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Delanghe JR, Speeckaert MM, Maenhout T. Factors to take into account when interpreting 25-hydroxy-vitamin D serum levels. Acta Clin Belg 2024; 79:97-102. [PMID: 38454315 DOI: 10.1080/17843286.2024.2327218] [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: 12/25/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Assessing vitamin D status, typically evaluated using serum or plasma 25-hydroxy vitamin D [25(OH)D] concentration, is complex because of various influencing factors. METHODS Seasonality significantly affects intra-individual variability in 25(OH)D levels. This variation can be addressed by employing cosinor functions that are tailored to the geographical location of the patient to correct for seasonal effects. In addition to seasonality, genetic factors, such as DBP polymorphism and body composition, particularly adiposity, play crucial roles. Dialysis patients with DBP 2-2 phenotype exhibit higher vitamin D requirements. Genotyping/phenotyping of DBP allows for better tailored vitamin D supplementation. The lipid-soluble nature of vitamin D also interacts with plasma components such as serum triglycerides, which can influence vitamin D measurements. Adiposity, which is negatively correlated with vitamin D concentration, necessitates body mass-based mathematical adjustments for accurate vitamin D assessment in subjects with extreme BMI values. CONCLUSIONS Accordingly, vitamin D replacement therapy must be personalized, taking into account factors such as body size and seasonal variations, to effectively reach the target serum 25(OH)D concentrations.
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Affiliation(s)
| | - Marijn M Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
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Schneider S, Biggerstaff DL, Barber TM. Helpful or harmful? The impact of the ketogenic diet on eating disorder outcomes in type 1 diabetes mellitus. Expert Rev Endocrinol Metab 2022; 17:319-331. [PMID: 35748612 DOI: 10.1080/17446651.2022.2089112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/09/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Eating disorders (EDs) are common complications in people with type 1 diabetes (PwT1D), given the rigid focus on food and insulin dose adjustment. Dietary recommendations for T1D match those for the general population, yet many fail to achieve target HbA1c. Evidence suggests that lower carbohydrate meals and thus reduced insulin requirements may decrease inconsistencies in insulin absorption, maintain euglycemia and weight. Dietary restriction is a recognized risk factor for ED development, and Ketogenic Diets (KD) involve restriction of common family-based foods, thus impacting social normality and microbiome diversity. We reviewed the current literature on PwT1D following a KD to understand effects on ED risks. AREAS COVERED Published data from MEDLINE, Embase, and PsycINFO were used. Search terms included: type 1 diabetes mellitus; or insulin dependent diabetes or T1D AND EDs or anorexia or bulimia or disordered eating AND low-carbohydrate diet or carbohydrate restricted diet or low carb diet or ketogenic diet. EXPERT OPINION Research into the effects of KDs on ED outcomes in PwT1D are limited, given the concerns over risks of diabetic ketoacidosis, hypoglycemia, and dyslipidemia. Longer term studies on the participants' experience and motivations of adhering or admonishing the diet are needed.
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Affiliation(s)
- Suzanne Schneider
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Deborah L Biggerstaff
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Thomas M Barber
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Coventry, UK
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Coley-Grant D, Jawad M, Ashby HL, Cornes MP, Kumar B, Hallin M, Nightingale PG, Ford C, Gama R. The Relationship Between Intact Parathyroid Hormone and 25-Hydroxyvitamin D in United Kingdom Resident South Asians and Whites: A Comparative, Cross-Sectional Observational Study. Horm Metab Res 2021; 53:672-675. [PMID: 34233374 DOI: 10.1055/a-1521-5026] [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: 10/20/2022]
Abstract
Ethnic differences in intact parathyroid hormone (iPTH) at similar total 25 hydroxyvitamin D [25(OH)D] concentrations have been reported between US resident Whites, Blacks, and Hispanics, but this has not been studied between South Asians and Whites. We, therefore, compared the iPTH relationship to 25(OH)D in UK resident South Asians and Whites. A comparative, cross-sectional observational study in which demographic and laboratory data on South Asian and White residents of Wolverhampton, UK were analyzed. Log-log models measured the association between 25(OH)D and the interaction term of ethnicity and iPTH. Seven hundred and seventy-two patients consisting of 315 white subjects (208 women) and 457 South Asian subjects (331 women) were studied. Compared to South Asians, White subjects were older, had higher serum concentrations of 25(OH)D, creatinine (lower eGFR), adjusted calcium and magnesium, but similar concentrations of iPTH and phosphate. In an adjusted model, variables significantly associated with 25(OH)D included age, creatinine, adjusted calcium and ethnicity; but not iPTH and the interaction term of ethnicity and iPTH (beta coefficient -0.071, 95% CI -0.209, 0.067, p=0.32). In our study cohort, iPTH was not, per se, influenced by 25 (OH)D. We found no ethnic differences in the association between iPTH and 25(OH)D between South Asians and White UK residents.
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Affiliation(s)
- Deon Coley-Grant
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Mohammed Jawad
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Helen L Ashby
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Michael P Cornes
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Bharan Kumar
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Magnus Hallin
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Peter G Nightingale
- Wellcome Trust Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Clare Ford
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
| | - Rousseau Gama
- Blood Sciences, Black Country Pathology Services, New Cross Hospital, Wolverhampton, United Kingdom
- School of Medicine and Clinical Practice, Wolverhampton University, Wolverhampton, United Kingdom
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Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study. Int Immunopharmacol 2020; 88:107001. [PMID: 33182040 PMCID: PMC7489890 DOI: 10.1016/j.intimp.2020.107001] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 02/07/2023]
Abstract
Differential distributions of vitamin D were observed in the Indian population. Vitamin D levels was inversely correlated with SARS-CoV-2 infection rate. COVID-19 mortality rate was negatively associated with mean vitamin D levels.
Background The role of vitamin D in the susceptibility and severity of various viral diseases has been well documented. Recently, some reports highlighted the possible importance of vitamin D in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although India receives adequate sunlight throughout the year, the majority of Indians are deficient in vitamin D levels. In the present study, we hypothesized that vitamin D deficiency would be associated with the SARS-CoV-2 infection rate and mortality in the Indian population. Materials and methods SARS-CoV-2 infection and mortality data were obtained from the Government of India's official website (accessed on 16th August 2020). Various literature databases like PubMed and Google Scholar were searched to find the mean of 25-hydroxyvitamin D [25(OH)D] levels in different states and union territories of India, Pearson correlation was carried out to investigate the possible link between mean 25(OH)D levels and SARS-CoV-2 infection and mortality per million of the population. Results An inverse correlation was observed between the mean level of 25(OH)D and SARS-CoV-2 infection rate (r = −0.43, p = 0.02) and mortality rate (r = −0.42, p = 0.02). Conclusions The present observational study revealed an association of vitamin D with SARS-CoV-2 infection and related mortality. Further studies are required to validate our observations.
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Effects of vitamin D supplementation on the glycemic control of pre-diabetic individuals: a systematic review. NUTR HOSP 2020; 38:186-193. [PMID: 33319569 DOI: 10.20960/nh.03309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: research shows the potential effect of vitamin D supplementation with an improvement in the glycemic profile of pre-diabetic patients. Objective: this study evaluates the effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals. Methods: we analyzed studies published over the last ten years, and indexed in the Science Direct, PubMed, and LILACS databases. We searched studies using health descriptors related to vitamin D, pre-diabetes, and glycemic control markers. We considered randomized controlled trials eligible for inclusion. All phases of selection, data extraction, and risk of bias assessment were carried out by two independent evaluators. Results: we identified 309 articles, of which 4 met the inclusion criteria. Of these, 3 studies have shown that vitamin D supplementation does not alter glycemic control markers in pre-diabetic individuals. Only one study showed a positive effect after supplementation with 60,000 IU/month of vitamin D3 for 12 months, with a significant reduction in the concentrations of glycated hemoglobin, fasting glucose, and two-hour postprandial glucose. Conclusion: there is insufficient scientific evidence to confirm the beneficial effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals.
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Mogili KD, Karuppusami R, Thomas S, Chandy A, Kamath MS, TK A. Prevalence of vitamin D deficiency in infertile women with polycystic ovarian syndrome and its association with metabolic syndrome – A prospective observational study. Eur J Obstet Gynecol Reprod Biol 2018; 229:15-19. [DOI: 10.1016/j.ejogrb.2018.08.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 07/09/2018] [Accepted: 08/02/2018] [Indexed: 02/06/2023]
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Akcan FA, Dündar Y, Akcan HB, Uluat A, Cebeci D, Sungur MA, Ünlü İ. Clinical role of vitamin D in prognosis of otitis media with effusion. Int J Pediatr Otorhinolaryngol 2018; 105:1-5. [PMID: 29447793 DOI: 10.1016/j.ijporl.2017.11.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 11/28/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate the clinical role of Vitamin D in prognosis of Otitis media with effusion. METHODS This prospective-controlled study was conducted at otolaryngology department in Duzce University, Turkey. The study group comprised children who were diagnosed with Otitis media with effusion between September 2016 and February 2017. Control group was conducted with children underwent circumcision or inguinal hernia repair operations that confirmed with ENT examination they do not have any sign of otitis media. After 3 months of follow-up without any treatment, unresolved cases who were accepted as chronic otitis media with effusion were operated under general anesthesia for ventilation tube application. Study and control groups were assessed depending on the serum 25(OH)Vitamin D levels at the end of 3 months; < 15 ng/mL was accepted as vitamin D deficiency. The results were compared with the control group in terms of vitamin D levels. Also, subgroup analysis was performed addressing to the complete recovery otitis media with effusion and chronic otitis media with effusion. RESULTS One-hundred-seventy-four children with otitis media with effusion and 80 control patients were included to the study. One-hundred-eight (62%) out of 174 patients with otitis media with effusion was completely recovered after a 3-months follow up. Of those 66 out of 174 children, they had persistent diseases, underwent ventilation tube insertion after a 3-months follow-up. The mean 25(OH)Vitamin D level was 18.98 ± 10.60 in otitis media with effusion group and 28.07 ± 14.10 in control group and the difference was statistically significant between the study and control group (p < 0.001). Vitamin D deficiency was observed in 33 out of 66 patients (50.0%) in chronic otitis media with effusion group whilst 35 out of 108 patients (32.4%) in complete recovery otitis media with effusion group (p = 0.021). The rate of 25(OH)Vitamin D deficiency was 25% in control group which was statistically different from chronic otitis media with effusion and recovery chronic otitis media with effusion groups (p = 0.006). CONCLUSIONS This study not only shows the relationship between Vitamin D and otitis media with effusion development, but also demonstrates the effects of Vitamin D on otitis media with effusion prognosis. There is a significant association between 25(OH)Vitamin D deficiency and follow-up outcomes of otitis media with effusion.
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Affiliation(s)
- Fatih Alper Akcan
- Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey.
| | - Yusuf Dündar
- Wayne State University, Department of Otolaryngology -Head &Neck Surgery, Detroit, MI, USA
| | - Hümeyra Bayram Akcan
- Ministry of Health, Atatürk Hospital, Department of Internal Medicine, Düzce, Turkey
| | - Ahmet Uluat
- Ministry of Health, Evliya Çelebi Training and Research Hospital, Department of Otolaryngology, Kutahya, Turkey
| | - Derya Cebeci
- Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey
| | - Mehmet Ali Sungur
- Düzce University School of Medicine, Department of Biostatistics, Düzce, Turkey
| | - İlhan Ünlü
- Düzce University School of Medicine, Department of Otorhinolaryngology, Düzce, Turkey
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Das G, Taylor PN, Javaid H, Tennant BP, Geen J, Aldridge A, Okosieme O. SEASONAL VARIATION OF VITAMIN D AND SERUM THYROTROPIN LEVELS AND ITS RELATIONSHIP IN A EUTHYROID CAUCASIAN POPULATION. Endocr Pract 2017; 24:53-59. [PMID: 29144817 DOI: 10.4158/ep-2017-0058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE It is unclear whether seasonal variations in vitamin D concentrations affect the hypothalamo-pituitary-thyroid axis. We investigated the seasonal variability of vitamin D and serum thyrotropin (TSH) levels and their interrelationship. METHODS Analysis of 401 patients referred with nonspecific symptoms of tiredness who had simultaneous measurements of 25-hydroxyvitamin D3 (25[OH]D3) and thyroid function. Patients were categorized according to the season of blood sampling and their vitamin D status. RESULTS 25(OH)D3 levels were higher in spring-summer season compared to autumn-winter (47.9 ± 22.2 nmol/L vs. 42.8 ± 21.8 nmol/L; P = .02). Higher median (interquartile range) TSH levels were found in autumn-winter (1.9 [1.2] mU/L vs. 1.8 [1.1] mU/L; P = .10). Across different seasons, 25(OH)D3 levels were observed to be higher in lower quartiles of TSH, and the inverse relationship was maintained uniformly in the higher quartiles of TSH. An independent inverse relationship could be established between 25(OH)D3 levels and TSH by regression analysis across both season groups (autumn-winter: r = -0.0248; P<.00001 and spring-summer: r = -0.0209; P<.00001). We also observed that TSH varied according to 25(OH)D3 status, with higher TSH found in patients with vitamin D insufficiency or deficiency in comparison to patients who had sufficient or optimal levels across different seasons. CONCLUSION Our study shows seasonal variability in 25(OH)D3 production and TSH secretion in euthyroid subjects and that an inverse relationship exists between them. Further studies are needed to see if vitamin D replacement would be beneficial in patients with borderline thyroid function abnormalities. ABBREVIATIONS 25(OH)D2 = 25-hydroxyvitamin D2; 25(OH)D3 = 25-hydroxyvitamin D3; AITD = autoimmune thyroid disease; FT4 = free thyroxine; TFT = thyroid function test; TSH = thyrotropin; UVB = ultraviolet B.
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Seasonal Variation in Vitamin D in Association with Age, Inflammatory Cytokines, Anthropometric Parameters, and Lifestyle Factors in Older Adults. Mediators Inflamm 2017; 2017:5719461. [PMID: 29104377 PMCID: PMC5618765 DOI: 10.1155/2017/5719461] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/09/2017] [Indexed: 02/07/2023] Open
Abstract
Vitamin D deficiency is present even in sunny regions. Ageing decreases pre-vitamin D production in the skin and is associated with altered cytokine profile. We performed a multivariate analysis considering lifestyle factors, anthropometric, and inflammatory markers according to seasonal variation in Mexican healthy older adults. The same cohort was followed during 12 months. Vitamin D deficiency/insufficiency was found in 91.3% of the subjects despite living in appropriate latitude (25°40′0″N). 25(OH)D levels remained below <30 ng/mL through all seasons. Vitamin D deficiency did not correlate to sun exposure or dietary intake. Gender was the strongest associated factor, explaining a variance of 20%. Waist circumference (WC) greater than 88 cm was a risk factor for vitamin D deficiency. Age (>74 years) combined with WC (>88 cm) and BMI (>32.7) showed a high probability (90%) of vitamin D deficiency. Remarkably, an increase in one centimeter in WC decreased 25(OH)D by 0.176 ng/mL, while an increase in one point BMI decreased 25(OH)D by 0.534 ng/mL. A cutoff point of 74 years of age determined probability of vitamin D hipovitaminosis. Vitamin D deficiency was correlated with TNF-α serum levels, possibly increasing the susceptibility of older adults to a proinflammatory state and its related diseases.
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Affiliation(s)
- Gautam Das
- Department of Diabetes and Endocrinology, Prince Charles Hospital; Cwm Taf University Health Board; Merthyr Tydfil UK
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Jolliffe DA, Hanifa Y, Witt KD, Venton TR, Rowe M, Timms PM, Hyppönen E, Walton RT, Griffiths CJ, Martineau AR. Environmental and genetic determinants of vitamin D status among older adults in London, UK. J Steroid Biochem Mol Biol 2016; 164:30-35. [PMID: 26776442 DOI: 10.1016/j.jsbmb.2016.01.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/11/2015] [Accepted: 01/09/2016] [Indexed: 02/06/2023]
Abstract
Despite the high prevalence of vitamin D deficiency among older adults in the UK, studies investigating the determinants of vitamin D status in this group are lacking. We conducted a cross-sectional study in 222 older adults living in sheltered accommodation in London, UK, who were screened for participation in a clinical trial of vitamin D supplementation for the prevention of acute respiratory infection. Details of potential demographic and lifestyle determinants of vitamin D status were collected by questionnaire and blood samples were taken for analysis of serum 25-hydroxyvitamin D (25[OH]D) concentration and DNA extraction. Fifteen single nucleotide polymorphisms (SNP) in 6 genes (DBP, DHCR7, CYP2R1, CYP27B1, CYP24A1, VDR) previously reported to associate with circulating 25(OH)D concentration were typed using Taqman allelic discrimination assays. Linear regression was used to identify environmental and genetic factors independently associated with serum 25(OH)D concentration. Mean serum 25(OH)D concentration was 42.7nmol/L (SD 22.0); 144/222 (64.9%) participants had serum 25(OH)D concentrations <50nmol/L. The following factors were independently associated with lower serum 25(OH)D concentration: non-white ethnicity (-8.6nmol/L, 95% CI -14.9 to -2.3, P=0.008); lack of vitamin D supplement consumption (-17.1nmol/L, 95% CI -23.3 to -10.9, P<0.001) vs. taking a daily supplement; sampling in Q1/January-March (-12.2nmol/L, 95% CI -21.5 to -2.9, P=0.01), and sampling in Q4/October-December (-10.3nmol/L, 95% CI -20.2 to -0.4, P=0.04) vs. sampling in Q3/July-September. None of the 15 SNP investigated independently associated with serum 25(OH)D concentration after correcting for multiple comparisons. In conclusion, vitamin D deficiency was highly prevalent among the older adults in this study; non-White ethnicity, lack of vitamin D supplement consumption and sampling in winter and spring independently associated with lower vitamin D status.
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Affiliation(s)
- David A Jolliffe
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
| | - Yasmeen Hanifa
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Karolina D Witt
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | | | - Marion Rowe
- Homerton University Hospital, Homerton Row, London E9 6SR, UK
| | - Peter M Timms
- Homerton University Hospital, Homerton Row, London E9 6SR, UK
| | - Elina Hyppönen
- School of Population Health, University of South Australia, Adelaide, Australia
| | - Robert T Walton
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Christopher J Griffiths
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Adrian R Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK.
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Kwon JW, Choi JA, La TY. Serum 25-hydroxyvitamin D level is associated with myopia in the Korea national health and nutrition examination survey. Medicine (Baltimore) 2016; 95:e5012. [PMID: 27861336 PMCID: PMC5120893 DOI: 10.1097/md.0000000000005012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The aim of this article was to assess the associations of serum 25-hydroxyvitamin D [25(OH)D] and daily sun exposure time with myopia in Korean adults.This study is based on the Korea National Health and Nutrition Examination Survey (KNHANES) of Korean adults in 2010-2012; multiple logistic regression analyses were performed to examine the associations of serum 25(OH)D levels and daily sun exposure time with myopia, defined as spherical equivalent ≤-0.5D, after adjustment for age, sex, household income, body mass index (BMI), exercise, intraocular pressure (IOP), and education level. Also, multiple linear regression analyses were performed to examine the relationship between serum 25(OH)D levels with spherical equivalent after adjustment for daily sun exposure time in addition to the confounding factors above.Between the nonmyopic and myopic groups, spherical equivalent, age, IOP, BMI, waist circumference, education level, household income, and area of residence differed significantly (all P < 0.05). Compared with subjects with daily sun exposure time <2 hour, subjects with sun exposure time ≥2 to <5 hour, and those with sun exposure time ≥5 hour had significantly less myopia (P < 0.001). In addition, compared with subjects were categorized into quartiles of serum 25(OH)D, the higher quartiles had gradually lower prevalences of myopia after adjustment for confounding factors (P < 0.001). In multiple linear regression analyses, spherical equivalent was significantly associated with serum 25(OH)D concentration after adjustment for confounding factors (P = 0.002).Low serum 25(OH)D levels and shorter daily sun exposure time may be independently associated with a high prevalence of myopia in Korean adults. These data suggest a direct role for vitamin D in the development of myopia.
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Jee D, Kim EC, Cho E, Arroyo JG. Positive Association between Blood 25-Hydroxyvitamin D Levels and Pterygium after Control for Sunlight Exposure. PLoS One 2016; 11:e0157501. [PMID: 27286036 PMCID: PMC4902231 DOI: 10.1371/journal.pone.0157501] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 05/31/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the association between blood 25-hydroxyvitamin D levels and pterygium. Methods Korean National Health and Nutrition Examination Survey 2008–2011 were used for the present epidemiologic study. A total of 19,178 participants aged ≥ 30 years were evaluated for blood 25-hydroxyvitamin D levels and performed ophthalmic slit lamp examinations. Pterygium was considered as a growth of fibrovascular tissue over the cornea. Results The average blood 25-hydroxyvitamin D levels were 18.6 ng/mL, and prevalence of pterygium was 6.5%. The odds of pterygium significantly increased across blood 25-hydroxyvitamin D quintiles after controlling sun exposure time as well as other confounders such as sex, age, smoking, diabetes, hypertension (P < 0.001). The odds ratios (OR) for pterygium was 1.51 (95% Confidence Interval[95%CI]; 1.19–1.92) in the highest blood vitamin D quintile. Stratified analysis by sex showed a positive association between blood 25-hydroxyvitamin D levels and pterygium in both men (quintile 5 versus 1, OR; 1.68, 95%CI; 1.19–2.37) and women (quintile 5 versus 1, OR; 1.37, 95% CI; 1.00–1.88). Conclusions Even after controlling sun light exposure time, we found a positive association between blood 25-hydroxyvitamin D levels and pterygium in a representative Korean population. The mechanism underlying this association is unknown.
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Affiliation(s)
- Donghyun Jee
- Department of Ophthalmology and Visual Science, St. Vincent's Hospital, College of Medicine, Catholic University of Korea, Suwon, Korea
| | - Eun Chul Kim
- Department of Ophthalmology and Visual Science, Bucheon St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Bucheon, Korea
- * E-mail:
| | - Eunyoung Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, United States of America
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, United States of America
| | - Jorge G. Arroyo
- Department of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
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Jee D, Kang S, Yuan C, Cho E, Arroyo JG. Serum 25-Hydroxyvitamin D Levels and Dry Eye Syndrome: Differential Effects of Vitamin D on Ocular Diseases. PLoS One 2016; 11:e0149294. [PMID: 26894581 PMCID: PMC4760949 DOI: 10.1371/journal.pone.0149294] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 01/29/2016] [Indexed: 12/15/2022] Open
Abstract
Purpose To investigate associations between serum 25-hydroxyvitamin D levels and dry eye syndrome (DES), and to evaluate the differential effect of vitamin D on ocular diseases including age-related macular disease (AMD), diabetic retinopathy (DR), cataract, and DES. Methods A total of 16,396 participants aged >19 years were randomly selected from the Korean National Health and Nutrition Examination Survey. All participants participated in standardized interviews, blood 25-hydroxyvitamin D level evaluations, and comprehensive ophthalmic examinations. DES was defined by a history of clinical diagnosis of dry eyes by a physician. The association between vitamin D and DES was compared to the associations between vitamin D and AMD, DR, cataract, and DES from our previous studies. Results The odds of DES non-significantly decreased as the quintiles of serum 25-hydroxyvitamin D levels increased (quintile 5 versus 1, OR = 0.85, 95%CI: 0.55–1.30, P for trend = 0.076) after adjusting for potential confounders including age, sex, hypertension, diabetes, smoking status, and sunlight exposure times. The relative odds of DES (OR = 0.70, 95% CI: 0.30–1.64) and cataract (OR = 0.76, 95% CI: 0.59–0.99) were relatively high, while those of DR (OR = 0.37, 95% CI: 0.18–0.76) and late AMD (OR = 0.32, 95% CI: 0.12–0.81) were lower in men. Conclusions The present study does not support an association between serum 25-hydroxyvitamin D levels and DES. The preventive effect of serum 25-hydroxyvitamin D may be more effective for DR and late AMD than it is for cataract and DES.
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Affiliation(s)
- Donghyun Jee
- Department of Ophthalmology and Visual Science, College of Medicine, Catholic University of Korea, Suwon, Korea
- Department of Epidemiology and Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Seungbum Kang
- Department of Ophthalmology and Visual Science, Daejeon St. Mary’s Hospital, College of Medicine, Catholic University of Korea, Daejeon, Korea
- * E-mail:
| | - Changzheng Yuan
- Department of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Eunyoung Cho
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Dermatology, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States of America
| | - Jorge G. Arroyo
- Department of Ophthalmology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America
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15
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Jee D, do Han K, Kim EC. Inverse association between high blood 25-hydroxyvitamin D levels and diabetic retinopathy in a representative Korean population. PLoS One 2014; 9:e115199. [PMID: 25485770 PMCID: PMC4259490 DOI: 10.1371/journal.pone.0115199] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 11/19/2014] [Indexed: 12/13/2022] Open
Abstract
Purpose To investigate the association between 25-hydroxyvitamin D and diabetic retinopathy (DR). Methods A population-based cross-sectional study using a nation-wide, systemically stratified, multistage, clustered sampling method included a total of 18,363 subjects aged ≥40 years who participated in the Korean National Health and Nutrition Examination Survey during 2008–2012. All participants participated in standardized interviews, blood 25-hydroxyvitamin D level evaluations, and comprehensive ophthalmic examinations. Seven standard retinal fundus photographs were obtained from both eyes after pupil dilatation. DR was graded according to the modified Airlie House classification system. Results The blood 25-hydroxyvitamin D levels were 19.2 ng/mL in men and 17.9 ng/mL in women. After adjusting for potential confounders, including age, sex, diabetes duration, hemoglobin A1c levels, and hypertension, the odds ratios (OR) for any DR and proliferative DR among men decreased significantly in the highest blood 25-hydroxyvitamin D level quintile relative to the lowest quintile (OR, 0.37; 95% confidence interval [CI], 0.18–0.76; P for trend = 0.004 and OR, 0.15; 95% CI, 0.03–0.83; P for trend = 0.043). Conclusions This study provides the first epidemiologic findings of the inverse relationships of blood 25-hydroxyvitamin D levels with any DR and proliferative DR only in men. Considering anti-angiogenic and anti-fibrotic action of vitamin D, further studies including longitudinal and interventional analysis are warranted.
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Affiliation(s)
- Donghyun Jee
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Epidemiology and Biostatistics, Harvard School of Public Health, Boston, MA, United States of America
- * E-mail:
| | - Kyung do Han
- Department of Biostatistics, Department of Preventive medicine, The College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Eun Chul Kim
- Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Jang H, Koo FK, Ke L, Clemson L, Cant R, Fraser DR, Seibel MJ, Tseng M, Mpofu E, Mason RS, Brock K. Culture and Sun Exposure in Immigrant East Asian Women Living in Australia. Women Health 2013; 53:504-18. [DOI: 10.1080/03630242.2013.806386] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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17
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Penny H, Frame S, Dickinson F, Garrett G, Young AR, Sarkany R, Chitalia N, Hampson G, Goldsmith D. Determinants of vitamin D status in long-term renal transplant patients. Clin Transplant 2012; 26:E617-23. [PMID: 23083399 DOI: 10.1111/ctr.12039] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2012] [Indexed: 12/11/2022]
Abstract
In this study, we explored the determinants of vitamin D status in a large cohort of stable, Long-term renal transplant (RTx) patients. Serum 25(OH)D concentrations, and bone biochemistry parameters, were retrospectively analyzed from 266 RTx patients (>10 yr post-engraftment) presenting to clinic over the course of a year. Forty-five percent of the cohort were vitamin D deficient (<37.5 nM), 38% insufficient (37.5 75-nM), and 17% sufficient (>75 nM). Serum 25(OH)D concentrations were higher in patients presenting in summer (p<0.001) and in more active patients (p<0.05). RTx patients with non-melanoma skin cancer (NMSC) (n=45) had higher 25(OH)D concentrations than patients without NMSC (n=221; p<0.05) despite these patients being older, having worse eGFR, transplanted for longer, and less active physically (p<0.05). Lower 25(OH)D concentrations were associated with higher PTH concentrations (p<0.05) which, in the setting of widespread hypovitaminosis, suggests that secondary hyperparathyroidism was common in this cohort. In conclusion, season and activity status are important determinants of vitamin D status. We report, for the first time, that NMSC is associated with higher 25(OH)D, probably through increased UV radiation exposure. Long-term RTx patients may benefit from oral vitamin D supplementation, but this requires a randomized controlled trial to confirm.
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Affiliation(s)
- Hugo Penny
- Department of Nephrology and Transplantation, Guy's and St Thomas' NHS Foundation Trust, London, UK
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