific associations. The Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study (HELENA-CSS) was conducted in 1053 European adolescents (mean age, 14.9 years) in a school setting in 9 countries. Three anthropometric markers of body fat and a dietary index were calculated. Total energy intake was estimated from a questionnaire. C-reactive protein, leptin, and vitamin D were assessed, and physical activity, cardiorespiratory fitness, and muscular strength were measured. Center, socioeconomic status, pubertal status, and season were used as potential confounders. The main outcome was the homeostasis model assessment used as a marker of insulin resistance. Correlations, analyses of covariance, and logistic regression models were used. In males, leptin was the only risk factor for insulin resistance after adjusting for confounders including markers of body fat (odds ratios (ORs) from 1.49 to 1.60). In females, leptin, vitamin D, and fitness were the remaining independent risk factors for insulin resistance after adjustments (OR 2.11; 95% confidential interval (CI) 1.29-3.45; OR 0.50, 95% CI 0.31-0.80; and OR 0.54, 95% CI 0.33-0.87, respectively). Our observations suggest a gender dimorphism in the identification of risk factors for high insulin resistance. Preventive strategies should focus on improving modifiable factors such as cardiorespiratory fitness and on ensuring vitamin D sufficiency. Randomized controlled trials focusing on these strategies are necessary to test their efficacy.
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Affiliation(s)
- David Jiménez-Pavón
- a GENUD (Growth, Exercise, Nutrition and Development) Research Group, Department of Physiotherapy and Nursing, Faculty of Health Sciences, University of Zaragoza, Avd., Domingo Miral s/n. CP: 50009, Zaragoza, Spain
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Circulating 25-hydroxyvitamin D levels and hypertension risk. Eur J Epidemiol 2013; 28:611-6. [PMID: 23821243 DOI: 10.1007/s10654-013-9817-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 05/24/2013] [Indexed: 12/29/2022]
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