Dahl salt-sensitive rats excrete 25-hydroxyvitamin D into urine

Effect of vitamin D3 supplementation on blood pressure in adults: An updated meta-analysis

BACKGROUND AND AIMS

Previous randomized clinical trials (RCTs) of the effects of vitamin D3 supplementation (VD3S) on blood pressure have generated inconsistent results. We evaluated the effect of VD3S on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a meta-analysis.

DATA SYNTHESIS

Literature searches of PubMed, Scopus, Ovid, and Google scholar for publications in English were conducted up to April 2015. RCTs that assessed the effect of VD3S on SBP and DBP were selected.

CONCLUSIONS

A total of 30 RCTs with 41 arms including 4744 participants were included. The mean duration of the studies was 5.6 ± 4.0 months, and doses of VD3S varied between 200 and 12,000 IU/day. VD3S had no effect on SBP (-0.68 mmHg, 95%CI: -2.19 to 0.84), and DBP (-0.57 mmHg, 95%CI: -1.36 to 0.22). Subgroup analysis revealed that daily vitamin D3 therapy at a dose of >800 IU/day for <6 months in subjects ≥50 years old reduced both SBP and DBP (p < 0.001). In addition, VD3S showed hypotensive effects in healthy subjects and hypertensive patients, but a hypertensive effect in overweight and obese subjects. However, after excluding overweight and obese subjects, VD3S significantly reduced SBP and DBP. VD3S in combination with calcium supplementation significantly elevated SBP (3.64 mmHg, 95%CI: 3.15-4.13) and DBP (1.71 mmHg, 95%CI: 1.25-2.18). No evidence of publication bias was found. The effects of VD3S on blood pressure depend on dose of supplementation, treatment regimens, trial duration, and population subgroup. Supplementation may be beneficial at daily doses >800 IU/day for <6 months in subjects ≥50 years old.

Comparative efficacy of vitamin D status in reducing the risk of bladder cancer: A systematic review and network meta-analysis

OBJECTIVES

The optimal concentration of individual vitamin D intake for preventing bladder cancer has not, to our knowledge, been defined. To evaluate the comparative efficacy of different serum 25-hydroxyvitamin D concentrations in preventing bladder cancer, we conducted a systematic search of the literature published up to April 2015.

METHODS

We applied a pairwise meta-analysis to estimate direct evidence from intervention-control studies and a network meta-analysis within a Bayesian framework to combine direct and indirect evidence. Moreover, a dose-response curve was utilized to predict the optimal median serum 25-hydroxyvitamin D concentration based on the odds ratio (OR) for each quintile concentration.

METHODS

Seven studies of a total of 90757 participants, including 2509 bladder cancer patients, were included. Two prospective cohort studies with 57 591 participants and 494 bladder cancer patients, and five case-control studies with 33 166 participants and 2264 bladder cancer patients. From the network meta-analysis, we observed that sufficient serum 25-hydroxyvitamin D concentrations (>75 nmol/L) were superior to all other 25-hydroxyvitamin D concentrations in decreasing the risk of bladder cancer: OR = 0.68 and 95% credible interval (CrI) 0.52 to 0.87 compared with severely deficient concentrations (<25 nmol/L); OR = 0.65 and 95% CrI 0.49 to 0.86 compared with moderately deficient concentrations (25-37.5 nmol/L); OR = 0.61 and 95% CrI 0.47 to 0.80 compared with slightly deficient concentrations (37.5-50 nmol/L); and OR = 0.65 and 95% CrI 0.48 to 0.85 compared with insufficient concentrations (50-75 nmol/L). In addition, we noted a roughly inverse correlation between bladder cancer risk and 25-hydroxyvitamin D concentrations (R(2) = 0.98, P = 0.007).

CONCLUSIONS

Ensuring sufficient serum 25-hydroxyvitamin D concentrations might play an important role in decreasing the risk of bladder cancer. The serum 25-hydroxyvitamin D concentration ≥74 nmol/L was associated with a 60% lower risk of bladder cancer incidence.

High dietary salt does not significantly affect plasma 25-hydroxyvitamin D concentrations of Sprague Dawley rats

BACKGROUND

The Dahl salt-sensitive rat, but not the Dahl salt-resistant rat, develops hypertension and hypovitaminosis D when fed a high salt diet. Since the salt-sensitive rat and salt-resistant rat were bred from the Sprague Dawley rat, the aim of this research was to test the hypothesis that salt-resistant and Sprague Dawley rats would be similar in their vitamin D endocrine system response to high salt intake.

FINDINGS

Sprague Dawley, salt-sensitive, and salt-resistant rats were fed high (80 g/kg, 8%) or low (3 g/kg, 3%) salt diets for three weeks. The blood pressure of Sprague Dawley rats increased from baseline to week 3 during both high and low salt intake and the mean blood pressure at week 3 of high salt intake was higher than that at week 3 of low salt intake (P < 0.05). Mean plasma 25-hydroxyvitamin D concentrations (marker of vitamin D status) of Sprague Dawley, salt-sensitive, and salt-resistant rats were similar at week 3 of low salt intake. Mean plasma 25-hydroxyvitamin D concentrations of Sprague Dawley and salt-resistant rats were unaffected by high salt intake, whereas the mean plasma 25-hydroxyvitamin D concentration of salt-sensitive rats at week 3 of high salt intake was only 20% of that at week 3 of low salt intake.

CONCLUSIONS

These data indicate that the effect of high salt intake on the vitamin D endocrine system of Sprague Dawley rats at week 3 was similar to that of salt-resistant rats. The salt-sensitive rat, thus, appears to be a more appropriate model than the Sprague Dawley rat for assessing possible effects of salt-sensitivity on vitamin D status of humans.

High dietary cholecalciferol increases plasma 25-hydroxycholecalciferol concentration, but does not attenuate the hypertension of Dahl salt-sensitive rats fed a high salt diet

The Dahl salt-sensitive rat, a model for salt-induced hypertension, develops hypovitaminosis D during high salt intake, which is caused by loss of protein-bound vitamin D metabolites into urine. We tested the hypothesis that high dietary cholecalciferol (5- and 10-fold standard) would increase plasma 25-hydroxycholecalciferol (25-OHD(3)) concentration (indicator of vitamin D status) of salt-sensitive rats during high salt intake. Salt-sensitive rats were fed 0.3% salt (low salt, LS), 3% salt (HS), 3% salt and 7.5 microg cholecalciferol/d (HS-D5), or 3% salt and 15 microg cholecalciferol/d (HS-D10) and sacrificed at week 4. Plasma 25-OHD(3) concentrations of the two groups of HS-D rats were similar to that of LS rats and more than twice that of HS rats. Urinary cholecalciferol metabolite content of HS-D rats was more than seven times that of HS rats. Systolic blood pressures of the hypertensive HS and HS-D rats did not significantly differ, whereas LS rats were not hypertensive. We conclude that high dietary cholecalciferol increases plasma 25-OHD(3) concentration, but does not attenuate the hypertension of salt-sensitive rats during high salt intake. Low salt intake may be necessary to both maintain optimal vitamin D status and prevent hypertension in salt-sensitive individuals.

Black and white female adolescents lose vitamin D metabolites into urine

BACKGROUND

The black American population has a higher prevalence of salt sensitivity compared with the white American population. Dahl salt-sensitive rats, models of salt-induced hypertension, excrete protein-bound vitamin D metabolites into urine, a process that is accelerated during high salt intake. We tested the hypothesis that urinary vitamin D metabolite content and 25-hydroxyvitamin D (25-OHD) binding activity of black female adolescents would be greater than that of white female adolescents.

METHODS

Female adolescents (11-15 years old, 11 black and 10 white) were fed low (1.3 g, 56 mmol/24 hours sodium) and high salt (3.86 g, 168 mmol/24 hours sodium) diets for 3 weeks in a randomized order cross-over study design.

RESULTS

White and black adolescents had similar mean urinary vitamin D metabolite content (low salt, black versus white: 50 +/- 10 versus 58 +/- 17 pmol/24 hours; high salt, black versus white: 47 +/- 7 versus 79 +/- 16 pmol/24 hours). Mean urinary 25-OHD binding activities of the black and white adolescents did not significantly differ. Urinary 25-OHD binding activity of 10/11 black adolescents and 7/10 white adolescents was greater at week 3 of high salt intake than at week 3 of low salt intake (r = 0.50, P = 0.002, n = 17). Plasma 24,25-dihydroxyvitamin D concentrations of the white female adolescents were significantly higher than that of the black female adolescents (P < 0.001).

CONCLUSION

Urinary loss of vitamin D metabolites may be one cause of low vitamin D status, in addition to low dietary intake and reduced skin synthesis.

Dahl salt-sensitive rats develop hypovitaminosis D and hyperparathyroidism when fed a standard diet

The Dahl salt-sensitive rat (S), a model for salt-sensitive hypertension, excretes protein-bound 25-hydroxyvitamin D (25-OHD) into urine when fed a low salt diet. Urinary 25-OHD increases during high salt intake. We tested the hypothesis that continuous loss of 25-OHD into urine would result in low plasma 25-OHD concentration in mature S rats raised on a standard diet. Dahl S and salt-resistant (R) male rats were raised to maturity (12-month-old) on a commercial rat diet (1% salt) and switched to 0.3% (low) or 2% (high) salt diets 3 weeks before euthanasia. Urine (24 h) was collected at the end of the dietary treatments. Urinary 25-OHD and urinary 25-OHD binding activity of S rats were three times that of R rats, resulting in lower plasma 25-OHD and 24,25-dihydroxyvitamin D concentrations in S rats than in R rats (P < 0.001). Plasma parathyroid hormone concentrations of S rats were twice that of R rats. S rats fed 2% salt had higher plasma 1,25-dihydroxyvitamin D concentrations than those fed 0.3% salt (P = 0.002). S rats excreted more calcium into urine than R rats (P < 0.001) and did not exhibit the expected calciuric response to salt. Proteinuria of the S rats was three times that of the R rats, suggesting kidney damage in the S rats. Low plasma 25-OHD and 24,25-dihydroxyvitamin D and high plasma 1,25-dihydroxyvitamin D and PTH concentrations seen in the mature S rats have also been reported for elderly patients with low-renin (salt-induced) hypertension. An implication of this study is that low vitamin D status may occur with age in salt-sensitive individuals, even when salt intake is normal.