1
|
Mendes MM, Gomes APO, Araújo MM, Coelho ASG, Carvalho KMB, Botelho PB. Prevalence of vitamin D deficiency in South America: a systematic review and meta-analysis. Nutr Rev 2023; 81:1290-1309. [PMID: 36882047 DOI: 10.1093/nutrit/nuad010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
CONTEXT Vitamin D deficiency is considered a global public health issue, even in low-latitude countries where there is abundant sunlight radiation. Nevertheless, the prevalence of vitamin D insufficiency and deficiency in the South American continent has not been well characterized. OBJECTIVE The aim of this review was to estimate the prevalence of vitamin D deficiency (25-hydroxy-calciferol < 20 ng/mL) in South American populations. DATA SOURCES Seven electronic databases (MEDLINE, Web of Science, Embase, Biblioteca Virtual de Saúde, SciELO, Scopus, and Google Scholar) were searched systematically for observational studies published before July 1, 2021, and reporting vitamin D status of healthy adults in South America. DATA EXTRACTION Data were extracted using a standardized form. Risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence. All steps were conducted independently by two authors. Data were pooled using a random-effects model. Stratified meta-analysis and meta-regression were conducted (R software). DATA ANALYSIS Of 9460 articles identified, 96 studies with a total of 227 758 participants were included. The overall prevalence of vitamin D deficiency was 34.76% (79 studies; 95%CI, 29.68-40.21; I2 = 99%). There were significant differences in prevalence rates related to age, sex, country, latitude, season, and year of publication. CONCLUSION The prevalence of vitamin D deficiency is unexpectedly elevated in South American populations. Public health strategies should include efforts to prevent, detect, and treat vitamin D deficiency. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42020169439.
Collapse
Affiliation(s)
- Marcela M Mendes
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Anna P O Gomes
- Department of Clinical Nutrition, Faculty of Nutrition, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Maísa M Araújo
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Alexandre S G Coelho
- Department of Biology, Agronomy School, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Kênia M B Carvalho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| | - Patrícia B Botelho
- Department of Nutrition, Faculty of Health Sciences, University of Brasília, Brasília, Federal District, Brazil
| |
Collapse
|
2
|
García-Vigara A, Monllor-Tormos A, García-Pérez MÁ, Tarín JJ, Cano A. Genetic variants of the vitamin D receptor are related to dynapenia in postmenopausal women. Maturitas 2023; 171:40-44. [PMID: 37001478 DOI: 10.1016/j.maturitas.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 03/05/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Dynapenia increases with age and in the case of women is possibly influenced by menopause, yet whether vitamin D affects this increase remains controversial. The influence of genetic variants (single nucleotide polymorphisms) of the vitamin D receptor on dynapenia is an understudied area. AIM To analyze the association between genetic variants of the vitamin D receptor gene and dynapenia in a cohort of community-dwelling postmenopausal women. METHODS We performed a cross-sectional study of 463 women in a university hospital. Grip strength was used as an indicator of dynapenia. Differences in grip strength among single nucleotide polymorphisms rs11568820 and rs2228570 genotypes of the vitamin D receptor gene were assessed after adjusting for confounding variables, and the percentage of phenotypic variance was estimated by linear regression. RESULTS Dynapenia (grip strength <20 kg) was diagnosed in 178 of the women (38.45 %). A difference in grip strength, corresponding to variants of the vitamin D receptor gene single nucleotide polymorphism rs11568820, was found when using an additive model of inheritance, with lower grip strength for the TT genotype (ANOVA, p = 0.030, close to the 0.025 significance level determined by Bonferroni correction). Assuming a recessive inheritance model for allele T, the between-group difference in grip strength was significant (TT = 19.79 ± 3.10 kg vs. CC/CT = 21.58 ± 3.49 kg, p = 0.008) after adjusting for age, body mass index, comorbidities, and sociodemographic variables. More women with dynapenia had the TT genotype (60.71 %) than the CC or CT genotype (37.01 %) (p = 0.012). CONCLUSION This study demonstrates that the TT genotype of the rs11568820 SNP of the vitamin D receptor gene was associated with decreased grip strength in community-dwelling postmenopausal women.
Collapse
Affiliation(s)
- Alicia García-Vigara
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario-INCLIVA, Av. Blasco Ibáñez 17, 46010 Valencia, Spain.
| | - Aitana Monllor-Tormos
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario-INCLIVA, Av. Blasco Ibáñez 17, 46010 Valencia, Spain
| | - Miguel Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, and INCLIVA, Burjassot 46100, Valencia, Spain.
| | - Juan J Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Dr. Moliner 50, 46100 Burjassot, Valencia, Spain.
| | - Antonio Cano
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario-INCLIVA, Av. Blasco Ibáñez 17, 46010 Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain.
| |
Collapse
|
3
|
Welford AE, Darling AL, Allison SJ, Lanham-New SA, Greig CA. Lack of significant seasonal association between serum 25(OH)D concentration, muscle mass and strength in postmenopausal women from the D-FINES longitudinal study. J Nutr Sci 2022; 11:e107. [PMID: 36588541 PMCID: PMC9794962 DOI: 10.1017/jns.2022.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 12/14/2022] Open
Abstract
The aim of the present study was to assess the seasonal relationship between serum 25(OH)D concentration, lean mass and muscle strength. This was a secondary data analysis of a subgroup of 102 postmenopausal women participating in the 2006-2007 D-FINES (Vitamin D, Food Intake, Nutrition and Exposure to Sunlight in Southern England) study. The cohort was assessed as two age subgroups: <65 years (n=80) and ≥65 years (n=22). Outcome measures included lean mass (DXA), muscle strength (handgrip dynamometry) and serum 25(OH)D concentration (enzymeimmunoassay). Derived outcomes included appendicular skeletal muscle mass (ASM) and relative appendicular skeletal muscle index (RASM). Sarcopenia status was assessed using the European Working Group on Sarcopenia in Older People 2018 criteria. Non-parametric partial correlation using BMI as a covariate was used to evaluate the study aims. There were no statistically significant associations between total lean mass, ASM or RASM and 25(OH)D in any group at any season. There was a trend for handgrip strength to be positively associated with serum 25(OH)D concentration. There was a trend showing a higher prevalence of sarcopenia in women ≥65 years. Sarcopenia status appeared transient for five women. In conclusion, the present study found no significant association between vitamin D status and functional indicators of musculoskeletal health, which were additionally not affected by season.
Collapse
Key Words
- 1,25(OH)2D, 1,25-dihydroxyvitamin D
- 25(OH)D, 25-hydroxyvitamin D
- ASM, appendicular skeletal mass
- BMI, body mass index
- D-FINES, Vitamin D
- DEQAS, vitamin D quality assurance scheme
- DXA, dual X-ray absorptiometry
- EWGSOP, European Working Group on Sarcopenia in Older People
- Food Intake, Nutrition and Exposure to Sunlight in Southern England
- GP, General Practitioner
- HGS, handgrip strength
- Longitudinal
- Muscle mass
- Muscle strength
- PAL, physical activity level
- RASM, relative appendicular skeletal mass
- SPSS, Statistical Package for Social Sciences
- Sarcopenia
- Seasonal variation
- UK, United Kingdom
- USA, United States of America
- VDR, vitamin D receptor
- Vitamin D
- kg, kilogram
- ng/ml, nanograms per millilitre
- nmol/l, nanomoles per litre
Collapse
Affiliation(s)
- Anneka E. Welford
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- Leicester Diabetes Centre, University of Leicester, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Andrea L. Darling
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Sarah J. Allison
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Susan A. Lanham-New
- Nutrition, Food and Exercise Sciences Department, School of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Carolyn A. Greig
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust & University of Birmingham, Birmingham, UK
| |
Collapse
|
4
|
Liu L, Xie K, Yin M, Chen X, Chen B, Ke J, Wang C. Lower serum levels of vitamin D in adults with urinary tract infection. Infection 2022; 50:739-746. [PMID: 35013942 DOI: 10.1007/s15010-021-01750-2] [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: 07/26/2021] [Accepted: 12/20/2021] [Indexed: 11/05/2022]
Abstract
PURPOSE We aimed to explore the association between urinary tract infection (UTI) in adults and serum 25-hydroxyvitamin D (25OHD), which was used to access vitamin D status. METHODS Serum levels of 25OHD were retrospectively analyzed in 234 subjects (190 females and 44 males): 120 UTI patients (females = 103) and 114 age- and sex-matched healthy controls (females = 87). Serum 25OHD concentrations were categorized as follows: (1) < 20 ng/mL, 20 to < 30 ng/mL, and ≥ 30 ng/mL; (2) < 20 ng/mL and ≥ 20 ng/mL. RESULTS Serum 25OHD levels were lower in patients with UTI (p < 0.01). Women with UTI presented significantly lower 25OHD concentrations than those without UTI (p < 0.01). No association between serum 25OHD levels and UTI in men was found (p > 0.05). The multivariable logistic regression models showed significant associations between UTI and 25OHD, female sex, neutrophilic lymphocyte ratio and C-reactive protein (p < 0.05). CONCLUSION Lower 25OHD concentrations associated with UTI were most prominent among women. The associations between UTI and low serum 25OHD levels as well as female sex were independent of each other.
Collapse
Affiliation(s)
- Lingling Liu
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China
| | - Kehang Xie
- Department of Neurology, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Zhuhai, 519000, Guangdong province, China
| | - Mengmeng Yin
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China
| | - Xiaoqiu Chen
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China
| | - Binhuan Chen
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China
| | - Jianting Ke
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China
| | - Cheng Wang
- Department of Nephrology, Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong province, China.
| |
Collapse
|
5
|
Cheong WF, Ji S, Cazenave-Gassiot A, Thu WPP, Logan S, Cauley J, Kramer MS, Yong EL. Predictors of circulating vitamin D levels in healthy mid-life Singaporean women. Arch Osteoporos 2021; 16:26. [PMID: 33559771 DOI: 10.1007/s11657-021-00880-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Vitamin D levels were lowest in Indian and Malay compared to Chinese women, and in younger and employed women. The main reason for hypovitaminosis D in study women was deficient cutaneous production. Supplementation in regions with abundant sunshine should consider ethnicity and opportunities for exposure to sunlight. INTRODUCTION Little is known about variations in circulating vitamin D levels in multiethnic mid-life women living in communities with year-round sunlight. Our study describes the circulating vitamin D levels and their sociodemographic predictors in mid-life Singaporean women. METHODS Prospective cross-sectional study of healthy Singaporean women, age 45-69 years, who were not consuming vitamin D supplements. Total 25-hydroxyvitaminD [25(OH)D], the sum of 25(OH)D2 and 25(OH)D3, was measured by liquid chromatography-tandem mass spectrometry. RESULTS The analytic cohort of 721 women, mean age 55.2±6.0 (±SD) years, was of Chinese (82%), Indian (11%), and Malay (7%) ethnicity. Their mean 25(OH)D level was 24.8±7.8ng/mL. One-third (32.6%) of the women had deficient 25(OH)D (≤20ng/mL) and 3.5% were severely deficient (<12ng/mL). 25(OH)D3 comprised 98% of the total circulating 25(OH)D level. Adjusted mean total 25(OH)D levels were significantly lower for women of Indian and Malay (vs Chinese) ethnicity, who were premenopausal or working outside the home. Indian and Malay women had higher odds (adjusted OR 5.58 (95% CI 3.22, 9.87) and 3.83 (95% CI 1.97, 7.57), respectively) of low 25(OH)D compared to Chinese women. Obesity was not an independent predictor of low 25(OH)D, as its strong crude association was confounded by ethnicity. The adjusted odds of low 25(OH)D was reduced in women ≥65 years (adjusted OR 0.37 (95% CI 0.14, 0.87)) compared to those aged 45-55 years. CONCLUSION One-third of mid-life Singaporean women were 25(OH)D deficient, and the major independent predictors of deficiency were Indian or Malay ethnicity and younger age. Vitamin D supplementation in mid-life women should be targeted to those with documented deficiency or limited cutaneous production.
Collapse
Affiliation(s)
- Wei Fun Cheong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Shanshan Ji
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, 117456, Republic of Singapore
| | - Amaury Cazenave-Gassiot
- Singapore Lipidomics Incubator, Life Sciences Institute, National University of Singapore, Singapore, 117456, Republic of Singapore
- Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117596, Republic of Singapore
| | - Win Pa Pa Thu
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Susan Logan
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore
| | - Jane Cauley
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA
| | - Michael S Kramer
- Departments of Epidemiology, Biostatistics & Occupational Health and of Pediatrics, Faculty of Medicine, McGill University, Montreal, Quebec, H3G 1Y6, Canada
| | - Eu-Leong Yong
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road, Level 12, Singapore, 119228, Republic of Singapore.
| |
Collapse
|
6
|
Vallejo MS, Blümel JE, Arteaga E, Aedo S, Tapia V, Araos A, Sciaraffia C, Castelo-Branco C. Gender differences in the prevalence of vitamin D deficiency in a southern Latin American country: a pilot study. Climacteric 2020; 23:410-416. [PMID: 32367772 DOI: 10.1080/13697137.2020.1752171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Aim: This study aimed to study the prevalence of vitamin D deficiency, assessing the influence of sex, age, and season of the year.Methods: A cross-sectional study was conducted with 1329 healthy subjects (668 women and 661 men) aged 18-89 years in Santiago, Chile. Age (years), body mass index, medical history, working status, sex, and date of blood sample were collected.Results: Men were slightly older than women (53.1 ± 18.2 vs. 50.0 ± 15.6 years; p < 0.01) and a higher percentage worked outside the home (73.1% vs. 51.9%, p < 0.001). The mean serum concentration of 25-hydroxyvitamin D (25(OH)-D) was 23.3 ± 9.3 ng/ml in women and 20.9 ± 9.5 ng/ml in men (p < 0.001). The levels of 25(OH)-D by season were 26.7 ± 9.0, 23.6 ± 9.7, 19.4 ± 8.5, and 19.1 ± 9.5 ng/ml (for summer, fall, winter, and spring, respectively; p < 0.05). The prevalence of vitamin D deficiency increases with age, rising from 36.5% under 40 years to 48.0% over 60 years (p < 0.004). Male sex, winter and spring, and age showed negative correlation with levels of 25(OH)-D (p < 0.05). Multivariate linear regression showed a final model that incorporates: age (coefficient: -0.06; 95% confidence interval [CI]: -0.09 to -0.03; p < 0.001), male sex (coefficient: -2.00; 95% CI: -2.96 to -1.05; p < 0.001), summer (coefficient: 7.30; 95% CI: 6.17 to 8.43; p < 0.001), and fall (coefficient: 4.27; 95% CI: 3.04 to 5.50; p < 0.001).Conclusions: Vitamin D deficiency is more prevalent in men than in women, in the elderly, and during the winter and spring seasons.
Collapse
Affiliation(s)
- M S Vallejo
- Clínica Quilín, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - J E Blümel
- Department of Medicine South, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - E Arteaga
- Department of Endocrinology and CETREN, Faculty of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - S Aedo
- School of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - V Tapia
- Clínica Quilín, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - A Araos
- Clínica Quilín, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - C Sciaraffia
- Clínica Quilín, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - C Castelo-Branco
- Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, University of Barcelona, Hospital Clinic-Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| |
Collapse
|
7
|
Evolving Role of Vitamin D in Immune-Mediated Disease and Its Implications in Autoimmune Hepatitis. Dig Dis Sci 2019; 64:324-344. [PMID: 30370494 DOI: 10.1007/s10620-018-5351-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/09/2018] [Indexed: 12/11/2022]
Abstract
Vitamin D has immunomodulatory, anti-inflammatory, antioxidant, and anti-fibrotic actions that may impact on the occurrence and outcome of immune-mediated disease. The goals of this review are to describe the nature of these expanded roles, examine the implications of vitamin D deficiency in autoimmune hepatitis, and identify opportunities for future investigation. Abstracts were identified in PubMed by multiple search terms. Full-length articles were selected for review, and secondary and tertiary bibliographies were developed. Vitamin D receptors are expressed on the principal cell populations involved in the innate and adaptive immune responses. Macrophages and dendritic cells can produce 1,25-dihydroxyvitamin D within the microenvironment. This active form of vitamin D can inhibit immune cell proliferation, promote an anti-inflammatory cytokine profile, expand regulatory T cells, enhance glucocorticoid actions, increase glutathione production, and inhibit hepatic stellate cells. Vitamin D deficiency has been commonly present in patients with immune-mediated liver and non-liver diseases, and it has been associated with histological severity, advanced hepatic fibrosis, and non-response to conventional glucocorticoid therapy in autoimmune hepatitis. Vitamin D analogues with high potency, low calcemic effects, and independence from hepatic hydroxylation are possible interventions. In conclusion, vitamin D has properties that could ameliorate immune-mediated disease, and vitamin D deficiency has been a common finding in immune-mediated liver and non-liver diseases, including autoimmune hepatitis. Loss of vitamin D-dependent homeostatic mechanisms may promote disease progression. Vitamin D analogues that are independent of hepatic hydroxylation constitute an investigational opportunity to supplement current management of autoimmune hepatitis.
Collapse
|