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Obeid JM, Sadeghi JK, Wolf AS, Bremner RM. Sleep, Nutrition, and Health Maintenance in Cardiothoracic Surgery. Thorac Surg Clin 2024; 34:213-221. [PMID: 38944448 DOI: 10.1016/j.thorsurg.2024.04.004] [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] [Indexed: 07/01/2024]
Abstract
Cardiothoracic surgeons work in high-intensity environments starting in surgical training and throughout their careers. They deal with critical patients. Their routine procedures are delicate, require extensive attention to detail, and can have detrimental effects on patients' lives. Cardiothoracic surgeons are required to perform at their best capacity incessantly. To do this, they must safeguard their mental and physical well-being. Preserving health through sleep, nutrition, exercise, and routine medical checkups ensures a cardiothoracic surgeon's well-being. Great personal effort and discipline is required to maintain health in a busy schedule. We offer our best recommendations from expert peers in the field.
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Affiliation(s)
- Joseph M Obeid
- Department of Cardiothoracic Surgery, Temple University Hospital, 3401 N Broad Street, Parkinson Pavilion, Suite 501C, Philadelphia, PA 19140, USA
| | - John K Sadeghi
- Department of Cardiothoracic Surgery, Temple University Hospital, 3401 N Broad Street, Parkinson Pavilion, Suite 501C, Philadelphia, PA 19140, USA
| | - Andrea S Wolf
- New York Mesothelioma Program, Department of Thoracic Surgery, The Icahn School of Medicine at Mount Sinai, 1190 Fifth Avenue, Box 1023, New York, NY 10029, USA
| | - Ross M Bremner
- Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, 500 W. Thomas Road, Suite 500, Phoenix, AZ 85013, USA; School of Medicine, Creighton University, Phoenix Health Sciences Campus, 3100 N Central Avenue, Phoenix, AZ 85012, USA.
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Bassett E, Gjekmarkaj E, Mason AM, Zhao SS, Burgess S. Vitamin D, chronic pain, and depression: linear and non-linear Mendelian randomization analyses. Transl Psychiatry 2024; 14:274. [PMID: 38965219 PMCID: PMC11224391 DOI: 10.1038/s41398-024-02997-7] [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] [Received: 02/07/2023] [Revised: 06/21/2024] [Accepted: 06/27/2024] [Indexed: 07/06/2024] Open
Abstract
Vitamin D deficiency has been linked to various chronic pain conditions. However, randomized trials of vitamin D supplementation have had mixed results. In contrast, systematic reviews of randomized trials indicate a protective effect of vitamin D supplementation on depression. We undertake a Mendelian randomization investigation in UK Biobank, a study of UK residents aged 40-65 at recruitment. We perform linear and non-linear Mendelian randomization analyses for four outcomes: fibromyalgia, clinical fatigue, chronic widespread pain, and probable lifetime major depression. We use genetic variants from four gene regions with known links to vitamin D biology as instruments. In linear analyses, genetically-predicted levels of 25-hydroxyvitamin D [25(OH)D], a clinical marker of vitamin D status, were not associated with fibromyalgia (odds ratio [OR] per 10 nmol/L higher 25(OH)D 1.02, 95% confidence interval [CI] 0.93, 1.12), clinical fatigue (OR 0.99, 95% CI 0.94, 1.05), chronic widespread pain (OR 0.95, 95% CI 0.89, 1.02), or probable lifetime major depression (OR 0.97, 95% CI 0.93, 1.01). In non-linear analyses, an association was observed between genetically-predicted 25(OH)D levels and depression in the quintile of the population with the lowest 25(OH)D levels (OR 0.75, 95% CI 0.59, 0.94); associations were null in other strata. Our findings suggest that population-wide vitamin D supplementation will not substantially reduce pain or depression; however, targeted supplementation of deficient individuals may reduce risk of depression.
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Affiliation(s)
- Emily Bassett
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0SR, UK
| | - Eva Gjekmarkaj
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, CB1 8RN, UK
| | - Amy M Mason
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0BD, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Sizheng Steven Zhao
- Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Science, School of Biological Sciences, Faculty of Biological Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, CB2 0SR, UK.
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0BD, UK.
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Chokshi SN, Mudiganty S, Clement RC, Accousti W. Vitamin D deficiency in Scheuermann's disease is associated with increased adverse outcomes. SICOT J 2024; 10:13. [PMID: 38568088 PMCID: PMC10989516 DOI: 10.1051/sicotj/2024010] [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] [Received: 02/20/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Scheuermann's disease is a diagnosis of hyperkyphosis commonly encountered in pediatric patients. Studies in animal models suggest an association with vitamin D deficiency, however, extensive studies have not been performed in humans. This study analyzes the role of vitamin D deficiency on unfavorable results in patients with Scheuermann's disease. METHODS The TriNetX database was utilized to perform a retrospective analysis. Patients in the United States aged 0-18 years with Scheuermann's disease were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes and categorized into those with and without a diagnosis of vitamin D deficiency. Comparison of patient groups depending on age, sex, ethnic origin, prior diagnosis of fibromyalgia, anxiety disorder, myositis, and major depressive disorder. Statistical analysis was conducted to identify the association between vitamin D levels and unfavorable results including pain, depression, suicide attempt, emergency department (ED) consult, hospitalization, and procedures on the spine or spinal cord. RESULTS In total, 11,277 patients were identified, 39% of whom had a concurrent diagnosis of scoliosis. A total of 1,024 (9.08%) were deficient in vitamin D. Patients with vitamin D deficiency had greater odds of pain (P < 0.0001), depression (P < 0.0001), suicide attempt (P = 0.0021), ED visits (P = 0.0246), and hospital admission (P < 0.0015). Conversely, patients with vitamin D deficiency had decreased odds of surgery on the spine or spinal cord (P = 0.0009). CONCLUSION Vitamin D deficiency is associated with an elevated risk of pain, depression, suicide attempts, ED visits, and hospitalization. Our analysis highlights the need for more research to study the effect of vitamin D on Scheuermann's disease. LEVEL OF EVIDENCE Level III, Prognostic.
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Affiliation(s)
- Shivan N. Chokshi
- John Sealy School of Medicine 301 University Blvd, The University of Texas Medical Branch Galveston TX 77555 USA
| | - Srikanth Mudiganty
- Department of Orthopaedic Surgery, Louisiana State University New Orleans LA 70112 USA
| | | | - William Accousti
- Department of Orthopaedic Surgery, Louisiana State University New Orleans LA 70112 USA
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Itkonen ST, Karhu P, Pellinen T, Lehtovirta M, Kaartinen NE, Männistö S, Päivärinta E, Pajari AM. Effects of partial replacement of red and processed meat with non-soya legumes on bone and mineral metabolism and amino acid intakes in BeanMan randomised clinical trial. Br J Nutr 2024; 131:82-91. [PMID: 37424311 DOI: 10.1017/s0007114523001514] [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] [Indexed: 07/11/2023]
Abstract
The transition towards more plant-based diets may pose risks for bone health such as low vitamin D and Ca intakes. Findings for the contribution of animal and plant proteins and their amino acids (AA) to bone health are contradictory. This 6-week clinical trial aimed to investigate whether partial replacement of red and processed meat (RPM) with non-soya legumes affects AA intakes and bone turnover and mineral metabolism in 102 healthy 20-65-year-old men. Participants were randomly assigned to diet groups controlled for RPM and legume intake (designed total protein intake (TPI) 18 E%): the meat group consumed 760 g RPM per week (25 % TPI) and the legume group consumed non-soya legume-based products (20 % TPI) and 200 g RPM per week, the upper limit of the Planetary Health Diet (5 % TPI). No differences in bone (bone-specific alkaline phosphatase; tartrate-resistant acid phosphatase 5b) or mineral metabolism (25-hydroxyvitamin D; parathyroid hormone; fibroblast growth factor 23; phosphate and Ca) markers or Ca and vitamin D intakes were observed between the groups (P > 0·05). Methionine and histidine intakes were higher in the meat group (P ≤ 0·042), whereas the legume group had higher intakes of arginine, asparagine and phenylalanine (P ≤ 0·013). Mean essential AA intakes in both groups met the requirements. Increasing the proportion of non-soya legumes by reducing the amount of RPM in the diet for 6 weeks did not compromise bone turnover and provided on average adequate amounts of AA in healthy men, indicating that this ecologically sustainable dietary change is safe and relatively easy to implement.
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Affiliation(s)
- Suvi T Itkonen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Piia Karhu
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Tiina Pellinen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Mikko Lehtovirta
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | | | - Satu Männistö
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Essi Päivärinta
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Anne-Maria Pajari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
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Yu J, Zhuang C, Guo W, Zhou X, Chen Y, Wang L, Li W, Zhu Y, Zhuang R, Tian K. Causal relationship between breakfast skipping and bone mineral density: a two-sample Mendelian randomized study. Front Endocrinol (Lausanne) 2023; 14:1200892. [PMID: 38027166 PMCID: PMC10660815 DOI: 10.3389/fendo.2023.1200892] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the causal association between breakfast skipping and bone mineral density (BMD) through two-sample Mendelian randomisation (MR) analysis. Methods A two-sample MR approach was adopted to explore the causal relationship of breakfast skipping with BMDs (across three skeletal sites and five age groups). Publicly available genome-wide association study summary data were used for MR analysis. We used five methods to estimate the causal associations between breakfast skipping and BMDs: inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. IVW was used for the main analysis and the remaining four methods were used as supplementary analyses. The heterogeneity of the MR results was determined using IVW and MR-Egger methods. The pleiotropy of the MR results was determined using MR-Egger intercept. Furthermore, a leave-one-out test was performed to determine whether the MR results were affected by a single nucleotide polymorphism. Results With the IVW method, we did not find any causal relationship between breakfast skipping and forearm, femoral neck, and lumbar spine BMD. Subsequently, when we included BMD data stratified by five different age groups in the analysis, the results showed that there was no apparent causal effect between breakfast skipping and age-stratified BMD. This finding was supported by all four supplementary methods (P > 0.05 for all methods). No heterogeneity or horizontal pleiotropy was detected in any of the analyses (P > 0.05). The leave-one-out tests conducted in the analyses did not identify any single nucleotide polymorphism that could have influenced the MR results, indicating the reliability of our findings. Conclusion No causal effect was found between breakfast skipping and BMD (across three skeletal sites and five age groups).
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Affiliation(s)
- Jinsheng Yu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chen Zhuang
- Alberta Institute, Wenzhou Medical University, Wenzhou, China
| | - Wenxuan Guo
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Xing Zhou
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yixuan Chen
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Likang Wang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenkai Li
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yiwen Zhu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rujie Zhuang
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Kun Tian
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
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Tzvetkov J, Stephen LA, Dillon S, Millan JL, Roelofs AJ, De Bari C, Farquharson C, Larson T, Genever P. Spatial Lipidomic Profiling of Mouse Joint Tissue Demonstrates the Essential Role of PHOSPHO1 in Growth Plate Homeostasis. J Bone Miner Res 2023; 38:792-807. [PMID: 36824055 PMCID: PMC10946796 DOI: 10.1002/jbmr.4796] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/19/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023]
Abstract
Lipids play a crucial role in signaling and metabolism, regulating the development and maintenance of the skeleton. Membrane lipids have been hypothesized to act as intermediates upstream of orphan phosphatase 1 (PHOSPHO1), a major contributor to phosphate generation required for bone mineralization. Here, we spatially resolve the lipid atlas of the healthy mouse knee and demonstrate the effects of PHOSPHO1 ablation on the growth plate lipidome. Lipids spanning 17 subclasses were mapped across the knee joints of healthy juvenile and adult mice using matrix-assisted laser desorption ionization imaging mass spectrometry (MALDI-IMS), with annotation supported by shotgun lipidomics. Multivariate analysis identified 96 and 80 lipid ions with differential abundances across joint tissues in juvenile and adult mice, respectively. In both ages, marrow was enriched in phospholipid platelet activating factors (PAFs) and related metabolites, cortical bone had a low lipid content, whereas lysophospholipids were strikingly enriched in the growth plate, an active site of mineralization and PHOSPHO1 activity. Spatially-resolved profiling of PHOSPHO1-knockout (KO) mice across the resting, proliferating, and hypertrophic growth plate zones revealed 272, 306, and 296 significantly upregulated, and 155, 220, and 190 significantly downregulated features, respectively, relative to wild-type (WT) controls. Of note, phosphatidylcholine, lysophosphatidylcholine, sphingomyelin, lysophosphatidylethanolamine, and phosphatidylethanolamine derived lipid ions were upregulated in PHOSPHO1-KO versus WT. Our imaging pipeline has established a spatially-resolved lipid signature of joint tissues and has demonstrated that PHOSPHO1 ablation significantly alters the growth plate lipidome, highlighting an essential role of the PHOSPHO1-mediated membrane phospholipid metabolism in lipid and bone homeostasis. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Jordan Tzvetkov
- York Biomedical Research Institute and Department of BiologyUniversity of YorkYorkUK
| | | | - Scott Dillon
- Wellcome‐Medical Research Council (MRC) Cambridge Stem Cell InstituteUniversity of CambridgeCambridgeUK
| | - Jose Luis Millan
- Sanford Burnham Prebys, Medical Discovery InstituteLa JollaCAUSA
| | - Anke J. Roelofs
- Centre for Arthritis and Musculoskeletal HealthUniversity of AberdeenAberdeenUK
| | - Cosimo De Bari
- Centre for Arthritis and Musculoskeletal HealthUniversity of AberdeenAberdeenUK
| | | | - Tony Larson
- York Biomedical Research Institute and Department of BiologyUniversity of YorkYorkUK
| | - Paul Genever
- York Biomedical Research Institute and Department of BiologyUniversity of YorkYorkUK
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Chen X, Zhang Q, Song T, Zhang W, Yang Y, Duan N, Cong F. Vitamin D deficiency triggers intrinsic apoptosis by impairing SPP1-dependent antiapoptotic signaling in chronic hematogenous osteomyelitis. Gene 2023; 870:147388. [PMID: 37024063 DOI: 10.1016/j.gene.2023.147388] [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: 11/21/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023]
Abstract
Chronic hematogenous osteomyelitis (CHOM) is a common bone disease characterized by the development of sequestra after bacterial infection. Emerging evidence has shown that vitamin D (VD) deficiency raises the risk of osteomyelitis, but the underlying mechanisms remain obscure. Here, we establish a CHOM model in VD diet-deficient mice by intravenous inoculation of Staphylococcus aureus. Whole-genome microarray analyses using osteoblast cells isolated from sequestra reveal significant downregulation of SPP1 (secreted phosphoprotein 1). Molecular basis investigations show that VD sufficiency activates the VDR/RXR (VD receptor/retinoid X receptor) heterodimer to recruit NCOA1 (nuclear receptor coactivator 1) and transactivate SPP1 in healthy osteoblast cells. Secreted SPP1 binds to the cell surface molecule CD40 to activate serine/threonine-protein kinase Akt1, which then phosphorylates forkhead box O3a (FOXO3a), blocking FOXO3a-mediated transcription. By contrast, VD deficiency impairs the NCOA1-VDR/RXR-mediated overexpression of SPP1, leading to the inactivation of Akt1 and the accumulation of FOXO3a. FOXO3a then upregulates the expression of the apoptotic genes BAX (Bcl2-associated X-protein), BID (BH3 interacting death domain), and BIM (Bcl2-interacting mediator of cell death), to induce apoptosis. Administration of the NCOA1 inhibitor gossypol to the CHOM mice also promotes the occurrence of sequestra. VD supplementation can reactivate the SPP1-dependent antiapoptotic signaling and improve the outcomes of CHOM. Collectively, our data reveal that VD deficiency promotes bone destruction in CHOM by the removal of SPP1-dependent antiapoptotic signaling.
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Affiliation(s)
- Xun Chen
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Qian Zhang
- The department of surgery room, Xi'an Daxing Hospital, Xi'an 710016, Shaanxi, China
| | - Tao Song
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Wentao Zhang
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Yan Yang
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Ning Duan
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China
| | - Fei Cong
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710054, China.
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Babić Leko M, Jureško I, Rozić I, Pleić N, Gunjača I, Zemunik T. Vitamin D and the Thyroid: A Critical Review of the Current Evidence. Int J Mol Sci 2023; 24:ijms24043586. [PMID: 36835005 PMCID: PMC9964959 DOI: 10.3390/ijms24043586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Vitamin D is necessary for the normal functioning of many organs, including the thyroid gland. It is, therefore, not surprising that vitamin D deficiency is considered a risk factor for the development of many thyroid disorders, including autoimmune thyroid diseases and thyroid cancer. However, the interaction between vitamin D and thyroid function is still not fully understood. This review discusses studies involving human subjects that (1) compared vitamin D status (primarily determined by serum calcidiol (25-hydroxyvitamin D [25(OH)D]) levels) with thyroid function assessed by thyroid stimulating hormone (TSH), thyroid hormones, and anti-thyroid antibody levels; and (2) evaluated the effect of vitamin D supplementation on thyroid function. Due to the many inconsistencies in the results between the studies, it is still difficult to draw a definite conclusion on how vitamin D status affects thyroid function. Studies in healthy participants observed either a negative correlation or no association between TSH and 25(OH)D levels, while the results for thyroid hormones showed high variability. Many studies have observed a negative association between anti-thyroid antibodies and 25(OH)D levels, but equally many studies have failed to observe such an association. Regarding the studies that examined the effect of vitamin D supplementation on thyroid function, almost all observed a decrease in anti-thyroid antibody levels after vitamin D supplementation. Factors that could contribute to the high variability between the studies are the use of different assays for the measurement of serum 25(OH)D levels and the confounding effects of sex, age, body-mass index, dietary habits, smoking, and the time of year when the samples were collected. In conclusion, additional studies with larger numbers of participants are needed to fully understand the effect of vitamin D on thyroid function.
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Griffis CE, Pletta AM, Mutschler C, Ahmed AE, Lorimer SD. Proportion of Navy Recruits Diagnosed With Symptomatic Stress Fractures During Training and Monetary Impact of These Injuries. Clin Orthop Relat Res 2022; 480:2111-2119. [PMID: 35901437 PMCID: PMC9555899 DOI: 10.1097/corr.0000000000002304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lower extremity stress fractures result in lost time from work and sport and incur costs in the military when they occur in service members. Hypovitaminosis D has been identified as key risk factor in these injuries. An estimated 33% to 90% of collegiate and professional athletes have deficient vitamin D levels. Other branches of the United States military have evaluated the risk factors for stress fractures during basic training, including vitamin D deficiency. To the best of our knowledge, a study evaluating the correlation between these injuries and vitamin D deficiency in US Navy recruits and a cost analysis of these injuries has not been performed. Cutbacks in military medical staffing mean more active-duty personnel are being deferred for care to civilian providers. Consequently, data that previously were only pertinent to military medical providers have now expanded to the nonmilitary medical community. QUESTIONS/PURPOSES We therefore asked: (1) What proportion of US Navy recruits experience symptomatic lower extremity stress fractures, and what proportion of those recruits had hypovitaminosis vitamin D on laboratory testing? (2) What are the rehabilitation costs involved in the treatment of lower extremity stress fractures, including the associated costs of lost training time? (3) Is there a cost difference in the treatment of stress fractures between recruits with lower extremity stress fractures who have vitamin D deficiency and those without vitamin D deficiency? METHODS We retrospectively evaluated the electronic medical record at Naval Recruit Training Command in Great Lakes, IL, USA, of all active-duty males and females trained from 2009 until 2015. We used ICD-9 and ICD-10 diagnosis codes to identify those diagnosed with symptomatic lower extremity stress fractures. Data collected included geographic region of birth, preexisting vitamin D deficiency, vitamin D level at the time of diagnosis, medical history, BMI, age, sex, self-reported race or ethnicity, hospitalization days, days lost from training, and the number of physical therapy, primary care, and specialty visits. To ascertain the proportion of recruits who developed symptomatic stress fractures, we divided the number of recruits who were diagnosed with a stress fracture by the total number who trained over that span of time, which was 204,774 individuals. During the span of this study, 45% (494 of 1098) of recruits diagnosed with a symptomatic stress fracture were female and 55% (604 of 1098) were male, with a mean ± SD age of 24 ± 4 years. We defined hypovitaminosis D as a vitamin D level lower than 40 ng/mL. Levels less than 40 ng/mL were defined as low normal and levels less than 30 ng/mL as deficient. Vitamin D levels were obtained at the discretion of the individual treating provider without standardization of protocol. Cost was defined as physical therapy visits, primary care visits, orthopaedic visits, diagnostic imaging costs, laboratory costs, hospitalizations, if applicable, and days lost from training. Diagnostic studies and laboratory tests were incorporated as indirect costs into initial and follow-up physical therapy visits. Evaluation and management code fee schedules for initial visits and follow-up visits were used as direct costs. We obtained these data from the Centers for Medicare & Medicaid Services website. Per capita cost was calculated by taking the total cost and dividing it by the study population. Days lost from training is based on a standardized government military salary of recruits to include room and board. RESULTS We found that 0.5% (1098 of 204,774) of recruits developed a symptomatic lower extremity stress fracture. Of the recruits who had vitamin D levels drawn at the time of stress fracture, 95% (416 of 437 [95% confidence interval (CI) 94% to 98%]; p > 0.99) had hypovitaminosis D (≤ 40 ng/mL) and 82% (360 of 437 [95% CI 79% to 86%]; p > 0.99) had deficient levels (≤ 30 ng/mL) on laboratory testing, when evaluated. The total treatment cost was USD 9506 per recruit. Days lost in training was a median of 56 days (4 to 108) for a per capita cost of USD 5447 per recruit. Recruits with deficient vitamin D levels (levels ≤ 30 ng/mL) incurred more physical therapy treatment costs than did those with low-normal vitamin D levels (levels 31 to 40 ng/mL) (mean difference USD 965 [95% CI 2 to 1928]; p = 0.049). CONCLUSION The cost of lost training and rehabilitation associated with symptomatic lower extremity stress fractures represents a major financial burden. Screening for and treatment of vitamin D deficiencies before recruit training could offer a cost-effective solution to decreasing the stress fracture risk. Recognition and treatment of these deficiencies has a role beyond the military, as hypovitaminosis and stress fractures are common in collegiate or professional athletes. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Clare E Griffis
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
| | - Aileen M Pletta
- Naval Special Warfare Center, San Diego, CA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
| | - Christian Mutschler
- Navy Medicine Readiness and Training Command Camp Pendleton, Oceanside, CA, USA
| | - Anwar E Ahmed
- Uniformed Service University of the Health Sciences/Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MS, USA
| | - Shannon D Lorimer
- Naval Medical Center Portsmouth, Portsmouth, VA, USA
- Captain James A. Lovell Federal Health Care Center, North Chicago, IL, USA
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Prevalence of Vitamin D Deficiency in Patients With Charcot Arthropathy: A Single-Center Analysis. J Am Acad Orthop Surg Glob Res Rev 2022; 6:01979360-202210000-00007. [PMID: 36734652 PMCID: PMC9592263 DOI: 10.5435/jaaosglobal-d-22-00162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 08/14/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Vitamin D deficiency may be a potentially modifiable risk factor in patients with orthopaedic conditions including Charcot arthropathy. The purpose of this study was to determine the prevalence of vitamin D deficiency and insufficiency in patients with Charcot arthropathy. METHODS All patients with Charcot arthropathy seen in our foot and ankle surgery clinic from January 2017 through June 2021 were screened for serum 25-hydroxyvitamin D levels. Patients were categorized as sufficient, insufficient, or deficient based on previously accepted guidelines. The prevalence of vitamin D deficiency and insufficiency was calculated. RESULTS A total of 57 subjects were included in this study after meeting the inclusion criteria. Of these, 27 (47.4%) were found to be deficient in vitamin D, 21 (36.8%) were insufficient in vitamin D, and 9 (15.8%) were sufficient in vitamin D. Overall, 84.2% of the cohort was found to be either insufficient or deficient in vitamin D. CONCLUSION Vitamin D insufficiency and deficiency is highly prevalent in patients with Charcot arthropathy. As such, it is possible that this may play a role in the pathogenesis of Charcot arthropathy and may represent a potentially modifiable risk factor that could be optimized during the management of patients with Charcot arthropathy.
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Lachowicz K, Stachoń M. Determinants of Dietary Vitamin D Intake in Population-Based Cohort Sample of Polish Female Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12184. [PMID: 36231482 PMCID: PMC9564653 DOI: 10.3390/ijerph191912184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Vitamin D has a pleiotropic effect and its deficiency is a risk factor for many diseases. The purpose of this study was to analyze the dietary intake of vitamin D and the factors determining this intake by female post-primary school students in Poland. The study was conducted on a nationwide sample of 4469 female Polish adolescents (aged 14-20) recruited from all regions across Poland. The vitamin D intake was assessed using VIDEO-FFQ (Vitamin D Estimation Only-Food Frequency Questionnaire). The median dietary vitamin D intake was 2.33 μg per day and it was lower than the 15 μg recommended in Poland for more than 98% of the group. The highest vitamin D intake per day was noted for fish (0.52 μg), whereas the lowest was noted for fats (0.04 μg). Factors that influenced the dietary vitamin D intake were the amount and species of fish consumed, region of residence, use of vitamin D supplements, and vegetarian or vegan diets. In contrast, vitamin D intake did not depend on body mass index and age. Based on the results of the survey, it can be concluded that the alarmingly low intake of vitamin D by Polish female adolescents is a result of the limited supply of vitamin D primarily from fish and fish products. This may be due to insufficient nutritional knowledge, indicating an urgent need to educate the surveyed population in this area.
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Sirajudeen S, Shah I, Ayoub MA, Karam SM, Al Menhali A. Long-Term Vitamin D Deficiency Results in the Inhibition of Cell Proliferation and Alteration of Multiple Gastric Epithelial Cell Lineages in Mice. Int J Mol Sci 2022; 23:ijms23126684. [PMID: 35743124 PMCID: PMC9224370 DOI: 10.3390/ijms23126684] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
Over one billion people globally are vitamin D (VD) deficient. Studies on the biological roles of VD are numerous but very little on the stomach. This project aims to understand how gastric homeostasis is affected by VD deficiency caused by prolonged exposure to darkness alone or combined with VD deficient diet. Three groups of C57/BL6 mice were subjected to different light exposure conditions and diets for 12 months (n = 8−12/group): control—12 h/12 h light/dark SDL (Standard Diet/Light), 24 h dark SDD (Standard Diet/Dark), and 24 h dark VDD (VD deficient diet/Dark). Stomach samples were collected for different multi-label lectin-/immuno-histochemical and qRT-PCR analyses, and the serum for LC-MS-MS. We found that the membrane VD receptor is expressed widely in the stomach when compared to nuclear VD receptors. Compared to SDL, VDD mice developed mucous cell expansion with increased mucins-mRNA (3.27 ± 2.73 (p < 0.05)) increased apoptotic cells, 15 ± 7 (p ≤ 0.001)); decreased cell proliferation, 4 ± 4 (p < 0.05)) and decreased acid secretion 33 ± 2 μEq/kg (p ≤ 0.0001)). Interestingly, mice exposed to full darkness developed mild VD deficiency with higher VD epimer levels: 11.9 ± 2.08 ng/mL (p ≤ 0.0001)), expansion in zymogenic cell number (16 ± 3 (p ≤ 0.01)), and a reduction in acid secretion (18 ± 2 μEq/kg (p ≤ 0.0001)). In conclusion, changes in light exposure or VD levels have serious physiological effects on the gastric mucosa, which should be considered during the management of gastric disorders.
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Affiliation(s)
- Shaima Sirajudeen
- Department of Biology, College of Science, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (S.S.); (M.A.A.)
- Zayed Centre for Scientific Research, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (I.S.); (S.M.K.)
| | - Iltaf Shah
- Zayed Centre for Scientific Research, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (I.S.); (S.M.K.)
- Department of Chemistry, College of Science, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates
| | - Mohammed Akli Ayoub
- Department of Biology, College of Science, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (S.S.); (M.A.A.)
| | - Sherif M. Karam
- Zayed Centre for Scientific Research, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (I.S.); (S.M.K.)
- Department of Anatomy, College of Medicine and Health Sciences, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates
| | - Asma Al Menhali
- Department of Biology, College of Science, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (S.S.); (M.A.A.)
- Zayed Centre for Scientific Research, United Arab Emirates University (UAEU), Al Ain P.O. Box 15551, United Arab Emirates; (I.S.); (S.M.K.)
- Correspondence:
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Haris A, Lam YPY, Wootton CA, Theisen A, Marzullo BP, Schorr P, Volmer DA, O’Connor PB. Differentiation of Dihydroxylated Vitamin D 3 Isomers Using Tandem Mass Spectrometry. JOURNAL OF THE AMERICAN SOCIETY FOR MASS SPECTROMETRY 2022; 33:1022-1030. [PMID: 35561028 PMCID: PMC9164238 DOI: 10.1021/jasms.2c00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Vitamin D compounds are a group of secosteroids derived from cholesterol that are vital for maintaining bone health in humans. Recent studies have shown extraskeletal effects of vitamin D, involving vitamin D metabolites such as the dihydroxylated vitamin D3 compounds 1,25-dihydroxyvitamin D3 and 24,25-dihydroxyvitamin D3. Differentiation and characterization of these isomers by mass spectrometry can be challenging due to the zero-mass difference and minor structural differences between them. The isomers usually require separation by liquid chromatography (LC) prior to mass spectrometry, which adds extra complexity to the analysis. Herein, we investigated and revisited the use of fragmentation methods such as collisional induced dissociation (CID), infrared multiphoton dissociation (IRMPD), electron induced dissociation (EID), and ultraviolet photodissociation (UVPD), available on a 12T Fourier transform ion cyclotron resonance mass spectrometer (FT-ICR MS) to generate characteristic fragments for the dihydroxylated vitamin D3 isomers that can be used to distinguish between them. Isomer-specific fragments were observed for the 1,25-dihydroxyvitamin D3, which were clearly absent in the 24,25-dihydroxyvitamin D3 MS/MS spectra using all fragmentation methods mentioned above. The fragments generated due to cleavage of the C-6/C-7 bond in the 1,25-dihydroxyvitamin D3 compound demonstrate that the fragile OH groups were retained during fragmentation, thus enabling differentiation between the two dihydroxylated vitamin D3 isomers without the need for prior chromatographic separation or derivatization.
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Affiliation(s)
- Anisha Haris
- Department
of Chemistry, University of Warwick, Coventry CV4 7AL, U.K.
| | - Yuko P. Y. Lam
- Department
of Chemistry, University of Warwick, Coventry CV4 7AL, U.K.
| | | | - Alina Theisen
- Department
of Chemistry, University of Warwick, Coventry CV4 7AL, U.K.
| | - Bryan P. Marzullo
- Department
of Chemistry, University of Warwick, Coventry CV4 7AL, U.K.
| | - Pascal Schorr
- Institut
für Chemie, Humboldt-Universität
zu Berlin, 12489 Berlin, Germany
| | - Dietrich A. Volmer
- Institut
für Chemie, Humboldt-Universität
zu Berlin, 12489 Berlin, Germany
| | - Peter B. O’Connor
- Department
of Chemistry, University of Warwick, Coventry CV4 7AL, U.K.
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Formulation Strategies for Improving the Stability and Bioavailability of Vitamin D-Fortified Beverages: A Review. Foods 2022; 11:foods11060847. [PMID: 35327269 PMCID: PMC8955538 DOI: 10.3390/foods11060847] [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: 02/23/2022] [Revised: 03/14/2022] [Accepted: 03/14/2022] [Indexed: 12/26/2022] Open
Abstract
Vitamin D is a lipophilic bioactive that plays an important role in bone health. Fortification of beverages, such as milk, fruit juices, teas, and vegetable drinks, could be an efficient strategy to prevent vitamin D deficiency and its associated effects on health. This review summarizes the current understanding of beverage fortification strategies with vitamin D and the resulting effects on the stability, bioaccessibility, and sensory properties of the formulated products. The direct addition technique has been the conventional approach to fortifying beverages. In addition, encapsulation has been pointed out as a desirable delivery approach to increase stability, preserve bioactivity, and enhance the absorption of vitamin D in beverage systems. The literature reports the potential applicability of several methods for encapsulating vitamin D in beverages, including spray drying, micro/nanoemulsions, nanostructured lipid carriers, liposomes, and complexation to polymers. Some of these delivery systems have been assessed regarding vitamin D stability, but there is a lack of kinetic data that allow for the prediction of its stability under industrial processing conditions. Moreover, in some cases, the applicability of some of these delivery systems to real beverages as well as the in vivo efficacy were not evaluated; thus, fortification strategies with a global outreach are lacking.
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Davarzani S, Djafarian K, Clark CCT, Babaei N, Ghorbaninejad P, Ebaditabar M, Shab-Bidar S. The interaction of aging with serum 25(OH)D and 1,25(OH)2 D status on muscle strength. Int J Clin Pract 2021; 75:e14510. [PMID: 34118106 DOI: 10.1111/ijcp.14510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND To investigate the combination relationship of age with serum 25-hydroxyvitamin D (25(OH) D) and 1,25-(OH)2D3 levels on muscle strength. METHODS We performed a cross-sectional study on 270 subjects containing 115 men and 155 women. Serum concentration of 25(OH) D and 1,25-(OH)2D3 were assessed. Hand grip strength (HGS) was measured using a digital dynamometer. RESULTS There was no significant difference in mean of HGS among tertiles of 25(OH)D (P = .350) and 1,25(OH)2 D (P = .467) before and after controlling for potential confounding factors. A significant difference in HGS was found between age categories in both crude (P < .001) and adjusted models (P = .018), where mean grip strength increased in the three first age categories, but decreased in the last group (48-69 years old). There was also a significant interaction between age and 25(OH) D (P = .049) and 1,25-(OH)2D3 (P = .047) on HGS, in which the combination effect increased the mean of muscle strength up to middle age after adjusting for confounders. CONCLUSIONS Serum 25(OH)D and 1,25(OH)2 D were not related to muscle strength. However, age, and combination of age with both 25(OH)D and 1,25(OH)2 D, significantly resulted in improving in muscle strength up to middle age.
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Affiliation(s)
- Samira Davarzani
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Cain C T Clark
- Centre for Sport, Exercise, and Life Sciences, Coventry University, Coventry, UK
| | - Nadia Babaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Parivash Ghorbaninejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mojdeh Ebaditabar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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16
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Improving Vitamin D Intake in Young Children-Can an Infographic Help Parents and Carers Understand the Recommendations? Nutrients 2021; 13:nu13093140. [PMID: 34579017 PMCID: PMC8469200 DOI: 10.3390/nu13093140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/02/2021] [Accepted: 09/07/2021] [Indexed: 12/30/2022] Open
Abstract
Vitamin D deficiency is a serious public health issue in the United Kingdom. Those at increased risk, such as pregnant women, children under 5 years and people from ethnic groups with dark skin, are not all achieving their recommended vitamin D. Effective vitamin D education is warranted. A qualitative study was undertaken to evaluate the acceptability and understanding of a vitamin D infographic, developed using recommendations from previous research. Fifteen parents/carers, recruited through local playgroups and adverts on popular parent websites, participated in focus groups and telephone interviews. The majority were female, White British and educated to degree level. A thematic analysis methodology was applied. The findings indicated that understanding and acceptability of the infographic were satisfactory, but improvements were recommended to aid interpretation and create more accessible information. These included additional content (what vitamin D is; other sources; its health benefits; methods/doses for administration and scientific symbols used) and improved presentation (eye-catching, less text, simpler language, more images and a logo). Once finalized, the infographic could be a useful tool to educate families around vitamin D supplementation guidelines, support the UK Healthy Start vitamins scheme and help improve vitamin D status for pregnant and lactating women and young children.
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17
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Berger MB, Bosh KB, Jacobs TW, Cohen DJ, Schwartz Z, Boyan BD. Growth factors produced by bone marrow stromal cells on nanoroughened titanium-aluminum-vanadium surfaces program distal MSCs into osteoblasts via BMP2 signaling. J Orthop Res 2021; 39:1908-1920. [PMID: 33002223 PMCID: PMC8012402 DOI: 10.1002/jor.24869] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 09/21/2020] [Accepted: 09/29/2020] [Indexed: 02/04/2023]
Abstract
Statement of Clinical Significance: There remains the need to develop materials and surfaces that can increase the rate of implant osseointegration. Though osteoanabolic agents, like bone morphogenetic protein (BMP), can provide signaling for osteogenesis, the appropriate design of implants can also produce an innate cellular response that may reduce or eliminate the need to use additional agents to stimulate bone formation. Studies show that titanium implant surfaces that mimic the physical properties of osteoclast resorption pits regulate cellular responses of bone marrow stromal cells (MSCs) by altering cell morphology, transcriptomes, and local factor production to increase their differentiation into osteoblasts without osteogenic media supplements required for differentiation of MSCs on tissue culture polystyrene (TCPS). The goal of this study was to determine how cells in contact with biomimetic implant surfaces regulate the microenvironment around these surfaces in vitro. Two different approaches were used. First, unidirectional signaling was assessed by treating human MSCs grown on TCPS with conditioned media from MSC cultures grown on Ti6Al4V biomimetic surfaces. In the second set of studies, bidirectional signaling was assessed by coculturing MSCs grown on mesh inserts that were placed into culture wells in which MSCs were grown on the biomimetic Ti6Al4V substrates. The results show that biomimetic Ti6Al4V surface properties induce MSCs to produce factors within 7 days of culture that stimulate MSCs not in contact with the surface to exhibit an osteoblast phenotype via endogenous BMP2 acting in a paracrine signaling manner.
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Affiliation(s)
- Michael B. Berger
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Kyla B. Bosh
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Thomas W. Jacobs
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - D. Joshua Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA;,Department of Periodontology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Barbara D. Boyan
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA;,Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University, Georgia Institute of Technology, Atlanta, GA, USA
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The Interdependency and Co-Regulation of the Vitamin D and Cholesterol Metabolism. Cells 2021; 10:cells10082007. [PMID: 34440777 PMCID: PMC8392689 DOI: 10.3390/cells10082007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/30/2022] Open
Abstract
Vitamin D and cholesterol metabolism overlap significantly in the pathways that contribute to their biosynthesis. However, our understanding of their independent and co-regulation is limited. Cardiovascular disease is the leading cause of death globally and atherosclerosis, the pathology associated with elevated cholesterol, is the leading cause of cardiovascular disease. It is therefore important to understand vitamin D metabolism as a contributory factor. From the literature, we compile evidence of how these systems interact, relating the understanding of the molecular mechanisms involved to the results from observational studies. We also present the first systems biology pathway map of the joint cholesterol and vitamin D metabolisms made available using the Systems Biology Graphical Notation (SBGN) Markup Language (SBGNML). It is shown that the relationship between vitamin D supplementation, total cholesterol, and LDL-C status, and between latitude, vitamin D, and cholesterol status are consistent with our knowledge of molecular mechanisms. We also highlight the results that cannot be explained with our current knowledge of molecular mechanisms: (i) vitamin D supplementation mitigates the side-effects of statin therapy; (ii) statin therapy does not impact upon vitamin D status; and critically (iii) vitamin D supplementation does not improve cardiovascular outcomes, despite improving cardiovascular risk factors. For (iii), we present a hypothesis, based on observations in the literature, that describes how vitamin D regulates the balance between cellular and plasma cholesterol. Answering these questions will create significant opportunities for advancement in our understanding of cardiovascular health.
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Schacter GI, Leslie WD. Diabetes and Osteoporosis: Part I, Epidemiology and Pathophysiology. Endocrinol Metab Clin North Am 2021; 50:275-285. [PMID: 34023043 DOI: 10.1016/j.ecl.2021.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Both diabetes and osteoporosis are increasingly prevalent diseases, in part owing to aging populations worldwide. Epidemiologic data have shown that other organs may be adversely affected by diabetes, including the skeleton, in what has become known as diabetes-induced osteoporosis, which represents the combined impact of conventional osteoporosis with the additional fracture burden attributed to diabetes. There is an increased risk of fracture in patients with Type 1 and Type 2 diabetes, and some antidiabetic medications also may contribute to increased risk of fracture in diabetes.
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Affiliation(s)
- G Isanne Schacter
- Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, GF-335, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
| | - William D Leslie
- Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, C5121, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.
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Computed Tomography Osteodensitometry for Assessment of Bone Mineral Density of the Canine Head-Preliminary Results. Animals (Basel) 2021; 11:ani11051413. [PMID: 34069215 PMCID: PMC8156747 DOI: 10.3390/ani11051413] [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: 03/22/2021] [Revised: 04/22/2021] [Accepted: 05/10/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Metabolic bone disease can have disastrous consequences on canine health. Unlike in human medicine where awareness of osteoporosis and bone mineral density (BMD) disorders have led to the holistic application of osteodensitometry, application of osteodensitometry in dogs is limited. We aimed to assess the utility of quantitative computed tomography (qCT) bone mineral density (BMD) measurement of the canine calvarium using semiautomated osteodensitometry software and define host factors associated with canine BMD in a skeletally healthy population. Calvarium qCT can be used to rapidly obtain BMD measurement of dogs. Canine BMD was negatively associated with weight, whereas there was no relationship between BMD and age or sex. Many chronic canine diseases can significantly affect bone health via a variety of pathophysiological mechanisms. This efficient qCT method could facilitate rapid BMD screening in dogs undergoing CT evaluation and ultimately encourage further BMD investigation. Abstract Despite bone mineral density (BMD) being regularly measured in human patients, BMD studies in clinical cohorts of dogs is lacking. In order to facilitate BMD assessment and in turn better identify dogs suffering from metabolic bone disease, rapid, easy and precise computed tomography (qCT) techniques are required. In this study we aimed to assess the utility of quantitative computed tomography (qCT) bone mineral density (BMD) measurement of the canine calvarium using a semiautomated osteodensitometry software and define host factors associated with canine bone mineral density in a skeletally healthy population. Calvarial qCT at the level of the temporomandibular joints was performed on 323 dogs using a dedicated osteodensitometry calibration phantom during a clinically indicated head computed tomography (CT). Calvarial BMD was analyzed using a dedicated semiautomatic osteodensitometry software for contouring of the calvarial lamellar bone margins and BMD calculation. The mean duration of the calvarial qCT scanning was 64.6 s, and the mean duration of BMD analysis was 34 s, with a mean of two manual adjustments required for the bone margin tracing. The median BMD of all dogs in our study was 659 mg Calcium hydroxyapatite/mL. There was a negative linear correlation between BMD and body weight, but no correlation with age, sex or neutered status. Canine BMD assessment using qCT of the calvarium is a practical and fast technique that can be added to a clinical CT examination with minimal extra time requirements. Canine BMD host-dependent factors exhibit different relationships from that of humans; however, further investigation is warranted.
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Vitamin D and sleep duration: Is there a bidirectional relationship? Horm Mol Biol Clin Investig 2020; 41:/j/hmbci.ahead-of-print/hmbci-2020-0025/hmbci-2020-0025.xml. [DOI: 10.1515/hmbci-2020-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 10/26/2020] [Indexed: 11/15/2022]
Abstract
Abstract
Vitamin D contributes to numerous physiological processes within the body but primarily calcium and bone homeostasis. Emerging evidence highlights a novel role for vitamin D in maintaining and regulating optimal sleep. Sleep is a known regulator of bone health, highlighting the interconnectedness between vitamin D concentrations, sleep duration and bone metabolism. It is possible that the relationship between sleep length and vitamin D is bidirectional, with vitamin D playing a role in sleep health and conversely, sleep affecting vitamin D levels. Nevertheless, limited information on the direction of the interaction is available, and much remains to be learned concerning the complex relationship between insufficient sleep duration and vitamin D deficiency. Given the potential to implement interventions to improve sleep and vitamin D supplementation, understanding this relationship further could represent a novel way to support and improve health.
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Umigai N, Kozai Y, Saito T, Takara T. Effects of paprika carotenoid supplementation on bone turnover in postmenopausal women: a randomized, double-blind, placebo-controlled, parallel-group comparison study. Food Nutr Res 2020; 64:4565. [PMID: 33240029 PMCID: PMC7672447 DOI: 10.29219/fnr.v64.4565] [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: 03/22/2020] [Revised: 07/23/2020] [Accepted: 07/24/2020] [Indexed: 11/20/2022] Open
Abstract
Background Paprika (Capsicum annuum L.) is a good source of carotenoids, including capsanthin, β-carotene, β-cryptoxanthin, and zeaxanthin. Several epidemiological studies have shown a beneficial association of intake of these carotenoids or their blood concentration with bone mineral density (BMD) and fracture risk. However, little information is available regarding the effect of intake of these carotenoids on bone metabolism in postmenopausal women. Objective The objective of the present study was to investigate the effects of paprika carotenoid extract (PCE) on bone turnover in healthy, postmenopausal women. Design We conducted a randomized, double-blind, placebo-controlled, parallel-group comparison study. One hundred participants were randomly assigned to PCE or placebo groups. Each group was given a 20 mg PCE (equivalent to 1.4 mg of carotenoids) a day or a placebo for 24 weeks. We measured bone resorption markers (tartrate-resistant acid phosphatase 5b [TRACP-5b] and serum type I collagen cross-linked N-telopeptide [sNTX]) at 12 and 24 weeks and bone formation markers (bone alkaline phosphatase and osteocalcin) at 24 weeks. Results The percentage decrease of TRACP-5b at 24 weeks was significantly higher for PCE than the placebo. There were no significant differences in sNTX or bone formation markers, although PCE decreased each marker compared with the placebo. Conclusion Our findings suggest that PCE supplementation suppresses bone resorption and contributes to maintaining bone quality in postmenopausal women.
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Affiliation(s)
| | - Yusuke Kozai
- Department of Dentomaxillofacial Diagnosis and Treatment, Kanagawa Dental University, Kanagawa, Japan
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Kalavathy N, Anantharaj N, Sharma A, Chauhan T. Effect of serum vitamin D, calcium, and phosphorus on mandibular residual ridge resorption in completely edentulous participants: A clinical study. J Prosthet Dent 2020; 127:93-99. [PMID: 33218746 DOI: 10.1016/j.prosdent.2020.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
STATEMENT OF PROBLEM Published data regarding association between edentulous mandibular residual ridge resorption and nutritional status of geriatric patients is limited. PURPOSE The purpose of this clinical study was to evaluate the degree of mandibular residual ridge resorption in completely edentulous participants and to investigate the role of dietary nutrients in the resorption process. MATERIAL AND METHODS Three hundred (55% men and 45% women; aged between 35 and 85 years) completely edentulous participants with specific inclusion and exclusion criteria were enrolled for the study. A standardized panoramic radiograph was made, measurements were made digitally, and the amount of resorption was calculated using the Wical and Swoope method. The blood plasma levels of vitamin D3 were analyzed by using the direct competitive chemiluminescence immunoassay (CLIA) method, whereas the total calcium and phosphorus were determined by using spectrophotometer method. Statistical data of serum nutrient levels (calcium, phosphorus, and vitamin D3), age, sex, and residual ridge resorption were subjected to the Mann-Whitney U test, the Spearman correlation test, and a stepwise multiple linear regression analysis (α=.05). RESULTS Calcium (P=.003) and phosphorus (P<.001) levels were significantly increased in the female participants as compared with the male participants. Vitamin D3 levels were similar in all the participants. Moreover, metabolic levels of calcium (rho=-0.09), phosphorus (rho=-0.10), and vitamin D3 (rho=-0.02) were found to be reduced with increasing age. However, male participants had increased mandibular residual ridge resorption (P<.001) with positive correlation (rho=0.06) when compared with female participants. Mandibular ridge resorption was increased with a decrease in levels of serum nutrients. CONCLUSIONS Increased levels of mandibular residual ridge resorption were observed in participants with decreased levels of systemic biochemical parameters, including calcium, phosphorus, and vitamin D3. Moreover, male participants showed increased residual ridge resorption when compared with female participants, who showed a significantly higher level of serum nutrient levels. Serum nutrient levels decreased, whereas mandibular residual ridge resorption increased with age.
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Affiliation(s)
- Natarajan Kalavathy
- Professor, Department of Prosthodontics, D.A.P.M.R.V. Dental College, Bangalore, Karnataka, India.
| | - Nikhil Anantharaj
- Post-Graduate student, Department of Prosthodontics, D.A.P.M.R.V. Dental College, Bangalore, Karnataka, India
| | - Ankita Sharma
- Post-Graduate student, Department of Prosthodontics, D.A.P.M.R.V. Dental College, Bangalore, Karnataka, India
| | - Tanuj Chauhan
- Post-Graduate student, Department of Prosthodontics, D.A.P.M.R.V. Dental College, Bangalore, Karnataka, India
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Ahi S, Dehdar MR, Hatami N. Vitamin D deficiency in non-autoimmune hypothyroidism: a case-control study. BMC Endocr Disord 2020; 20:41. [PMID: 32192469 PMCID: PMC7082994 DOI: 10.1186/s12902-020-0522-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/05/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Although in many studies, the relationship between autoimmune hypothyroidism (Hashimoto) and Vitamin D deficiency was shown, no research has been performed on the role of vitamin D in non-autoimmune hypothyroidism. METHODS This was a case-control study in Endocrinology clinic of Jahrom (south of Iran). The patients with Hashimoto (n = 633) and non-Hashimoto hypothyroidism (n = 305), along with a control group (n = 200) were evaluated. 25(OH) D level, T3 and T4 levels were studied and Anti TPO and Anti TG tests were performed. The results of vitamin D level were analyzed and interpreted using SPSS in terms of the cause of hypothyroidism (immune and non-immune). RESULTS The results of the study showed a significantly lower level of vitamin D in both immune and non-immune Hashimoto's thyroiditis (HT) in comparison to healthy controls (P < 0.05). We observed a significant inverse correlation between the vitamin D and TGAb level (p = 0.001, r = - 0.261) and a direct correlation of vitamin D with TSH level (p = 0.008, r = 0.108) in Hashimoto thyroiditis patients. CONCLUSION Finally, the results indicated that non-autoimmune hypothyroidism, as well as HT, is associated with vitamin D deficiency. The role of vitamin D deficiency in Hashimoto thyroiditis was thought to be in the association of higher autoantibody (TGAb) level; while, there should be further studies determining vitamin D deficiency's role in non-immune hypothyroidism.
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Affiliation(s)
- Salma Ahi
- Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
| | | | - Naser Hatami
- Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran
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Abstract
Stroke is the first cause of disability in the population and post-stroke patients admitted to rehabilitation units often present a malnutrition status which can influence nutritional indices and then vitamin levels. Vitamin D deficiency seems implicated beyond stroke severity and stroke risk, and also affects post-stroke recovery. Some studies on vitamin D levels and outcome in stroke patients are available but very few data on vitamin D levels and outcome after rehabilitation treatment are reported. This literature review shows the possible relationship between vitamin D deficiency and recovery in post-stroke patients undergoing rehabilitation treatment. Moreover, because several studies have reported that single nucleotide polymorphisms and promoter methylation in genes are involved in vitamin D metabolism and might affect circulating vitamin D levels, these aspects are evaluated in the current paper. From the studies evaluated in this review, it emerges that vitamin D deficiency could not only have an important role in the recovery of patients undergoing rehabilitation after a stroke, but that genetic and epigenetic factors related to vitamin D levels could have a crucial role on the rehabilitation outcome of patients after stroke. Therefore, further studies are necessary on stroke patients undergoing rehabilitation treatment, including: (a) the measurement of the 25(OH) vitamin D serum concentrations at admission and post rehabilitation treatment; (b) the identification of the presence/absence of CYP2R1, CYP27B1, CYP24A1 and VDR polymorphisms, and (c) analysis of the methylation levels of these genes pre- and post-rehabilitation treatment.
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The Association of Vitamin D Status with Lipid Profile and Inflammation Biomarkers in Healthy Adolescents. Nutrients 2020; 12:nu12020590. [PMID: 32102427 PMCID: PMC7071498 DOI: 10.3390/nu12020590] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/20/2020] [Accepted: 02/21/2020] [Indexed: 01/19/2023] Open
Abstract
Background: The association between vitamin D status and inflammatory biomarkers and lipid profile is not well known, especially in adolescents. Therefore, the aim of the current study is to investigate the association of vitamin D status with serum lipids and inflammatory biomarkers, including IL-10, IL-6, hsCRP, and TNFR-2, in male adolescents. Methods and materials: A sample of seventy-one high school male students, aged 17 years old, from a high school in Tehran were enrolled in the study. They were divided into four groups including group with serum vitamin D below 25 (ng/mL) (SVD < 25; n = 36), 25 and above (ng/mL) (SVD ≥ 25; n = 35), negative-hsCRP (n = 48), and positive-hsCRP (n = 23). Weight, height, body mass index, dietary intake, serum lipids, and inflammatory biomarkers, including IL-10, IL-6, hsCRP, and TNFR-2, were measured. Results: In the (SVD < 25) group, the serum level of TNFR-2 was significantly higher compared to that in the (SVD ≥ 25) group. There was a significant negative association between serum TNFR-2 and vitamin D levels in the whole sample. We found significant lower levels of IL-10 in positive-hsCRP group compared to the negative-hsCRP group. In addition, there was a significant negative correlation between the serum vitamin D level and hsCRP in both hsCRP groups. The HDL level was lower in the (SVD < 25) group compared to that in the (SVD ≥ 25) group. Finally, there was a negative correlation between the serum HDL and hsCRP levels in the positive-hsCRP subjects. Conclusion: Based on the findings it can be concluded that serum vitamin D affects HDL and inflammation status. Although serum levels of HDL and inflammation status are both predictors of metabolic syndrome and cardiovascular disease, further studies are needed to prove it, especially in adolescents.
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Çubukçu M, Acı R, Müderrisoğlu S. Evaluation of Vitamin D Levels According to Age, Sex and Seasonal Characteristics in Samsun. ANKARA MEDICAL JOURNAL 2019. [DOI: 10.17098/amj.652002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Kader S, Comaklı H, Tekindal M. Evaluation of Serum Vitamin D Levels according to Gender and Age at Karapınar City: A Follow-Up Study from Turkey. DUBAI MEDICAL JOURNAL 2019. [DOI: 10.1159/000503899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Safari A, Borhani-Haghighi A, Dianatpour M, Heydari ST, Foroughinia F, Ranjbar Omrani G. Circulating Serum Amyloid A, hs-CRP and Vitamin D Levels in Postmenopausal Osteoporosis. Galen Med J 2019; 8:e1548. [PMID: 34466525 PMCID: PMC8343903 DOI: 10.31661/gmj.v8i0.1548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/17/2019] [Accepted: 07/28/2019] [Indexed: 01/04/2023] Open
Abstract
Background: Both vitamin D and inflammation were investigated as important players in the pathogenesis of postmenopausal osteoporosis. This study compared vitamin D, inflammatory the biomarkers serum levels and their association with bone mineral density (BMD) in case and control groups to evaluate the possible immune-regulatory effect of vitamin D in this population. Materials and Methods: Participants in post-menopausal age, were categorized to 44 osteoporotic vs. 44 healthy aged-matched women according to WHO criteria. Total BMD, T- scores, Z-scores as well as fracture risk were measured in both groups, using Hologic system Dual-energy X-ray absorptiometry (DEXA). Serum 25-OH vitamin D, high sensitive CRP (hs-CRP) and serum amyloid A (SAA) were compared between groups. The association between serum biomarkers level and BMD were also investigated. The same evaluations were performed for vitamin D deficient (<20 ng/mL) and non-deficient (≥20 ng/mL) subgroups. Results: Vitamin D deficiency was higher in the osteoporotic group (32.6%) in comparison with the control group (25.6%), but the differences were not significant (P=0.47). There were no significant differences in serum levels of hs-CRP and SAA (P=0.83 and P=0.39) as well. No significant association between serum inflammatory biomarkers, vitamin D, and BMD were detected (P≥0.05). The results were the same for vitamin D deficient and non-deficient subgroups (P≥0.05). Conclusion: In the current study, the beneficial effects of vitamin D as a result of its immune-regulatory mechanisms was not reached. Larger scale studies might pave the way to define vitamin D benefits in postmenopausal osteoporosis.
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Affiliation(s)
- Anahid Safari
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | | | - Mehdi Dianatpour
- Stem Cells Technology Research Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Seyed Taghi Heydari
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farzaneh Foroughinia
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Clinical Pharmacy Department, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamhossein Ranjbar Omrani
- Endocrinology & Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Correspondence to: Gholamhossein Ranjbar Omrani, Endocrinology & Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran Telephone Number: +98-713-6281569 Email Address:
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Abstract
Osteoarthritis (OA) is a chronic degenerative joint disease, in which metabolic imbalance in bone is observed. The pathological mechanism of metabolic imbalance is not clear yet, but the nutritional factors, particularly the vitamins, might be intrinsic to the development and progression of OA. In this review article, we have explored databases such as PubMed, Scopus, and Google Scholar articles until the beginning of 2017 and reviewed the role of fat-soluble vitamins in pathological and therapeutic aspects of OA. Vitamin D plays an important role in the development and maintenance of the skeleton, as well as bone and cartilage metabolism, and its deficiency is implicated in the pathological process of OA. Vitamin E enhances chondrocyte growth and exhibits an anti-inflammatory activity, as well as plays an important role in the prevention of cartilage degeneration. In human OA cartilage, vitamin K deficiency produces abnormal growth plate calcification and inappropriate mineralization of cartilage. Thus, these fat-soluble vitamins play a key role in the pathophysiology of OA, and supplementation of these vitamins may provide innovative approaches for OA management. However, vitamin A has a different role, which is a regulator of cartilage and skeletal formation. When metabolite levels of vitamin A are elevated in synovial fluid, they appear to drive OA development. The role of inhibitors of vitamin A here remains unclear. More investigations are needed to examine the effects of fat-soluble vitamins on the various molecular pathways of OA, as well as to assess the efficacy and safety of their usage clinically.
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Baatjes KJ, Kotze MJ, McCaul M, Conradie M. Baseline bone health status in multi-ethnic South African postmenopausal breast cancer patients at initiation of aromatase inhibitor therapy: A descriptive study. PLoS One 2019; 14:e0214153. [PMID: 30939140 PMCID: PMC6445512 DOI: 10.1371/journal.pone.0214153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 03/07/2019] [Indexed: 12/21/2022] Open
Abstract
Introduction Osteoporosis (OP) risk factor assessment and bone mineral density (BMD) testing are frequently omitted at baseline in aromatase inhibitor (AI) studies, which may lead to misinterpretation of AI associated bone loss. The present study describes bone health of South African postmenopausal women of predominantly Mixed Ancestry, prior to AI treatment. Methods This descriptive baseline study, nested in a prospective AI cohort study, included postmenopausal women with endocrine sensitive breast cancer, aged 50 to 80 years. A baseline questionnaire documented demographic-, medical-, lifestyle- and fracture history. Body weight was assessed clinically, and body composition and BMD measured via dual energy absorptiometry (DXA). Data was analysed in STATA 14 using descriptive and inferential statistics. Results 101 participants were recruited, with a mean age of 61±7 years. Nearly a third (n = 32) of women at baseline fulfilled global criteria for bone protection (BMD T-score ≥-2SD (n = 18); BMD T-score -1.5SD to < -2SD with risk factors (n = 14). Lower body weight, body mass index (BMI), fat mass index and lean mass index were significantly associated with the participants with a BMD measurement in keeping with a diagnosis of OP (p <0.001). Low vitamin D was present in 93% of the cohort tested (n = 95), whilst deficient vitamin D status (<20ng/ml) was documented in 52 women (55%). Conclusions In this study, a third of postmenopausal women considered for AI therapy fulfilled international criteria for bone protective pharmacological intervention. This emphasizes the need for clinical risk and BMD assessment in postmenopausal breast cancer patients at baseline. Body composition and bone health associations highlight bone fragility associated with lower body weight.
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Affiliation(s)
- Karin J. Baatjes
- Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
- * E-mail:
| | - Maritha J. Kotze
- Division of Chemical Pathology, Department of Pathology Faculty of Medicine and Health Sciences, Stellenbosch University and the National Health Laboratory Service, Tygerberg Hospital, Tygerberg, South Africa
| | - Micheal McCaul
- Biostatistics Unit, Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Tygerberg, South Africa
| | - Magda Conradie
- Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences Stellenbosch University, Tygerberg, South Africa
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Inhibition of early response genes prevents changes in global joint metabolomic profiles in mouse post-traumatic osteoarthritis. Osteoarthritis Cartilage 2019; 27:504-512. [PMID: 30572121 PMCID: PMC6391201 DOI: 10.1016/j.joca.2018.11.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 11/09/2018] [Accepted: 11/21/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Although joint injury itself damages joint tissues, a substantial amount of secondary damage is mediated by the cellular responses to the injury. Cellular responses include the production and activation of proteases (MMPs, ADAMTSs, Cathepsins), and the production of inflammatory cytokines. The trajectory of cellular responses is driven by the transcriptional activation of early response genes, which requires Cdk9-dependent RNA Polymerase II phosphorylation. Our objective was to determine whether inhibition of cdk9-dependent early response gene activation affects changes in the joint metabolome. DESIGN To model post-traumatic osteoarthritis, we subjected mice to non-invasive Anterior Cruciate Ligament (ACL)-rupture joint injury. Following injury, mice were treated with flavopiridol - a potent and selective inhibitor of Cdk9 kinase activity - to inhibit Cdk9-dependent transcriptional activation, or vehicle control. Global joint metabolomics were analyzed 1 h after injury. RESULTS We found that injury induced metabolomic changes, including increases in Vitamin D3 metabolism, anandamide, and others. Inhibition of primary response gene activation immediately after injury largely prevented the global changes in the metabolomics profiles. Cluster analysis of joint metabolomes identified groups of injury-induced and drug-responsive metabolites. CONCLUSIONS Metabolomic profiling provides an instantaneous snapshot of biochemical activity representing cellular responses. We identified two sets of metabolites that change acutely after joint injury: those that require transcription of primary response genes, and those that do not. These data demonstrate the potential for inhibition of early response genes to alter the trajectory of cell-mediated degenerative changes following joint injury, which may offer novel targets for cell-mediated secondary joint damage.
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Casey C, Woodside JV, McGinty A, Young IS, McPeake J, Chakravarthy U, Rahu M, Seland J, Soubrane G, Tomazzoli L, Topouzis F, Vioque J, Fletcher AE. Factors associated with serum 25-hydroxyvitamin D concentrations in older people in Europe: the EUREYE study. Eur J Clin Nutr 2019; 73:319-328. [PMID: 30367156 DOI: 10.1038/s41430-018-0353-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/15/2018] [Accepted: 09/28/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES We aimed to describe serum 25-hydroxyvitamin D (25OHD) concentrations in older Europeans and to investigate associations between 25OHD and lifestyle factors, including dietary intake and supplement use. SUBJECTS/METHODS Men and women aged ≥ 65 years were recruited from seven centres across north to south Europe. Serum 25OHD2 and 25OHD3 concentrations were measured by liquid chromatography tandem mass spectrometry (LC-MS/MS) in 4495 samples and total 25OHD (25OHD2 + 25OHD3) was adjusted for season of blood collection. RESULTS The mean (25th, 75th quartile) of seasonally adjusted 25OHD was 46 (34, 65) nmol/L, with the highest concentration of 25OHD in Bergen [61 (49, 79) nmol/L], and the lowest in Paris [36 (24, 57) nmol/L)]. Vitamin D deficiency (25-50 nmol/L) and vitamin D insufficiency (50-75 nmol/L) were found in 41 and 33% of the population, respectively. In multivariable analysis controlled for confounders, seasonally adjusted 25OHD concentrations were significantly (p < 0.05) lower in smokers and participants with self-reported diabetes and higher with increasing dietary vitamin D, and supplement use with fish liver oil, omega-3, and vitamin D. Additionally, in further analysis excluding Bergen, 25OHD was associated with higher intakes of oily fish and increasing UVB exposure. We observed low concentrations of 25OHD in older people in Europe. CONCLUSIONS Our findings of the higher 25OHD concentrations in supplement users (omega-3 fish oil, fish liver oil, vitamin D) add to current recommendations to reduce vitamin D deficiency. We were unable to fully assess the role of dietary vitamin D as we lacked information on vitamin D-fortified foods.
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Affiliation(s)
- Claire Casey
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jayne V Woodside
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK.
| | - Ann McGinty
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Ian S Young
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Jennifer McPeake
- Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Usha Chakravarthy
- Department of Ophthalmology, Queen's University Belfast, Belfast, Northern Ireland, UK
| | - Mati Rahu
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Johan Seland
- Eye Department, University of Bergen, Bergen, Norway
| | - Gisèle Soubrane
- Department of Ophthalmology, Hotel Dieu de Paris, University Paris Descartes, Paris, France
| | - Laura Tomazzoli
- Clinica Oculistica, Università degli Studi di Verona, Verona, Italy
| | - Fotis Topouzis
- Department of Ophthalmology, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Jésus Vioque
- University Miguel Hernandez, Ciberesp, Isabial-Fisabio, Alicante, Spain
| | - A E Fletcher
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
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Zendehdel A, Arefi M. Molecular evidence of role of vitamin D deficiency in various extraskeletal diseases. J Cell Biochem 2019; 120:8829-8840. [PMID: 30609168 DOI: 10.1002/jcb.28185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Role of vitamin D is not only limited to skeletal system but various other systems of the body, such as immune system, endocrine system, and cardiopulmonary system. MATERIALS AND METHODS It is supported by the confirmations of systems-wide expression of vitamin D receptor (VDR), endocrinal effect of calcitriol, and its role in immune responses. RESULTS Expression of VDR in various systems, immunoregulatory and hormonal response of vitamin D and deficiency of vitamin D may establish various pathologies in the body. CONCLUSION This review provides molecular evidence of relation of vitamin D with extra skeletal.
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Affiliation(s)
- Abolfazl Zendehdel
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arefi
- Department of Clinical Toxicology, School of Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Esmaeili SA, Mohammadian S, Radbakhsh S, Momtazi-Borojeni AA, Kheirmand Parizi P, Atabati H, Mardani F, Saburi E, Moghaddam AS. Evaluation of vitamin D 3 deficiency: A population-based study in northeastern Iran. J Cell Biochem 2018; 120:10337-10341. [PMID: 30556194 DOI: 10.1002/jcb.28317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 11/28/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIM In recent years, vitamin D deficiency has become a major worldwide problem that can exert harmful effects. The aim of the present study was to evaluate the sex- and age-related prevalence of vitamin D deficiency in people from Mashhad, northeastern Iran. METHODS In this cross-sectional study conducted over a period of 1 year (2015-2016), 7504 subjects who referred to Mashhad medical centers were randomly enrolled in the study. The study population was divided into four groups based on sex and age, as following: group 1, 6 to 18 years; group 2, 19 to 35 years; group 3, 36 to 50 years; and group 4, 51 to 65 years. Since vitamin D levels <10, 10 to 20, and 20 to 30 ng/mL are considered as severe, moderate, and mild deficiency, respectively, we used these criteria for categorizing our population. RESULTS Of the total population in our study, 65.26% (4902; 57.81% of men and 72.07% of women) showed some degree of vitamin D deficiency. In addition, we found that vitamin D deficiency was common in all age groups (6-18, 19-35, 36-50, and 51-65 years), and more common in women (58.5%, 80.12%, 63.83%, and 88.44%, respectively) than men (41.66%, 59.86%, 44.97%, and 84.75%, respectively). CONCLUSION Vitamin D deficiency is a major health problem in all age groups and is more common in women. This information would help to provide a progressive prevention program to maintain health and manage some of the vitamin-related disorders and diseases that especially affect women.
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Affiliation(s)
- Seyed-Alireza Esmaeili
- Division of Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Immunology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Division of Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Mohammadian
- Immunology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Division of Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shabnam Radbakhsh
- Department of Medical Biotechnology, Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Abbas Momtazi-Borojeni
- Halal Research Center of IRI, FDA, Tehran, Iran.,Division of Nanotechnology Research Center, Bu-Ali Research Institute, Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Kheirmand Parizi
- Division of Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hadi Atabati
- Division of Leishmaniasis Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Fatemeh Mardani
- Immunology Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Division of Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Saburi
- Division of Clinical Research Development Center, Imam Hasan Hospital, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Abbas Shapouri Moghaddam
- Department of Immunology, Bu-Ali Research Institute, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Mechenro J, Venugopal G, Buvnesh Kumar M, Balakrishnan D, Ramakrishna BS. Vitamin D status in Kancheepuram District, Tamil Nadu, India. BMC Public Health 2018; 18:1345. [PMID: 30518358 PMCID: PMC6280507 DOI: 10.1186/s12889-018-6244-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Vitamin D has multifarious roles in maintenance of health and prevention of disease. The present study was undertaken to assess the vitamin D status of a rural adult south Indian population and to identify its associations with socioeconomic status and cultural practices. METHODS Between June 2015 and July 2016, 424 healthy adults residing in Kattankulathur block in Tamil Nadu, India, provided venous blood samples and answered questions by personal interview. 25-hydroxy vitamin D was estimated by ELISA. RESULTS Fifty nine (13.9%) of the 424 participants had 25OHD levels below 12 ng/mL (vitamin D deficient) and 175 (41.3%) had 25OHD levels between 12 to 20 ng/mL (vitamin D insufficiency). In univariate analysis, demographic factors associated with vitamin D status included education, occupation, socioeconomic class, and birthplace; lifestyle factors included sun exposure time, skin surface exposed to sunlight, use of sunscreen, awareness of vitamin D, and consumption of fish; and hygiene related factors included source of drinking water, availability of tap water at home, and closed toilet at home. In ordinal logistic regression, the following variables were found to be independently associated with vitamin D sufficiency: Duration of daily sun exposure below 30 min (Odds ratio 0.31, 95% confidence intervals 0.14-0.71, P = 0.006), sun exposure 30-60 min (OR 0.49, 95% CI 0.30-0.80, P = 0.004), male gender (OR 2.00, 95% CI 1.30-3.09, P = 0.002), higher level of education (OR 0.80, 95% CI 0.69-0.94, P = 0.005), non-consumption of fatty fish (OR 0.48, 95% CI 0.24-0.85, P = 0.035) and presence of closed toilet system at home (OR 0.59, 95% CI 0.37-0.93). CONCLUSION VDD and VDI are highly prevalent in this rural Indian community. The study identifies socioeconomic and behavior patterns that negatively impact vitamin D sufficiency, thus providing a basis for targeted intervention.
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Affiliation(s)
- John Mechenro
- SRM Institute of Gastroenterology, Hepatobiliary Sciences & Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, Tamil Nadu, India.,Department of Medical Research, SRM Medical College Hospital & Research Centre, SRM University, Kancheepuram District, Kattankulathur, Tamil Nadu, India
| | - Giriprasad Venugopal
- SRM Institute of Gastroenterology, Hepatobiliary Sciences & Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, Tamil Nadu, India.,Department of Medical Research, SRM Medical College Hospital & Research Centre, SRM University, Kancheepuram District, Kattankulathur, Tamil Nadu, India
| | - M Buvnesh Kumar
- Department of Community Medicine, SRM Medical College Hospital & Research Centre, SRM University, Kancheepuram District, Kattankulathur, Tamil Nadu, India.,Department of Community Medicine, Chettinad Hospital & Research Institute, Kelambakkam, Tamil Nadu, India
| | - D Balakrishnan
- Department of Medical Research, SRM Medical College Hospital & Research Centre, SRM University, Kancheepuram District, Kattankulathur, Tamil Nadu, India
| | - Balakrishnan S Ramakrishna
- SRM Institute of Gastroenterology, Hepatobiliary Sciences & Transplantation, SIMS Hospital, Jawaharlal Nehru Road, Vadapalani, Chennai, Tamil Nadu, India. .,Department of Medical Research, SRM Medical College Hospital & Research Centre, SRM University, Kancheepuram District, Kattankulathur, Tamil Nadu, India.
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Anbarcioglu E, Kirtiloglu T, Öztürk A, Kolbakir F, Acıkgöz G, Colak R. Vitamin D deficiency in patients with aggressive periodontitis. Oral Dis 2018; 25:242-249. [PMID: 30169905 DOI: 10.1111/odi.12968] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/07/2018] [Accepted: 08/26/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Vitamin D deficiency is a frequent health problem worldwide, especially as fewer people spend much time in the sun. Vitamin D deficiency is linked to several infectious and inflammatory conditions, including periodontal disease. However, its role in aggressive periodontitis (AgP) has not been well studied. We evaluated the association between vitamin D concentration and periodontal disease, both AgP and chronic (CP) periodontitis. METHOD AND MATERIALS Forty-seven AgP 55 CP and 27 control subjects participated. All patients were tested for serum vitamin D concentration (25(OH)D), parathyroid hormone, and serum bone-related biomarkers (alkaline phosphatases, calcium, and phosphorus) regulated by vitamin D. RESULTS The patients with AgP had lower serum 25(OH)D concentration (11.22 ± 4.8 ng/ml) than controls (16.9 ± 6.4 ng/ml) and patients with CP (16.13 ± 8.3 ng/ml; overall p value 0.0002). These associations remained significant after adjustment for age and gender (p = 0.002). No significant differences were observed in any bone-related biomarker among the three groups, and no association was observed with periodontal disease indices. CONCLUSIONS Our results suggest that vitamin D deficiency may be a potential risk factor for AgP. Given the high prevalence of vitamin D deficiency in AgP patients, routine screening for vitamin D status may be advisable in these subjects.
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Affiliation(s)
- Emrah Anbarcioglu
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Tugrul Kirtiloglu
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ayla Öztürk
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Filiz Kolbakir
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Gökhan Acıkgöz
- Department of Periodontology, School of Dental Medicine, Ondokuz Mayıs University, Samsun, Turkey
| | - Ramis Colak
- Department of Endocrinology, School of Medicine, Ondokuz Mayıs University, Samsun, Turkey
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Altowijri A, Alloubani A, Abdulhafiz I, Saleh A. Impact of Nutritional and Environmental Factors on Vitamin D Deficiency. Asian Pac J Cancer Prev 2018; 19:2569-2574. [PMID: 30256062 PMCID: PMC6249461 DOI: 10.22034/apjcp.2018.19.9.2569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 07/29/2018] [Indexed: 11/27/2022] Open
Abstract
Background: Vitamin D can be obtained through a variety of food sources; however, ultraviolet rays in the sunlight can convert a natural substance in the skin known as ergosterol to vitamin D. Aim: This study aims to investigate the prevalence and risk factors linked to vitamin D deficiency among a group of apparently healthy young male and female Tabuk citizens in Saudi Arabia. Methods: A cross-sectional study that comprised a convenience sampling method of 350 male and female Tabuk citizens. Results: The results indicated a generalized vitamin D deficiency and severe deficiency among the participants, where 74.57% of the population had vitamin D deficiency, and 25.43% reported vitamin D sufficiency. There was a significant positive correlation among the BMI, exercise, exposure to sunlight, vitamin D intake, and calcium intake with vitamin D status (r = 0.574,** 0.525,** 0.515,** 0.466 and 0.465** at p-value < 0.001, respectively). Conclusion: The present study indicates vitamin D deficiency to be relatively common even among the population of Saudi Arabia, a country receiving adequate sunlight. Also, Vitamin D and calcium supplementation can prove to be beneficial in correcting the deficiency. Moreover, the individuals at a higher risk of vitamin insufficiency, such as women, need to be educated on the health benefits of vitamin D and calcium supplementation.
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Affiliation(s)
- Albaraa Altowijri
- Department of Hematology- Oncology, Vontz Center for molecular studies, University of Cincinnati, OH,USA.
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Berger MB, Cohen DJ, Olivares-Navarrete R, Williams JK, Cochran DL, Boyan BD, Schwartz Z. Human osteoblasts exhibit sexual dimorphism in their response to estrogen on microstructured titanium surfaces. Biol Sex Differ 2018; 9:30. [PMID: 29970177 PMCID: PMC6029108 DOI: 10.1186/s13293-018-0190-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/25/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osseointegration is dependent on the implant surface, surrounding bone quality, and the systemic host environment, which can differ in male and female patients. Titanium (Ti) implants with microstructured surfaces exhibit greater pullout strength when compared to smooth-surfaced implants and exhibit enhanced osteogenic cellular responses in vitro. Previous studies showed that 1α,25-dihydroxyvitamin D3 [1α,25(OH)2D3] has a greater effect on rat osteoblast differentiation on microstructured Ti compared to smooth Ti surfaces and tissue culture polystyrene (TCPS). The stimulatory effect of 17β-estradiol (E2) on differentiation is observed in female osteoblasts on micro-rough Ti, but it is not known if male osteoblasts behave similarly in response to E2 and microtopography. This study assessed whether human male and female osteoblasts exhibit sex-specific differences in response to E2 and 1α,25(OH)2D3 when cultured on microstructured Ti surfaces. METHODS Osteoblasts from three male and three female human donors were cultured on Ti discs with varying surface profiles: a smooth pretreatment (PT), a coarse grit-blasted/acid-etched (SLA), and an SLA surface having undergone modification in a nitrogen environment and stored in saline to maintain hydrophilicity (modSLA). Cells cultured on these surfaces were treated with E2 or 1α,25(OH)2D3. RESULTS Male and female human osteoblasts responded similarly to microstructure although there were donor-specific differences; cell number decreased, and osteocalcin (OCN), osteoprotegerin (OPG), and latent and active transforming growth factor 1 increased on SLA and modSLA compared to TCPS. Female osteoblasts had higher alkaline phosphatase activity and OCN production than male counterparts but produced less OPG. Both sexes responded similarly to 1α,25(OH)2D3. E2 treatment reduced cell number and increased osteoblast differentiation and factor production only in female cells. CONCLUSIONS Male and female human osteoblasts respond similarly to microstructure and 1α,25(OH)2D3 but exhibit sexual dimorphism in substrate-dependent responses to E2. E2 affected female osteoblasts, suggesting that signaling is sex-specific and surface-dependent. Donor osteoblasts varied in response, demonstrating the need to test multiple donors when examining human samples. Understanding how male and female cells respond to orthopedic biomaterials will enable greater predictability post-implantation as well as therapies that are more patient-specific.
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Affiliation(s)
- Michael B Berger
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | - David J Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | - Rene Olivares-Navarrete
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | | | - David L Cochran
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Barbara D Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA. .,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA.,Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
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Mano H, Ikushiro S, Saito N, Kittaka A, Sakaki T. Development of a highly sensitive in vitro system to detect and discriminate between vitamin D receptor agonists and antagonists based on split-luciferase technique. J Steroid Biochem Mol Biol 2018; 178:55-59. [PMID: 29101064 DOI: 10.1016/j.jsbmb.2017.10.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/20/2017] [Accepted: 10/31/2017] [Indexed: 11/19/2022]
Abstract
Split-luciferase techniques are widely used to detect protein-protein interaction and bioactive small molecules including some hormones and vitamins. Previously, we successfully expressed chimeric proteins of luciferase and the ligand binding domain (LBD) of the vitamin D receptor (VDR), LucC-LBD-LucN in COS-7 cells. The LucC-LBD-LucN biosensor was named split-luciferase vitamin D biosensor (SLDB). This biosensor can detect and discriminate between VDR agonists and antagonists in mammalian cells. In this study, we established an in vitro screening system for VDR ligands using the SLDB proteins expressed in Escherichia coli (E. coli) cells. Our in vitro screening system using cell lysate of recombinant E. coli cells could be completed within 30min, and its activity was unchanged after 10 freeze-thaw cycles. This highly sensitive and convenient system would be quite useful to screen VDR ligands with therapeutic potential for various bone-related diseases, age-related cognitive disorders, cancer, and immune disorders. In addition, our system might be applicable to diagnostic measurement of serum concentrations of 25-hydroxyvitamin D3 and 1α,25-dihydroxyvitamin D3.
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Affiliation(s)
- Hiroki Mano
- Department of Pharmaceutical Engineering, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Shinichi Ikushiro
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Nozomi Saito
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605 Japan
| | - Atsushi Kittaka
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605 Japan
| | - Toshiyuki Sakaki
- Department of Pharmaceutical Engineering, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan.
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Postmenopausal Breast Cancer, Aromatase Inhibitors, and Bone Health: What the Surgeon Should Know. World J Surg 2017; 40:2149-56. [PMID: 27189076 DOI: 10.1007/s00268-016-3555-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Breast cancer, as the most common malignancy in women, remains a major public health issue despite countless advances across decades. Endocrine therapy is the cornerstone of treatment of the hormone-sensitive subtype of breast cancer. The use of aromatase inhibitors (AIs) in the postmenopausal women has extended the survival beyond that of Tamoxifen, but harbors a subset of side effects, most notably accelerated bone loss. This, however, does not occur in all women undergoing treatment. It is vital to identify susceptible patients early, to limit such events, employ early treatment thereof, or alter drug therapy. International trials on AIs, predominantly performed in North American and European females, provide little information on what to expect in women in developing countries. Here, surgeons often prescribe and manage endocrine therapy. The prescribing surgeon should be aware of the adverse effect of the endocrine therapy and be able to attend to side effects. This review highlights clinical and biochemical factors associated with decrease in bone mineral density in an, as yet, unidentified subgroup of postmenopausal women. In the era of personalized medical care, appropriate management of bone health by surgeons based on these factors becomes increasingly important.
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Gillberg C, Fernell E, Kočovská E, Minnis H, Bourgeron T, Thompson L, Allely CS. The role of cholesterol metabolism and various steroid abnormalities in autism spectrum disorders: A hypothesis paper. Autism Res 2017; 10:1022-1044. [PMID: 28401679 PMCID: PMC5485071 DOI: 10.1002/aur.1777] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 12/15/2016] [Accepted: 01/30/2017] [Indexed: 01/25/2023]
Abstract
Based on evidence from the relevant research literature, we present a hypothesis that there may be a link between cholesterol, vitamin D, and steroid hormones which subsequently impacts on the development of at least some of the "autisms" [Coleman & Gillberg]. Our hypothesis, driven by the peer reviewed literature, posits that there may be links between cholesterol metabolism, which we will refer to as "steroid metabolism" and findings of steroid abnormalities of various kinds (cortisol, testosterone, estrogens, progesterone, vitamin D) in autism spectrum disorder (ASD). Further research investigating these potential links is warranted to further our understanding of the biological mechanisms underlying ASD. Autism Res 2017. © 2017 The Authors Autism Research published by Wiley Periodicals, Inc. on behalf of International Society for Autism Research. Autism Res 2017, 10: 1022-1044. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
- Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Elisabeth Fernell
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - Eva Kočovská
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Barts and London School of Medicine, Queen Mary University of London, Blizard Institute58 Turner StreetE1 2ABLondon
| | - Helen Minnis
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Thomas Bourgeron
- Institut Pasteur, Human Genetics and Cognitive Functions UnitParisFrance
- CNRS UMR 3571: Genes, Synapses and Cognition, Institut PasteurParisFrance
- Université Paris Diderot, Sorbonne Paris CitéHuman Genetics and Cognitive FunctionsParisFrance
- FondaMental FoundationCréteilFrance
| | - Lucy Thompson
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Institute of Health and Wellbeing, University of Glasgow, RHSC YorkhillGlasgowScotlandG3 8SJUnited Kingdom
| | - Clare S. Allely
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- School of Health SciencesUniversity of SalfordManchesterEngland
- Honorary Research Fellow in the College of MedicalVeterinary and Life Sciences affiliated to the Institute of Health and Wellbeing at the University of Glasgow
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Napartivaumnuay N, Gramlich L. The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition. Nutrients 2017; 9:nu9050481. [PMID: 28489034 PMCID: PMC5452211 DOI: 10.3390/nu9050481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/20/2017] [Accepted: 05/05/2017] [Indexed: 01/10/2023] Open
Abstract
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients. Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied. Results: The mean age at the initiation of HPN was 53.8 (20–79) years and 23 (37%) were male. The mean HPN duration was 56 (6–323) months and the most common diagnosis was short bowel syndrome. Based on a total of 186 patients, 62 patients were categorized based on serum vitamin D status as follows: 1 (24.2%) sufficient, 31 (50%) insufficient and 16 (25.8%) deficient. Despite an average of 1891 IU/day orally and 181 IU/day intravenously vitamin D, the mean vitamin D level was 25.6 ng/mL (insufficiency) and 26.2 ± 11.9 ng/mL in patients with the highest 10-year fracture risk. Conclusion: Suboptimal vitamin D levels are common among patients on long-term HPN despite nutrient intake that should meet requirements.
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Affiliation(s)
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada.
- Nutrition Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada.
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Alghadir AH, Gabr SA, Al-Eisa ES. Mechanical factors and vitamin D deficiency in schoolchildren with low back pain: biochemical and cross-sectional survey analysis. J Pain Res 2017; 10:855-865. [PMID: 28442927 PMCID: PMC5396951 DOI: 10.2147/jpr.s124859] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study was designed to evaluate the role of vitamin D, muscle fatigue biomarkers, and mechanical factors in the progression of low back pain (LBP) in schoolchildren. BACKGROUND Children and adolescents frequently suffer from LBP with no clear clinical causes, and >71% of schoolchildren aged 12-17 years will show at least one episode of LBP. MATERIALS AND METHODS A total of 250 schoolchildren aged 12-16 years were randomly enrolled in this study. For all schoolchildren height, weight, percentage of daily sun exposure and and areas of skin exposed to sun, method of carrying the bag, and bag weight and type were recorded over a typical school week. Pain scores, physical activity (PA), LBP, serum vitamin 25(OH)D level, serum bone-specific alkaline phosphatase, creatine kinase (CK), and lactate dehydrogenase (LDH) activities and calcium (Ca) concentrations were estimated using prevalidated Pain Rating Scale, modified Oswestry Low Back Pain Disability Questionnaire, short-form PA questionnaire, and colorimetric and immunoassay techniques. RESULTS During the period of October 2013-May 2014, LBP was estimated in 52.2% of the schoolchildren. It was classified into moderate (34%) and severe (18%). Girls showed a higher LBP (36%) compared with boys (24%). In schoolchildren with moderate and severe LBP significantly higher (P=0.01) body mass index, waist, hip, and waist-to-hip ratio measurements were observed compared with normal schoolchildren. LBP significantly correlated with less sun exposure, lower PA, sedentary activity (TV/computer use), and overloaded school bags. In addition, schoolchildren with severe LBP showed lower levels of vitamin 25(OH)D and Ca and higher levels of CK, LDH, and serum bone-specific alkaline phosphatase compared with moderate and healthy schoolchildren. Stepwise regression analysis revealed that age, gender, demographic parameters, PA, vitamin D levels, Ca, CK, and LDH associated with ~56.8%-86.7% of the incidence of LBP among schoolchildren. CONCLUSION In children and adolescents, LBP was shown to be linked with limited sun exposure, inadequate vitamin D diets, adiposity, lower PA, sedentary lifestyles, vitamin 25 (OH) D deficiency, and lower levels of Ca, CK, and LDH.
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Affiliation(s)
- Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Sami A Gabr
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Einas S Al-Eisa
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Vitamin D and Parathyroid Hormone Status in Female Garment Workers: A Case-Control Study in Bangladesh. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4105375. [PMID: 28473985 PMCID: PMC5394353 DOI: 10.1155/2017/4105375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 02/13/2017] [Indexed: 12/13/2022]
Abstract
Despite the abundant sunlight, vitamin D deficiency is prevalent in South Asian countries including Bangladesh. Information on vitamin D level is insufficient in adults particularly in female garment workers in Bangladesh. This study was designed to evaluate the status of vitamin D, parathormone (PTH), calcium, and alkaline phosphatase (ALP) among the female garment workers in Bangladesh. Blood samples were collected from female garment workers (n = 40, case group) and general female workers (n = 40, control group) in Dhaka. Serum vitamin D, PTH, calcium, and ALP were measured by chemiluminescence microparticle immunoassay. The mean level of vitamin D was significantly (p < 0.001) lower in case (14.2 ± 2.6 ng/mL) than in the control (22.4 ± 2.4 ng/mL) group. No significant difference was found at mean of PTH and calcium between case (33.9 ± 17.2 pg/mL; 9.1 ± 0.6 mg/dL, resp.) and control (35.9 ± 16.3 pg/mL; 9.3 ± 0.6 mg/dL, resp.) group. The mean ALP in case (117.2 ± 14.4 U/L) group was significantly (p < 0.001) higher than the control group (80.5 ± 30.6 U/L). Overall, PTH level did not show significant correlation with vitamin D. However, calcium and ALP levels showed a significant positive (p < 0.05) and negative (p < 0.001) correlation with vitamin D, respectively. This study indicates a high prevalence of vitamin D deficiency in the female garment workers in Bangladesh.
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Mano H, Nishikawa M, Yasuda K, Ikushiro S, Saito N, Sawada D, Honzawa S, Takano M, Kittaka A, Sakaki T. Novel screening system for high-affinity ligand of heredity vitamin D-resistant rickets-associated vitamin D receptor mutant R274L using bioluminescent sensor. J Steroid Biochem Mol Biol 2017; 167:61-66. [PMID: 27864003 DOI: 10.1016/j.jsbmb.2016.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 10/25/2016] [Accepted: 11/13/2016] [Indexed: 11/20/2022]
Abstract
Hereditary vitamin D-resistant rickets (HVDRR) is caused by mutations in the vitamin D receptor (VDR) gene. Arg274 located in the ligand binding domain (LBD) of VDR is responsible for anchoring 1α,25-dihydroxyvitamin D3 (1α,25(OH)2D3) by forming a hydrogen bond with the 1α-hydroxyl group of 1α,25(OH)2D3. The Arg274Leu (R274L) mutation identified in patients with HVDRR causes a 1000-fold decrease in the affinity for 1α,25(OH)2D3, and dramatically reduces vitamin D- related gene expression. Recently, we successfully constructed fusion proteins consisting of split-luciferase and LBD of the VDR. The chimeric protein LucC-LBD-LucN, which displays the C-terminal domain of luciferase (LucC) at its N-terminus, can detect and discriminate between VDR agonists and antagonists. The LucC-LBD (R274L)-LucN was constructed to screen high-affinity ligands for the mutant VDR (R274L). Of the 33 vitamin D analogs, 5 showed much higher affinities for the mutant VDR (R274L) than 1α,25(OH)2D3, and 2α-[2-(tetrazol-2-yl)ethyl]-1α,25-(OH)2D3 showed the highest affinity. These compounds might be potential therapeutics for HVDRR caused by the mutant VDR (R274L).
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Affiliation(s)
- Hiroki Mano
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Miyu Nishikawa
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan; Imizu Institute, Topu Bio Research Co., Ltd, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Kaori Yasuda
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Shinichi Ikushiro
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan
| | - Nozomi Saito
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605, Japan
| | - Daisuke Sawada
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605, Japan
| | - Shinobu Honzawa
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605, Japan
| | - Masashi Takano
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605, Japan
| | - Atsushi Kittaka
- Faculty of Pharmaceutical Sciences, Teikyo University, Itabashi, Tokyo 173-8605, Japan
| | - Toshiyuki Sakaki
- Department of Biotechnology, Faculty of Engineering, Toyama Prefectural University, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan; Imizu Institute, Topu Bio Research Co., Ltd, 5180 Kurokawa, Imizu, Toyama 939-0398, Japan.
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Abstract
The World Health Organization estimates that diabetes mellitus occurs in more than 415 million people; this number could double by the year 2040. Epidemiologic data have shown that the skeletal system may be a target of diabetes-mediated damage, leading to the development of diabetes-induced osteoporosis. T1D and T2D have been associated with an increased risk of fracture. Bone mineral density and fracture risk prediction tools developed for the general population capture some of the risk associated with diabetes. Recent adaptations to these tools have improved their efficacy in patients with diabetes.
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Affiliation(s)
- G Isanne Schacter
- Department of Medicine, University of Manitoba, GF-335, 820 Sherbrook Street, Winnipeg, Manitoba R3A 1R9, Canada
| | - William D Leslie
- Department of Medicine, University of Manitoba, C5121, 409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada.
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Kaul A, Gläser S, Hannemann A, Stubbe B, Felix SB, Nauck M, Ewert R, Friedrich N. No mediating effects of glycemic control and inflammation on the association between vitamin D and lung function in the general population. Respir Med 2017; 125:1-7. [PMID: 28340855 DOI: 10.1016/j.rmed.2017.02.015] [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] [Received: 01/04/2017] [Revised: 01/30/2017] [Accepted: 02/17/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Vitamin D deficiency is discussed to be associated with lung health. While former studies focused on subjects suffering from pulmonary diseases, we aimed to investigate the association of 25-hydroxy vitamin D [25(OH)D] with lung function in the general population and examined whether mediating effects of inflammation, glycemic control or renal function exist. METHODS 1404 participants from the Study of Health in Pomerania with pulmonary function testing assessed by expiratory volume in 1 s (FEV1), forced vital capacity (FVC), total lung capacity and Krogh index were used. Adjusted analysis of variance, linear regression models and mediation analyses were performed. RESULTS Significant positive associations between 25(OH)D levels and FEV1, FVC and Krogh index were found. Mediator analyses revealed no mediating effect of inflammation (fibrinogen), glycemic control (HbA1c) or renal function (eGFR) on associations with FEV1 or FVC. With respect to Krogh-Index, the association to 25(OH)D was slightly mediated by fibrinogen with a proportion mediated of 9.7%. CONCLUSION Significant positive associations of 25(OH)D with lung function were revealed in a general population. The proposed mediating effects of inflammation, glycemic control and renal function on these relations were not confirmed. Further studies examining the causality of the association between 25(OH)D and lung function are necessary.
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Affiliation(s)
- Anne Kaul
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Sven Gläser
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany; Vivantes Klinikum Spandau, Department of Pulmonary Medicine, Berlin, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Beate Stubbe
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Stefan B Felix
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany
| | - Ralf Ewert
- Department of Internal Medicine B - Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany; DZHK (German Centre for Cardiovascular Research), Greifswald Partner Site, Greifswald, Germany.
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Vitamin D regulates the production of vascular endothelial growth factor: A triggering cause in the pathogenesis of rheumatic heart disease? Med Hypotheses 2016; 95:62-66. [DOI: 10.1016/j.mehy.2016.09.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/19/2016] [Accepted: 09/01/2016] [Indexed: 11/23/2022]
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