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Lech MA, Warpechowski M, Wojszel A, Rentflejsz J, Świętek M, Wojszel ZB. Vitamin D Status among Patients Admitted to a Geriatric Ward-Are Recommendations for Preventing Its Deficiency Effective Enough? Nutrients 2024; 16:193. [PMID: 38257086 PMCID: PMC10819869 DOI: 10.3390/nu16020193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/01/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
Despite a decade of available recommendations aimed at preventing vitamin D (VD) deficiency in Poland, the efficacy of these measures among community-dwelling older individuals remains inconsistent. The PolSenior2 study provided valuable insights into VD status among community-dwelling older individuals in Poland. However, it is important to note that this research did not include the elderly living in care institutions. Therefore, our study concentrates on evaluating VD status in older patients admitted to a geriatrics ward to indirectly assess their adherence to existing recommendations and preventive actions in this particular setting (whether they translate into health-promoting behaviors (i.e., taking vitamin D supplements) and whether the recommended, optimal 25(OH)D concentration values are achieved). This approach offers a comprehensive understanding of VD status in a previously understudied population. We aimed to evaluate VD status in patients aged 70 and above within the geriatrics ward, exploring its association with age, sex, BMI, and the use of VD supplements. The study involved the measurement of serum VD concentration in 240 individuals. Of these participants, 177 (73.8%) were women, and 193 (80.4%) were over 75 years old. The median 25(OH)D concentration was found to be 22.95 (IQR, 13.7-33.0) ng/mL. Notably, profound deficiency (<10 ng/mL) was noted in 15% of the participants, while 67.5% exhibited VD inadequacy (<30 ng/mL). It is worth mentioning that only 18.3% of individuals took VD supplements preadmission. Insufficiency was more prevalent in nonsupplemented individuals (70.9% vs. 52.3%, p = 0.02) and those with a BMI ≥30 kg/m2 (76.2% vs. 59.2%, p = 0.007). The logistic regression model demonstrated that obese patients had over two times higher odds of VD inadequacy (OR = 2.21, p = 0.0074), as did nonsupplemented individuals (OR = 2.23, p = 0.0187). The high prevalence of VD deficiency and inadequacy in geriatric ward admissions emphasizes the urgent need for targeted interventions and enhanced education for older adults, caregivers, and physicians to improve adherence to preventive supplementation practices.
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Affiliation(s)
- Maksymilian Adam Lech
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Marcin Warpechowski
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Aleksandra Wojszel
- Interdisciplinary Student Scientific Society, Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland; (M.A.L.); (M.W.); (A.W.)
| | - Justyna Rentflejsz
- Doctoral School, Medical University of Bialystok, 15-089 Bialystok, Poland;
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
| | - Marta Świętek
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
| | - Zyta Beata Wojszel
- Department of Geriatrics, Medical University of Bialystok, 15-471 Bialystok, Poland
- Department of Geriatrics and Internal Medicine, Hospital of the Ministry of Interior in Bialystok, 15-471 Bialystok, Poland;
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Fitzgerald JS, Swanson BJ, Larson-Meyer DE. Vitamin D Knowledge, Awareness, and Attitudes of Adolescents and Adults: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:585-595. [PMID: 37389497 DOI: 10.1016/j.jneb.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 04/21/2023] [Accepted: 04/27/2023] [Indexed: 07/01/2023]
Abstract
INTRODUCTION The aims of this systematic review were 2-fold: (1) evaluate the effect of vitamin D educational interventions on serum 25-hydroxyvitamin D (25-OHD) concentration in adolescents (aged 10-19 years) and adults, and (2) assess the association between serum 25-OHD concentration and vitamin D knowledge, awareness of vitamin D deficiency risk, and attitudes toward behaviors associated with acquiring vitamin D. METHODS Medline, CINAHL, Embase, and SPORTDiscus were systematically searched for studies reporting associations between serum 25-OHD concentration and vitamin D knowledge, awareness, and attitudes. Results were summarized narratively. Effect sizes were calculated when data were available. RESULTS Eight studies reported experimental effects (2 randomized controlled trials, 1 cluster randomized trial, 4 quasi-experiments, 1 clinical audit), and 14 reported cross-sectional associations. Seven of 8 interventions reported no effect of educational interventions on serum 25-OHD concentration. A slight majority (53%; κ = 19) of studies reported statistically significant associations between serum 25-OHD concentration and vitamin D knowledge and attitudes. IMPLICATIONS FOR RESEARCH AND PRACTICE The few educational interventions employed to increase serum 25-OHD concentration lack effectiveness. Future studies may use randomized controlled trial designs, enroll those at risk for vitamin D insufficiency and underrepresented in the literature, increase the salience of the information to the target population, and include safe sun exposure recommendations.
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Affiliation(s)
- John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, ND.
| | - Brenna J Swanson
- Department of Nutrition and Dietetics, University of North Dakota, Grand Forks, ND
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Lee YB, Baek KH, Chung HY, Byun DW, Min YK. Raloxifene/Vitamin D Combination Therapy vs. Raloxifene Monotherapy on Serum 25-Hydroxy-Vitamin D Level among Postmenopausal Women with Osteoporosis or Osteopenia: A Randomized Controlled Trial. J Bone Metab 2022; 29:155-163. [PMID: 36153851 PMCID: PMC9511125 DOI: 10.11005/jbm.2022.29.3.155] [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: 04/28/2022] [Accepted: 06/26/2022] [Indexed: 11/11/2022] Open
Abstract
Background We compared the efficacy of a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU to raloxifene 60 mg alone on vitamin D status, as indicated by change in serum 25-hydroxy-vitamin D (25[OH]D) levels. Methods In this 16-week, open-label, randomized, active controlled, multicenter clinical trial conducted in 4 university-affiliated hospitals in Korea, postmenopausal women aged 55 to 70 years with osteoporosis or osteopenia were randomly assigned in a 1:1 ratio to receive raloxifene 60 mg/cholecalciferol 800 IU combination therapy or raloxifene 60 mg monotherapy. Primary endpoint was change in serum 25(OH)D level from baseline to 16 weeks after the intervention. Results A total of 96 participants were randomly assigned to raloxifene/vitamin D combination therapy (N=49) and raloxifene monotherapy (N=47) groups. At week 16, serum 25(OH)D level increased from baseline, only in the raloxifene/vitamin D combination therapy group. Change in serum 25(OH)D level from baseline to week 16 was higher in the raloxifene/vitamin D combination therapy group (2.7±6.5 ng/mL) than in the raloxifene monotherapy (−1.7±6.2 ng/mL; P=0.0034) group. Proportions and number of adverse events (AEs) categorized by the System-Organ Class were not different between the groups. There was only one severe AE case (spondylolisthesis; raloxifene/vitamin D group), unlikely to be related to trial intervention. Conclusions Among postmenopausal women with osteoporosis or osteopenia, a fixed dose combination of raloxifene 60 mg/vitamin D 800 IU showed superior efficacy in elevating serum 25(OH)D levels compared with raloxifene 60 mg alone during 16 weeks of follow-up. The safety of raloxifene/vitamin D combination was comparable to raloxifene alone.
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Affiliation(s)
- You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ho Yeon Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Dong-Won Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yong-Ki Min
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee J, Lee YJ, Kim Y. A high prevalence of prediabetes and vitamin D deficiency are more closely associated in women: results of a cross-sectional study. J Int Med Res 2021; 49:3000605211033384. [PMID: 34334004 PMCID: PMC8326633 DOI: 10.1177/03000605211033384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Many studies have shown that vitamin D deficiency is associated with insulin resistance and metabolic syndrome. However, few studies have shown independent associations between vitamin D deficiency and the metabolic characteristics of prediabetes. We aimed to evaluate the relationship between serum vitamin D concentration and metabolic risk factors in adults with prediabetes. METHODS We enrolled 161 patients aged 25 to 75 years in a cross-sectional study and collected clinical and biochemical data, including 25-hydroxyvitamin D (25[OH]D) status and fasting glucose concentration. Vitamin D status was defined as follows: deficiency (25[OH]D <49.9 ng/mL), insufficiency (49.9 to 74.9 nmol/L) or sufficiency (>74.9 nmol/L). Prediabetes was defined using fasting plasma glucose concentrations of 5.55 to 6.49 mmol/L. RESULTS The prevalences of vitamin D deficiency and insufficiency were 49.7% and 24.8%, respectively. Participants with vitamin D deficiency had a higher prevalence of prediabetes than those without (53.8% vs. 32.1%), and there was a significant relationship between female sex and vitamin D status (odds ratio: 1.382; 95% confidence interval: 0.335-5.693). CONCLUSION Vitamin D deficiency is more closely associated with a high prevalence of prediabetes in women than in men. Further studies are needed to elucidate the explanation for this association.
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Affiliation(s)
- Jeonghun Lee
- Department of Internal Medicine, Ye Hospital, Anyang, Korea
| | - Young Joo Lee
- Department of Obstetrics and Gynecology, Kyung Hee University Medical Center, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
| | - Youngsun Kim
- Department of Obstetrics and Gynecology, Kyung Hee University Medical Center, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea
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Jo S, Yoon S, Lee SY, Kim SY, Park H, Han J, Choi SH, Han JS, Yang JH, Kim TH. DKK1 Induced by 1,25D3 Is Required for the Mineralization of Osteoblasts. Cells 2020; 9:cells9010236. [PMID: 31963554 PMCID: PMC7017072 DOI: 10.3390/cells9010236] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 02/07/2023] Open
Abstract
1α,25-dihydroxyvitamin D3 (1,25D3), the most popular drug for osteoporosis treatment, drives osteoblast differentiation and bone mineralization. Wnt/β-catenin signaling is involved in commitment and differentiation of osteoblasts, but the role of the Dickkopf-related protein 1 (DKK1), a Wnt antagonist, in osteoblasts remains unknown. Here, we demonstrate the molecular mechanism of DKK1 induction by 1,25D3 and its physiological role during osteoblast differentiation. 1,25D3 markedly promoted the expression of both CCAAT/enhancer binding protein beta (C/EBPβ) and DKK1 at day 7 during osteoblast differentiation. Interestingly, mRNA and protein levels of C/EBPβ and DKK1 in osteoblasts were elevated by 1,25D3. We also found that C/EBPβ, in response to 1,25D3, directly binds to the human DKK1 promoter. Knockdown of C/EBPβ downregulated the expression of DKK1 in osteoblasts, which was partially reversed by 1,25D3. In contrast, overexpression of C/EBPβ upregulated DKK1 expression in osteoblasts, which was enhanced by 1,25D3. Furthermore, 1,25D3 treatment in osteoblasts stimulated secretion of DKK1 protein within the endoplasmic reticulum to extracellular. Intriguingly, blocking DKK1 attenuated calcified nodule formation in mineralized osteoblasts, but not ALP activity or collagen synthesis. Taken together, these observations suggest that 1,25D3 promotes the mineralization of osteoblasts through activation of DKK1 followed by an increase of C/EBPβ.
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Affiliation(s)
- Sungsin Jo
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea; (S.J.); (S.Y.); (S.Y.K.); (H.P.)
| | - Subin Yoon
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea; (S.J.); (S.Y.); (S.Y.K.); (H.P.)
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea
| | - So Young Lee
- Department of Biomedical Sciences, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea; (S.Y.L.); (J.-S.H.)
| | - So Yeon Kim
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea; (S.J.); (S.Y.); (S.Y.K.); (H.P.)
| | - Hyosun Park
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea; (S.J.); (S.Y.); (S.Y.K.); (H.P.)
| | | | - Sung Hoon Choi
- Department of Orthopaedic Surgery, Hanyang University Seoul Hospital, Seoul 04763, Korea;
| | - Joong-Soo Han
- Department of Biomedical Sciences, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea; (S.Y.L.); (J.-S.H.)
- Biomedical Research Institute and Department of Biochemistry and Molecular Biology, College of Medicine, Hanyang University, Seoul 04763, Korea
| | - Jae-Hyuk Yang
- Department of Orthopaedic Surgery, Hanyang University Guri Hospital, Gyeonggi-do 11923, Korea;
| | - Tae-Hwan Kim
- Hanyang University Institute for Rheumatology Research, Seoul 04763, Korea; (S.J.); (S.Y.); (S.Y.K.); (H.P.)
- Department of Translational Medicine, Graduate School of Biomedical Science and Engineering, Hanyang University, Seoul 04763, Korea
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul 04763, Korea
- Correspondence: ; Tel.: +82-2-2290-9245; Fax: +82-2-2298-8231
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Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients 2020; 12:nu12010202. [PMID: 31941004 PMCID: PMC7019719 DOI: 10.3390/nu12010202] [Citation(s) in RCA: 189] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/19/2019] [Accepted: 01/07/2020] [Indexed: 12/12/2022] Open
Abstract
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals—and their food sources—to aid the management of abnormal lipid metabolism in postmenopausal women.
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