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Delrue C, Speeckaert R, Delanghe JR, Prytuła A, Speeckaert MM. Investigating Vitamin D-Binding Protein's Role in Childhood Health and Development. Int J Mol Sci 2024; 25:6272. [PMID: 38892458 PMCID: PMC11172735 DOI: 10.3390/ijms25116272] [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: 05/20/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
Vitamin D-binding protein (DBP), also known as Gc-globulin, is a protein that affects several physiological processes, including the transport and regulation of vitamin D metabolites. Genetic polymorphisms in the DBP gene have a significant impact on vitamin D levels and may have implications for disease risk. DBP polymorphisms are linked to differential immune responses, which could influence the onset of juvenile diseases. This narrative review examines the various roles of DBP, with a focus on bone health, immunological regulation, and lipid metabolism in children. Chronic disorders affected by DBP polymorphisms include bone abnormalities, autoimmune diseases, cardiovascular issues, childhood asthma, allergies, cystic fibrosis, acute liver failure, celiac disease, inflammatory bowel disease, and chronic kidney disease. Future research should focus on identifying the processes that underpin the many roles that DBP plays and developing customized therapeutics to improve health outcomes in the juvenile population.
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Affiliation(s)
- Charlotte Delrue
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
| | | | - Joris R. Delanghe
- Department of Diagnostic Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Agnieszka Prytuła
- Department of Pediatrics, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
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2
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Zhu L, Li S, Zhong L, Xu S, Zhu H. Optimal vitamin D supplement dosage for improving insulin resistance in children and adolescents with overweight/obesity: a systematic review and network meta-analysis. Eur J Nutr 2024; 63:763-775. [PMID: 38160221 PMCID: PMC10948536 DOI: 10.1007/s00394-023-03301-x] [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: 02/20/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE We conducted a network meta-analysis which aims to evaluate the comparative efficacy of different supplementation dosages of vitamin D on cardiometabolic and bone-metabolic indicators as well as insulin resistance in children and adolescents with overweight/obesity. METHODS Eligible studies published before December 10, 2022 were retrieved from PubMed, EMBASE, Cochrane Library, and Web of Science. Mean difference and 95% confidence interval (CI) were used to express pooled estimates. Network meta-analysis of multiple doses, including low (< 1000 IU/day, LDS), medium (1000-2000 IU/day, MDS), high (2000-4000 IU/day, HDS), and extremely high (> 4000 IU/day, EHDS) dosage strategy, was conducted using STATA/MP 14.0. RESULTS Our network meta-analysis of 15 RCTs suggested that, compared with placebo and LDS, EHDS was increased 25-(OH)-D, with a pooled MD of 8.65 (95% CI 4.72-12.58) and 7.66 (95% CI 0.91-14.41), respectively. Meanwhile, EHDS also decreased ho meostasis model assessment-insulin resistance (HOMA-IR) (MD: - 0.74; 95% CI: - 1.45 to - 0.04) and C-reactive protein (CRP) (MD: - 18.99; 95% CI - 21.60 to - 16.38), and EHDS was also better than LDS (MD: - 18.47; 95% CI - 20.66 to - 16.28) and MDS (MD: - 19.69; 95% CI - 22.17 to - 17.21) in decreasing CRP. Ranking probability suggested that EHDS ranked best for increasing 25-(OH)-D, and decreasing HOMA-IR and CRP, with a probability of 86.1%, 83.1%, and 76.6%, respectively. CONCLUSIONS The results of our network meta-analysis suggest that EHDS may be the best strategy for vitamin D supplementation to reduce inflammatory responses as well as improve insulin resistance in children and adolescents with overweight/obesity. PROSPERO REGISTRATION NUMBER CRD42023387775.
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Affiliation(s)
- Linlian Zhu
- Department of Nutriology, Dongtai People's Hospital, Dongtai, 224200, Jiangsu Province, China
| | - Shan Li
- Department of Integrated TCM and Western Medicine, Dongtai People's Hospital, Dongtai, 224200, Jiangsu Province, China
| | - Lijuan Zhong
- Department of Endocrinology, Dongtai People's Hospital, Dongtai, 224200, Jiangsu Province, China
| | - Shiping Xu
- Department of Cardiovascular Medicine, Dongtai People's Hospital, Dongtai, 224200, Jiangsu Province, China.
| | - Hongbin Zhu
- Department of Endocrinology, Dongtai People's Hospital, Dongtai, 224200, Jiangsu Province, China.
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Singh A, Singh N. Vitamin D intervention as a curative measure for glucose intolerance in obese children and adolescents: a systematic review on randomized control trials. Eur J Pediatr 2024; 183:1475-1483. [PMID: 38206398 DOI: 10.1007/s00431-023-05407-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024]
Abstract
Vitamin D deficiency is associated with obesity and its associated metabolic disorders, as specified in many epidemiological studies. The assertion that vitamin D can mitigate insulin insensitivity in obese children and adolescents lacks adequate empirical substantiation. Thus, the study utilized some clinical trials on vitamin D interventions to examine the impact of vitamin D supplementation on insulin resistance in obese children and adolescents. The literature was extracted by applying the PRISMA method through electronic databases such as Scopus, Science Direct, Medline, the Cochrane Library, and PubMed from 2012 to 2022. All the articles were in English, and the inclusion criteria for each article were based on the study design and the anthropometric and biochemical parameters of the subjects. A total of 572 research articles were acquired, out of which only seven closely adhered to the inclusion criteria of the study. The studies in this systematic review are based on randomized control trials. The age range of the children in this study spans from 2 to 19 years, and the follow-up period ranges from 3 to 12 months. The range of daily vitamin D doses provided varied from 2000 to 10,000 IU. The results indicate that four randomized controlled trials have demonstrated a positive impact on glycemic parameters, such as insulin levels, fasting blood sugar, and insulin resistance, in the subjects following vitamin D treatment. However, the three trials did not provide sufficient evidence to support a statistically significant effect. CONCLUSION The present review highlights that a significant proportion of the studies incorporated in the analysis demonstrate that the administration of vitamin D may be a preventive measure in ameliorating insulin resistance among pediatric patients with obesity, but it is advisable to implement a prolonged intervention with a substantial sample size and perform micro-level analysis at the gene level to evaluate the impact of vitamin D treatment. WHAT IS KNOWN • Childhood obesity and its associated metabolic disorder is a concerned global problem. • Several studies showed an association of vitamin D deficiency with adiposity- induced metabolicdisorders which are still controversial. This study focused on finding interlink between vitamin Dsupplementation with obesity induced insulin resistance in children and adolescents. WHAT IS NEW • This study supports that high dosage of Vitamin D in long term may be protective against insulinresistance in obese paediatric individuals. • A new factor is also reported in the study that vitamin D may alter the composition of gut microbiotawhich represents a compelling approach to the therapeutic management of obesity and diabetes.
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Affiliation(s)
- Ayushi Singh
- Department of Food and Nutrition, School of Home Science, Babasaheb Bhimrao Ambedkar University, Lucknow, Uttar Pradesh, India.
| | - Neetu Singh
- Department of Food and Nutrition, School of Home Science, Babasaheb Bhimrao Ambedkar University, Lucknow, Uttar Pradesh, India
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Jiang Q, Prabahar K, Saleh SAK, Adly HM, Velu P, Adi AR, Baradwan S, Hajkhalaf MI, Baredwan A, Gari F, Kord-Varkaneh H. The Effects of Vitamin D Supplementation on C-Reactive Protein and Systolic and Diastolic Blood Pressure in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. J Acad Nutr Diet 2024; 124:387-396.e5. [PMID: 38441080 DOI: 10.1016/j.jand.2023.10.013] [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: 03/15/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.
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Affiliation(s)
- Qidong Jiang
- Intensive Care Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Saleh A K Saleh
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M Adly
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Periyannan Velu
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Chidambaram, Tamil Nadu, India
| | | | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Ahlam Baredwan
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faris Gari
- Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hamed Kord-Varkaneh
- Department of Nutrition and Food Hygiene, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Gholamzad A, Khakpour N, Kabipour T, Gholamzad M. Association between serum vitamin D levels and lipid profiles: a cross-sectional analysis. Sci Rep 2023; 13:21058. [PMID: 38030665 PMCID: PMC10687006 DOI: 10.1038/s41598-023-47872-5] [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: 06/20/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023] Open
Abstract
Vitamin D is an essential nutrient that plays a crucial role in calcium homeostasis and bone health. Recent research suggests that vitamin D may also have an impact on lipid metabolism, specifically the level of circulating lipids in the blood. We aim to investigate it role among healthy participate. We conducted a cross-sectional study of 15,600 patients who were referred to the laboratories of university hospitals. We measured the serum levels of Vitamin D as well as triglycerides, total cholesterol, LDL, and HDL using ELISA. We found that the mean serum level of Vitamin D was 40.31 ± 20.79 ng/mL. Of the participants, 16.7% had a serum level of Vitamin D less than 20 ng/mL, 57.7% had a level between 21 and 40 ng/mL, and 13.5% had a level between 41 and 60 ng/mL. Additionally, 12.2% had a level greater than 60 ng/mL. We performed a one-way analysis of variance and found that as the serum level of Vitamin D increased, the mean LDL level decreased significantly. Our study provides evidence of a significant relationship between serum levels of Vitamin D and LDL levels in patients. The findings suggest that vitamin D status may play a role in regulating lipid metabolism and may have implications for the prevention and treatment of cardiovascular disease. Further research is needed to elucidate the underlying mechanisms of this relationship and to determine optimal levels of vitamin D intake for maintaining lipid profiles.
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Affiliation(s)
- Amir Gholamzad
- Department of Laboratory Medicine, Faculty of Paramedical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Niloofar Khakpour
- Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
- Department of Bacteriology and Virology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tina Kabipour
- Department of Laboratory Medicine, Faculty of Paramedical Sciences, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mehrdad Gholamzad
- Farhikhtegan Medical Convergence Sciences Research Center, Farhikhtegan Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
- Department of Microbiology and Immunology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
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Isart FA, Isart-Infante FJ, Heidel RE. Association of Blood Calcidiol Levels and Metabolic Syndrome in Children and Adolescents With Vitamin D Deficiency. Clin Pediatr (Phila) 2023:99228231204444. [PMID: 37978861 DOI: 10.1177/00099228231204444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
This retrospective cohort study aimed to determine whether severe calcidiol deficiency [25-hydroxyvitamin (OH)D <30 nmol/L] improvement has a beneficial effect on cardiometabolic parameters in children and adolescents (5-17 years) with or without metabolic syndrome (MetS). Logistic regression analysis was performed to test for multivariate associations between potential confounders and changes in vitamin D (VD) status from baseline to follow-up care when predicting binary categorical outcomes. Of 562 participants, 146 (26%) had MetS. Individuals with severe VD deficiency (VDD) were more likely to have MetS with elevated blood pressure than those with sufficient (≥75 nmol) VD levels (adjusted odds ratio [AOR], 4.46; 1.08-18.43; p < .05) at follow-up. In the logistic regression model, every unit increase in VD across time decreased the odds of MetS (AOR, 0.98; 95% confidence interval: [0.96, 0.99]; p < .05). Improvement in VD status demonstrated a beneficial metabolic effect in children and adolescents with severe VDD.
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Affiliation(s)
- Fernando A Isart
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
- Kids'n Teens Clinics P.A., Houston, TX, USA
| | | | - R Eric Heidel
- Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN, USA
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Elmoselhi AB, Bouzid A, Allah MS, Ibrahim Z, Bajbouj K, Abou Assaleh RS, Venkatachalam T, Madkour M, Siddiqui R, Khan NA, Hamoudi RA. Unveiling the molecular Culprit of arterial stiffness in vitamin D deficiency and obesity: Potential for novel therapeutic targets. Heliyon 2023; 9:e22067. [PMID: 38027669 PMCID: PMC10658375 DOI: 10.1016/j.heliyon.2023.e22067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 10/13/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
Cardiovascular diseases (CVDs) are highly associated with both vitamin D deficiency and obesity, two prevalent health conditions worldwide. Arterial stiffness, an independent predictor of CVDs, is particularly elevated in both conditions, yet the molecular mechanisms underlying this phenomenon remain elusive, hindering effective management of CVDs in this population. We recruited 20 middle-aged Emiratis, including 9 individuals with vitamin D deficiency (Vit D level ≤20 ng) and obesity (BMI ≥30) and 11 individuals as control with Vit D level >20 ng and BMI <30. We measured arterial stiffness using pulse wave velocity (PWV) and performed whole transcriptome sequencing to identify differentially expressed genes (DEGs) and enriched pathways. We validated these findings using qRT-PCR, Western blot, and multiplex analysis. PWV was significantly higher in the vitamin D deficient and obese group relative to controls (p ≤ 0.05). The DEG analysis revealed that pathways related to interleukin 1 (IL-1), nitrogen metabolism, HIF-1 signaling, and MAPK signaling were over-activated in the vitamin D deficient and obese group. We found that HIF-1alpha, NOX-I, NOX-II, IL-1b, IL-8, IL-10, and VEGF were significantly upregulated in the vitamin D deficient and obese group (p < 0.05). Our study provides new insights into the molecular mechanisms of arterial stiffness in vitamin D deficiency and obesity, demonstrating the role of oxidative stress and inflammation in this process. Our findings suggest that these biomarkers may serve as potential therapeutic targets for early prevention of CVDs. Further studies are needed to investigate these pathways and biomarkers with larger cohort.
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Affiliation(s)
- Adel B. Elmoselhi
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amal Bouzid
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed Seif Allah
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Cardiology Department, University Hospital Sharjah, United Arab Emirates
| | - Zeinab Ibrahim
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Khuloud Bajbouj
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rebal S. Abou Assaleh
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Thenmozhi Venkatachalam
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mohamed Madkour
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, American University of Sharjah, University City, Sharjah 26666, United Arab Emirates
- Department of Medical Biology, Faculty of Medicine, Istinye University, Istanbul, 34010, Turkey
| | - Naveed Ahmed Khan
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Medical Biology, Faculty of Medicine, Istinye University, Istanbul, 34010, Turkey
| | - Rifat A. Hamoudi
- College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Division of Surgery and Interventional Science, University College London, London, United Kingdom
- ASPIRE Precision Medicine Research Institute Abu Dhabi, University of Sharjah, Sharjah, United Arab Emirates
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Mihuta MS, Paul C, Borlea A, Roi CM, Pescari D, Velea-Barta OA, Mozos I, Stoian D. Connections between serum Trimethylamine N-Oxide (TMAO), a gut-derived metabolite, and vascular biomarkers evaluating arterial stiffness and subclinical atherosclerosis in children with obesity. Front Endocrinol (Lausanne) 2023; 14:1253584. [PMID: 37850094 PMCID: PMC10577381 DOI: 10.3389/fendo.2023.1253584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Childhood obesity leads to early subclinical atherosclerosis and arterial stiffness. Studying biomarkers like trimethylamine N-oxide (TMAO), linked to cardio-metabolic disorders in adults, is crucial to prevent long-term cardiovascular issues. Methods The study involved 70 children aged 4 to 18 (50 obese, 20 normal-weight). Clinical examination included BMI, waist measurements, puberty stage, the presence of acanthosis nigricans, and irregular menstrual cycles. Subclinical atherosclerosis was assessed by measuring the carotid intima-media thickness (CIMT), and the arterial stiffness was evaluated through surrogate markers like the pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures. The blood biomarkers included determining the values of TMAO, HOMA-IR, and other usual biomarkers investigating metabolism. Results The study detected significantly elevated levels of TMAO in obese children compared to controls. TMAO presented positive correlations to BMI, waist circumference and waist-to-height ratio and was also observed as an independent predictor of all three parameters. Significant correlations were observed between TMAO and vascular markers such as CIMT, PWV, and peripheral BP levels. TMAO independently predicts CIMT, PWV, peripheral BP, and central SBP levels, even after adding BMI, waist circumference, waist-to-height ratio, puberty development and age in the regression model. Obese children with high HOMA-IR presented a greater weight excess and significantly higher vascular markers, but TMAO levels did not differ significantly from the obese with HOMA-IR Conclusion Our study provides compelling evidence supporting the link between serum TMAO, obesity, and vascular damage in children. These findings highlight the importance of further research to unravel the underlying mechanisms of this connection.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Andreea Borlea
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Denisa Pescari
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Dana Stoian
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
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Halschou-Jensen PM, Sauer J, Bouchelouche P, Fabrin J, Brorson S, Ohrt-Nissen S. Improved Healing of Diabetic Foot Ulcers After High-dose Vitamin D: A Randomized Double-blinded Clinical Trial. INT J LOW EXTR WOUND 2023; 22:466-474. [PMID: 34213957 DOI: 10.1177/15347346211020268] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background. Chronic foot ulcers are a major cause of morbidity in people with diabetes with a lifetime risk of 25%. Treatment is challenging and the recurrence rates of foot ulcers are >50% after 3 years. Vitamin D deficiency is more common in people with diabetes with chronic foot ulcers, compared to both people without diabetes as well as people with diabetes but without foot ulcers. Purpose/aim of study. To assess the efficacy of high-dose compared to low-dose Cholecalciferol vitamin D3 on healing of chronic diabetic foot ulcers. Materials and methods. We included people with diabetes with one or more foot ulcers lasting for more than 6 weeks. Patients were randomly allocated to either a daily oral intake of high-dose (170 μg) or low-dose (20 μg) vitamin D3 (Cholecalciferol). We saw patients in the outpatient clinic after 4, 12, 24, 36, and 48 weeks. At each visit, we measured the ulcer with a specialized camera, and associated software and the area (cm2) was calculated. Patients and assessors were blinded to treatment allocation. We followed all patients for 48 weeks or until wound healing or surgical treatment. Findings/results. We included 48 patients in the analysis (24 in each group), with a total of 64 ulcers. Among them 41 ulcers were followed until healing or 48-week follow-up and 20 ulcers were surgically treated during the study period. Three patients were lost for follow-up. The intention-to-treat analysis showed a significantly higher rate of ulcer healing in the high-dose group with 21 of 30 (70%) healed ulcers compared to 12 of 34 (35%) in the low-dose group (P = .012). Median ulcer reduction at final follow-up was 100% (interquartile range [IQR]: 72-100) in the high-dose group and 57% (IQR: -28 to 100) in the low-dose group. Furthermore, we found a significant effect of high-dose vitamin D on ulcer reduction in the repeated measures analysis of variance. Conclusions. We found high-dose vitamin D3 to be efficient, compared to low-dose vitamin D3, in promoting healing in chronic diabetic foot ulcers.
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Affiliation(s)
| | - Jannie Sauer
- Zealand University Hospital, Køge, Sjælland, Denmark
| | | | - Jesper Fabrin
- Zealand University Hospital, Køge, Sjælland, Denmark
| | - Stig Brorson
- Zealand University Hospital, Køge, Sjælland, Denmark
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10
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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11
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Levita J, Wilar G, Wahyuni I, Bawono LC, Ramadaini T, Rohani R, Diantini A. Clinical Toxicology of Vitamin D in Pediatrics: A Review and Case Reports. TOXICS 2023; 11:642. [PMID: 37505607 PMCID: PMC10385357 DOI: 10.3390/toxics11070642] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 07/20/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023]
Abstract
Intoxication of vitamin D is not a common case in pediatrics. Vitamin D supplements are sold as OTC drugs; however, there is a lack of public education about the permissible limits of vitamin D intake which may lead to vitamin D toxicity (VDT). This review aims to give insights to readers or practitioners about the clinical toxicology of vitamin D in pediatrics, which includes the mechanism of VDT, case reports, and the management of vitamin D poisoning. VDT refers to serum 25(OH)D levels, particularly when the level exceeds 100 ng/mL (250 nmol/L) or is defined as hypervitaminosis D. Hypercalcemia is a common condition of vitamin D toxicity. Vitamin D and its metabolites in moderate levels can induce hypercalcemia, as indicated by the elevation of osteoclastic bone resorption, the presence of calcium in renal tubules, intestinal calcium intake (through increased production of calcium-binding protein in enterocytes), and the decrease of parathyroid hormone synthesis. VDT in pediatrics can be managed by discontinuing vitamin D intake; using activated charcoal, furosemide, prednisone, and calcitonin; rehydration using intravenous sodium chloride 0.9%; and dextrose fluid therapy. It is important for parents to be more careful when providing vitamin D to their children.
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Affiliation(s)
- Jutti Levita
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Gofarana Wilar
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Ika Wahyuni
- Master Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Lidya Cahyo Bawono
- Master Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Tiara Ramadaini
- Master Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Rohani Rohani
- Master Program in Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
| | - Ajeng Diantini
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Sumedang 45363, Indonesia
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12
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Mihuta MS, Paul C, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Stoian D. Unveiling the Silent Danger of Childhood Obesity: Non-Invasive Biomarkers Such as Carotid Intima-Media Thickness, Arterial Stiffness Surrogate Markers, and Blood Pressure Are Useful in Detecting Early Vascular Alterations in Obese Children. Biomedicines 2023; 11:1841. [PMID: 37509481 PMCID: PMC10376407 DOI: 10.3390/biomedicines11071841] [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: 06/01/2023] [Revised: 06/17/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Obese children present a higher cardio-metabolic risk. Measuring vascular biomarkers that assess the evolution of arterial stiffness, subclinical atherosclerosis, and hypertension in such patients could be helpful in the long term. We studied 84 children, aged from 6 to 18 years: 50 obese subjects, versus 34 of normal weight. Clinical examination involved: BMI, waist circumference, waist-to-height ratio, and detection of the presence of acanthosis nigricans and irregular menstrual cycles (the latter in adolescent girls). The carotid intima-media thickness (CIMT) was measured with the Aixplorer MACH 30 echography device. The pulse wave velocity (PWV), augmentation index (AIx), and peripheral and central blood pressures (i.e., SBP, DBP, cSBP, cDBP, and cPP) were acquired through a Mobil-O-Graph device. Obese subjects underwent body composition analysis with a Tanita BC-418. Blood tests were: HOMA-IR, lipid panel, uric acid, and 25-OH vitamin D. All vascular biomarkers presented increased values in obese subjects versus controls. The following cut-off values were significant in detecting obesity: for PWV > 4.6 m/s, cSBP > 106 mmHg for the <12-year-olds, PWV > 4.5 m/s and cSBP > 115 mmHg for the 12-15-year-olds, and PWV > 5 m/s, cSBP > 123 mmHg for the >15-year-olds. AIx is higher in obese children, regardless of their insulin resistance status. Waist circumference and waist-to-height ratio correlate to all vascular parameters. HOMA-IR is an independent predictor for all vascular parameters except CIMT. Cut-off values for PWV of >4.8 m/s, SBP > 125 mmHg, and a cSBP > 117 mmHg predicted the presence of acanthosis nigricans. Obese girls with irregular menses displayed significantly higher PWV, SBP, and DPB. Elevated levels of uric acid, LDL-c, non-LDL-c, triglycerides, and transaminases, and low levels of HDL-c and 25-OH vitamin D correlated with higher arterial stiffness and CIMT values. We conclude that CIMT and the markers of arterial stiffness are useful in the early detection of vascular damage in obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Borlea
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences-Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Dana Stoian
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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13
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Corsello A, Macchi M, D'Oria V, Pigazzi C, Alberti I, Treglia G, Cosmi VD, Mazzocchi A, Agostoni C, Milani GP. Effects of vitamin D supplementation in obese and overweight children and adolescents: a systematic review and meta-analysis. Pharmacol Res 2023; 192:106793. [PMID: 37178775 DOI: 10.1016/j.phrs.2023.106793] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/15/2023]
Abstract
Due to the lipophilic nature of vitamin D, overweight and obese patients have an increased risk of inadequate circulating 25-hydroxy-vitamin D (25(OH)D) concentrations. Vitamin D deficiency has in turn several consequences especially among children and adolescents. Therefore, a few supplementation strategies of vitamin D for pediatric subjects with an excessive body weight have been proposed, but their efficacy remains controversial. The aim of this systematic review and meta-analysis is to evaluate the effect of vitamin D supplementation in overweight and obese children and adolescents. Three databases (PubMed, Embase and Web of Science) were searched to collect randomized controlled trials on the effect of vitamin D supplementation in the pediatric overweight or obese population. Twenty-three studies were included in the systematic review. Results on modification of metabolic or cardiovascular outcomes were controversial. On the other hand, the meta-analysis showed a mean difference by 1.6ng/mL in subjects supplemented with vitamin D as compared to placebo. In conclusion, vitamin D supplementation slightly increases 25(OH)D levels in pediatric subjects with overweight and obesity. However, the effects on metabolic and cardiovascular outcomes remain controversial. New efforts should be devoted to promoting effective interventions to improve the health of children and adolescents with overweight and obesity.
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Affiliation(s)
- Antonio Corsello
- Department of Health Science and Community Health, University of Milan, Italy
| | - Marina Macchi
- Department of Health Science and Community Health, University of Milan, Italy
| | - Veronica D'Oria
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Pigazzi
- Department of Health Science and Community Health, University of Milan, Italy
| | - Ilaria Alberti
- Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Valentina De Cosmi
- Department of Health Science and Community Health, University of Milan, Italy; Department of Food Safety, Nutrition and Veterinary Public Health, Istituto Superiore di Sanità - Italian National Institute of Health, Rome, Italy
| | - Alessandra Mazzocchi
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Gregorio Paolo Milani
- Department of Health Science and Community Health, University of Milan, Italy; Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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14
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Leed A, Sheridan E, Baker B, Bamford S, Emmanouilidis E, Stewart F, Ostafe K, Sarwari M, Lim K, Zheng M, Islam SMS, Bolton KA, Grimes CA. Dietary Intake and Arterial Stiffness in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2092. [PMID: 37432233 DOI: 10.3390/nu15092092] [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: 03/06/2023] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 07/12/2023] Open
Abstract
Arterial stiffness is a risk factor for cardiovascular disease that is affected by diet. However, research understanding how these dietary risk factors are related to arterial stiffness during childhood is limited. The purpose of this review was to determine whether various dietary factors were associated with arterial stiffness in the pediatric population. Five databases were systematically searched. Intervention studies, cross-sectional and cohort studies were included that investigated nutrient or food intake and outcomes of arterial stiffness, primarily measured by pulse wave velocity (PWV) and augmentation index (AIx), in the pediatric population (aged 0-18 years). A final 19 studies (six intervention and 13 observational) were included. Only two intervention studies, including a vitamin D and omega-3 supplementation trial, found protective effects on PWV and AIx in adolescents. Findings from observational studies were overall inconsistent and varied. There was limited evidence to indicate a protective effect of a healthy dietary pattern on arterial stiffness and an adverse effect of total fat intake, sodium intake and fast-food consumption. Overall, results indicated that some dietary factors may be associated with arterial stiffness in pediatric populations; however, inconsistencies were observed across all study designs. Further longitudinal and intervention studies are warranted to confirm the potential associations found in this review.
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Affiliation(s)
- Allanah Leed
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Emma Sheridan
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Brooke Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sara Bamford
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Elana Emmanouilidis
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Fletcher Stewart
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristen Ostafe
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Mustafa Sarwari
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
| | - Carley A Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong 3216, Australia
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15
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Calcaterra V, Verduci E, Milanta C, Agostinelli M, Todisco CF, Bona F, Dolor J, La Mendola A, Tosi M, Zuccotti G. Micronutrient Deficiency in Children and Adolescents with Obesity-A Narrative Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040695. [PMID: 37189944 DOI: 10.3390/children10040695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/26/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023]
Abstract
Childhood obesity represents a serious public health burden. Despite excessive dietary consumption, children with obesity present high rates of micronutrient deficiencies, such as deficiencies in minerals and specific vitamins; micronutrient deficiencies may have a pathogenic role in obesity-related metabolic comorbidities. In this narrative review, we analyzed the main deficiencies associated with obesity, their clinical consequences, and the evidence about a possible supplementation. Iron; vitamins A, B, C, D, and E; folic acid; zinc; and copper deficiencies represent the most common deficient microelements. The relationship between obesity and multiple micronutrient deficiencies remains unclear, and different mechanisms have been proposed. The medical care plan for pediatric obesity should include food choices with high nutritional content as part of a crucial approach to obesity-related complications. Unfortunately, only a few studies are available regarding the efficacy of oral supplementation or weight loss for treating them; thus, continuous nutritional monitoring is necessary.
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Affiliation(s)
- Valeria Calcaterra
- Pediatrics and Adolescentology Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Elvira Verduci
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
- Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Chiara Milanta
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | | | | | - Federica Bona
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Jonabel Dolor
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Alice La Mendola
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Martina Tosi
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Department, Buzzi Children's Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milan, 20157 Milan, Italy
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16
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Stounbjerg NG, Mølgaard C, Cashman KD, Michaelsen KF, Damsgaard CT. Vitamin D status of 3-year-old children in Denmark: determinants and associations with bone mineralisation and blood lipids. Eur J Nutr 2023; 62:1441-1451. [PMID: 36637493 DOI: 10.1007/s00394-023-03084-1] [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: 03/22/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023]
Abstract
PURPOSE Low vitamin D status is a global problem and has been associated with reduced skeletal and cardiometabolic health. However, evidence in young children is lacking. We, therefore, aimed to characterise vitamin D status in toddlers, identify its determinants, and explore if vitamin D status was associated with bone mineralisation and lipid profile. METHODS We used cross-sectional data from 3-year-old children (n = 323) living in Denmark (latitude: 55°N). Bone mineralisation (n = 108) was measured by DXA. Blood samples were analysed for serum 25-hydroxyvitamin D (s-25(OH)D) by LC-MS/MS, triacylglycerol, and total, low- and high density lipoprotein cholesterol. RESULTS Mean ± SD s-25(OH)D was 69 ± 23 nmol/L, but varied with season. During winter, 38% had inadequate s-25(OH)D (< 50 nmol), whereof 15% had deficiency (< 30 nmol/L); these numbers were only 7 and 1% during summer. In terms of status determinants, supplement use (66% were users) was associated with s-25(OH)D (P < 0.001), whereas dietary vitamin D intake (median [25-75th percentile] of 1.3 [0.9-1.9] µg/d), sex, parental education, BMI, and physical activity were not. There were no associations between s-25(OH)D and blood lipids or bone measurements, using either unadjusted or adjusted regression models. CONCLUSION More than 1/3 of Danish toddlers had inadequate vitamin D intake during winter, but acceptable mean vitamin D status. In addition to season, supplement use was the main determinant of vitamin D status, which was, however, not associated with bone mineralisation or lipid profile. The results support recommendations of vitamin D supplements during winter at northern latitudes, but potential health effects need further investigation.
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Affiliation(s)
- Nanna G Stounbjerg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, Frederiksberg, Denmark.
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, Frederiksberg, Denmark
| | - Kevin D Cashman
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, Frederiksberg, Denmark
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, Frederiksberg, Denmark
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17
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Yari Z, Nikooyeh B, Neyestani TR. Circulating 25-hydroxyvitamin D is associated with metabolic phenotypes of obesity: National Food and Nutrition Surveillance. Nutr Res 2023; 110:14-22. [PMID: 36640580 DOI: 10.1016/j.nutres.2022.12.006] [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: 07/22/2022] [Revised: 12/15/2022] [Accepted: 12/18/2022] [Indexed: 12/24/2022]
Abstract
Different phenotypes of obesity are each related with different complications and comorbidities. We hypothesized that suboptimal vitamin D status is directly associated with an unhealthy metabolic status, especially if allied with obesity. This cross-sectional study was performed in the framework of the National Food and Nutrition Surveillance. Overall, 1098 men and women participated in this study. In addition to height and weight, serum concentrations of 25-hydroxyvitamin D (25(OH)D) and glycemic and lipidemic status were evaluated. Then participants were classified into 4 groups based on body mass index and lipidemic and glycemic profile status, as follows: hyperglycemic-dyslipidemic obese (HDO), hyperglycemic-dyslipidemic nonobese (HDNO), normoglycemic-normolipidemic obese (NNO), and normoglycemic-normolipidemic nonobese (NNNO). In this study, 31.6% of participants were classified as HDO, 7.5% as HDNO, 34.5% as NNO, and 26.4% as NNNO. The frequency of suboptimal vitamin D status was more prevalent in HDO (81.8%) than in other phenotypes (HDNO, 80%; NNO, 77.6%; NNNO, 73.8%; P = .015). In the multivariate model, suboptimal vitamin D status significantly increased the odds of being NNO (odds ratio [OR], 1.28; 95% CI, 0.84-1.95), HDNO (OR, 1.48; 95% CI, 0.77-2.83), and HDO (OR, 1.73; 95% CI, 1.11-2.7) compared with the NNNO group. Likewise, in multivariate model, per each unit (ng/mL) increment in 25(OH)D concentration, the odds of HDNO and HDO decreased significantly by 4% (OR, 0.96; 95% CI, 0.94-0.98) and 7% (OR, 0.93; 95% CI, 0.92-0.95), respectively. The results of the study showed a significant relationship between serum 25(OH)D concentrations and metabolic obesity phenotypes; these data confirm the association between suboptimal vitamin D status and metabolic complications, especially in obese individuals.
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Affiliation(s)
- Zahra Yari
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahareh Nikooyeh
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Tirang R Neyestani
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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18
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Mihuta MS, Stoian D, Borlea A, Roi CM, Velea-Barta OA, Mozos I, Paul C. Evaluating the Arterial Stiffness as a Useful Tool in the Management of Obese Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020183. [PMID: 36832311 PMCID: PMC9955158 DOI: 10.3390/children10020183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 01/20/2023]
Abstract
Childhood obesity speeds up the development of arterial stiffness and progressively increases the values of arterial pressure. The purpose of this study is to investigate the value of using pulse wave analysis (PWA) to measure arterial stiffness as a sign of vascular wall impairment in obese children. The research was focused on 60 subjects: 33 obese and 27 normal-weight. Ages ranged from 6 to 18 years old. PWA includes parameters such as pulse wave velocity (PWV), augmentation index (AIx), peripheral and central blood pressure (SBP, DBP, cSBP, cDBP), heart rate, and central pulse pressure (cPP). The device used was a Mobil-O-Graph. Blood parameters were taken from the subject's medical history, not older than 6 months. A high BMI and a large waist circumference are linked to a high PWV. The levels of LDL-c, triglycerides (TG), non-HDL-c, TG/HDL-c ratio, and total cholesterol-HDL-c ratio significantly correlate to PWV, SBP, and cSBP. Alanine aminotransferase is a reliable predictor of PWV, AIx, SBP, DBP, and cDBP, while aspartate aminotransferase is a significant predictor of AIx, mean arterial pressure (MAP), cSBP, and cPP. 25-OH-Vitamin D negatively correlates with PWV, SBP, and MAP and significantly predicts the MAP. Cortisol and TSH levels are not significant to arterial stiffness in obese children without specific comorbidities and neither is fasting glucose in obese children without impaired glucose tolerance. We conclude that PWA contributes valuable data regarding patients' vascular health and should be considered a reliable tool in the management of obese children.
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Affiliation(s)
- Monica Simina Mihuta
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dana Stoian
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Center of Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
- Correspondence:
| | - Andreea Borlea
- 2nd Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Cristina Mihaela Roi
- Department of Doctoral Studies, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Oana-Alexandra Velea-Barta
- 3rd Department of Odontotherapy and Endodontics, Faculty of Dental Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Mozos
- Department of Functional Sciences—Pathophysiology, Center for Translational Research and Systems Medicine, Victor Babes University of Medicine and Pharmacy, 300173 Timisoara, Romania
| | - Corina Paul
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania
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19
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Senkevich OA, Chernobrovkina MA, Kovalsky YG. Vitamin D Supplementation of 7–8 Years Old Children from Different Geographical Areas (48–52° North Latitude): Cross Sectional Study. CURRENT PEDIATRICS 2022. [DOI: 10.15690/vsp.v21i6.2461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background. The prevalence of vitamin D deficiency in children by their geographic latitude of residence requires follow-up study. This is crucial for implementation of preventive measures that can reduce the risk of developing pathological conditions associated with vitamin D deficiency.Objective. The aim of the study is to study the vitamin D supplementation of 7–8 years old children living in different geographical latitudes of one subject of Russian Federation.Methods. The study included relatively healthy children living in three geographical areas (northern — 52°, central — 50°, southern — 48°) of one region (Khabarovsk Krai). Vitamin D supplementation was evaluated by 25(OH)D serum concentration via enzyme-linked immunosorbent assay. Vitamin D insufficiency was diagnosed at 25(OH)D concentration of 21–30 ng/ml, deficiency — 10–20 ng/ml, severe deficiency — < 10 ng/ml; optimal 25(OH)D concentration was considered as 30–100 ng/ml.Results. The increase in prevalence of vitamin D deficiency and insufficiency has been revealed with gradual increase from southern (57%) to central (73%) and northern (83%) geographic areas in 7–8 years old children living in the same region. The prevalence of vitamin D deficiency and insufficiency (25(OH)D ≤ 30 ng/mL) among children living in the northern geographic area was greater by 3.8-fold (95% confidence interval 1.2–12.7) then among peers living in the southern areas.Conclusion. One factor affecting 25(OH)D serum concentration in children of this region is the insolation level determined by the geographical latitude of residence. The 4°N difference is significant in determining vitamin D status in residents of relatively high latitudes. Further studies of factors associated with 25(OH)D concentration in children living in different latitudes are required (insolation level, number of sunny days per year, food and household characteristics in families).
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Abstract
Childhood obesity is, according to the WHO, one of the most serious challenges of the 21st century. More than 100 million children have obesity today. Already during childhood, almost all organs are at risk of being affected by obesity. In this review, we present the current knowledge about diseases associated with childhood obesity and how they are affected by weight loss. One major causative factor is obesity-induced low-grade chronic inflammation, which can be observed already in preschool children. This inflammation-together with endocrine, paracrine, and metabolic effects of obesity-increases the long-term risk for several severe diseases. Type 2 diabetes is increasingly prevalent in adolescents and young adults who have had obesity during childhood. When it is diagnosed in young individuals, the morbidity and mortality rate is higher than when it occurs later in life, and more dangerous than type 1 diabetes. Childhood obesity also increases the risk for several autoimmune diseases such as multiple sclerosis, Crohn's disease, arthritis, and type 1 diabetes and it is well established that childhood obesity also increases the risk for cardiovascular disease. Consequently, childhood obesity increases the risk for premature mortality, and the mortality rate is three times higher already before 30 years of age compared with the normal population. The risks associated with childhood obesity are modified by weight loss. However, the risk reduction is affected by the age at which weight loss occurs. In general, early weight loss-that is, before puberty-is more beneficial, but there are marked disease-specific differences.
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Affiliation(s)
- Claude Marcus
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Pernilla Danielsson
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Emilia Hagman
- Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
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Liu J, Fu L, Jin S, Jia Y, Zhang J, Sun C, Na L. Vitamin D status in children and its association with glucose metabolism in northern China: a combination of a cross-sectional and retrospective study. BMJ Open 2022; 12:e061146. [PMID: 36446458 PMCID: PMC9710338 DOI: 10.1136/bmjopen-2022-061146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study aimed to explore the vitamin D status of children in northern China and the association between vitamin D and glucose metabolism. DESIGN Cross-sectional study was conducted among child participants and retrospective study designs were conducted among adult participants. SETTING AND PARTICIPANTS Both studies were recruited from Harbin, 326 children were included in children's study, 8469 adults were included in adult study. PRIMARY AND SECONDARY OUTCOME MEASURES Physical examination, lifestyle and dietary habit data were recorded in all the participants. Serum insulin, glucose, 25(OH)D3 concentrations in children and serum glucose and lipids levels in adults were measured. Rickets history was also investigated in adults, which was used to define vitamin D deficiency in childhood. The associations were tested by linear regression and binary logistic regression. RESULT In the children's study, only 10.7% of participants were vitamin D sufficient (≥30 ng/mL). Inverse correlations between serum 25(OH)D3 concentration and fasting insulin and homeostasis model assessment - insulin resistance (HOMA-IR) were found, and children with lower serum 25(OH)D3 concentrations were likely to have insulin resistance (IR) (OR: 0.955, 95% CI: 0.917 to 0.995, p value: 0.027). In an adult study, rickets in childhood increased the risk of type 2 diabetes in male participants (OR=1.414, 95% CI=1.013 to 1.972; p value=0.042), but this result was not observed in female participants. CONCLUSION Our findings suggest that vitamin D deficiency is widespread in northern China. Vitamin D deficiency in childhood was associated with IR and increased the risk of type 2 diabetes in male adults.
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Affiliation(s)
- Junyi Liu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Liqun Fu
- Department of Clinical Nutrition, Shanghai University of Medicine & Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Shanshan Jin
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yubing Jia
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Jingyi Zhang
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Changhao Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixin Na
- Department of Nutrition and food hygiene, College of Public Health, Shanghai University of Medicine and Health Sciences, Shanghai, China
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22
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Yin WJ, Yu LJ, Wang P, Tao RX, Jiang XM, Zhang Y, Zhu DM, Zhu P. Sleep patterns modify the association of 25(OH)D with poor cardiovascular health in pregnant women. Front Nutr 2022; 9:1013960. [PMID: 36451743 PMCID: PMC9702519 DOI: 10.3389/fnut.2022.1013960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/01/2022] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND The relationship between vitamin D status and gestational cardiovascular health (CVH) is inconsistent in previous studies. Emerging evidence shows that sleep behaviors are related to vitamin D metabolism. However, no studies evaluate the interaction of vitamin D and sleep behaviors on gestational CVH. OBJECTIVE We aimed to estimate the relationship between 25-hydroxyvitamin D [25(OH)D] concentrations and gestational CVH, and whether the relationship was modified by sleep behaviors. METHODS The data of this study was from a multicenter birth cohort study. A total of 9,209 pregnant women at 16-23 weeks of gestation were included. 25(OH)D concentrations were measured from collected blood. Sleep patterns consisted of major sleep behaviors including duration, chronotype, insomnia, snoring, and excessive daytime sleepiness. Data on poor CVH was based on four "clinical" CVH metrics, including body mass index, blood pressure, total cholesterol, and glucose levels. RESULTS The proportion of women with poor CVH was 25.0%. The relative risk (RR) (95%CI) of poor CVH was 0.67 (0.58-0.76) in women with 25(OH)D ≥ 50 nmol/L after multivariate adjustments. Lower 25(OH)D concentrations were significantly associated with poor CVH. Such association was also evident in subgroups analysis. We found a significant interaction of 25(OH)D (P for interaction = 0.01) with sleep patterns on the risk of poor CVH. A negative dose-response relation was observed between 25(OH)D concentrations and poor CVH risk in healthy or intermediate sleep, not poor sleep. 25(OH)D concentrations were lower and the risk of poor CVH was higher in pregnant women with poor sleep patterns (P < 0.05). CONCLUSION Our study suggests that sleep patterns modify the association of 25(OH)D concentrations with the CVH among pregnant women.
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Affiliation(s)
- Wan-jun Yin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Li-jun Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Peng Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
| | - Rui-xue Tao
- Department of Obstetrics and Gynecology, Hefei First People’s Hospital, Hefei, China
| | - Xiao-min Jiang
- Department of Obstetrics and Gynecology, Anhui Province Maternity and Child Health Hospital, Hefei, China
| | - Ying Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dao-min Zhu
- Department of Sleep Disorders, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
| | - Peng Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- MOE Key Laboratory of Population Health Across Life Cycle, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China
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Vrech M, Ferruzzi A, Pietrobelli A. Effects of micronutrient and phytochemical supplementation on cardiovascular health in obese and overweight children: a narrative review. Curr Opin Clin Nutr Metab Care 2022; 25:430-435. [PMID: 36082931 DOI: 10.1097/mco.0000000000000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Cardiovascular damage could begin early in life. Our aim was to examine the current state of the art related to micronutrient supplementation on vascular health in obese and overweight children. We considered only the studies performed over the past few years. RECENT FINDINGS Vitamin D supplementation in the obese pediatric population with vitamin D deficiency could improve the vascular health of these subjects. The evidence is less clear on supplementation with other micronutrients. Zinc supplementation is currently the most supported by the literature. SUMMARY As of today, we can only speculate that supplementation with other micronutrients could improve the vascular health of obese and overweight children. Strong limitations are the different instrumental methods used to assess vascular health in obese children and adolescents under micronutrients supplementation. Actually, indirect indicators more reliable to evaluate vascular health seem to be lipid profile and insulin sensitivity. Furthermore, there is a particular lack of studies in this area in recent years, especially in the pediatric population. Additional studies performed in this population should be pursued to clarify significant relationships between micronutrients and vascular health.
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Affiliation(s)
- Massimiliano Vrech
- Department of Surgical Science, Dentistry, Gynecology and Pediatrics, Pediatric Unit, Verona University Medical School, Verona, Italy
| | - Alessandro Ferruzzi
- Department of Surgical Science, Dentistry, Gynecology and Pediatrics, Pediatric Unit, Verona University Medical School, Verona, Italy
| | - Angelo Pietrobelli
- Department of Surgical Science, Dentistry, Gynecology and Pediatrics, Pediatric Unit, Verona University Medical School, Verona, Italy
- Pennington Biomedical Research Center, LSU System, Baton Rouge, Los Angeles, USA
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Adiposity Metabolic Consequences for Adolescent Bone Health. Nutrients 2022; 14:nu14163260. [PMID: 36014768 PMCID: PMC9414751 DOI: 10.3390/nu14163260] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 12/20/2022] Open
Abstract
Infancy and adolescence are crucial periods for bone health, since they are characterized by intense physical growth and bone development. The unsatisfactory acquisition of bone mass in this phase has consequences in adult life and increases the risk of developing bone diseases at more advanced ages. Nutrient deficiencies, especially calcium and vitamin D, associated with a sedentary lifestyle; lack of sun exposure; and epigenetic aspects represent some of the main risk factors for poor bone quality. In addition, recent studies relate childhood obesity to impaired bone health; however, studies on the adiposity effects on bone health are scarce and inconclusive. Another gap concerns the implications of obesity on child sexual maturity, which can jeopardize their genetic potential bone mass and increase fracture risk. Therefore, we reviewed the analyzed factors related to bone health and their association with obesity and metabolic syndrome in adolescents. We concluded that obesity (specifically, accumulated visceral fat) harms bones in the infant–juvenile phase, thereby increasing osteopenia/osteoporosis in adults and the elderly. Thus, it becomes evident that forming and maintaining healthy eating habits is necessary during infancy and adolescence to reduce the risk of fractures caused by bone-metabolic diseases in adulthood and to promote healthy ageing.
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Abstract
Arterial stiffness is a strong predictor of cardiovascular events and all-cause mortality in middle-aged and old adults. Arterial stiffness has been limited to being an intermediate marker of atherosclerotic cardiovascular events in adolescents and young adult studies. The paucity of normative longitudinal data and repeated gold-standard assessments of arterial stiffness among the young population has occasioned a huge knowledge gap in its clinical utility. This review summarizes recent longitudinal evidence in a large adolescent population, supporting the value of arterial stiffness as a novel risk factor for hypertension, overweight/obesity and insulin resistance. Preventing or decreasing arterial stiffness during adolescence may confer cardiometabolic health benefits in later life, but further pathological and mechanistic research is needed. The review also offers suggestions for incorporating arterial stiffness measures into routine paediatric and young adult clinical practice.
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Krivošíková K, Krivošíková Z, Wsolová L, Seeman T, Podracká Ľ. Hypertension in obese children is associated with vitamin D deficiency and serotonin dysregulation. BMC Pediatr 2022; 22:289. [PMID: 35581625 PMCID: PMC9112480 DOI: 10.1186/s12887-022-03337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/04/2022] [Indexed: 11/20/2022] Open
Abstract
Background Obesity and hypertension represent serious health issues affecting the pediatric population with increasing prevalence. Hypovitaminosis D has been suggested to be associated with arterial hypertension. Serotonin by modulating nitric oxide synthase affect blood pressure regulation. The biological mechanism by which vitamin D specifically regulates serotonin synthesis was recently described. The aim of this paper is to determine the associations between vitamin D, serotonin, and blood pressure in obese children. Methods One hundred and seventy-one children were enrolled in the prospective cross-sectional study. Two groups of children divided according to body mass index status to obese (BMI ≥95th percentile; n = 120) and non-obese (n = 51) were set. All children underwent office and ambulatory blood pressure monitoring and biochemical analysis of vitamin D and serotonin. Data on fasting glucose, insulin, HOMA, uric acid, and complete lipid profile were obtained in obese children. Results Hypertension was found only in the group of obese children. Compared to the control group, obese children had lower vitamin D and serotonin, especially in winter. The vitamin D seasonality and BMI-SDS were shown as the most significant predictors of systolic blood pressure changes, while diastolic blood pressure was predicted mostly by insulin and serotonin. The presence of hypertension and high-normal blood pressure in obese children was most significantly affected by vitamin D deficiency and increased BMI-SDS. Conclusions Dysregulation of vitamin D and serotonin can pose a risk of the onset and development of hypertension in obese children; therefore, their optimization together with reducing body weight may improve the long-term cardiovascular health of these children. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03337-8.
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Affiliation(s)
- Katarína Krivošíková
- Department of Pediatrics, National Institute of Children's Diseases and Faculty of Medicine, Comenius University, Limbová 1, Bratislava, 831 01, Slovak Republic.
| | - Zora Krivošíková
- Department of Clinical and Experimental Pharmacotherapy, Faculty of Medicine, Slovak Medical University, Bratislava, Slovak Republic
| | - Ladislava Wsolová
- Department of Biophysics, Informatics and Biostatistics, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Tomáš Seeman
- Department of Pediatrics, 2nd Medical Faculty, Charles University Prague, Prague, Czech Republic.,Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Ľudmila Podracká
- Department of Pediatrics, National Institute of Children's Diseases and Faculty of Medicine, Comenius University, Limbová 1, Bratislava, 831 01, Slovak Republic
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刘 瑞, 陈 阳, 武 海, 熊 凤, 何 方, 李 园. [Levels of fat-soluble vitamins A, D, and E and their influencing factors in children with obesity]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:572-578. [PMID: 35644199 PMCID: PMC9154372 DOI: 10.7499/j.issn.1008-8830.2111031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/01/2022] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To investigate the levels of fat-soluble vitamins A, D, and E in children with obesity and their influencing factors. METHODS A total of 273 children with obesity who attended the Department of Clinical Nutrition, Xi'an Children's Hospital, from January 2019 to April 2021 were enrolled as the obesity group. A total of 226 children with normal body weight who underwent physical examination during the same period were enrolled as the control group. Anthropometric parameters and body composition were measured for both groups, and the serum concentrations of vitamins A, D, and E were also measured. RESULTS Compared with the control group, the obesity group had significantly higher serum levels of vitamin A [(1.32±0.21) μmol/L vs (1.16±0.21) μmol/L, P<0.001] and vitamin E [(9.3±1.4) mg/L vs (8.3±1.2) mg/L, P<0.001] and a significant reduction in the level of 25-hydroxyvitamin D [(49±22) nmol/L vs (62±24) nmol/L, P<0.001]. In the obesity group, the prevalence rates of marginal vitamin A deficiency, vitamin D deficiency/insufficiency, and vitamin E insufficiency were 5.5% (15/273), 56.8% (155/273), and 4.0% (11/273), respectively. After adjustment for body mass index Z-score and waist-to-height ratio, serum vitamin A level was positively correlated with age (P<0.001), while vitamins E and 25-hydroxyvitamin D levels were negatively correlated with age in children with obesity (P<0.001). After adjustment for age, the serum levels of vitamin A, vitamin E and 25-hydroxyvitamin D were not correlated with degree of obesity, percentage of body fat, and duration of obesity in children with obesity, while the serum levels of vitamins A and E were positively correlated with waist-to-height ratio (P<0.001). CONCLUSIONS There are higher serum levels of vitamins A and E in children with obesity, especially in those with abdominal obesity, while serum vitamin D nutritional status is poor and worsens with age. Therefore, vitamin D nutritional status should be taken seriously for children with obesity, and vitamin D supplementation should be performed when necessary.
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Affiliation(s)
| | | | - 海滨 武
- 西安市儿童医院/陕西省儿科疾病研究所, 陕西西安710003
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Bacchetta J, Edouard T, Laverny G, Bernardor J, Bertholet-Thomas A, Castanet M, Garnier C, Gennero I, Harambat J, Lapillonne A, Molin A, Naud C, Salles JP, Laborie S, Tounian P, Linglart A. Vitamin D and calcium intakes in general pediatric populations: A French expert consensus paper. Arch Pediatr 2022; 29:312-325. [PMID: 35305879 DOI: 10.1016/j.arcped.2022.02.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/20/2022] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Nutritional vitamin D supplements are often used in general pediatrics. Here, the aim is to address vitamin D supplementation and calcium nutritional intakes in newborns, infants, children, and adolescents to prevent vitamin D deficiency and rickets in general populations. STUDY DESIGN We formulated clinical questions relating to the following categories: the Patient (or Population) to whom the recommendation will apply; the Intervention being considered; the Comparison (which may be "no action," placebo, or an alternative intervention); and the Outcomes affected by the intervention (PICO). These PICO elements were arranged into the questions to be addressed in the literature searches. Each PICO question then formed the basis for a statement. The population covered consisted of children aged between 0 and 18 years and premature babies hospitalized in neonatology. Two groups were assembled: a core working group and a voting panel from different scientific pediatric committees from the French Society of Pediatrics and national scientific societies. RESULTS We present here 35 clinical practice points (CPPs) for the use of native vitamin D therapy (ergocalciferol, vitamin D2 and cholecalciferol, vitamin D3) and calcium nutritional intakes in general pediatric populations. CONCLUSION This consensus document was developed to provide guidance to health care professionals on the use of nutritional vitamin D and dietary modalities to achieve the recommended calcium intakes in general pediatric populations. These CPPs will be revised periodically. Research recommendations to study key vitamin D outcome measures in children are also suggested.
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Affiliation(s)
- J Bacchetta
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Filières Santé Maladies Rares OSCAR, ORKID et ERKNet, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, Bron 69677 CEDEX, France; INSERM U1033, LYOS, Prévention des Maladies Osseuses, Lyon, France; Faculté de Médecine Lyon Est, Université de Lyon, Lyon, France.
| | - T Edouard
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Unité d'Endocrinologie, Génétique et Pathologies Osseuses, Filières Santé Maladies Rares OSCAR et BOND, Hôpital des Enfants, Toulouse, France
| | - G Laverny
- Institut de Génétique et de Biologie Moléculaire et Cellulaire, CNRS UMR7104, INSERM U1258, Université de Strasbourg, Illkirch, France
| | - J Bernardor
- INSERM U1033, LYOS, Prévention des Maladies Osseuses, Lyon, France; Département de Pédiatrie, CHU de Nice, Nice, France
| | - A Bertholet-Thomas
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Filières Santé Maladies Rares OSCAR, ORKID et ERKNet, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, Bron 69677 CEDEX, France; INSERM U1033, LYOS, Prévention des Maladies Osseuses, Lyon, France
| | - M Castanet
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Département de Pédiatrie, Filière Santé Maladies Rares OSCAR, CHU Rouen, Rouen, France
| | - C Garnier
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Filières Santé Maladies Rares OSCAR, ORKID et ERKNet, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, Bron 69677 CEDEX, France
| | - I Gennero
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Unité d'Endocrinologie, Génétique et Pathologies Osseuses, Filières Santé Maladies Rares OSCAR et BOND, Hôpital des Enfants, Toulouse, France
| | - J Harambat
- Centre de Référence Maladies Rénales Rares, Unité de Néphrologie Pédiatrique, Hôpital Pellegrin-Enfants, Bordeaux, France; INSERM U1219, Bordeaux, France
| | - A Lapillonne
- Service de Pédiatrie et Réanimation Néonatales, EHU 7328 Université de Paris, Hôpital Necker- Enfants Malades, Paris, France; CNRC, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - A Molin
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Département de Génétique, Filière Santé Maladies Rares OSCAR, CHU Caen, Caen, France
| | - C Naud
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Filières Santé Maladies Rares OSCAR, ORKID et ERKNet, Hôpital Femme Mère Enfant, 59 Boulevard Pinel, Bron 69677 CEDEX, France
| | - J P Salles
- Centre de Référence des Maladies Rares du Calcium et du Phosphore, Unité d'Endocrinologie, Génétique et Pathologies Osseuses, Filières Santé Maladies Rares OSCAR et BOND, Hôpital des Enfants, Toulouse, France
| | - S Laborie
- Service de Réanimation Néonatale, Hôpital Femme Mère Enfant, Bron, France
| | - P Tounian
- Service de Nutrition et Gastroentérologie Pédiatriques, Hôpital Trousseau, Faculté de Médecine Sorbonne Université, Paris, France
| | - A Linglart
- AP-HP, Centre de Référence des Maladies Rares du Calcium et du Phosphore, Service d'Endocrinologie et diabète de l'enfant, Filières Santé Maladies Rares OSCAR, ERN endoRARE et BOND, Plateforme d'expertise des maladies rares Paris Saclay, Hôpital Bicêtre Paris-Saclay, Université Paris Saclay, INSERM U1185, Le Kremlin Bicêtre, France
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Hertiš Petek T, Petek T, Močnik M, Marčun Varda N. Systemic Inflammation, Oxidative Stress and Cardiovascular Health in Children and Adolescents: A Systematic Review. Antioxidants (Basel) 2022; 11:894. [PMID: 35624760 PMCID: PMC9137597 DOI: 10.3390/antiox11050894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/16/2022] [Accepted: 04/24/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
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Affiliation(s)
- Tjaša Hertiš Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Tadej Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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Coelho SR, Faria JCP, Fonseca FLA, de Souza FIS, Sarni ROS. Is There an Association between Vitamin D Concentrations and Overweight in Children and Adolescents? J Trop Pediatr 2022; 68:6573448. [PMID: 35466380 DOI: 10.1093/tropej/fmac033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To describe the 25-hydroxyvitamin D [25(OH)D] concentrations in children and adolescents and to verify the association with the body mass index z-score (ZBMI), lipid profile and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR). METHOD Cross-sectional study with 170 children and adolescents aged between 4 and 15 years (106 normal weight and 64 overweight) from a public institution in Santo André-Brazil. Weight, height and waist circumference were verified and ZBMI and waist-to-height ratio (WHtR) were calculated. Biochemical analysis: 25(OH)D levels [deficiency: 25(OH)D < 20 ng/ml]; glycemia and insulin (HOMA-IR), lipid profile and ultra-sensitive C-reactive protein. RESULTS Mean age was 8.37 ± 3.17 years; 89 (52.4%) were male; 77 (45.3%) Caucasians and 121 (71.2%) pre-pubescent. Overweight was observed in 64 (37.6%), dyslipidemia in 108 (63.5%) and 25(OH)D deficiency in 117 (68.8%) of the individuals. ZBMI (r = -0.209; p = 0.006), WHtR (r = -0.154; p = 0.045), triglycerides (TGs) (r = -0.161; p = 0.037) and TGs/high-density lipoprotein (HDL) ratio (r = -0.168; p = 0.028) were inversely correlated with 25(OH)D concentrations. Overweight children and adolescents were four times more likely to have vitamin D deficiency (odds ratio = 4.28; 95% confidence interval 1.152 to 4.907; p = 0.019), after adjustment for pubertal development (prepubertal), sex (male), HDL-c (<45 mg/dl), non-HDL (>120 mg/dl), TG/HDL ratio (>2.0) and HOMA-IR. CONCLUSIONS A high prevalence of vitamin D deficiency (68.8%) was observed. There was an independent association between vitamin D deficiency and overweight, not observed for dyslipidemia and insulin resistance. The data point to the need for periodic monitoring of serum concentrations of 25(OH)D and reinforcement of guidelines for combating and preventing overweight in the pediatric age group.
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Affiliation(s)
- Stephanie Ramos Coelho
- Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil
| | | | - Fernando Luiz Affonso Fonseca
- Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil.,Department of Pediatrics, Centro Universitário-FMABC, Santo André 09060-870, Brazil
| | - Fabiola Isabel Suano de Souza
- Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil.,Department of Pediatrics, Centro Universitário-FMABC, Santo André 09060-870, Brazil
| | - Roseli Oselka Saccardo Sarni
- Department of Pediatrics, Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil.,Department of Pediatrics, Centro Universitário-FMABC, Santo André 09060-870, Brazil
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Thams L, Stounbjerg NG, Hvid LG, Mølgaard C, Hansen M, Damsgaard CT. Effects of high dairy protein intake and vitamin D supplementation on body composition and cardiometabolic markers in 6-8-y-old children-the D-pro trial. Am J Clin Nutr 2022; 115:1080-1091. [PMID: 35015806 DOI: 10.1093/ajcn/nqab424] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/23/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Increasing evidence suggests that prevention of lifestyle diseases should begin early. Dairy protein and vitamin D can affect body composition and cardiometabolic markers, yet evidence among well-nourished children is sparse. OBJECTIVES We investigated combined and separate effects of high dairy protein intake and vitamin D on body composition and cardiometabolic markers in children. METHODS In a 2 × 2-factorial, randomized trial, 200 white, Danish, 6-8-y-old children substituted 260 g/d dairy in their diet with high-protein (HP; 10 g protein/100 g) or normal-protein (NP; 3.5 g protein/100 g) yogurt and received blinded tablets with 20 µg/d vitamin D3 or placebo for 24 wk during winter. We measured body composition (by DXA), blood pressure, and fasting blood glucose, insulin, C-peptide, and lipids. RESULTS In total, 184 children (92%) completed the study. Baseline median (25th-75th percentile) dairy protein intake was median: 3.7 (25th-75th percentile: 2.5-5.1) energy percentage (E%) and increased to median: 7.2 (25th-75th percentile: 4.7-8.8) E% and median: 4.2 (25th-75th percentile: 3.1-5.3) E% with HP and NP. Mean ± SD serum 25-hydroxyvitamin D concentration changed from 81 ± 17 to 89 ± 18 nmol/L and 48 ± 13 nmol/L with vitamin D and placebo, respectively. There were no combined effects of dairy protein and vitamin D, except for plasma glucose, with the largest increase in the NP-vitamin D group (Pinteraction = 0.005). There were smaller increases in fat mass index (P = 0.04) with HP than with NP, and the same pattern was seen for insulin, HOMA-IR, and C-peptide (all P = 0.06). LDL cholesterol was reduced with vitamin D compared with placebo (P < 0.05). Fat-free mass and blood pressure were unaffected. CONCLUSIONS High compared with normal dairy protein intake hampered an increase in fat mass index. Vitamin D supplementation counteracted the winter decline in 25-hydroxyvitamin D and the increase in LDL cholesterol observed with placebo. This study adds to the sparse evidence on dairy protein in well-nourished children and supports a vitamin D intake of ∼20 µg/d during winter. This trial was registered at clinicaltrials.gov as NCT03956732.
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Affiliation(s)
- Line Thams
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Nanna G Stounbjerg
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Lars G Hvid
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Mølgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
| | - Mette Hansen
- Section for Sport Science, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
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Effect of Vitamin D and Docosahexaenoic Acid Co-Supplementation on Vitamin D Status, Body Composition, and Metabolic Markers in Obese Children: A Randomized, Double Blind, Controlled Study. Nutrients 2022; 14:nu14071397. [PMID: 35406010 PMCID: PMC9003047 DOI: 10.3390/nu14071397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 12/10/2022] Open
Abstract
Obese children are at high risk of developing vitamin D deficiency. Omega-3 polyunsaturated fatty acids and their derivatives might have a beneficial effect on vitamin D status of obese children, due to their anti-inflammatory action, and increasing its absorption. This multicenter, randomized, double-blind controlled study aims to investigate the effect of vitamin D and docosahexaenoic acid (DHA) co-supplementation for six months on vitamin D status, body composition, and metabolic markers of obese children with vitamin D deficiency. A total of 108 children were enrolled and 73 children completed the study: 33 were supplemented with an oral dose of 500 mg of DHA and 1200 IU/day of vitamin D3 and 41 were supplemented with 1200 IU/day of vitamin D3 + wheat germ oil. At the end of the study, more than 50% of the subjects improved their vitamin D status. However, co-supplementation was not more effective than vitamin D plus wheat germ oil. Fat mass percentage was significantly reduced, and body mass index improved in both groups, even if all the subjects were still obese at the end of the study. Children receiving both vitamin D and DHA presented a higher increase of DHA levels that could be relevant to prevent inflammatory-associated complications of obesity, but they had no effect on vitamin D levels.
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Emulsion-filled gels of soy protein isolate for vehiculation of vitamin D3: Effect of protein solubility on their mechanical and rheological characteristics. FOOD BIOSCI 2022. [DOI: 10.1016/j.fbio.2021.101455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Zandieh N, Hemami MR, Darvishi A, Hasheminejad SM, Abdollahi Z, Zarei M, Heshmat R. Economic evaluation of a national vitamin D supplementation program among Iranian adolescents for the prevention of adulthood type 2 diabetes mellitus. BMC Complement Med Ther 2022; 22:1. [PMID: 34980092 PMCID: PMC8722369 DOI: 10.1186/s12906-021-03474-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 12/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to evaluate the cost-effectiveness of vitamin D supplementation in preventing type 2 diabetes mellitus (T2DM) among Iranian adolescents. METHODS This analytical observational study was conducted, using the decision tree model constructed in TreeAge Pro to assess the cost per quality-adjusted life-year (QALY) of monthly intake vitamin D supplements to prevent T2DM compared to no intervention from the viewpoint of Iran's Ministry of Health and through an one-year horizon. In the national program of vitamin D supplementation, 1,185,211 Iranian high-school students received 50,000 IU vitamin D supplements monthly for nine months. The costs-related data were modified to 2018. The average cost and effectiveness were compared based on the Incremental Cost-Effectiveness Ratio (ICER). RESULTS Our analytical analysis estimated the 4071.25 (USD / QALY) cost per AQALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the ICER threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood T2DM. It means that vitamin D supplementation costs were substantially less than the costs of T2DM treatments than the no intervention. CONCLUSIONS Based on the findings, the national vitamin D supplementation program for Iranian adolescents could be a cost-effective strategy to reduce the risk of diabetes in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.
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Affiliation(s)
- Narges Zandieh
- Faculty of pharmacy, Tehran Medical sciences, Islamic Azad University, Tehran, Iran
| | | | - Ali Darvishi
- Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Zahra Abdollahi
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Maryam Zarei
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, 1941933111, Iran.
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Busnatu SS, Serbanoiu LI, Lacraru AE, Andrei CL, Jercalau CE, Stoian M, Stoian A. Effects of Exercise in Improving Cardiometabolic Risk Factors in Overweight Children: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10010082. [PMID: 35052246 PMCID: PMC8775269 DOI: 10.3390/healthcare10010082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/28/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022] Open
Abstract
This meta-analysis aims to evaluate the effects of exercise in improving cardiometabolic risk factors in overweight children and adolescents until the adolescent age, which is 18 years. A systemic search was conducted using the electronic databases PubMed/Medline, Cochrane Library, and Google Scholar, from inception to 29 June 2021. All statistical analyses were conducted in Review Manager 5.4.1. All studies meeting the inclusion criteria were selected. A random-effect model was used to pool the studies, and the results are reported in the odds ratio (OR) and corresponding 95% Confidence interval (CI). Twelve randomized control trials were selected for meta-analysis. Significant results were obtained for BMI in children after the interventions (0.38 95% CI 0.14, 0.62; p = 0.002; I2 = 65%). LDL level was also found significantly reduced (0.41 95% CI 0.01, 0.82; p = 0.05; I2 = 83%). Other factors such as HDL level, blood pressure, blood glucose level, body weight, and waist circumference were also analyzed. We found that exercise interventions significantly improved several cardiometabolic risk factors such as BMI, LDL level, BP, and blood glucose level. However, no significant effect on HDL concentration, waist circumference, and body weight were found. Long-term interventions are needed to attain improvement in all cardiometabolic risk factors.
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Affiliation(s)
- Stefan Sebastian Busnatu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Liviu Ionut Serbanoiu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
- Correspondence:
| | - Andreea Elena Lacraru
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Catalina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Cosmina Elena Jercalau
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Marilena Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
| | - Anca Stoian
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 050474 Bucharest, Romania; (S.S.B.); (A.E.L.); (C.L.A.); (C.E.J.); (M.S.); (A.S.)
- Department of Diabetes, Nutrition and Metabolic Diseases, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Saleh N, Seif AA, Bahaa I, Abdel-Hady EA. Comparative Effect of Vitamin D3 and Carbenoxolone Treatments in Metabolic Syndrome Rats. Can J Physiol Pharmacol 2021; 100:412-421. [PMID: 34855519 DOI: 10.1139/cjpp-2021-0400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors including central obesity, hypertension, insulin resistance, dyslipidemia, and hyperglyemia. MetS is found to be a positive predictor of cardiovascular morbidity and mortality. The present study was planned to test the efficacy of vitamin D3 supplementation as compared to cortisol inhibition on MetS parameters. Wistar rats were allocated into four groups: controls, untreated MetS, and MetS treated with either vitamin D3 (10 μg/kg), or carbenoxolone (50 mg/kg). MetS was induced by combination of high fat diet and oral fructose. After the induction period (8 weeks), MetS was confirmed and treatment modalities started for a further 4 weeks. Compared to untreated MetS, vitamin D3 and carbenoxolone treated rats showed significant reduction in blood pressure, body mass index, lee index, waist circumference, retroperitoneal fat, and improvement of dyslipidemia. Meanwhile, treatment with carbenoxolone significantly lowered the elevated liver enzymes, vitamin D3 resulted in improved insulin sensitivity, enhanced glucose uptake by muscles and replenished glycogen content in the liver and muscles near control levels. In conclusion, although treatment with vitamin D3 or carbenoxolone reduced the risk factors associated with MetS, vitamin D3 was effective in ameliorating insulin resistance which is the hallmark of MetS.
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Affiliation(s)
- Nermine Saleh
- Ain Shams University Faculty of Medicine, 68792, Physiology Department, Cairo, Egypt;
| | - Ansam Aly Seif
- Ain Shams University Faculty of Medicine, 68792, Physiology Department, Cairo, Egypt;
| | - Ienass Bahaa
- Ain Shams University Faculty of Medicine, 68792, Physiology Department, Cairo, Egypt;
| | - Enas A Abdel-Hady
- Ain Shams University Faculty of Medicine, 68792, Physiology Department, Cairo, Egypt;
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Bilezikian JP, Formenti AM, Adler RA, Binkley N, Bouillon R, Lazaretti-Castro M, Marcocci C, Napoli N, Rizzoli R, Giustina A. Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Rev Endocr Metab Disord 2021; 22:1201-1218. [PMID: 34940947 PMCID: PMC8696970 DOI: 10.1007/s11154-021-09693-7] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2021] [Indexed: 02/07/2023]
Abstract
The 4th International Conference on Controversies in Vitamin D was held as a virtual meeting in September, 2020, gathering together leading international scientific and medical experts in vitamin D. Since vitamin D has a crucial role in skeletal and extra-skeletal systems, the aim of the Conference was to discuss improved management of vitamin D dosing, therapeutic levels and form or route of administration in the general population and in different clinical conditions. A tailored approach, based on the specific mechanisms underlying vitamin D deficiency in different diseases that were discussed, was recommended. Specifically, in comparison to healthy populations, higher levels of vitamin D and greater amounts of vitamin D were deemed necessary in osteoporosis, diabetes mellitus, obesity (particularly after bariatric surgery), and in those treated with glucocorticoids. Emerging and still open issues were related to target vitamin D levels and the role of vitamin D supplementation in COVID-19 since low vitamin D may predispose to SARS-CoV-2 infection and to worse COVID-19 outcomes. Finally, whereas oral daily cholecalciferol appears to be the preferred choice for vitamin D supplementation in the general population, and in most clinical conditions, active vitamin D analogs may be indicated in patients with hypoparathyroidism and severe kidney and liver insufficiency. Parenteral vitamin D administration could be helpful in malabsorption syndromes or in states of vitamin D resistance.Specific guidelines for desired levels of vitamin D should be tailored to the different conditions affecting vitamin D metabolism with the goal to define disease-specific normative values.
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Affiliation(s)
- John P Bilezikian
- Department of Medicine, Endocrinology Division, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Anna Maria Formenti
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital, Milano, Italy
| | - Robert A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of chronic diseases, metabolism and ageing, Leuven, KU, Belgium
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina - Universidade Federal de Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Rome, Italy
| | - Rene Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital, Milano, Italy.
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Mechanisms Involved in the Relationship between Vitamin D and Insulin Resistance: Impact on Clinical Practice. Nutrients 2021; 13:nu13103491. [PMID: 34684492 PMCID: PMC8539968 DOI: 10.3390/nu13103491] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/25/2021] [Accepted: 09/29/2021] [Indexed: 12/29/2022] Open
Abstract
Recent evidence has revealed anti-inflammatory properties of vitamin D as well as extra-skeletal activity. In this context, vitamin D seems to be involved in infections, autoimmune diseases, cardiometabolic diseases, and cancer development. In recent years, the relationship between vitamin D and insulin resistance has been a topic of growing interest. Low 25-hydroxyvitamin D (25(OH)D) levels appear to be associated with most of the insulin resistance disorders described to date. In fact, vitamin D deficiency may be one of the factors accelerating the development of insulin resistance. Vitamin D deficiency is a common problem in the population and may be associated with the pathogenesis of diseases related to insulin resistance, such as obesity, diabetes, metabolic syndrome (MS) and polycystic ovary syndrome (PCOS). An important question is the identification of 25(OH)D levels capable of generating an effect on insulin resistance, glucose metabolism and to decrease the risk of developing insulin resistance related disorders. The benefits of 25(OH)D supplementation/repletion on bone health are well known, and although there is a biological plausibility linking the status of vitamin D and insulin resistance supported by basic and clinical research findings, well-designed randomized clinical trials as well as basic research are necessary to know the molecular pathways involved in this association.
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Cai B, Luo X, Zhang P, Luan Y, Cai X, He X. Effect of vitamin D supplementation on markers of cardiometabolic risk in children and adolescents: A meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2021; 31:2800-2814. [PMID: 34353700 DOI: 10.1016/j.numecd.2021.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS An increasing attention to the effect of vitamin D supplementation on cardiometabolic risk markers in children and adolescents has been gained recently. However, the results are inconsistent. Therefore, we conducted a meta-analysis to examine the effect of vitamin D supplementation on cardiometabolic risk markers in children and adolescents. METHODS AND RESULTS Eligible randomized controlled trials (RCTs) were identified by searching PubMed, EMBASE and Web of Science. The results of this study are synthetized and reported in accordance with the PRISMA statement. GRADE system was used to assess the certainty of evidence. A total of 9 RCTs were identified and included in the meta-analysis. We found that vitamin D supplementation did not affect the changes of cardiometabolic risk markers including high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG), body mass index (BMI), waist circumferences, systolic blood pressure (SDP) and diastolic blood pressure (DBP). However, vitamin D supplementation showed a beneficial effect on fasting glucose (MD, -1.54 mg/dl, 95% CI -2.98 to -0.10) and TG (MD, -24.76 mg/dl, 95% CI -37.66 to -11.86) in the sub-group analysis of total vitamin D supplementation ≥ 200,000 IU. CONCLUSIONS Vitamin D supplementation appeared to have a beneficial effect on reducing fasting glucose and TG level when total vitamin D supplementation ≥200,000 IU but not HDL-C, LDL-C TC, blood pressure and waist circumferences levels in children and adolescents. Further studies are needed to address this issue.
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Affiliation(s)
- Bin Cai
- Department of Quality Management, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Shaoxing People's Hospital, Shaoxing, China
| | - Xi Luo
- Department of Clinical Nutrition, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Pianhong Zhang
- Department of Clinical Nutrition, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Yi Luan
- Department of Cardiovascular, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xueli Cai
- Department of Quality Management, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoming He
- The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Zandieh N, Rezaei Hemami M, Darvishi A, Hasheminejad SM, Abdollahi Z, Zarei M, Heshmat R. The cost-effectiveness analysis of a nationwide vitamin D supplementation program among Iranian adolescents for adulthood cardiovascular diseases prevention. Public Health 2021; 198:340-347. [PMID: 34509859 DOI: 10.1016/j.puhe.2021.07.019] [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: 03/21/2021] [Revised: 06/18/2021] [Accepted: 07/17/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate a national vitamin D supplementation program's cost-effectiveness among Iranian adolescents to prevent cardiovascular diseases (CVDs) in adulthood. STUDY DESIGN A cost-effectiveness analytical study. METHODS A decision tree model was adopted to evaluate the cost per quality-adjusted life-year (QALY) of monthly intake of nine pearls of 50,000 IU vitamin D for nine months to prevent CVD a one-year horizon compared to no intervention. The analysis was conducted in Iranian adolescents in first or second high school grades of 47 climatically different Iran regions. RESULTS Our analytical analysis estimated the 1090$ cost per QALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the incremental cost-effectiveness ratio (ICER) threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood CVD. It means that vitamin D supplementation costs were substantially less than the costs of CVD treatments compared to the no intervention. CONCLUSIONS Based on these findings, the national program of vitamin D supplementation in adolescents would be cost effective to prevent CVD development in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.
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Affiliation(s)
- Narges Zandieh
- Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohsen Rezaei Hemami
- University of Aberdeen, Aberdeen Centre for Health Data Sciences, Southampton, UK
| | - Ali Darvishi
- Department of Management and Health Economics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Zahra Abdollahi
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education
| | - Maryam Zarei
- Office of Community Nutrition, Deputy of Health, Iran Ministry of Health and Medical Education
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Simsek B, Selte A, Egeli BH, Çakatay U. Effects of vitamin supplements on clinical cardiovascular outcomes: Time to move on! - A comprehensive review. Clin Nutr ESPEN 2021; 42:1-14. [PMID: 33745562 PMCID: PMC9587338 DOI: 10.1016/j.clnesp.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/30/2021] [Accepted: 02/05/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND & AIMS Vitamin supplementations have increasingly been advertised on media and reported to be widely used by the general public to improve cardiovascular health. Due to the COVID-19 pandemic, people have become more interested in ways to improve and maintain their health. Increased awareness of people on healthy lifestyle is translating into inquisition regarding dietary supplements. AIM First, focus on the most commonly used vitamin supplements and comprehensively review the evidence for and against recommending them to patients to improve and/or maintain cardiovascular health. Second, illustrate how the interest in studies shifted over time from Vitamin A, E, C, and B to Vitamin D and observational studies led to randomized controlled trials. METHODS A thorough PubMed search with the phrase: "Vitamin supplements and cardiovascular health" was performed. In the present review, focus was maintained on the evidence for the use of vitamin supplements in the prevention of major cardiovascular events and/or the maintenance of cardiovascular health by comprehensively reviewing all previous studies indexed in PubMed. Studies with clinical 'hard' end-points were included only. RESULTS A total of 87 studies met the inclusion criteria and were reviewed in the present article. High-quality evidence suggesting benefits for the use of vitamin supplements to maintain or improve cardiovascular health in people is minimal to non-existent. CONCLUSIONS Vitamin supplementation does not improve clinical cardiovascular outcomes in general population. Counseling on the importance of maintaining a healthy lifestyle with adequate and nutritious food intake seems more appropriate to improve and maintain cardiovascular health.
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Affiliation(s)
- Bahadir Simsek
- Cerrahpasa Medical School, Istanbul University-Cerrahpasa, 34098, Fatih/Istanbul, Turkey.
| | - Atakan Selte
- Cerrahpasa Medical School, Istanbul University-Cerrahpasa, 34098, Fatih/Istanbul, Turkey.
| | - Bugra Han Egeli
- Graduate Medical Sciences, Boston University School of Medicine, 72 E Concord St L-317, 02118, Boston, MA, USA.
| | - Ufuk Çakatay
- Cerrahpasa Medical School, Department of Medical Biochemistry, Istanbul University-Cerrahpasa, 34098, Fatih/Istanbul, Turkey.
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42
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Role of Vitamin D in the Metabolic Syndrome. Nutrients 2021; 13:nu13030830. [PMID: 33802330 PMCID: PMC7999005 DOI: 10.3390/nu13030830] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of hypovitaminosis D has risen in developed countries over the past few years in association with lifestyle changes and an increase in unhealthy habits. Vitamin D deficiency has been implicated in various diseases, including metabolic syndrome (MetS), which is clinically defined by a set of metabolic and vascular disorders. The objective of this study was to review scientific evidence on the relationship between MetS and vitamin D deficiency to support the development of prevention strategies and health education programs. An inverse relationship has been reported between plasma vitamin D concentrations and the features that define MetS, i.e., elevated serum concentrations of glucose, total cholesterol, low-density lipoproteins, triglycerides, glycosylated hemoglobin, and a high body mass index. Numerous studies have described the benefits of vitamin D supplementation to improve outcomes in individuals with MetS. Interventions to maintain optimal vitamin D concentrations are proposed as a preventive strategy against MetS.
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Rojas LZ, Quintero-Lesmes DC, Gamboa-Delgado EM, Guio E, Serrano NC. Prevalence of vitamin D status and its association with overweight or obesity in a population of Colombian children and adolescents. J Nutr Sci 2020; 9:e55. [PMID: 33354326 PMCID: PMC7737171 DOI: 10.1017/jns.2020.47] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/27/2020] [Accepted: 10/14/2020] [Indexed: 12/02/2022] Open
Abstract
The present study aimed to estimate the prevalence of 25-OH-D status (insufficiency and deficiency) in children and adolescents residing in Bucaramanga, Colombia and to determine its association with excess weight. A case-control study was nested in the SIMBA II cohort in children and adolescents between the ages of 11 and 20 years old. Cases were defined as those children and adolescents with overweight or obesity. The control group was composed of children and adolescents from the same population sample with similar sociodemographic and economic characteristics but without overweight or obesity diagnosis. 25-hydroxyvitamin D (25-OH-D) was quantified in serum using a chemiluminescent microparticle immunoassay. Logistic regression models were used to assess the association between vitamin D status and overweight or obesity adjusted for the main confounding variables. A total of 494 children and adolescents cases were 138 (52⋅17% boys and 47⋅83% girls; median age 16⋅0 [Q1 15; Q3 18]). The median BMI S-Score minors age in the cases was 1⋅36 [Q1 1⋅06; Q3 2⋅00] and BMI (kg/m2) 28⋅0 [Q1 26⋅2; Q3 30⋅8]. The prevalence of vitamin D in the cases was deficiency 16⋅67%, insufficiency 57⋅25%, sufficiency 26⋅09. 25-OH-D insufficiency was associated with overweight or obesity after adjusting for the main confounding variables (OR 1⋅73; 95% CI 1⋅05-2⋅84). Our study concludes that the 25-OH-D insufficiency is common in children and adolescents in Bucaramanga, Colombia, and it was associated with overweight or obesity.
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Affiliation(s)
- Lyda Z. Rojas
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Doris C. Quintero-Lesmes
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Edna M. Gamboa-Delgado
- Universidad Industrial de Santander, Escuela de Nutrición y Dietética, carrera 32 No. 29–32, Bucaramanga, Santander, Colombia
| | - Elizabeth Guio
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
| | - Norma C. Serrano
- Fundación Cardiovascular de Colombia, Dirección de Investigaciones, Calle 155A No. 23–58, Urbanización el Bosque, Floridablanca, Colombia
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Serrano NC, Romero SL, Suárez DP, Rojas LZ, Gamboa-Delgado EM, Forero M, Guio E, Quintero-Lesmes DC. Efficacy of oral Vitamin D supplementation in reducing body mass index and lipid profile in adolescents and young adults in Colombia: A pilot clinical trial protocol nested in the SIMBA cohort. Medicine (Baltimore) 2020; 99:e21722. [PMID: 32871891 PMCID: PMC7458167 DOI: 10.1097/md.0000000000021722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND In recent years, the role of vitamin D (VD) as a protective factor in cardiovascular disease has been recognized. Thus, there is a need to study the effect of vitamin D supplementation in the control of different cardiovascular risk factors and metabolic syndrome, especially in young populations where few studies have been conducted. METHODS Pilot study of a randomized, parallel two-arm, triple-blind clinical controlled trial in 150 adolescents and young adults in the city of Bucaramanga-Colombia. The intervention group will receive 1000 IU of VD and the control group 200 IU of VD daily for 15 weeks. The main outcomes are: serum calcifediol levels (25(OH) D), body mass index and lipid profile; secondary outcomes are complementary to the previous ones (skin folds, waist-hip ratio). Other variables will be analyzed such as assessment of dietary intake, physical activity, sun exposure, cigarette and tobacco consumption and compliance with VD supplementation. DISCUSSION This study is innovative since there is little evidence from clinical trials in adolescents and young adults; similar studies are not known in our context. The results of this study may facilitate the recommendation of oral vitamin D supplementation in the population of interest. In addition, it is a low-cost and easy-to-apply intervention that could contribute to the formulation and implementation of health policies. TRIAL REGISTRATION NCT04377386.
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Affiliation(s)
| | | | | | | | | | - Mario Forero
- Hospital Internacional de Colombia, Piedecuesta, Colombia
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Damsgaard CT. Can vitamin D supplementation improve childhood cardiometabolic status?-data from 2 randomized trials. Am J Clin Nutr 2020; 111:737-738. [PMID: 32005985 DOI: 10.1093/ajcn/nqaa021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Camilla T Damsgaard
- Paediatric and International Nutrition, Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
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Sirtuin-1 and Its Relevance in Vascular Calcification. Int J Mol Sci 2020; 21:ijms21051593. [PMID: 32111067 PMCID: PMC7084838 DOI: 10.3390/ijms21051593] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/16/2022] Open
Abstract
Vascular calcification (VC) is highly associated with cardiovascular disease and all-cause mortality in patients with chronic kidney disease. Dysregulation of endothelial cells and vascular smooth muscle cells (VSMCs) is related to VC. Sirtuin-1 (Sirt1) deacetylase encompasses a broad range of transcription factors that are linked to an extended lifespan. Sirt1 enhances endothelial NO synthase and upregulates FoxOs to activate its antioxidant properties and delay cell senescence. Sirt1 reverses osteogenic phenotypic transdifferentiation by influencing RUNX2 expression in VSMCs. Low Sirt1 hardly prevents acetylation by p300 and phosphorylation of β-catenin that, following the facilitation of β-catenin translocation, drives osteogenic phenotypic transdifferentiation. Hyperphosphatemia induces VC by osteogenic conversion, apoptosis, and senescence of VSMCs through the Pit-1 cotransporter, which can be retarded by the sirt1 activator resveratrol. Proinflammatory adipocytokines released from dysfunctional perivascular adipose tissue (PVAT) mediate medial calcification and arterial stiffness. Sirt1 ameliorates release of PVAT adipokines and increases adiponectin secretion, which interact with FoxO 1 against oxidative stress and inflammatory arterial insult. Conclusively, Sirt1 decelerates VC by means of influencing endothelial NO bioavailability, senescence of ECs and VSMCs, osteogenic phenotypic transdifferentiation, apoptosis of VSMCs, ECM deposition, and the inflammatory response of PVAT. Factors that aggravate VC include vitamin D deficiency-related macrophage recruitment and further inflammation responses. Supplementation with vitamin D to adequate levels is beneficial in improving PVAT macrophage infiltration and local inflammation, which further prevents VC.
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