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Upadhyay PK, Thakur N, Vishwakarma VK, Srivastav RK, Ansari TM. Role of Vitamin D in Management of Diabetes and Unresolved Cardiovascular Diseases. Curr Diabetes Rev 2024; 20:e010923220647. [PMID: 37680158 DOI: 10.2174/1573399820666230901151019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/03/2023] [Accepted: 08/08/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Vitamin D deficiency is becoming a widely recognized global health issue. Serum values of 25-(OH) vitamin D (<20 ng/ml) are used to identify vitamin D deficiency. By prompting vascular endothelial cells to activate their nuclear receptor in cardio-myocytes, Vitamin D regulates obesity, Renin-angiotensin system (RAS), energy consumption, and pancreatic cell function. Vitamin D deficiency has been associated with diabetes, asthma, hyperlipidaemia, and pulmonary hypertension in humans. METHODS PubMed and Google Scholar databases were utilised to search the literature on vitamin D and related diseases. RESULT It is also linked to an elevated risk of death and heart disease. On the other hand, metaanalyses of vitamin D intervention and trials have found no substantial changes in insulin sensitivity, lipid markers, or blood pressure, which result in the association between deficiency of vitamin D and cardiovascular disease. CONCLUSION In this review, we present the most recent research on the effects of Vitamin D therapy on various cardiovascular diseases and diabetes, and explain the underlying mechanisms.
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Affiliation(s)
- Prabhat Kumar Upadhyay
- Institute of Pharmaceutical Research, GLA University, Mathura 281406, Uttar Pradesh, India
| | - Navneet Thakur
- Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ritesh Kumar Srivastav
- Faculty of Pharmacy, Kamla Nehru Institute of Management and Technology, Sultanpur 228119, India
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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Frentusca C, Babes K, Galusca D. VITAMIN D DEFICIENCY AS AN INDEPENDENT PREDICTOR OF CARDIOVASCULAR DISEASE. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:319-325. [PMID: 38356981 PMCID: PMC10863965 DOI: 10.4183/aeb.2023.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Context In addition to traditional risk factors for cardiovascular diseases, there are new risk factors with potentially relevant prognostic, such as vitamin D deficiency. Objective The study aims to analyze the relationship between vitamin D deficiency and the occurrence of cardiovascular disease, in patients who already have at least one cardiovascular risk factor. Design It is a prospective, observational study. Follow- up time was 24 months. Subjects and methods A total of 77 patients were included in the study, aged over 18 years, who had at least one cardiovascular risk factor. Their vitamin D levels were measured and they were monitored for a period of 2 years, in order to see which one developed cardiovascular diseases. Results Of the 77 patients, 56 (72.7%) had serum deficient levels of vitamin D and the mean serum level was 16 ng/mL (± 8.6 ng/mL). Statistically significant differences were observed only in the case of dyslipidemia (p=0.0334). The evolution to cardiovascular disease occurred in 39 of the cases (50.6%). The only independent risk factors for progression to cardiovascular disease demonstrated in this study were serum vitamin D (OR = 0.9024, 95% CI: 0.83-0.97 and age (OR = 1.1313, 95% CI: 1.05-1.21). Conclusion The results shows that patients with cardiovascular risk factors and advanced age are at a higher risk of developing cardiovascular disease, if they also have vitamin D deficiency.
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Affiliation(s)
- C.F. Frentusca
- Oradea County Emergency Hospital - Endocrinology, Oradea, Romania
| | - K. Babes
- Oradea County Emergency Hospital - Department of Intensive Care Cardiology, Oradea, Romania
- University of Oradea, Faculty of Medicine and Pharmacy, Oradea, Romania
| | - D.I. Galusca
- Oradea County Emergency Hospital - Endocrinology, Oradea, Romania
- University of Oradea, Faculty of Medicine and Pharmacy, Oradea, Romania
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Nardin M, Verdoia M, Laera N, Cao D, De Luca G. New Insights into Pathophysiology and New Risk Factors for ACS. J Clin Med 2023; 12:jcm12082883. [PMID: 37109221 PMCID: PMC10146393 DOI: 10.3390/jcm12082883] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Cardiovascular disease still represents the main cause of mortality worldwide. Despite huge improvements, atherosclerosis persists as the principal pathological condition, both in stable and acute presentation. Specifically, acute coronary syndromes have received substantial research and clinical attention in recent years, contributing to improve overall patients' outcome. The identification of different evolution patterns of the atherosclerotic plaque and coronary artery disease has suggested the potential need of different treatment approaches, according to the mechanisms and molecular elements involved. In addition to traditional risk factors, the finer portrayal of other metabolic and lipid-related mediators has led to higher and deep knowledge of atherosclerosis, providing potential new targets for clinical management of the patients. Finally, the impressive advances in genetics and non-coding RNAs have opened a wide field of research both on pathophysiology and the therapeutic side that are extensively under investigation.
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Affiliation(s)
- Matteo Nardin
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
- Third Medicine Division, Department of Medicine, ASST Spedali Civili, 25123 Brescia, Italy
| | - Monica Verdoia
- Division of Cardiology, Ospedale degli Infermi, ASL Biella, 13900 Biella, Italy
- Department of Translational Medicine, Eastern Piedmont University, 13100 Novara, Italy
| | - Nicola Laera
- Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Davide Cao
- Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy
| | - Giuseppe De Luca
- Division of Cardiology, AOU "Policlinico G. Martino", Department of Clinical and Experimental Medicine, University of Messina, 98166 Messina, Italy
- Division of Cardiology, IRCCS Hospital Galeazzi-Sant'Ambrogio, 20161 Milan, Italy
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Sghaireen MG, Ganji KK, Srivastava KC, Alam MK, Nashwan S, Migdadi FH, Al-Qerem A, Khader Y. Vitamin D, Cholesterol, and DXA Value Relationship with Bimaxillary Cone Beam CT Values. J Clin Med 2023; 12:jcm12072678. [PMID: 37048761 PMCID: PMC10094997 DOI: 10.3390/jcm12072678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/18/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
We evaluated the correlation that Vitamin D (Vit D), cholesterol levels, and T- and Z-scores of dual-energy X-ray absorptiometry (DXA) scans have with cone beam computed tomography values assessed in the anterior and posterior regions of maxillary and mandibular jaws. In total, 187 patients were recruited for this clinical study. Patients’ ages ranged between 45 and 65 years. Patients with valid DXA results, serum Vit D and cholesterol levels, and no evidence of bone disorders in the maxilla or mandibular region were included in the study and grouped in the control (non-osteoporosis) and case (osteoporosis) groups. Patients with a history of medical or dental disease that might complicate the dental implant therapy, chronic alcohol users, and patients who took calcium or Vit D supplements were excluded. The outcome variables assessed in the investigation were Vit D, cholesterol, Z-values, and cone beam computed tomography values. Regarding the case group, a significant (p < 0.05) inverse relationship was observed between Vit D and cholesterol. Although insignificant (p > 0.05), a positive relationship was found between Vit D and the cone beam computed tomography values in all regions of the jaws, except the mandibular posterior region (p < 0.05). Pearson correlation analysis was carried out. Vit D and cholesterol showed a statistically insignificant (p > 0.05) negative association with the cone beam computed tomography values in all regions of the jaws. However, the Z-values were highly correlated with the cone beam computed tomography values in all regions of the jaws (r > 7, p < 0.05). Vit D, cholesterol levels, and Z-values in women and men from young adulthood to middle age (45–65) were related with the cone beam computed tomography values of the jaws.
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Affiliation(s)
| | - Kiran Kumar Ganji
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia
| | - Shadi Nashwan
- Department of Computer Science, College of Computer and Information Sciences, Jouf University, Sakaka 72341, Saudi Arabia
| | | | - Ahmad Al-Qerem
- Department of Computer Science, Faculty of Information Technology, Zarqa University, Zarqa 13110, Jordan
| | - Yousef Khader
- Department of Public Health, Jordan University of Science & Technology, Ar-Ramtha 3030, Jordan
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Mehdawi A, Mohammad BA, Mosleh I, Khader HA, Habash M, Nassar RI, Awwad S, Hasoun L, Abu-Samak MS. Combined Effect of Omega-3 Fatty Acid and Vitamin D 3 on Oxidized LDL-C and Non-HDL-C Levels in People With Vitamin D Deficiency: A Randomized Controlled Trial. J Cardiovasc Pharmacol 2023; 81:251-258. [PMID: 36630694 DOI: 10.1097/fjc.0000000000001398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023]
Abstract
ABSTRACT The present randomized clinical trial (RCT) was conducted on Jordanian participants with vitamin D deficiency (VDD) with no other medical conditions, to evaluate the combined effect of 1,25-dihydroxy vitamin D 3 (Vit.D 3 ) and omega-3 fatty acid (n-3FA) supplements (D+) on oxidized low-density lipoprotein (Ox-LDL) and non-high-density lipoprotein cholesterol (non-HDL-C) levels as common predictors of cardiovascular diseases (CVDs). Participants were randomized into 4 groups as follows: a control group (C) that received no supplementations, a Vit.D 3 group that received 50,000 IU of Vit.D 3 every week, an n-3FA group that received 300 mg of omega-3 fatty acid every day, and a D+ group that received a combination of both supplements, with the same dosage administered by the previous groups but with a 4-6-hour time interval between Vit.D 3 and n-3FA administration to avoid any possible interaction. All supplementations were administered orally for 8 weeks. Forty-seven participants were allocated to each group. Twenty-six in the control group, 37 participants in the Vit.D 3 group, 37 participants in the n-3FA group, and 46 participants in the D+ group completed the study to the end. The D+ supplementations significantly increased non-HDL-C (118.99 ± 60.98 to 155.26 ± 43.36 mg/dL, P << 0.05) but decreased Ox-LDL-C levels (69.29 ± 37.69 to 52.81 ± 17.30 pg/mL, P = 0.03). The stepwise regression showed that the serum LDL-C level was the main independent variable involved in the elevation of non-HDL levels (R 2 = 0.837) observed at the end of the trial in the D+ group. The groups that were supplemented with either Vit.D 3 alone or n-3FA alone had an insignificant decrease in the level of Ox-LDL-C. In conclusion, despite the observed hyperlipidemic effect, the combination treatment is recommended by the research team because the decrease in Ox-LDL may offset the hyperlipidemic effect.
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Affiliation(s)
- Amani Mehdawi
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Beisan A Mohammad
- Department of Pharmaceutical Sciences, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Ibrahim Mosleh
- Department of Medical Laboratory Sciences, University of Jordan, Amman, Jordan
| | - Heba A Khader
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, The Hashemite University,, Zarqa, Jordan
| | - Maha Habash
- Michael Sayegh Faculty of Pharmacy, Aqaba University of Technology, Aqaba, Jordan; and
| | - Razan I Nassar
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Shady Awwad
- Department of Pharmaceutical Chemistry & Pharmacognosy, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Luai Hasoun
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mahmoud S Abu-Samak
- Department of Clinical Pharmacy and Therapeutics, Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
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Efficacy of vitamin D supplementation in reducing body mass index and lipid profile in healthy young adults in Colombia: a pilot randomised controlled clinical trial. J Nutr Sci 2023; 12:e29. [PMID: 36843975 PMCID: PMC9947753 DOI: 10.1017/jns.2022.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 02/24/2023] Open
Abstract
The objective of the present study was to evaluate the efficacy of oral administration of vitamin D supplementation in reducing BMI and lipid profile in adolescents and young adults from a cohort in Bucaramanga, Colombia. One hundred and one young adults were randomly assigned to one of two doses of vitamin D [1000 international units (IU) or 200 IU] administered daily for 15 weeks. The primary outcomes were serum 25(OH)D levels, BMI and lipid profile. The secondary outcomes were waist-hip ratio, skinfolds and fasting blood glucose. We found a mean ± sd plasma concentration of 25-hydroxyvitamin D [25(OH)D] was 25⋅0 ± 7⋅0 ng/ml at baseline, and after 15 weeks, it increased to 31⋅0 ± 10⋅0 ng/ml in the participants who received a daily dose of 1000 IU, (P < 0⋅0001). For the participants in the control group (200 IU), it went from 26⋅0 ± 8⋅0 ng/ml to 29⋅0 ± 8⋅0 ng/ml (P = 0⋅002). There were no differences between groups in body mass index. There was a statistically significant decrease in LDL-cholesterol between the intervention group v. the control group (mean difference -11⋅50 mg/dl (95 % CI -21⋅86 to -1⋅15; P = 0⋅030). The conclusions of the present study were two different doses of vitamin D supplementation (200 IU v. 1000 IU) produced changes in serum 25(OH)D levels over 15 weeks of administration in healthy young adults. No significant changes were found in the body mass index when the effect of the treatments was compared. A significant reduction in LDL-cholesterol was found when comparing the two intervention groups. Trial registration: NCT04377386.
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8
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Li X, Luan Y, Li Y, Ye S, Wang G, Cai X, Liang Y, Kord Varkaneh H, Luan Y. The effect of high-fructose corn syrup vs. sucrose on anthropometric and metabolic parameters: A systematic review and meta-analysis. Front Nutr 2022; 9:1013310. [PMID: 36238453 PMCID: PMC9551185 DOI: 10.3389/fnut.2022.1013310] [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: 08/06/2022] [Accepted: 09/06/2022] [Indexed: 11/17/2022] Open
Abstract
High-fructose corn syrup (HFCS) has been speculated to have stronger negative metabolic effects than sucrose. However, given the current equivocality in the field, the aim of the present study was to determine the impact of HFCS use compared to sucrose on anthropometric and metabolic parameters. We searched PubMed, Scopus, Cochrane Central and web of sciences, from database inception to May 2022. A random effects model and the generic inverse variance method were applied to assess the overall effect size. Heterogeneity analysis was performed using the Cochran Q test and the I2 index. Four articles, with 9 arms, containing 767 participants were included in this meta-analysis. Average HFCS and sucrose usage equated to 19% of daily caloric intake. Combined data from three studies indicated that HFCS intake does not significantly change the weight (weighted mean difference (WMD): −0.29 kg, 95% CI: −1.34, 0.77, I2 = 0%) when compared to the sucrose group. Concordant results were found for waist circumstance, body mass index, fat mass, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Moreover, overall results from three studies indicated a significant increase in CRP levels (WMD: 0.27 mg/l, 95% CI: 0.02, 0.52, I2 = 23%) in the HFCS group compared to sucrose. In conclusion, analysis of data from the literature suggests that HFCS consumption was associated with a higher level of CRP compared to sucrose, whilst no significant changes between the two sweeteners were evident in other anthropometric and metabolic parameters.
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Affiliation(s)
- Xiang Li
- The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Yunqi Luan
- Beijing Institute for Drug Control (Beijing Center for Vaccine Control), Beijing, China
| | - Yuejin Li
- The General Surgery Department, The First People's Hospital of Yunnan Province, Kunming, China
| | - Shili Ye
- Faculty of Mathematics and Physics, Southwest Forestry University, Kunming, China
| | - Guihui Wang
- Department of Endocrinology, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Xinlun Cai
- Department of Endocrinology, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, China
| | - Yucai Liang
- Lairui Biotechnology (Yunnan) Co., Ltd. Yunnan, China
| | | | - Yunpeng Luan
- The First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, China
- Key Laboratory for Forest Resources Conservation and Utilization in the Southwest Mountains of China, Ministry of Education, Southwest Forestry University, Kunming, China
- *Correspondence: Yunpeng Luan
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Single bout of exercise triggers the increase of vitamin D blood concentration in adolescent trained boys: a pilot study. Sci Rep 2022; 12:1825. [PMID: 35115578 PMCID: PMC8814171 DOI: 10.1038/s41598-022-05783-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 01/17/2022] [Indexed: 02/07/2023] Open
Abstract
Vitamin D is necessary for musculoskeletal health, however, the supplementation of vitamin D above the sufficiency level does not bring additional bone mass density (BMD), unlike physical exercise which enhances the bone formatting process. Regular physical activity has been shown to upregulate VDR expression in muscles and to increase circulating vitamin D. Here we investigate whether a single bout of exercise might change 25(OH)D3 blood concentration and how it affects metabolic response to exercise. Twenty-six boys, 13.8 years old (SD ± 0.7) soccer players, participated in the study. The participants performed one of two types of exercise: the first group performed the VO2max test until exhaustion, and the second performed three times the repeated 30 s Wingate Anaerobic Test (WAnT). Blood was collected before, 15 min and one hour after the exercise. The concentration of 25(OH)D3, parathyroid hormone (PTH), interleukin-6 (IL-6), lactate, non-esterified fatty acids (NEFA) and glycerol were determined. 25(OH)D3 concentration significantly increased after the exercise in all boys. The most prominent changes in 25(OH)D3, observed after WAnT, were associated with the rise of PTH. The dimensions of response to the exercises observed through the changes in the concentration of 25(OH)D3, PTH, NEFA and glycerol were associated with the significant increases of IL-6 level. A single bout of exercise may increase the serum’s 25(OH)D3 concentration in young trained boys. The intensive interval exercise brings a more potent stimulus to vitamin D fluctuations in young organisms. Our results support the hypothesis that muscles may both store and release 25(OH)D3.
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Environmental Factors That Affect Parathyroid Hormone and Calcitonin Levels. Int J Mol Sci 2021; 23:ijms23010044. [PMID: 35008468 PMCID: PMC8744774 DOI: 10.3390/ijms23010044] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 12/19/2021] [Indexed: 12/23/2022] Open
Abstract
Calciotropic hormones, parathyroid hormone (PTH) and calcitonin are involved in the regulation of bone mineral metabolism and maintenance of calcium and phosphate homeostasis in the body. Therefore, an understanding of environmental and genetic factors influencing PTH and calcitonin levels is crucial. Genetic factors are estimated to account for 60% of variations in PTH levels, while the genetic background of interindividual calcitonin variations has not yet been studied. In this review, we analyzed the literature discussing the influence of environmental factors (lifestyle factors and pollutants) on PTH and calcitonin levels. Among lifestyle factors, smoking, body mass index (BMI), diet, alcohol, and exercise were analyzed; among pollutants, heavy metals and chemicals were analyzed. Lifestyle factors that showed the clearest association with PTH levels were smoking, BMI, exercise, and micronutrients taken from the diet (vitamin D and calcium). Smoking, vitamin D, and calcium intake led to a decrease in PTH levels, while higher BMI and exercise led to an increase in PTH levels. In terms of pollutants, exposure to cadmium led to a decrease in PTH levels, while exposure to lead increased PTH levels. Several studies have investigated the effect of chemicals on PTH levels in humans. Compared to PTH studies, a smaller number of studies analyzed the influence of environmental factors on calcitonin levels, which gives great variability in results. Only a few studies have analyzed the influence of pollutants on calcitonin levels in humans. The lifestyle factor with the clearest relationship with calcitonin was smoking (smokers had increased calcitonin levels). Given the importance of PTH and calcitonin in maintaining calcium and phosphate homeostasis and bone mineral metabolism, additional studies on the influence of environmental factors that could affect PTH and calcitonin levels are crucial.
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Morvaridzadeh M, Agah S, Alibakhshi P, Heydari H, Hoseini AS, Palmowski A, Toupchian O, Abdollahi S, Rezamand G, Heshmati J. Effects of Calcium and Vitamin D Co-supplementation on the Lipid Profile: A Systematic Review and Meta-analysis. Clin Ther 2021; 43:274-296. [PMID: 34456059 DOI: 10.1016/j.clinthera.2021.07.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/22/2021] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Calcium and vitamin D co-supplementation is common and widely used, but randomized, controlled trials (RCTs) have yielded inconclusive results concerning its impact on the serum lipid profile. METHODS A comprehensive literature search of Medline, Web of Science, Scopus, Embase, Cochrane Central Register of Controlled Trials, and clinical trial registry databases was conducted to identify placebo-controlled RCTs that were published through September 2020 and that evaluated the impact of calcium and vitamin D co-supplementation on total cholesterol (TC), triglycerides (TGs), low- and very-low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (HDL-C). Standardized mean differences (SMDs) were pooled using random-effects meta-analysis models. FINDINGS Thirteen studies in a total of 2304 participants met the inclusion criteria. Calcium and vitamin D co-supplementation was associated with significant reductions in both TC (SMD, -0.81; 95% CI, -1.35 to -0.27; I2 = 94.6%) and TGs (SMD, -0.50; 95% CI, -0.91 to -0.08; I2 = 91.5%), and with a significant increase in HDL-C (SMD, 1.22; 95% CI, 0.60 to 1.83; I2 = 95.4%). However, calcium and vitamin D co-supplementation were not found to be associated with significantly decreased low-density lipoprotein cholesterol (SMD, -0.39; 95% CI, -0.78 to 0.01; I2 = 90.1%) or very-low-density lipoprotein cholesterol (SMD, -0.01; 95% CI, -0.70 to 0.69; I2 = 82.3%). IMPLICATIONS The findings from the present systematic review and meta-analysis suggest that calcium and vitamin D co-supplementation has a beneficial effect on TC, TG, and HDL-C. Larger-scale, well-designed RCTs are needed to clarify the effect of calcium and vitamin D co-supplementation on all lipid-profile components.
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Affiliation(s)
- Mojgan Morvaridzadeh
- Department of Nutritional Science, Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahram Agah
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Pooya Alibakhshi
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ava Sadat Hoseini
- Department of Education and Health Promotion, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Omid Toupchian
- Department of Nutrition and Public Health, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Shima Abdollahi
- Department of Nutrition and Public Health, School of Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Gholamreza Rezamand
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Javad Heshmati
- Department of Nutritional Science, Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Abiri B, Vafa M, Azizi-Soleiman F, Safavi M, Kazemi SM, Salehi M, Zaeri F, Sadeghi H. Changes in Bone Turnover, Inflammatory, Oxidative Stress, and Metabolic Markers in Women Consuming Iron plus Vitamin D Supplements: a Randomized Clinical Trial. Biol Trace Elem Res 2021; 199:2590-2601. [PMID: 32975739 DOI: 10.1007/s12011-020-02400-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/16/2020] [Indexed: 11/25/2022]
Abstract
We aimed to investigate whether combination of vitamin D and iron supplementation, comparing vitamin D alone, could modify bone turnover, inflammatory, oxidative stress, and metabolic markers. Eighty-seven women with hemoglobin (Hb) ≤ 12.7 g/dL and 25OHD ≤ 29 ng/mL vitamin D deficiency/insufficiency aged 18-45 years were randomly assigned into two groups: (1) receiving either 1000 IU/day vitamin D3 plus 27 mg/day iron (D-Fe); (2) vitamin D3 plus placebo supplements (D-P), for 12 weeks. In D-Fe group, significant decrease in red blood cells (RBC) (P = 0.001) and hematocrit (Hct) (P = 0.004) and increases in mean corpuscular hemoglobin concentration (MCHC) (P = 0.001), 25OHD (P < 0.001), osteocalcin (P < 0.001), high-density cholesterol (HDL) (P = 0.041), and fasting blood sugar (FBS) (P < 0.001) were observed. D-P group showed significant decrease in RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), mean corpuscular volume (MCV) (P = 0.004), mean corpuscular hemoglobin (MCH) (P < 0.001), MCHC (P = 0.005), serum ferritin (P < 0.001), and low-density cholesterol (LDL) (P = 0.016) and increases of 25OHD (P < 0.001), osteocalcin (P < 0.001), C-terminal telopeptide (CTX) (P = 0.025), triglyceride (TG) (P = 0.004), FBS (P < 0.001), and interleukin-6 (IL-6) (P = 0.001) at week 12. After the intervention, the D-P group had between-group increases in mean change in the osteocalcin (P = 0.007) and IL-6 (P = 0.033), and decreases in the RBC (P < 0.001), Hb (P < 0.001), Hct (P < 0.001), and MCV (P = 0.001), compared with the D-Fe group. There were significant between-group changes in MCH (P < 0.001), MCHC (P < 0.001), ferritin (P < 0.001), and serum iron (P = 0.018). Iron-vitamin D co-supplementation does not yield added benefits for improvement of bone turnover, inflammatory, oxidative stress, and metabolic markers, whereas, vitamin D alone may have some detrimental effects on inflammatory and metabolic markers. IRCT registration number: IRCT201409082365N9.
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Affiliation(s)
- Behnaz Abiri
- Department of Nutrition, Faculty of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Vafa
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Shahid Hemmat Highway, Tehran, P.O.BOX: 1449614535, Iran.
| | - Fatemeh Azizi-Soleiman
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Morteza Safavi
- Department of Clinical Nutrition, School of Nutrition & Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyyed Morteza Kazemi
- Bone, Joint, and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masood Salehi
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farid Zaeri
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Homa Sadeghi
- School of Public Health, Department of Nutrition and Food Science, Texas Woman's University, Denton Campus, Denton, TX, 76204, USA
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13
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Miao J, Bachmann KN, Huang S, Su YR, Dusek J, Newton-Cheh C, Arora P, Wang TJ. Effects of Vitamin D Supplementation on Cardiovascular and Glycemic Biomarkers. J Am Heart Assoc 2021; 10:e017727. [PMID: 33960201 PMCID: PMC8200713 DOI: 10.1161/jaha.120.017727] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Experimental and observational studies have suggested a link between vitamin D and cardiovascular and metabolic disease, but this has not been confirmed in randomized controlled trials. We sought to determine whether vitamin D supplementation reduces biomarkers of insulin resistance, inflammation, neurohormonal activation, and lipids. Methods and Results This was a prespecified, secondary analysis of the DAYLIGHT (Vitamin D Therapy in Individuals at High Risk of Hypertension) randomized controlled trial. We measured circulating homeostatic model assessment of insulin resistance, hs-CRP (high-sensitivity C-reactive protein), N-terminal pro-B-type natriuretic peptide, renin, aldosterone, and lipids at baseline and at 6 months in 289 individuals with low vitamin D status (25-hydroxyvitamin-D [25-OH-D] ≤25 ng/mL) receiving low-dose (400 IU/d) versus high-dose (4000 IU/d) vitamin D3 for 6 months. A meta-analysis of randomized controlled trials reporting biomarker changes after vitamin D supplementation was then performed. Levels of 25-OH-D increased in the high-dose relative to the low-dose vitamin D group (+15.5 versus +4.6 ng/mL, P<0.001). Changes in biomarkers of glycemia, inflammation, and neurohormonal activation did not differ by dose. Lipids did not differ between groups, other than triglycerides, which increased in the high-dose compared with the low-dose group (+11.3 versus -6.2 mg/dL, P<0.001). The meta-analysis showed potential modest decreases in homeostatic model assessment of insulin resistance and hs-CRP, but no changes in low-density lipoprotein, after vitamin D supplementation compared with control groups. Conclusions In the DAYLIGHT randomized controlled trial, high-dose vitamin D supplementation did not improve biomarkers of glycemia, inflammation, neurohormonal activation, or lipids. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01240512.
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Affiliation(s)
- Jennifer Miao
- Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Katherine N Bachmann
- Veterans Health AdministrationTennessee Valley Healthcare System Nashville TN.,Division of Diabetes, Endocrinology, and Metabolism Department of Medicine Vanderbilt University Medical Center Nashville TN.,Vanderbilt Translational and Clinical Cardiovascular Research Center Vanderbilt University School of Medicine Nashville TN
| | - Shi Huang
- Vanderbilt Translational and Clinical Cardiovascular Research Center Vanderbilt University School of Medicine Nashville TN.,Department of Biostatistics Vanderbilt University Medical Center Nashville TN
| | - Yan Ru Su
- Division of Cardiovascular Medicine Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Jeffery Dusek
- Department of Family Medicine and Community Health Case Western University Medical Center Cleveland OH
| | | | - Pankaj Arora
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL.,Section of Cardiology Birmingham Veterans Affairs Medical Center Birmingham AL
| | - Thomas J Wang
- Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX
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14
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Effects of Vitamin D Supplementation on Lipid Profile in Adults with the Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2020; 12:nu12113352. [PMID: 33143204 PMCID: PMC7692169 DOI: 10.3390/nu12113352] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) increases the risk of cardiovascular disease, with atherogenic dyslipidemia being a major contributing factor. METHODS A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to assess whether vitamin D supplementation (VDS) alleviates dyslipidemia in adults with MetS. Scientific databases (PUBMED, MEDLINE, CINAHL, EMBASE, Cochrane Library, ClinicalTrials.gov, International Clinical Trials Registry Platform) and the gray literature were searched for randomized controlled trials of VDS, reporting on blood lipids. A narrative review, meta-analyses, sensitivity analyses, and appraisal of the risk of bias and overall quality of evidence produced were conducted. RESULTS Seven studies were included, and four were meta-analyzed. The risk of bias was generally low, and the final quality of evidence was low or very low. VDS, whether in high or low dose, significantly increased endline vitamin D blood levels; did not affect total, low-density, high-density cholesterol levels, and novel lipid-related biomarkers; yet, significantly increased triglycerides (TG) levels compared with placebo (MD: 30.67 (95%CI: 4.89-56.45) mg/dL; p = 0.02 for low-dose VDS; and MD: 27.33 (95%CI: 2.06-52.59) mg/dL; p = 0.03 for high-dose VDS). Pertaining heterogeneity was high (I2 = 86%; and I2 = 51%, respectively), and some included studies had significantly higher baseline TG in the intervention arm. The sensitivity analyses revealed robust results. CONCLUSION VDS seems not to affect blood lipids in adults with MetS.
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15
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Mazurenko E, Rymar O, Shcherbakova L, Mazdorova E, Malyutina S. The Risk of Osteoporotic Forearm Fractures in Postmenopausal Women in a Siberian Population Sample. J Pers Med 2020; 10:jpm10030077. [PMID: 32752025 PMCID: PMC7565918 DOI: 10.3390/jpm10030077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/18/2023] Open
Abstract
The reduction in bone and muscle mass increases in menopausal women and poses a threat to the loss of self-dependence in the elderly. The aim of the study was to assess the frequency of osteoporotic forearm fractures (OFF) in postmenopausal women and to study their association with risk factors for chronic non-communicable diseases (NCD). The study was based on the Russian arm of the Health, Alcohol and Psychosocial Factors In Eastern Europe (HAPIEE) project (Novosibirsk). In a subsample of postmenopausal women aged 55–84 years old (n = 2005), we assessed the history of OFF during the last 3 years and risk factors for fracture and common NCD/. Cross-sectional associations between OFF history and potential determinants were analyzed using multivariable-adjusted logistic regression. A history of OFF in the last 3 years was found in 3.9% women. In a multivariable-adjusted model, the risk of OFF was directly associated with smoking in the past (OR = 2.23; 95% Cl 1.10–4.55), total cholesterol level higher than 200 mg/dL (OR = 1.98; 95% Cl 1.19–3.29), and it was inversely associated with body mass index (OR = 0.91; 95% Cl 0.86–0.96). In studied population sample of postmenopausal women the cross-sectional determinants of osteoporotic forearm fractures were smoking in the past and high total cholesterol value; body mass index protectively related to the risk of osteoporotic fractures. These findings might have implications for fracture prevention in postmenopausal women.
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Affiliation(s)
- Elena Mazurenko
- Research Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630089, Russia; (O.R.); (L.S.); (E.M.); (S.M.)
- Novosibirsk Research Institute of Traumatology and Orthopedics named after Ya. L. Tsivyan, Novosibirsk 630112, Russia
- Correspondence: ; Tel.: +7-(952)-945-72-11
| | - Oksana Rymar
- Research Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630089, Russia; (O.R.); (L.S.); (E.M.); (S.M.)
| | - Liliya Shcherbakova
- Research Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630089, Russia; (O.R.); (L.S.); (E.M.); (S.M.)
| | - Ekaterina Mazdorova
- Research Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630089, Russia; (O.R.); (L.S.); (E.M.); (S.M.)
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine–Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630089, Russia; (O.R.); (L.S.); (E.M.); (S.M.)
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16
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Vitamin D as a Potential Therapy for Multiple Sclerosis: Where Are We? Int J Mol Sci 2020; 21:ijms21093102. [PMID: 32354174 PMCID: PMC7247155 DOI: 10.3390/ijms21093102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 04/27/2020] [Indexed: 02/06/2023] Open
Abstract
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system and is caused by an aberrant immune response to myelin sheath. Disease-modifying medications, which mainly aim to suppress such aberrant immune response, have significantly improved MS treatment. However, the disease severity continues to worsen. In contrast, progressively more data suggest that 1,25-dihydroxyvitamin D or 1,25(OH)2D, i.e., the active vitamin D, suppresses the differentiation of potentially pathogenic T cells associated with MS, enhances the differentiation of regulatory T cells that suppress the pathogenic T cells, and promotes remyelination. These novel 1,25(OH)2D functions have encouraged investigators to develop vitamin D as a potential therapy for MS. However, because of the hypercalcemia that is associated with high 1,25(OH)2D concentrations, supplementation of native vitamin D has been a major focus in clinical trials for the treatment of MS, but such trials have produced mixed data. In this article, we will review current progress in the supplementation of different vitamin D forms for the treatment of experimental autoimmune encephalomyelitis (i.e., an MS animal model) as well as MS. Furthermore, we will review alternative strategies that our laboratory and others are pursuing in an attempt to circumvent the hurdles that are hampering the effective use of vitamin D as a potential therapy for MS.
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17
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Li GHY, Robinson-Cohen C, Sahni S, Au PCM, Tan KCB, Kung AWC, Cheung CL. Association of Genetic Variants Related to Serum Calcium Levels with Reduced Bone Mineral Density. J Clin Endocrinol Metab 2020; 105:5606940. [PMID: 31650181 PMCID: PMC7453037 DOI: 10.1210/clinem/dgz088] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 10/03/2019] [Indexed: 12/11/2022]
Abstract
CONTEXT The role of serum calcium in bone metabolism is unknown, even though calcium/vitamin D supplementations have been widely used and are expected to improve bone health. We aim to determine the independent role of serum calcium in bone mineral density (BMD). DESIGN AND SETTING Two epidemiological analyses with 5478 and 5556 participants from the National Health and Nutrition Examination Survey (NHANES) 2003 to 2006 and the Hong Kong Osteoporosis Study (HKOS) to evaluate the cross-sectional association of serum calcium with BMD. Two-sample Mendelian randomization (MR) studies using genetic variations as instrumental variables to infer causality. Summary statistics of genome-wide association study of serum calcium (N = 39 400) and lifelong whole-body BMD (N = 66 628) were used. MAIN OUTCOME MEASURE BMD measured by dual-energy X-ray absorptiometry. RESULTS In NHANES 2003-6 and HKOS, each standard deviation (SD) increase in serum calcium was significantly associated with 0.036-0.092 SD decrease in BMD at various sites (all P < .05). In multivariable inverse-variance weighted MR analysis, genetic predisposition to higher serum calcium level was inversely associated with whole-body BMD after adjustment for serum parathyroid hormone, vitamin D, and phosphate (-0.431 SD per SD increase in serum calcium; 95% CI: -0.773 to -0.089, P = .014). Similar estimates were obtained in sensitivity analyses. CONCLUSIONS Our study reveals that genetic predisposition to higher serum calcium level per se may have a negative impact on bone metabolism. Whether increased serum calcium caused by calcium/vitamin D supplementations would have the same negative effect on bone remains unknown, which warrants further investigation. In addition to other adverse clinical outcomes, careful use of high-dose supplementations is required.
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Affiliation(s)
- Gloria Hoi-Yee Li
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Cassianne Robinson-Cohen
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Shivani Sahni
- Marcus Institute, Hebrew SeniorLife, Harvard Medical School, Boston, Massachusetts
| | - Philip Chun-Ming Au
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Kathryn Choon-Beng Tan
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Annie Wai-Chee Kung
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Centre for Genomic Sciences, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Department of Medicine, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong
- Correspondence and Reprint Requests: Ching-Lung Cheung, Assistant Professor, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China. E-mail:
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18
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Prtina A, Grabež M, Vujnić M, Rašeta-Simović N. The role of high-dose vitamin D supplementation on disease severity and lipid profile in psoriatic patients: A pilot study. SCRIPTA MEDICA 2020. [DOI: 10.5937/scriptamed51-28287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: Psoriasis is a chronic inflammatory skin disease that is associated with a higher prevalence of cardiovascular (CV) risk factors. The effect of vitamin D on bone health has been long known, but its extraskeletal role especially in cardiovascular disease and skin disease, is the subject of recent research. This study aimed to assess the influence of high-dose vitamin D supplementation on the Psoriasis Area and Severity Index (PASI) score and lipid profile in patients with psoriasis. Methods: The study included 20 adult patients with chronic plaque psoriasis. They received vitamin D capsules in a daily dose of 5,000 IU over 12 weeks. Measured serum concentrations of lipid metabolism parameters were triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL) and high-density lipoproteins (HDL). PASI was used to determine the severity of the disease. Results: High-doses vitamin D supplementation had a significant influence on reduction in PASI score in all patients (17.99 ± 12.42 vs 10.27 ± 8.53; p < 0.001). The supplementation of high dose vitamin D induced statistically significant lowering of the TC, LDL-C and TG in the psoriatic patients (p < 0.05). Furthermore, significant increase in serum HDL-C level was observed. The change of PASI score showed week positive correlation with the changes in serum TC and LDL-C (r = 0.303, p = 0.03 and r = 0.357 p = 0.013). Conclusion: High-dose vitamin D supplementation had a positive impact on clinical status of the chronic plaque psoriasis patients, measured by PASI score. It also improved the serum lipid profile of these patients. Double-blinded prospective studies are needed in order to get more comprehensive data related to vitamin D, lipid metabolism and severity of psoriasis.
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Abstract
Understanding of vitamin D physiology is important because about half of the population is being diagnosed with deficiency and treated with supplements. Clinical guidelines were developed based on observational studies showing an association between low serum levels and increased cardiovascular risk. However, new randomized controlled trials have failed to confirm any cardiovascular benefit from supplementation in the general population. A major concern is that excess vitamin D is known to cause calcific vasculopathy and valvulopathy in animal models. For decades, administration of vitamin D has been used in rodents as a reliable experimental model of vascular calcification. Technically, vitamin D is a misnomer. It is not a true vitamin because it can be synthesized endogenously through ultraviolet exposure of the skin. It is a steroid hormone that comes in 3 forms that are sequential metabolites produced by hydroxylases. As a fat-soluble hormone, the vitamin D-hormone metabolites must have special mechanisms for delivery in the aqueous bloodstream. Importantly, endogenously synthesized forms are carried by a binding protein, whereas dietary forms are carried within lipoprotein particles. This may result in distinct biodistributions for sunlight-derived versus supplement-derived vitamin D hormones. Because the cardiovascular effects of vitamin D hormones are not straightforward, both toxic and beneficial effects may result from current recommendations.
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Affiliation(s)
- Linda L Demer
- From the Departments of Medicine (L.L.D., J.J.H., Y.T.) .,Physiology (L.L.D., Y.T.).,Bioengineering (L.L.D.)
| | - Jeffrey J Hsu
- From the Departments of Medicine (L.L.D., J.J.H., Y.T.)
| | - Yin Tintut
- From the Departments of Medicine (L.L.D., J.J.H., Y.T.).,Physiology (L.L.D., Y.T.).,Orthopaedic Surgery (Y.T.), University of California, Los Angeles
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20
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Guénard F, Jacques H, Gagnon C, Marette A, Vohl MC. Acute Effects of Single Doses of Bonito Fish Peptides and Vitamin D on Whole Blood Gene Expression Levels: A Randomized Controlled Trial. Int J Mol Sci 2019; 20:ijms20081944. [PMID: 31010033 PMCID: PMC6514567 DOI: 10.3390/ijms20081944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/18/2019] [Accepted: 04/19/2019] [Indexed: 12/18/2022] Open
Abstract
Fish contains high quality proteins and essential nutrients including 25-hydroxyvitamin D (25(OH)D). Fish peptide consumption can lower cardiovascular disease (CVD) risk factors, and studies have shown an association between 25(OH)D deficiency, CVD and CVD risk factors, such as diabetes. This study investigated acute effects of a single dose of cholecalciferol (VitD3), bonito fish peptide hydrolysate (BPH), or a combination of both on CVD risk factors and whole blood gene expression levels. A randomized, crossover, placebo controlled trial was conducted in 22 adults. They ingested, in random order and at 7-day intervals, 1000 IU of VitD3, 3 g of BPH, a combination of both, or a placebo. A 180 min oral glucose tolerance test was performed. Differences in whole-genome expression levels after versus before each supplementation were computed for 18 subjects. We observed that 16, 1 and 5 transcripts were differentially expressed post- vs. pre-ingestion for VitD3, BPH or VitD3 + BPH treatments, respectively. VitD3-containing treatments affected the expression of the solute carrier family 25 member 20 (SLC25A20) gene involved in fatty acid oxidation, various transcription factors and genes related to glucose metabolism. These results suggest that VitD3 rapidly modulates genes related to CVD risk factors in blood while BPH seems to moderately modulate gene expression levels.
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Affiliation(s)
- Frédéric Guénard
- School of Nutrition, Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Food (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
| | - Hélène Jacques
- School of Nutrition, Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Food (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
| | - Claudia Gagnon
- Institute of Nutrition and Functional Food (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
- Endocrinology and Nephrology Unit, CHU de Quebec Research Center, 2705 Laurier Blvd, Quebec, QC G1V 4G2, Canada.
- Department of Medicine, Laval University, 1050 avenue de la Médecine, Quebec, QC G1V 0A6, Canada.
| | - André Marette
- Institute of Nutrition and Functional Food (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
- Quebec Heart and Lung Institute (IUCPQ) Research Center, 2725 chemin Sainte-Foy, Quebec, QC G1V 4G5, Canada.
| | - Marie-Claude Vohl
- School of Nutrition, Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
- Institute of Nutrition and Functional Food (INAF), Laval University, 2440 Hochelaga Blvd, Quebec, QC G1V 0A6, Canada.
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21
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Hiemstra T, Lim K, Thadhani R, Manson JE. Vitamin D and Atherosclerotic Cardiovascular Disease. J Clin Endocrinol Metab 2019; 104:4033-4050. [PMID: 30946457 PMCID: PMC7112191 DOI: 10.1210/jc.2019-00194] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/29/2019] [Indexed: 02/07/2023]
Abstract
CONTEXT A large body of experimental and observational data has implicated vitamin D deficiency in the development of cardiovascular disease. However, evidence to support routine vitamin D supplementation to prevent or treat cardiovascular disease is lacking. EVIDENCE ACQUISITION A comprehensive literature review was performed using Pubmed and other literature search engines. EVIDENCE SYNTHESIS Mounting epidemiological evidence and data from Mendelian randomization studies support a link between vitamin D deficiency and adverse cardiovascular health outcomes, but randomized trial evidence to support vitamin D supplementation is sparse. Current public health guidelines restrict vitamin D intake recommendations to the maintenance of bone health and prevention of fractures. Two recently published large trials (VITAL and ViDA) that assessed the role of moderate-to-high dose vitamin D supplementation as primary prevention for cardiovascular outcomes in the general population had null results, and previous randomized trials have also been generally negative. These findings from general population cohorts that are largely replete in vitamin D may not be applicable to chronic kidney disease (CKD) populations, in which the use of active (1α-hydroxylated) vitamin D compounds is prevalent, or to other high-risk populations. Additionally, recent trials in the CKD population, and trials using vitamin D analogues have been limited. CONCLUSIONS Current randomized trials of vitamin D supplementation do not support benefits for cardiovascular health, but the evidence remains inconclusive. Additional randomized trials assessing larger numbers of participants with low baseline vitamin D levels, having longer follow-up periods, and testing higher vitamin D dosages, are needed to guide clinical practice.
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Affiliation(s)
- Thomas Hiemstra
- Cambridge Clinical Trials Unit, Addenbrookes Hospital, Cambridge, UK
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Kenneth Lim
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ravi Thadhani
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School and Harvard T.H. Chan School of Public Health, Boston, MA
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22
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Durgarao Y, Manjrekar PA, Adhikari P, Chakrapani M, Rukmini MS. Comprehensive Review on Diabetes Associated Cardiovascular Complications - The Vitamin D Perspective. Cardiovasc Hematol Disord Drug Targets 2019; 19:139-153. [PMID: 30648528 DOI: 10.2174/1871529x19666190114155302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/14/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D, a steroid hormone is primarily known for its role in calcium and bone mineral homeostasis. Over the years, vitamin D has been implicated in various non-skeletal diseases. The extraskeletal phenomenon can be attributed to the presence of vitamin D receptors (VDRs) in almost all cells and identification of 1-α hydroxylase in extrarenal tissues. The vitamin D deficiency (VDD) pandemic was globally reported with increasing evidence and paralleled the prevalence of diabetes, obesity and cardiovascular diseases (CVDs). A dependent link was proposed between hypovitaminosis D glycemic status, insulin resistance and also the other major factors associated with type 2 diabetes leading to CVDs. Insulin resistance plays a central role in both type 2 diabetes and insulin resistance syndrome. These 2 disorders are associated with distinct etiologies including hypertension, atherogenic dyslipidemia, and significant vascular abnormalities that could lead to endothelial dysfunction. Evidence from randomised clinical trials and meta-analysis, however, yielded conflicting results. This review summarizes the role of vitamin D in the regulation of glucose homeostasis with an emphasis on insulin resistance, blood pressure, dyslipidaemia, endothelial dysfunction and related cardiovascular diseases and also underline the plausible mechanisms for all the documented effects.
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Affiliation(s)
- Y Durgarao
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Poornima A Manjrekar
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prabha Adhikari
- Department of Internal Medicine, Yenepoya University, Mangalore, Karnataka, India
| | - M Chakrapani
- Department of Internal Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - M S Rukmini
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Yang Y, Liu G, Zhang Y, Xu G, Yi X, Liang J, Zhao C, Liang J, Ma C, Ye Y, Yu M, Qu X. Association Between Bone Mineral Density, Bone Turnover Markers, and Serum Cholesterol Levels in Type 2 Diabetes. Front Endocrinol (Lausanne) 2018; 9:646. [PMID: 30459714 PMCID: PMC6232230 DOI: 10.3389/fendo.2018.00646] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 10/12/2018] [Indexed: 11/13/2022] Open
Abstract
Purpose: The association between bone mineral density (BMD), bone turnover markers, and serum cholesterol in healthy population has already been proved. However, in patients with type 2 diabetes mellitus (T2D), it has not been adequately analyzed. In this study, we investigated the correlation between BMD, bone turnover markers, and serum cholesterol levels in people with T2D. Methods: We enrolled 1,040 men and 735 women with T2D from Zhongshan Hospital between October 2009 and January 2013. Their general condition, history of diseases and medication, serum markers, and BMD data were collected. We used logistic regression analysis to identify the association between serum cholesterol levels and BMD as well as bone turnover markers. Results: In multivariate regression analysis, we observed that in men with T2D, high high-density lipoprotein-cholesterol and total cholesterol levels were significantly associated with low total lumbar, femur neck, and total hip BMD, while low-density lipoprotein-cholesterol level was only inversely associated with total lumbar and femur neck BMD. Total cholesterol and low-density lipoprotein-cholesterol levels were also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps. In women with T2D, high-density lipoprotein-cholesterol level was observed to be negatively correlated with total lumbar, femur neck, and total hip BMD, while total cholesterol and low-density lipoprotein-cholesterol levels were only associated with BMD at the total lumbar. Furthermore, total cholesterol was also negatively associated with osteocalcin, procollagen type I N-terminal propeptide, and β-crosslaps; high-density lipoprotein-cholesterol was only related to osteocalcin and parathyroid hormone, while low-density lipoprotein-cholesterol was only related to β-crosslaps in women. Conclusion: Our study suggests a significantly negative correlation between serum cholesterol levels and BMD in both men and women with T2D. The associations between serum cholesterol levels and bone turnover markers were also observed in T2D patients.
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Affiliation(s)
- Yinqiu Yang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guangwang Liu
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yao Zhang
- Department of Endocrinology, Department of Infectious Disease, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Guiping Xu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
- VIP Clinical Department, Fujian Provincial Hospital, Fuzhou, China
| | - Xilu Yi
- Department of Endocrinology, Zhongshan Hospital, Songjiang Central Hospital, Fudan University, Shanghai, China
| | - Jing Liang
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chenhe Zhao
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jun Liang
- Department of Endocrinology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Chao Ma
- Department of Orthopaedics, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, The Affiliated XuZhou Hospital of Medical College of Southeast University, Xuzhou Clinical Medical College of Nanjing University of Chinese Medicine, Xuzhou, China
| | - Yangli Ye
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mingxiang Yu
- Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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24
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Exebio JC, Ajabshir S, Campa A, Li T, Zarini GG, Huffman FG. The Effect of Vitamin D Supplementation on Blood Lipids in Minorities with Type 2 Diabetes. INTERNATIONAL JOURNAL OF DIABETES AND CLINICAL RESEARCH 2018; 5:093. [PMID: 31497649 PMCID: PMC6731032 DOI: 10.23937/2377-3634/1410093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Vitamin D deficiency and type 2 diabetes are common among Hispanics and African Americans in the US. The aim of the study was to determine the effect of supplemental vitamin D intake (4000 IU/day or 6000 IU/day of vitamin D3 over a 6-month period) on blood lipids in a sample of African Americans and Hispanics with type 2 diabetes and vitamin D insufficiency. MATERIALS AND METHODS Participants (n = 75) were recruited by community outreach. Participants in both groups were required to take either 4000 IU or 6000 IU of vitamin D (Cholecalciferol) per day given in the form of a pill in a single daily dose. Mixed model was used to compare treatment effects (4000 IU vs. 6000 IU) on the outcome variables. Bonferroni multiple comparison test was used to detect significant changes from baseline, 3 months, and 6 months. RESULTS A significant decrease in total cholesterol (from 193.88 ± 41.03 to 180.48 ± 27.53 mg/dl, P = 0.040) and triglycerides (from 201.44 ± 91.35 to 172.92 ± 76.87 mg/dl, P = 0.037) was found for the 6000 IU group at 6 months. The significance was lost after adjusting for confounders. CONCLUSION Our results suggest that the positive effect of vitamin D supplementation on lipid profile may be mediated by other cofactors related to vitamin D metabolism among Hispanic and African American participants with type 2 diabetes.
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Affiliation(s)
- Joel C Exebio
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
- Dietetics and Nutrition Department, School of Allied Health, Keiser University, USA
| | - Sahar Ajabshir
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
- Cellular Biology and Pharmacology Department, Herbert Wertheim College of Medicine, Florida International University, USA
| | - Adriana Campa
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Tan Li
- Biostatistics Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Gustavo G Zarini
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Fatma G Huffman
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
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Hyppönen E, Boucher BJ. Adiposity, vitamin D requirements, and clinical implications for obesity-related metabolic abnormalities. Nutr Rev 2018; 76:678-692. [DOI: 10.1093/nutrit/nuy034] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Elina Hyppönen
- Australian Centre for Population Health Research, Sansom Institute for Health Research, University of South Australia, South Australian Health & Medical Research Institute, Adelaide, Australia
| | - Barbara J Boucher
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Calder PC, Bosco N, Bourdet-Sicard R, Capuron L, Delzenne N, Doré J, Franceschi C, Lehtinen MJ, Recker T, Salvioli S, Visioli F. Health relevance of the modification of low grade inflammation in ageing (inflammageing) and the role of nutrition. Ageing Res Rev 2017; 40:95-119. [PMID: 28899766 DOI: 10.1016/j.arr.2017.09.001] [Citation(s) in RCA: 277] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 08/03/2017] [Accepted: 09/05/2017] [Indexed: 02/06/2023]
Abstract
Ageing of the global population has become a public health concern with an important socio-economic dimension. Ageing is characterized by an increase in the concentration of inflammatory markers in the bloodstream, a phenomenon that has been termed "inflammageing". The inflammatory response is beneficial as an acute, transient reaction to harmful conditions, facilitating the defense, repair, turnover and adaptation of many tissues. However, chronic and low grade inflammation is likely to be detrimental for many tissues and for normal functions. We provide an overview of low grade inflammation (LGI) and determine the potential drivers and the effects of the "inflamed" phenotype observed in the elderly. We discuss the role of gut microbiota and immune system crosstalk and the gut-brain axis. Then, we focus on major health complications associated with LGI in the elderly, including mental health and wellbeing, metabolic abnormalities and infections. Finally, we discuss the possibility of manipulating LGI in the elderly by nutritional interventions. We provide an overview of the evidence that exists in the elderly for omega-3 fatty acid, probiotic, prebiotic, antioxidant and polyphenol interventions as a means to influence LGI. We conclude that slowing, controlling or reversing LGI is likely to be an important way to prevent, or reduce the severity of, age-related functional decline and the onset of conditions affecting health and well-being; that there is evidence to support specific dietary interventions as a strategy to control LGI; and that a continued research focus on this field is warranted.
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Affiliation(s)
- Philip C Calder
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom; NIHR Southampton Biomedical Research Centre, University Hospital NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Nabil Bosco
- Nestlé Research Center Asia, 21 Biopolis Road, 138567, Singapore
| | | | - Lucile Capuron
- INRA, Nutrition and Integrative Neurobiology, 33076 Bordeaux, France; Nutrition and Integrative Neurobiology (NutriNeuro), UMR 1286, University of Bordeaux, 33076 Bordeaux, France
| | - Nathalie Delzenne
- Metabolism and Nutrition Research Group, Louvain Drug Research Institute, Catholic University of Louvain, B-1200 Brussels, Belgium
| | - Joel Doré
- MetaGénoPolis, INRA, Université Paris-Saclay, 78350 Jouy-en-Josas, France
| | - Claudio Franceschi
- IRCCS, Institute of Neurological Sciences of Bologna, Bologna 40124, Italy
| | - Markus J Lehtinen
- DuPont Nutrition and Health, Global Health and Nutrition Science, 02460 Kantvik, Finland
| | - Tobias Recker
- International Life Sciences Institute European Branch, 1200 Brussels, Belgium.
| | - Stefano Salvioli
- Department of Experimental, Diagnostic, and Specialty Medicine, University of Bologna, 40126 Bologna, Italy
| | - Francesco Visioli
- Department of Molecular Medicine, University of Padova, 35121 Padova, Italy; IMDEA-Food, 28049 Madrid, Spain
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No effect of vitamin D supplementation on cardiovascular risk factors in subjects with metabolic syndrome: a pilot randomised study. ACTA ACUST UNITED AC 2017; 2:e52-e60. [PMID: 29242845 PMCID: PMC5728078 DOI: 10.5114/amsad.2017.70504] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 07/31/2017] [Indexed: 12/17/2022]
Abstract
Introduction Patients with metabolic syndrome (MetS) may have lower 25-hydroxyvitamin D (25(OH)VitD) serum levels compared with non-MetS individuals. Vitamin D (VitD) deficiency is associated with various cardiovascular disease (CVD) risk factors. Yet, the effect of VitD supplementation on MetS remains uncertain. Our aim was to examine the effect of VitD supplementation on CVD risk factors in MetS subjects. Material and methods This pilot study had a PROBE (prospective, randomised, open-label, blinded end-point) design. Fifty patients with MetS were included and randomised either to dietary instructions (n = 25) (control group) or dietary instructions plus VitD 2000 IU/day (n = 25) (VitD group) for 3 months. This study is registered in ClinicalTrials.gov (NCT01237769). Results In both groups a similar small weight reduction was achieved. In the VitD group serum 25(OH)VitD levels significantly increased by 91% (from 16.0 (3.0–35.0) to 30.6 (8.4–67.0) ng/ml, p < 0.001), while in the control group no significant change was observed (from 10.0 (4.0–39.6) to 13.0 (3.5–37.0) ng/ml). In both groups triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting glucose, haemoglobin A1c, homeostasis model assessment index and diastolic blood pressure did not significantly change. Systolic blood pressure decreased by 3.7% (from 134 ±14 to 129 ±13 mm Hg, p = 0.05) in the VitD group, while it decreased by 1.5% (from 132 ±13 to 130 ±16 mm Hg, p = NS) in the control group (p = NS between groups). In the VitD group serum 25(OH)VitD increase was negatively correlated with SBP decrease (r = –0.398, p = 0.049). Conclusions VitD supplementation (2000 IU/day) did not affect various CVD risk factors in patients with MetS.
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Vitamin D and Cardiovascular Disease: Controversy Unresolved. J Am Coll Cardiol 2017; 70:89-100. [PMID: 28662812 DOI: 10.1016/j.jacc.2017.05.031] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 05/15/2017] [Accepted: 05/17/2017] [Indexed: 12/17/2022]
Abstract
Vitamin D deficiency is typically caused by inadequate cutaneous synthesis secondary to decreased exposure to sunlight. Serum levels of 25-hydroxyvitamin D l <20 ng/ml are diagnostic of vitamin D deficiency. Vitamin D has various cardiovascular pleiotropic effects by activating its nuclear receptor in cardiomyocytes and vascular endothelial cells and by regulating the renin-angiotensin-aldosterone system, adiposity, energy expenditure, and pancreatic cell activity. In humans, vitamin D deficiency is associated with the following: vascular dysfunction; arterial stiffening; left ventricular hypertrophy; and worsened metrics of diabetes, hypertension, and hyperlipidemia. It is also linked with worse cardiovascular morbidity and mortality. However, meta-analyses of vitamin D supplementation trials have failed to show clear improvements in blood pressure, insulin sensitivity, or lipid parameters, thus suggesting that the link between vitamin D deficiency and cardiovascular disease may be an epiphenomenon. Ongoing larger randomized trials will clarify whether monitoring and supplementation of vitamin D play roles in cardiovascular protection.
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Vitamin D Receptor Gene Polymorphisms Modify Cardiometabolic Response to Vitamin D Supplementation in T2DM Patients. Sci Rep 2017; 7:8280. [PMID: 28811597 PMCID: PMC5557960 DOI: 10.1038/s41598-017-08621-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 07/04/2017] [Indexed: 01/08/2023] Open
Abstract
There is conflicting evidence on the favorable effects of vitamin D supplementation on metabolic profile in Type 2 diabetes mellitus (T2DM) patients and this might be due to genetic variations in vitamin D receptors (VDRs). Thus, we studied the metabolic effects of a 12-month vitamin D supplementation in T2DM patients according to VDR polymorphisms. A total of 204 T2DM subjects received 2000 IU vitamin D3 daily for 12 months. Serum 25(OH)D and metabolic profiles were measured at baseline and after 12 months. VDR polymorphisms (Taq-I, Bsm-I, Apa-I and Fok-I) were identified using TaqMan genotyping assays. Vitamin D supplementation significantly increased HOMA β-cell function (p = 0.003) as well as significantly decreased triglycerides, total and LDL-cholesterol (p < 0.001). The lowest increment in 25(OH)D levels was detected in patients with Fok-I CC genotypes (p < 0.0001). With vitamin D supplementation, Taq-I GG genotype carriers showed significant improvements in triglycerides, LDL- and total cholesterol, insulin, HbA1c and HOMA-IR (p < 0.005, 0.01, < 0.001, < 0.005, 0.03 and 0.01, respectively). Similarly, Bsm-I TT genotype carriers showed significant improvements in triglycerides (p = 0.01), insulin and HOMA-IR (p-values < 0.05). In conclusion, improvements in metabolic profile due to vitamin D supplementation is influenced by VDR polymorphisms, specifically for carriers of Taq-I GG and Bsm-I TT genotypes.
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Ponda MP, Liang Y, Kim J, Hutt R, Dowd K, Gilleaudeau P, Sullivan-Whalen MM, Rodrick T, Kim DJ, Barash I, Lowes MA, Breslow JL. A randomized clinical trial in vitamin D-deficient adults comparing replenishment with oral vitamin D 3 with narrow-band UV type B light: effects on cholesterol and the transcriptional profiles of skin and blood. Am J Clin Nutr 2017; 105:1230-1238. [PMID: 28228421 PMCID: PMC5402037 DOI: 10.3945/ajcn.116.150367] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/30/2017] [Indexed: 12/11/2022] Open
Abstract
Background: Vitamin D deficiency, defined as a serum 25-hydroxyvitamin D [25(OH)D] concentration <20 ng/mL, is correlated with a more atherogenic lipid profile. However, oral vitamin D supplementation does not lower LDL-cholesterol concentrations or raise HDL-cholesterol concentrations. This uncoupling between association and causation may result from a failure of oral vitamin D to mimic the effect of dermally synthesized vitamin D in response to ultraviolet type B (UVB) light.Objective: We tested the hypothesis that, in vitamin D-deficient adults, the replenishment of vitamin D with UVB exposure would lower LDL-cholesterol concentrations compared with the effect of oral vitamin D3 supplementation.Design: We performed a randomized clinical trial in vitamin D-deficient adults and compared vitamin D replenishment between subjects who received oral vitamin D3 (n = 60) and those who received narrow-band UVB exposure (n = 58) ≤6 mo.Results: There was no difference in the change from baseline LDL-cholesterol concentrations between oral vitamin D3 and UVB groups (difference in median of oral vitamin D3 minus that of UVB: 1.5 mg/dL; 95% CI: -5.0, 7.0 mg/dL). There were also no differences within groups or between groups for changes in total or HDL cholesterol or triglycerides. Transcriptional profiling of skin and blood, however, revealed significant upregulation of immune pathway signaling with oral vitamin D3 but significant downregulation with UVB.Conclusions: Correcting vitamin D deficiency with either oral vitamin D3 or UVB does not improve the lipid profile. Beyond cholesterol, these 2 modalities of raising 25(OH)D have disparate effects on gene transcription. This trial was registered at clinicaltrials.gov as NCT01688102.
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Affiliation(s)
| | - Yupu Liang
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Jaehwan Kim
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | - Richard Hutt
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Kathleen Dowd
- Rockefeller University Hospital Center for Clinical and Translational Science, and
| | - Patricia Gilleaudeau
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | | | - Tori Rodrick
- Laboratory of Biochemical Genetics and Metabolism
| | - Dong Joo Kim
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
| | - Irina Barash
- Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michelle A Lowes
- Laboratory of Investigative Dermatology, The Rockefeller University, New York, NY; and
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Patwardhan VG, Mughal ZM, Padidela R, Chiplonkar SA, Khadilkar VV, Khadilkar AV. Randomized Control Trial Assessing Impact of Increased Sunlight Exposure versus Vitamin D Supplementation on Lipid Profile in Indian Vitamin D Deficient Men. Indian J Endocrinol Metab 2017; 21:393-398. [PMID: 28553593 PMCID: PMC5434721 DOI: 10.4103/ijem.ijem_9_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite abundance of sunshine in India, Vitamin D deficiency is common and therefore there is an increasing trend toward taking Vitamin D supplements either as prescription medicine or as a nutritional supplement. Studies have suggested that duration of sun exposure may influence serum lipid profile. OBJECTIVES To study the effect of increased sunlight exposure versus Vitamin D supplementation on Vitamin D status and lipid profile in individuals with Vitamin D deficiency (25-hydroxyvitamin-D [25OHD] <50 nmol/L). DESIGN A prospective, randomized open-label trial was carried out in apparently healthy Indian men (40-60 years). Based on 25OHD concentrations, individuals were divided into control (>50 nmol/L, n = 50) and intervention (<50 nmol/L, n = 100) groups. Individuals from intervention group were randomly allocated to two groups; either "increased sunlight exposure group" (n = 50, received at least 20 min sunlight exposure to forearms and face between 11 a.m. and 3 p.m. over and above their current exposure) or "cholecalciferol supplement group" (n = 50, received oral cholecalciferol 1000 IU/day). RESULTS Significant increase in 25OHD concentrations was seen in both intervention groups (P < 0.01). Significant decrease in total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), and low-density-lipoprotein cholesterol (LDL-C) was seen in individuals with increased sunlight exposure (P < 0.05). Cholecalciferol supplement group showed a significant increase in TC and HDL-C (P < 0.05) and insignificant increase in LDL-C. CONCLUSIONS Increase in Vitamin D concentrations through sunlight exposure significantly reduced TC, LDL-C, and HDL-C concentrations, and cholecalciferol supplementation increased TC and HDL-C concentrations.
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Affiliation(s)
- Vivek G. Patwardhan
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Zulf M. Mughal
- Department of Pediatrics Endocrinology, Royal Manchester Children's Hospital, Manchester, England, UK
| | - Raja Padidela
- Department of Pediatrics Endocrinology, Royal Manchester Children's Hospital, Manchester, England, UK
| | - Shashi A. Chiplonkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vaman V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Anuradha V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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Dysfunctional immunometabolic effects of vitamin D deficiency, increased cardiometabolic risk. Potential epidemiological alert in America? ACTA ACUST UNITED AC 2017; 64:162-173. [PMID: 28440755 DOI: 10.1016/j.endinu.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/01/2016] [Accepted: 11/18/2016] [Indexed: 12/22/2022]
Abstract
Vitamin D deficiency is a serious public health problem worldwide that affects not only skeletal health, but also a wide range of acute and chronic diseases. However, there is still skepticism because of the lack of randomized, controlled trials to support association studies on the benefits of vitamin D for non-skeletal health. This review was based on articles published during the 1980-2015 obtained from the Cochrane Central Register of controlled trials, MEDLINE and PubMed, and focuses on recent challenges with regard to the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D levels from dietary sources, supplements, and sun exposure. The effect of vitamin D on epigenetic fetal programming and regulation of genes that may potentially explain why vitamin D could have such lifelong comprehensive health benefits is reviewed. Optimization of vitamin D levels in children and adults around the world has potential benefits to improve skeletal health and to reduce the risk of chronic diseases, including some types of cancer, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, and severe cardiovascular disorders such as atherothrombosis, neurocognitive disorders, and mortality.
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33
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Chen WR, Sha Y, Chen YD, Shi Y, Yin DW, Wang H. Vitamin D, parathyroid hormone, and serum lipid profiles in a middle-aged and elderly Chinese population. Endocr Pract 2016; 20:556-65. [PMID: 24449665 DOI: 10.4158/ep13329.or] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To explore the associations of serum vitamin D and parathyroid hormone (PTH) levels with serum lipid profiles and the risk of hyperlipidemia in a middle-aged and elderly population. METHODS A population-based cross-sectional study was conducted in the spring of 2012 among 1,203 Chinese participants, aged 52 to 101 years. 25-Hydroxyvitamin D [25(OH)D] was measured by chemiluminescence assay. (PTH) levels were measured with an electrochemiluminescence immunoassay (ECLIA) method. RESULTS A total of 1,203 participants, including 526 women (43.7%), were evaluated in 2012. The median concentrations of serum 25(OH)D and PTH for the entire group were 17.3 ng/mL and 38.3 pg/mL, respectively. Serum 25(OH)D and PTH levels were not independently associated with serum total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol levels in a multivariate adjusted linear regression analysis of 1,027 participants not receiving antihyperlipidemic treatment (P>.05). In logistic regression analyses, serum 25(OH)D and PTH levels were not associated with a risk of hyperlipidemia after adjustment for age, sex, heavy drinking, smoking, diabetes, obesity, family history of hyperlipidemia, body mass index (BMI), physical activity, glomerular filtration rate (GFR), fasting glucose, high-sensitivity C-reactive protein (hsCRP), calcium, and hemoglobin. CONCLUSIONS Serum 25(OH)D and PTH levels are not independently associated with serum lipid levels or an increased risk of hyperlipidemia in a middle-aged and elderly Chinese population.
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Affiliation(s)
- Wei Ren Chen
- Department of Cardiology, PLA General Hospital, Beijing
| | - Yuan Sha
- Department of South-building Cardiology, PLA General Hospital, Beijing
| | - Yun Dai Chen
- Department of Cardiology, PLA General Hospital, Beijing
| | - Yang Shi
- Department of South-building Cardiology, PLA General Hospital, Beijing
| | - Da Wei Yin
- Department of South-building Cardiology, PLA General Hospital, Beijing
| | - Hao Wang
- Department of South-building Cardiology, PLA General Hospital, Beijing
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Nikooyeh B, Neyestani TR, Zahedirad M, Mohammadi M, Hosseini SH, Abdollahi Z, Salehi F, Mirzay Razaz J, Shariatzadeh N, Kalayi A, Lotfollahi N, Maleki MR. Vitamin D-Fortified Bread Is as Effective as Supplement in Improving Vitamin D Status: A Randomized Clinical Trial. J Clin Endocrinol Metab 2016; 101:2511-9. [PMID: 27115063 DOI: 10.1210/jc.2016-1631] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Bread can potentially be a suitable vehicle for fortification with vitamin D. OBJECTIVE This study was undertaken to evaluate the following: 1) the bioavailability of vitamin D from the fortified Iranian bread and 2) the possible effects of daily consumption of the fortified bread on certain health aspects. DESIGN, SETTING, AND PARTICIPANTS This was a randomized, double-blind, placebo-controlled trial conducted over 8 weeks in 90 healthy subjects aged 20-60 years. INTERVENTION Subjects were randomly allocated to one of three groups: 1) fortified bread (FP; 50 g bread fortified with 25 μg vitamin D3 plus placebo daily; n = 30); 2) supplement (SP; 50 g plain bread plus 25 μg vitamin D supplement daily; n = 30); and 3) control (CP; 50 g plain bread plus placebo daily; n = 30). OUTCOME MEASURES Initial and final anthropometric and biochemical assessments were performed. RESULTS The within-group changes of serum 25-hydroxyvitamin D concentrations were 39.0 ± 22.6 (P < .001), 28.9 ± 31.2 (P < .001), and -9.2 ± 12.3 nmol/L in the FP, SP, and CP groups, respectively. Only in FP and SP groups, serum intact PTH concentrations decreased approximately 13.5% and 14.5%, respectively. Visceral fat also showed a significant decrement in FP (-1.05% ± 1.4%; P ≤ .001) and SP (-0.96% ± 1.7%; P = .006). Serum low-density lipoprotein cholesterol concentration showed a within-group reduction in FP (-10.4 ± 11.2 mg/dL; P < .001) and an insignificant decrement in SP (-6.6 ± 20.2 mg/dL; P = .083). Serum high-density lipoprotein increased in both vitamin D-supplemented groups (FP: 9.7 ± 7.6 vs SP: 5.7 ± 6.7 mg/dL; P < .001). CONCLUSION Vitamin D-fortified bread could be potentially effective in raising circulating 25-hydroxyvitamin D levels of the population to nearly adequate levels.
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Affiliation(s)
- Bahareh Nikooyeh
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Tirang R Neyestani
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Maliheh Zahedirad
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Mehrdad Mohammadi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - S Hedayat Hosseini
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Zahra Abdollahi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Foroozan Salehi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Jalaledin Mirzay Razaz
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Nastaran Shariatzadeh
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Ali Kalayi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Neda Lotfollahi
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
| | - Mohammad-Reza Maleki
- Laboratory of Nutrition Research (B.N., T.R.N., M.Z., N.S., A.K., N.L., M.-R.M.) and Departments of Food Technology Research (M.M.), Food Technology (S.H.H.), and Community Nutrition (J.M.R.), National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 198396-3113, Iran; and Office of Community Nutrition (Z.A., F.S.), Deputy of Health, Iran Ministry of Health, Treatment, and Medical Education, Tehran 558-14665, Iran
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Sogomonian R, Alkhawam H, Jolly J, Vyas N, Ahmad S, Moradoghli Haftevani E, Al-Khazraji A, Finkielstein D, Vittorio TJ. Serum vitamin D levels correlate to coronary artery disease severity: a retrospective chart analysis. Expert Rev Cardiovasc Ther 2016; 14:977-82. [PMID: 27187061 DOI: 10.1080/14779072.2016.1190273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND The pro-atherosclerotic nature of vitamin D deficiency has been shown to increase cardiovascular events. We further emphasized and evaluated the severity of coronary artery disease (CAD) with varying levels of vitamin D in relation to age, gender, ethnicity and baseline confounders. METHODS A retrospective, single-center study of 9,399 patients admitted between 2005 and 2014 for chest pain who underwent coronary angiography. Patients without a vitamin D level, measured as 25-dihydroxyvitamin D (25[OH]D) were excluded from our study. 25(OH)D deficiency and insufficiency were defined by having serum concentration levels of less than 20 ng/ml and 20 to 29.9 ng/ml, respectively, while normal levels were defined as greater than or equal to 30 ng/ml. We assessed levels of 25(OH)D and extent of coronary disease with coronary angiography as obstructive CAD (left main stenosis of ≥50% or any stenosis of ≥70%), non-obstructive CAD (≥1 stenosis ≥20% but no stenosis ≥70%) and normal coronaries (no stenosis >20%). RESULTS Among 9,399 patients, 1,311 qualified, of which 308 patients (23%) had normal 25(OH)D levels, 552 patients (42%) had 25(OH)D deficiency and 451 patients (35%) had 25(OH)D insufficiency. In an analysis of the extent of coronary disease, we identified 20% of patients having normal coronaries, 55% having obstructive CAD and 25% having non-obstructive CAD. Baseline clinical risk factors and co-morbidities did not differ between the groups. Patients with normal 25(OH)D levels were found to have normal coronaries compared to patients with 25(OH)D deficiency or insufficiency (OR: 7, 95% CI: 5.2 - 9.5, p < 0.0001). Comparing patients with normal 25(OH)D levels, patients with 25(OH)D deficiency or insufficiency (<29 ng/ml), 62% were found to have obstructive CAD (n = 624, OR: 2.9, 95% CI: 2.3-3.7, p < 0.0001) and 25% had non-obstructive CAD (n = 249, OR: 1.5, 95% CI: 1.1-2, p = 0.02). CONCLUSION Normal coronaries and CAD were shown to correlate with normal and low levels of 25(OH)D, respectively. There is an inverse relationship between the percentage of coronary artery occlusion and serum 25(OH)D concentrations. Vitamin D may provide benefits in risk stratification of patients with CAD and serve as a possible risk factor.
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Affiliation(s)
- Robert Sogomonian
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Hassan Alkhawam
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - JoshPaul Jolly
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Neil Vyas
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Sumair Ahmad
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | | | - Ahmed Al-Khazraji
- a Department of Medicine , Icahn School of Medicine at Mount Sinai , Elmhurst , NY , USA
| | - Dennis Finkielstein
- c Department of Cardiology , Icahn School of Medicine at Mount Sinai Beth Israel Medical Center , New York , NY , USA
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Protiva P, Pendyala S, Nelson C, Augenlicht LH, Lipkin M, Holt PR. Calcium and 1,25-dihydroxyvitamin D3 modulate genes of immune and inflammatory pathways in the human colon: a human crossover trial. Am J Clin Nutr 2016; 103:1224-31. [PMID: 27009752 PMCID: PMC4841933 DOI: 10.3945/ajcn.114.105304] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 02/16/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A high dietary calcium intake with adequate vitamin D status has been linked to lower colorectal cancer risk, but the mechanisms of these effects are poorly understood. OBJECTIVE The objective of this study was to elucidate the effects of a Western-style diet (WD) and supplemental calcium and/or 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on the colorectal mucosa. DESIGN We conducted 2 crossover trials to define molecular pathways in the human colorectum altered by 1) a 4-wk WD supplemented with and without 2 g calcium carbonate/d and 2) a 4-wk WD supplemented with 1,25(OH)2D3 (0.5 μg/d) with or without 2 g calcium carbonate/d. The primary study endpoint was genome-wide gene expression in biopsy specimens of the rectosigmoid colonic mucosa. Serum and urinary calcium concentrations were also measured. RESULTS Changes in urinary calcium accurately reflected calcium consumption. The WD induced modest upregulation of genes involved in inflammatory pathways, including interferon signaling, and calcium supplementation reversed these toward baseline. In contrast, supplementation of the WD with 1,25(OH)2D3 induced striking upregulation of genes involved in inflammation, immune response, extracellular matrix, and cell adhesion. Calcium supplementation largely abrogated these changes. CONCLUSIONS Supplementing 1,25(OH)2D3 to a WD markedly upregulated genes in immune response and inflammation pathways, which were largely reversed by calcium supplementation. This study provides clinical trial evidence of global gene expression changes occurring in the human colorectum in response to calcium and 1,25(OH)2D3 intervention. One action of 1,25(OH)2D3 is to upregulate adaptive immunity. Calcium appears to modulate this effect, pointing to its biological interaction in the mucosa. This trial was registered at clinicaltrials.gov as NCT00298545 Trial protocol is available at http://clinicalstudies.rucares.org (protocol numbers PHO475 and PHO554).
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Affiliation(s)
- Petr Protiva
- Yale University and Veterans Affairs Connecticut Healthcare System, New Haven, CT; The Rockefeller University, New York, NY
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Abstract
Vitamin D deficiency is a worldwide public health problem. Vitamin D deficiency plays key role in the pathophysiology of risk factors of metabolic syndrome which affect cardiovascular system, increase insulin resistance and obesity, stimulate rennin-angiotensin-aldosterone system that cause hypertension. The discovery of vitamin D receptor expressed ubiquitously in almost all body cells such as immune, vascular and myocardial cells, pancreatic beta cells, neurons and osteoblasts suggests an involvement of vitamin D mediated effects on metabolic syndrome. Moreover vitamin D deficiency as well as cardiovascular diseases and related risk factors frequently co-occur. This underlines the importance of understanding the role of vitamin D in the context of metabolic syndrome. The paper provides an insight into the physiology of vitamin D and relationship of vitamin D deficiency with risk factors of metabolic syndrome through observational and supplementation studies.
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Affiliation(s)
- Priyanka Prasad
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana 141004, Punjab, India.
| | - Anita Kochhar
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana 141004, Punjab, India.
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Ruwanpathirana T, Owen A, Renzaho AMN, Zomer E, Gambhir M, Reid CM. Can oral vitamin D prevent the cardiovascular diseases among migrants in Australia? Provider perspective using Markov modelling. Clin Exp Pharmacol Physiol 2016; 42:596-601. [PMID: 25854647 DOI: 10.1111/1440-1681.12399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 01/08/2023]
Abstract
The study was designed to model the effectiveness and cost effectiveness of oral Vitamin D supplementation as a primary prevention strategy for cardiovascular disease among a migrant population in Australia. It was carried out in the Community Health Service, Kensington, Melbourne. Best-case scenario analysis using a Markov model was employed to look at the health care providers' perspective. Adult migrants who were vitamin D deficient and free from cardiovascular disease visiting the medical centre at least once during the period from 1 January 2010 to 31 December 2012 were included in the study. The blood pressure-lowering effect of vitamin D was taken from a published meta-analysis and applied in the Framingham 10 year cardiovascular risk algorithm (with and without oral vitamin D supplements) to generate the probabilities of cardiovascular events. A Markov decision model was used to estimate the provider costs associated with the events and treatments. Uncertainties were derived by Monte Carlo simulation. Vitamin D oral supplementation (1000 IU/day) for 10 years could potentially prevent 31 (interquartile range (IQR) 26 to 37) non-fatal and 11 (IQR 10 to 15) fatal cardiovascular events in a migrant population of 10,000 assuming 100% compliance. The provider perspective incremental cost effectiveness per year of life saved was AU$3,992 (IQR 583 to 8558). This study suggests subsidised supplementation of oral vitamin D may be a cost effective intervention to reduce non-fatal and fatal cardiovascular outcomes in high-risk migrant populations.
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Affiliation(s)
| | - Alice Owen
- CCRE Therapeutics, The Alfred Centre, Melbourne, Vic., Australia
| | - Andre M N Renzaho
- Epidemiological Modelling Unit, Department of Epidemiology and Preventive Medicine, The Alfred Centre, Melbourne, Vic., Australia
| | - Ella Zomer
- Centre for International Health, Department of Epidemiology and Preventive Medicine, Burnet Institute, Monash University, Melbourne, Vic., Australia
| | - Manoj Gambhir
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Christopher M Reid
- CCRE Therapeutics, The Alfred Centre, Melbourne, Vic., Australia.,Priment, UCL, London, UK
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Pannu PK, Calton EK, Soares MJ. Calcium and Vitamin D in Obesity and Related Chronic Disease. ADVANCES IN FOOD AND NUTRITION RESEARCH 2016; 77:57-100. [PMID: 26944102 DOI: 10.1016/bs.afnr.2015.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is a pandemic of lifestyle-related diseases. In both developed and lesser developed countries of the world, an inadequacy of calcium intake and low vitamin D status is common. In this chapter, we explore a mechanistic framework that links calcium and vitamin D status to chronic conditions including obesity, systemic inflammation, endothelial dysfunction, dyslipidemia and cardiovascular disease, and type 2 diabetes mellitus. We also update the available clinical evidence, mainly from randomized controlled trials, to provide a synthesis of evidence in favor or against these hypotheses. There is consistent data to support calcium increasing whole body fat oxidation and increasing fecal fat excretion, while there is good cellular evidence for vitamin D reducing inflammation. Clinical trials support a marginal reduction in circulating lipids and some meta-analysis support an increase in insulin sensitivity following vitamin D. However, these mechanistic pathways and intermediate biomarkers of disease do not consistently transcribe into measurable health outcomes. Cementing the benefits of calcium and vitamin D for extraskeletal health needs a reexamination of the target 25(OH)D level to be achieved and the minimum duration of future trials.
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Affiliation(s)
- Poonam K Pannu
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Emily K Calton
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Mario J Soares
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
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Jung CH, Kim KJ, Kim BY, Kim CH, Kang SK, Mok JO. Relationship between vitamin D status and vascular complications in patients with type 2 diabetes mellitus. Nutr Res 2016; 36:117-24. [DOI: 10.1016/j.nutres.2015.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/24/2015] [Accepted: 11/11/2015] [Indexed: 01/08/2023]
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Lupton JR, Faridi KF, Martin SS, Sharma S, Kulkarni K, Jones SR, Michos ED. Deficient serum 25-hydroxyvitamin D is associated with an atherogenic lipid profile: The Very Large Database of Lipids (VLDL-3) study. J Clin Lipidol 2016; 10:72-81.e1. [PMID: 26892123 PMCID: PMC4762185 DOI: 10.1016/j.jacl.2015.09.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/15/2015] [Accepted: 09/14/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Cross-sectional studies have found an association between deficiencies in serum vitamin D, as measured by 25-hydroxyvitamin D (25[OH]D), and an atherogenic lipid profile. These studies have focused on a limited panel of lipid values including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG). OBJECTIVE Our study examines the relationship between serum 25(OH)D and an extended lipid panel (Vertical Auto Profile) while controlling for age, gender, glycemic status, and kidney function. METHODS We used the Very Large Database of Lipids, which includes US adults clinically referred for analysis of their lipid profile from 2009 to 2011. Our study focused on 20,360 subjects who had data for lipids, 25(OH)D, age, gender, hemoglobin A1c, insulin, creatinine, and blood urea nitrogen. Subjects were split into groups based on serum 25(OH)D: deficient (<20 ng/mL), intermediate (≥ 20-30 ng/mL), and optimal (≥ 30 ng/mL). The deficient group was compared to the optimal group using multivariable linear regression. RESULTS In multivariable-adjusted linear regression, deficient serum 25(OH)D was associated with significantly lower serum HDL-C (-5.1%) and higher total cholesterol (+9.4%), non-HDL-C (+15.4%), directly measured LDL-C (+13.5%), intermediate-density lipoprotein cholesterol (+23.7%), very low-density lipoprotein cholesterol (+19.0%), remnant lipoprotein cholesterol (+18.4%), and TG (+26.4%) when compared with the optimal group. CONCLUSION Deficient serum 25(OH)D is associated with significantly lower HDL-C and higher directly measured LDL-C, intermediate-density lipoprotein cholesterol, very low-density lipoproteins cholesterol, remnant lipoprotein cholesterol, and TG. Future trials examining vitamin D supplementation and cardiovascular disease risk should consider using changes in an extended lipid panel as an additional outcome measurement.
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Affiliation(s)
- Joshua R Lupton
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA
| | - Kamil F Faridi
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA
| | - Seth S Martin
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA
| | - Sristi Sharma
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Krishnaji Kulkarni
- Department of Research and Development, Atherotech Diagnostics Laboratory, Birmingham, AL, USA
| | - Steven R Jones
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA.
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Ramiro-Lozano JM, Calvo-Romero JM. Effects on lipid profile of supplementation with vitamin D in type 2 diabetic patients with vitamin D deficiency. Ther Adv Endocrinol Metab 2015; 6:245-8. [PMID: 26623001 PMCID: PMC4647130 DOI: 10.1177/2042018815599874] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Epidemiological studies suggest that vitamin D status may have an influence on lipid profile. PATIENTS AND METHODS We studied consecutive type 2 diabetic patients with vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) lower than 20 ng/ml). They were treated with 16,000 IU of calcifediol orally once a week for a minimum of 8 weeks. RESULTS A total of 28 patients were treated for a mean time of 84.1 days (range 56-120 days). All patients achieved serum levels of 25(OH)D higher than 20 ng/ml. There was significant reduction in total cholesterol (172.1 ± 32.4 versus 164.4 ± 27.3 mg/dl, p = 0.04). There were nonsignificant reductions in low-density lipoprotein (LDL) cholesterol, non-high-density lipoprotein (non-HDL) cholesterol and triglycerides. There was no change in HDL cholesterol. CONCLUSIONS Correction of vitamin D deficiency in type 2 diabetic patients decreases total cholesterol. Our results do not rule out reductions in LDL cholesterol, non-HDL cholesterol and triglycerides.
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Karamali M, Beihaghi E, Mohammadi AA, Asemi Z. Effects of High-Dose Vitamin D Supplementation on Metabolic Status and Pregnancy Outcomes in Pregnant Women at Risk for Pre-Eclampsia. Horm Metab Res 2015; 47:867-72. [PMID: 25938886 DOI: 10.1055/s-0035-1548835] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This study was designed to assess the beneficial effects of high-dose (cholecalciferol) vitamin D supplementation on metabolic profiles and pregnancy outcomes among pregnant women at risk for pre-eclampsia. This randomized double-blind placebo-controlled clinical trial was performed among 60 pregnant women at risk for pre-eclampsia according to abnormal uterine artery Doppler waveform. Subjects were randomly divided into 2 groups to receive 50 000 IU vitamin D supplements (n=30) or receive placebo (n=30) every 2 weeks from 20 to 32 weeks of gestation. Fasting blood samples were taken at baseline study and 12 weeks after the intervention to quantify relevant variables. Newborn's anthropometric measurements were determined. Pregnant women who received cholecalciferol supplements had significantly increased serum 25-hydroxyvitamin D concentrations (+17.92±2.28 vs. +0.27±3.19 ng/ml, p<0.001) compared with the placebo. The administration of cholecalciferol supplements, compared with the placebo, resulted in significant differences in serum insulin concentrations (+1.08±6.80 vs. +9.57±10.32 μIU/ml, p<0.001), homeostasis model of assessment-insulin resistance (HOMA-IR) (+0.19±1.47 vs. +2.10±2.67, p<0.001), homeostatic model assessment-beta cell function (HOMA-B) (+5.82±29.58 vs. +39.81±38.00, p<0.001) and quantitative insulin sensitivity check index (QUICKI) score (-0.009±0.03 vs. -0.04±0.03, p=0.004). Furthermore, cholecalciferol-supplemented pregnant women had increased HDL-cholesterol concentrations (+2.67 ± 8.83 vs. -3.23±7.76 mg/dl, p=0.008) compared with the placebo. Finally, cholecalciferol supplementation led to a significant rise in plasma total antioxidant capacity (TAC) concentrations (+79.00±136.69 vs. -66.91±176.02 mmol/l, p=0.001) compared with the placebo. Totally, the administration of cholecalciferol supplements among pregnant women at risk for pre-eclampsia for 12 weeks had favorable effects on insulin metabolism parameters, serum HDL-cholesterol, and plasma TAC concentrations.
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Affiliation(s)
- M Karamali
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, I. R. Iran
| | - E Beihaghi
- Department of Gynecology and Obstetrics, School of Medicine, Arak University of Medical Sciences, Arak, I. R. Iran
| | - A A Mohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, I. R. Iran
| | - Z Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I. R. Iran
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Yin K, You Y, Swier V, Tang L, Radwan MM, Pandya AN, Agrawal DK. Vitamin D Protects Against Atherosclerosis via Regulation of Cholesterol Efflux and Macrophage Polarization in Hypercholesterolemic Swine. Arterioscler Thromb Vasc Biol 2015; 35:2432-42. [PMID: 26381871 DOI: 10.1161/atvbaha.115.306132] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Prevalence of vitamin D (VD) deficiency and its association with the risk of cardiovascular disease prompted us to evaluate the effect of VD status on lipid metabolism and atherosclerosis in hypercholesterolemic microswine. APPROACH AND RESULTS Yucatan microswine were fed with VD-deficient (0 IU/d), VD-sufficient (1000 IU/d), or VD-supplemented (3000 IU/d) high-cholesterol diet for 48 weeks. Serum lipids and 25(OH)-cholecalciferol levels were measured biweekly. Histology and biochemical parameters of liver and arteries were analyzed. Effect of 1,25(OH)2D3 on cholesterol metabolism was examined in human hepatocyte carcinoma cell line (HepG2) and human monocytic cell line (THP-1) macrophage-derived foam cells. VD deficiency decreased plasma high-density lipoprotein levels, expression of liver X receptors, ATP-binding membrane cassette transporter A1, and ATP-binding membrane cassette transporter G1 and promoted cholesterol accumulation and atherosclerosis in hypercholesterolemic microswine. VD promoted nascent high-density lipoprotein formation in HepG2 cells via ATP-binding membrane cassette transporter A1-mediated cholesterol efflux. Cytochrome P450 (CYP)27B1 and VD receptor were predominantly present in the CD206(+) M2 macrophage foam cell-accumulated cores in coronary artery plaques. 1,25(OH)2D3 increased the expression of liver X receptors, ATP-binding membrane cassette transporter A1, and ATP-binding membrane cassette transporter G1 and promoted cholesterol efflux in THP-1 macrophage-derived foam cells. 1,25(OH)2D3 decreased intracellular free cholesterol and polarized macrophages to M2 phenotype with decreased expression of tumor necrosis factor-α, interleukin-1β, interleukin-6 under lipopolysaccharide stimulation. 1,25(OH)2D3 markedly induced CYP27A1 expression via a VD receptor-dependent c-Jun N-terminal kinase (JNK) 1/2 signaling pathway and increased 27-hydroxycholesterol levels, which induced liver X receptors, ATP-binding membrane cassette transporter A1, and ATP-binding membrane cassette transporter G1 expression and stimulated cholesterol efflux that was inhibited by VD receptor antagonist and JNK1/2 signaling inhibitor in THP-1 macrophage-derived foam cell. CONCLUSIONS VD protects against atherosclerosis in hypercholesterolemic swine via controlling cholesterol efflux and macrophage polarization via increased CYP27A1 activation.
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Affiliation(s)
- Kai Yin
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Yong You
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Vicki Swier
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Lin Tang
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Mohamed M Radwan
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Amit N Pandya
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE
| | - Devendra K Agrawal
- From the Center for Clinical & Translational Science, Creighton University School of Medicine, Omaha, NE.
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Determinants of parathyroid hormone response to vitamin D supplementation: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2015; 114:1360-74. [PMID: 26337807 DOI: 10.1017/s0007114515003189] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This systematic review aimed to assess the determinants of the parathyroid hormone (PTH) level response to vitamin D supplementation. We searched Medline, Google Scholar and the reference lists of previous reviews. All randomised controlled trials (RCT) on vitamin D supplementation that involved apparently healthy human subjects with a report of PTH were selected. Potential studies were screened independently and in duplicate. Results are summarised as mean differences with 95% confidence intervals. Quality assessment, subgroup analysis, meta-analysis and meta-regression analysis were carried out. Thirty-three vitamin D supplementation RCT were included. Vitamin D supplementation significantly raised circulating 25-hydroxyvitamin D (25(OH)D) with significant heterogeneity among studies with a pooled mean difference (PMD) of 15.5 ng/ml (test for heterogeneity: P<0·001 and I 2=97·3%). Vitamin D supplementation significantly reduced PTH level with PMD of -8·0 pg/ml, with significant heterogeneity ((test for heterogeneity: P<0·001) and the I 2 value was 97·3%). In the subgroup analyses, the optimum treatment effect for PTH was observed with Ca doses of 600-1200 mg/d (-22·48 pg/ml), after the duration of a >12-month trial (-18·36 pg/ml), with low baseline 25(OH)D concentration of <20 ng/ml (-16·70 pg/ml) and in those who were overweight and obese (-18·11 pg/ml). Despite the present meta-analysis being hindered by some limitations, it provided some interesting evidence, suggesting that suppression of PTH level needs higher vitamin D intake (75 μg/d) than the current recommendations and longer durations (12 months), which should be taken into account for nutritional recommendations.
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Cavalcante IGDM, Silva AS, Costa MJC, Persuhn DC, Issa CI, Freire TLDL, Gonçalves MDCR. Effect of vitamin D3 supplementation and influence of BsmI polymorphism of the VDR gene of the inflammatory profile and oxidative stress in elderly women with vitamin D insufficiency. Exp Gerontol 2015; 66:10-6. [DOI: 10.1016/j.exger.2015.03.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 03/14/2015] [Accepted: 03/27/2015] [Indexed: 12/31/2022]
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Kost RG, Corregano LM, Rainer T, Melendez C, Coller BS. A data-rich recruitment core to support translational clinical research. Clin Transl Sci 2015; 8:91-9. [PMID: 25381717 PMCID: PMC4405427 DOI: 10.1111/cts.12240] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Underenrollment of clinical studies wastes resources and delays assessment of research discoveries. We describe the organization and impact of a centralized recruitment core delivering comprehensive recruitment support to investigators. METHODS The Rockefeller University Center for Clinical and Translational Science supports a centralized recruitment core, call center, Research Volunteer Repository, data infrastructure, and staff who provide expert recruitment services to investigators. During protocol development, consultations aim to optimize enrollment feasibility, develop recruitment strategy, budget, and advertising. Services during study conduct include advertising placement, repository queries, call management, prescreening, referral, and visit scheduling. Utilization and recruitment outcomes are tracked using dedicated software. RESULTS For protocols receiving recruitment services during 2009-2013: median time from initiation of recruitment to the first enrolled participant was 10 days; of 4,047 first-time callers to the call center, 92% (n = 3,722) enrolled in the Research Volunteer Repository, with 99% retention; 23% of Repository enrollees subsequently enrolled in ≥1 research studies, with 89% retention. Of volunteers referred by repository queries, 49% (280/537) enrolled into the study, with 92% retained. CONCLUSIONS Provision of robust recruitment infrastructure including expertise, a volunteer repository, data capture and real-time analysis accelerates protocol accrual. Application of recruitment science improves the quality of clinical investigation.
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Affiliation(s)
- Rhonda G. Kost
- Center for Clinical and Translational ScienceThe Rockefeller UniversityNew YorkNew YorkUSA
| | - Lauren M. Corregano
- Center for Clinical and Translational ScienceThe Rockefeller UniversityNew YorkNew YorkUSA
| | - Tyler‐Lauren Rainer
- Center for Clinical and Translational ScienceThe Rockefeller UniversityNew YorkNew YorkUSA
| | - Caroline Melendez
- Center for Clinical and Translational ScienceThe Rockefeller UniversityNew YorkNew YorkUSA
- Delete Blood Cancer DKMSNew YorkNew YorkUSA
| | - Barry S. Coller
- Center for Clinical and Translational ScienceThe Rockefeller UniversityNew YorkNew YorkUSA
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Browne RW, Weinstock-Guttman B, Zivadinov R, Horakova D, Bodziak ML, Tamaño-Blanco M, Badgett D, Tyblova M, Vaneckova M, Seidl Z, Krasensky J, Bergsland N, Ramasamy DP, Hagemeier J, Qu J, Havrdova E, Ramanathan M. Serum lipoprotein composition and vitamin D metabolite levels in clinically isolated syndromes: Results from a multi-center study. J Steroid Biochem Mol Biol 2014; 143:424-33. [PMID: 24950029 DOI: 10.1016/j.jsbmb.2014.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
Abstract
CONTEXT High serum cholesterol is adversely associated with clinical and imaging disease progression outcomes in multiple sclerosis (MS) and in clinically isolated syndrome (CIS), the earliest stage of MS. Low vitamin D levels are associated with an increased risk of disease progression. OBJECTIVES To investigate the mechanisms mediating the adverse effects of cholesterol in CIS and to determine the role of the nexus between the vitamin D3 (D3) and cholesterol pathways. DESIGN Multi-center, prospective, longitudinal prospective study. SETTING University hospital multiple sclerosis centers. INTERVENTION Serum samples were obtained prior to any treatment from study subjects. METHODS Serum obtained prior to any treatment from 172 CIS patients enrolled in a multi-center, prospective, longitudinal study (119 females: 53 males, age: 28.1 ± SD 8.1 years) were analyzed for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoAII, ApoB, ApoE, and lipoprotein-a. Levels of 25-hydroxy vitamin D3 (25(OH)D3), 1,25-dihydroxy D3, and 24,25-dihydroxy D3 were measured using liquid chromatography-mass spectrometry. RESULTS Greater levels of HDL-C biomarkers (e.g., HDL-C itself, ApoAI, ApoAII and paroxonase arylesterase activity) and LDL-C biomarkers (e.g., LDL-C itself, Apo B) were associated with greater 25(OH)D3. The effects of HDL-C biomarkers were stronger than those of LDL-C. Free cholesterol and cholesteryl ester levels were positively associated with higher 25(OH)D3 levels. Cholesterol palmitate was particularly potent. The nexus between the D3 and cholesterol pathways was proximal to, or in linkage disequilibrium with, 7-dehydrocholesterol reductase DHCR7 rs1790349, endothelial lipase LIPG rs4939883 and proprotein convertase subtilisin/kexin type 9 PCSK9 rs11206510. CONCLUSIONS The associations between cholesterol biomarkers and vitamin D metabolite levels in CIS are consistent with the biochemical inter-dependence between the two pathways. Cholesterol biomarkers should be considered for inclusion as covariates when assessing vitamin D levels in CIS.
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Affiliation(s)
- Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | | | - Robert Zivadinov
- Department of Neurology, State University of New York, Buffalo, NY, USA; Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Mary Lou Bodziak
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | - Miriam Tamaño-Blanco
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Darlene Badgett
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; IRCCS, S. Maria Nascente, Don Gnocchi Foundation, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Murali Ramanathan
- Department of Neurology, State University of New York, Buffalo, NY, USA; Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA.
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Schnatz PF, Jiang X, Vila-Wright S, Aragaki AK, Nudy M, O’Sullivan DM, Jackson R, LeBlanc E, Robinson JG, Shikany JM, Womack CR, Martin LW, Neuhouser ML, Vitolins MZ, Song Y, Kritchevsky S, Manson JE. Calcium/vitamin D supplementation, serum 25-hydroxyvitamin D concentrations, and cholesterol profiles in the Women's Health Initiative calcium/vitamin D randomized trial. Menopause 2014; 21:823-33. [PMID: 24594863 PMCID: PMC5234488 DOI: 10.1097/gme.0000000000000188] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate whether increased serum 25-hydroxyvitamin D3 (25OHD3) concentrations, in response to calcium/vitamin D (CaD) supplementation, are associated with improved lipids in postmenopausal women. METHODS The parent trial was a double-blind, randomized, placebo-controlled, parallel-group trial designed to test the effects of CaD supplementation (1,000 mg of elemental calcium + 400 IU of vitamin D3 daily) versus placebo in postmenopausal women. Women from the general community, including multiple sites in the United States, were enrolled between 1993 and 1998. This cohort included 300 white, 200 African-American, and 100 Hispanic participants who were randomly selected from the Women's Health Initiative CaD trial. Serum 25OHD3 and lipid (fasting plasma triglycerides [TG], high-density lipoprotein cholesterol [HDL-C], and calculated low-density lipoprotein cholesterol [LDL-C]) levels were assessed before and after CaD randomization. RESULTS There was a 38% increase in mean serum 25OHD3 concentrations after 2 years (95% CI, 1.29-1.47, P < 0.001) for women randomized to CaD (24.3 ng/mL postrandomization mean) compared with placebo (18.2 ng/mL). Women randomized to CaD had a 4.46-mg/dL mean decrease in LDL-C (P = 0.03). Higher concentrations of 25OHD3 were associated with higher HDL-C levels (P = 0.003), along with lower LDL-C and TG levels (P = 0.02 and P < 0.001, respectively). CONCLUSIONS Supplemental CaD significantly increases 25OHD3 concentrations and decreases LDL-C. Women with higher 25OHD3 concentrations have more favorable lipid profiles, including increased HDL-C, lower LDL-C, and lower TG. These results support the hypothesis that higher concentrations of 25OHD3, in response to CaD supplementation, are associated with improved LDL-C.
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Affiliation(s)
- Peter F. Schnatz
- Department of ObGyn, The Reading Hospital; Reading, PA
- Department of Internal Medicine, The Reading Hospital; Reading, PA
- Jefferson Medical College of Thomas Jefferson University, Department of ObGyn, Philadelphia, PA
- Jefferson Medical College of Thomas Jefferson University, Department of Internal Medicine, Philadelphia, PA
| | - Xuezhi Jiang
- Department of ObGyn, The Reading Hospital; Reading, PA
| | | | - Aaron K. Aragaki
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA
| | - Matthew Nudy
- Department of ObGyn, The Reading Hospital; Reading, PA
- Jefferson Medical College of Thomas Jefferson University, Department of ObGyn, Philadelphia, PA
| | | | - Rebecca Jackson
- The Ohio State University, Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, Columbus, OH
| | - Erin LeBlanc
- Kaiser Permanente, Center for Health Research NW, Portland, Oregon
| | | | - James M. Shikany
- University of Alabama at Birmingham, School of Medicine, Division of Preventive Medicine, Birmingham, Alabama
| | | | - Lisa W. Martin
- George Washington University School of Medicine and Health Sciences, Department of Internal Medicine, Division of Cardiology, Washington, DC
| | - Marian L. Neuhouser
- Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Seattle, WA
| | - Mara Z. Vitolins
- Wake Forest University; Department of Epidemiology and Prevention, Winston-Salem, NC
| | - Yiqing Song
- Brigham and Women’s Hospital/Harvard Medical School, Department of Medicine, Division of Preventive Medicine, Boston MA
| | | | - JoAnn E. Manson
- Brigham and Women’s Hospital/Harvard Medical School, Department of Medicine, Division of Preventive Medicine, Boston MA
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