1
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Li J, Shi L, Sun J. The pathogenesis of post-stroke osteoporosis and the role oxidative stress plays in its development. Front Med (Lausanne) 2023; 10:1256978. [PMID: 37928460 PMCID: PMC10625412 DOI: 10.3389/fmed.2023.1256978] [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: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 11/07/2023] Open
Abstract
Cardiovascular disease and osteoporotic fractures (OF) are the main diseases affecting the health of middle-aged and elderly people. With the gradual increase of population aging in China and even the world, the incidence of the two and the prevalence of high-risk groups are also showing a continuous upward trend. The relationship between the two, especially the impact of cardiovascular disease on the risk and prognosis of OF, has attracted more and more attention. Therefore, it is of great significance to fully understand the pathogenesis of cardiovascular and cerebrovascular diseases and the resulting osteoporosis and to provide targeted interventions to prevent the occurrence of diseases and fractures. This article reviews the relationship between one of the Cardiovascular disease-stroke and related therapeutic drugs and the risk of OF, and the role of oxidative stress in its pathophysiological mechanism by reviewing relevant domestic and foreign literature in recent years, in order to gain a more comprehensive understanding of the association between stroke and OF, and then provide a basis and reference for screening high-risk groups of fractures and reducing the burden on the health system caused by the disease.
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Affiliation(s)
- JinYan Li
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Lin Shi
- Weifang People's Hospital, Weifang, China
| | - JianMin Sun
- School of Clinical Medicine, Weifang Medical University, Weifang, China
- Weifang People's Hospital, Weifang, China
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2
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Denniss RJ, Barker LA. Brain Trauma and the Secondary Cascade in Humans: Review of the Potential Role of Vitamins in Reparative Processes and Functional Outcome. Behav Sci (Basel) 2023; 13:bs13050388. [PMID: 37232626 DOI: 10.3390/bs13050388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/24/2023] [Accepted: 05/06/2023] [Indexed: 05/27/2023] Open
Abstract
An estimated sixty-nine million people sustain a traumatic brain injury each year. Trauma to the brain causes the primary insult and initiates a secondary biochemical cascade as part of the immune and reparative response to injury. The secondary cascade, although a normal physiological response, may also contribute to ongoing neuroinflammation, oxidative stress and axonal injury, continuing in some cases years after the initial insult. In this review, we explain some of the biochemical mechanisms of the secondary cascade and their potential deleterious effects on healthy neurons including secondary cell death. The second part of the review focuses on the role of micronutrients to neural mechanisms and their potential reparative effects with regards to the secondary cascade after brain injury. The biochemical response to injury, hypermetabolism and excessive renal clearance of nutrients after injury increases the demand for most vitamins. Currently, most research in the area has shown positive outcomes of vitamin supplementation after brain injury, although predominantly in animal (murine) models. There is a pressing need for more research in this area with human participants because vitamin supplementation post-trauma is a potential cost-effective adjunct to other clinical and therapeutic treatments. Importantly, traumatic brain injury should be considered a lifelong process and better evaluated across the lifespan of individuals who experience brain injury.
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Affiliation(s)
- Rebecca J Denniss
- Department of Psychology, The University of Sheffield, Sheffield S10 2TN, UK
| | - Lynne A Barker
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield S1 1WB, UK
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3
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Jiang Q, Zhang M, Mujumdar AS. UV induced conversion during drying of ergosterol to vitamin D in various mushrooms: Effect of different drying conditions. Trends Food Sci Technol 2020; 105:200-210. [PMID: 32982063 PMCID: PMC7508054 DOI: 10.1016/j.tifs.2020.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/28/2020] [Accepted: 09/19/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mushrooms are increasingly popular around the world as a nutritional food which is an excellent source of vitamin D2. Although natural mushrooms often contain very little vitamin D2 as many are grown in the dark, they are rich in ergosterol, a precursor to vitamin D2. Ergosterol can be converted to vitamin D2 under ultraviolet radiation. Due to the high water content of fresh mushroom, its quality deteriorates rapidly after harvest, and drying is the most commonly used technology to extend the shelf life. The vitamin D2 content of dried mushrooms depends on the drying conditions used. SCOPE AND APPROACH In this review, the chemistry of the photo-conversion process of ergosterol to vitamin D2 under ultraviolet radiation is introduced. The ergosterol and vitamin D contents in different mushroom varieties are discussed. The effects of several drying methods and the influence of different drying conditions are reviewed.Key findings and conclusions: Thermal drying in the presence of UV has been proven to convert ergosterol into vitamin D and enhance the nutritional content of all types of edible mushrooms. Solar drying, hot air drying, freeze drying, microwave drying and infrared drying can be used for mushrooms drying under selected operating conditions. A critical evaluation of published literature demonstrates the importance of applying appropriate drying methodology to maximize the nutritional value of various types of edible mushrooms.
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Affiliation(s)
- Qiyong Jiang
- State Key Laboratory of Food Science and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
- International Joint Laboratory on Food Safety, Jiangnan University, 214122, Wuxi, Jiangsu, China
| | - Min Zhang
- State Key Laboratory of Food Science and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
- Jiangsu Province Key Laboratory of Advanced Food Manufacturing Equipment and Technology, Jiangnan University, 214122, Wuxi, Jiangsu, China
| | - Arun S Mujumdar
- Department of Bioresource Engineering, Macdonald Campus, McGill University, Montreal, Quebec, Canada
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4
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Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for long-term enteral feeding. GASTROENTEROLOGIA Y HEPATOLOGIA 2020; 44:13-19. [PMID: 33268156 DOI: 10.1016/j.gastrohep.2020.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 05/02/2020] [Accepted: 05/08/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Vitamin D plays a major role in biological processes. Its deficiency is associated with increased morbidity and mortality. Patients who have undergone endoscopic gastrostomy (PEG) present with protein-energy malnutrition, and may be at risk for Vitamin D deficiency, due to their age, less sunlight exposure and lower dietary intake. We aimed to determine the prevalence of hypovitaminosis D in PEG-patients, its change under PEG-feeding, and its relationship with serum proteins and risk factors for Vitamin D deficiency. METHODS This was a prospective observational study, over 4 weeks, after gastrostomy. Data were collected at the initial PEG procedure (T0), and after 4 weeks (T1). Initial evaluation included age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and Vitamin D. At T1 we assessed Vit. D, albumin, and transferrin. Vitamin D was performed with Electrochemiluminescence through Elecsys 2010 assay. Patients were fed with blended homemade meals. RESULTS 200 patients (118 males), 22-92 years of age, were studied. There were initial low values for Vit. D (181), albumin (96), transferrin (121), and BMI (124). A correlation was found between Vit. D and serum albumin (r=0.49, p=0.005) but not with transferrin (r=0.26, p=0.195). At T1 the subgroup who had Vit. D levels assessed (n=48) was part of the initial study group maintained low levels of Vitamin D despite nutritional intervention. CONCLUSION We recommend systematic Vitamin D supplementation of PEG fed patients using homemade meals or at least screening for hypovitaminosis D as a routine part of their care.
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5
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Arabi SM, Bahrami LS, Ranjbar G, Tabesh H, Norouzy A. The effect of vitamin D supplementation on inflammation in critically ill patients: A systematic review. PHARMANUTRITION 2020. [DOI: 10.1016/j.phanu.2020.100196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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6
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Akimbekov NS, Ortoski RA, Razzaque MS. Effects of sunlight exposure and vitamin D supplementation on HIV patients. J Steroid Biochem Mol Biol 2020; 200:105664. [PMID: 32229174 DOI: 10.1016/j.jsbmb.2020.105664] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/02/2019] [Accepted: 03/21/2020] [Indexed: 02/08/2023]
Abstract
Unlike many vitamins derived predominantly from food sources, vitamin D is produced endogenously in the skin upon exposure to sunlight. Ethnicity, skin pigmentation, socioeconomic status, geographic location, climate and sunscreen; all of these factors contribute to the amount of insolation for any given individual. Insufficient insolation creates the prerequisites for vitamin D deficiency. This is particularly true in HIV-infected individuals, who are highly vulnerable to vitamin D insufficiency/deficiency, as it plays a huge role in the musculoskeletal and cardiovascular systems. Antiretroviral therapy may also be a factor in vitamin D deficiency. Today, as the issues of preventing common skeletal and non-skeletal diseases with HIV-infected people are becoming highly relevant, the maintenance of vitamin D levels through exposure to sunlight or supplementation appears to be an effective and safe solution. This review focuses on studies concerning the potential role of vitamin D supplementation through adequate sunlight exposure or dietary intake in HIV-infected people. The biology and epidemiology of HIV infection, as well as the issues related to vitamin D deficiency, its status on immune function, the effect of vitamin D against HIV disease progression and other health aspects of this vitamin, are briefly explained.
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Affiliation(s)
- Nuraly S Akimbekov
- Department of Biotechnology, Al-Farabi Kazakh National University, Almaty, Kazakhstan.
| | - Richard A Ortoski
- Department of Primary Care Education, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
| | - Mohammed S Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
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7
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Massironi S, Cavalcoli F, Rausa E, Invernizzi P, Braga M, Vecchi M. Understanding short bowel syndrome: Current status and future perspectives. Dig Liver Dis 2020; 52:253-261. [PMID: 31892505 DOI: 10.1016/j.dld.2019.11.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/08/2019] [Accepted: 11/18/2019] [Indexed: 02/08/2023]
Abstract
Short bowel syndrome (SBS) is a rare malabsorptive disorder as a result of the loss of bowel mass mostly secondary to surgical resection of the small intestine. Other causes are vascular diseases, neoplasms or inflammatory bowel disease. The spectrum of the disease is widely variable from single micronutrient malabsorption to complete intestinal failure, depending on the remaining length of the small intestine, the anatomical portion of intestine and the function of the remnant bowel. Over the last years, the management of affected patients has remarkably improved with the increase in patients' quality of life and survival, mainly thanks to advances in home-based parenteral nutrition (PN). In the last ten years new treatment strategies have become available together with increasing experience and the encouraging results with new drugs, such as teduglutide, have added a new dimension to the management of SBS. This review aims to summarize the knowledge available in the current literature on SBS epidemiology, pathophysiology, and its surgical (including intestinal lengthening procedures and intestinal transplantation) and medical management with emphasis on the recent advances. Moreover, this review attempts to provide the new understanding and recent approaches to SBS complications such as sepsis, catheter thrombosis, and intestinal failure-associated liver disease.
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Affiliation(s)
- Sara Massironi
- Gastroenterology and Endoscopy Unit, IRCCS Ca' Granda Foundation, Policlinico Hospital, University of the Study of Milan, Italy.
| | | | - Emanuele Rausa
- Division of Surgical Oncology, ASST Bergamo Ovest, Treviglio, Italy
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital, University of Milano, Bicocca School of Medicine, Monza, Italy
| | - Marco Braga
- Division of Surgery, San Gerardo Hospital, University of Milano - Bicocca School of Medicine, Monza, Italy
| | - Maurizio Vecchi
- Gastroenterology and Endoscopy Unit, IRCCS Ca' Granda Foundation, Policlinico Hospital, University of the Study of Milan, Italy
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8
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Chon HS, Sehovic M, Marchion D, Walko C, Xiong Y, Extermann M. Biologic Mechanisms Linked to Prognosis in Ovarian Cancer that May Be Affected by Aging. J Cancer 2019; 10:2604-2618. [PMID: 31258768 PMCID: PMC6584919 DOI: 10.7150/jca.29611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 04/27/2019] [Indexed: 12/20/2022] Open
Abstract
The increase of both life expectancy of the Western industrialized population and cancer incidence with aging is expected to result in a rapid expansion of the elderly cancer population, including patients with epithelial ovarian cancer (EOC). Although the survival of patients with EOC has generally improved over the past three decades, this progress has yet to provide benefits for elderly patients. Compared with young age, advanced age has been reported as an adverse prognostic factor influencing EOC. However, contradicting results have been obtained, and the mechanisms underlying this observation are poorly defined. Few papers have been published on the underlying biological mechanisms that might explain this prognosis trend. We provide an extensive review of mechanisms that have been linked to EOC prognosis and/or aging in the published literature and might underlie this relationship in humans.
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Affiliation(s)
- Hye Sook Chon
- Department of Gynecology Oncology, Moffitt Cancer Center and Research Institute, Tampa FL, USA
- University of South Florida, Tampa FL, USA
| | - Marina Sehovic
- Senior Adult Oncology Program, Moffitt Cancer Center and Research Institute, Tampa FL, USA
- Department of Individualized Cancer Management, Moffitt Cancer Center and Research Institute, Tampa FL, USA
| | - Douglas Marchion
- Department of Pathology, Moffitt Cancer Center and Research Institute, Tampa FL, USA
| | - Christine Walko
- Department of Individualized Cancer Management, Moffitt Cancer Center and Research Institute, Tampa FL, USA
| | - Yin Xiong
- Department of Pathology, Moffitt Cancer Center and Research Institute, Tampa FL, USA
| | - Martine Extermann
- Senior Adult Oncology Program, Moffitt Cancer Center and Research Institute, Tampa FL, USA
- Department of Individualized Cancer Management, Moffitt Cancer Center and Research Institute, Tampa FL, USA
- University of South Florida, Tampa FL, USA
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9
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Denniss RJ, Barker LA, Day CJ. Improvement in Cognition Following Double-Blind Randomized Micronutrient Interventions in the General Population. Front Behav Neurosci 2019; 13:115. [PMID: 31191268 PMCID: PMC6547837 DOI: 10.3389/fnbeh.2019.00115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/14/2019] [Indexed: 11/20/2022] Open
Abstract
The impact of poor nutrition on physiological health is well understood (Costarelli et al., 2013). Less is known about the effects of diet on brain function and cognition in the general population (Ames, 2010; Parletta et al., 2013; White et al., 2017) and we are still in the early stages of understanding the role of specific nutrients to normal and pathological neuronal functioning. In the present study, the putative effect of a multivitamin/mineral or vitamin D supplement on cognitive function over an 8-week period was compared with volunteers taking vitamin C. Healthy adults (N = 60) were recruited, age range 21-59 years ( x ¯ = 39.07 years, SD = 11.46), with participants randomly allocated to conditions in a double-blind protocol. Participants also completed a 14-day food diary to gather information on micronutrient intake. The cognitive test battery included measures from the Wechsler Adult Intelligence Scale-III (WAIS-III; Wechsler et al., 2008), Wechsler Memory Scale-IV (WMS-IV; Wechsler, 2009) and Delis-Kaplan Executive Function System (D-KEFS; Delis et al., 2001), along with the Doors and People (Baddeley et al., 1994) and a serial reaction time task. Analyses showed better performance on some tasks in all groups following the intervention period, notably on measures of verbal and visual memory and visuomotor processing speed. The Multivitamin group showed significant improvements on tasks of visual strategy generation (along with the Vitamin C group), motor planning, explicit and implicit learning, and working memory. This evidence suggests that sub-optimal micronutrient intake may have a negative effect on cognition across the lifespan.
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Affiliation(s)
- Rebecca J. Denniss
- Centre for Behavioural Science and Applied Psychology, Department of Psychology, Sociology and Politics, Sheffield Hallam University, Sheffield, United Kingdom
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10
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Vitamin D and Influenza-Prevention or Therapy? Int J Mol Sci 2018; 19:ijms19082419. [PMID: 30115864 PMCID: PMC6121423 DOI: 10.3390/ijms19082419] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 07/24/2018] [Accepted: 08/01/2018] [Indexed: 12/14/2022] Open
Abstract
Vitamin D generates many extraskeletal effects due to the vitamin D receptor (VDR) which is present in most tissues throughout the body. The possible role of vitamin D in infections is implied from its impact on the innate and adaptive immune responses. A significant effect is also the suppression of inflammatory processes. Because vitamin D could be acknowledged as a “seasonal stimulus”, as defined by R. Edgar Hope-Simpson, it would be crucial to prove it from a potential easy and cheap prophylaxis or therapy support perspective as far as influenza infections are concerned. The survey of the literature data generates some controversies and doubts about the possible role of vitamin D in the prevention of influenza virus. The most important point is to realise that the broad spectrum of this vitamin’s activity does not exclude such a possibility. According to most of the authors, more randomized controlled trials with effective, large populations are needed to explore the preventive effect of vitamin D supplementation on viral influenza infections.
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11
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Davila J, Konrad D. Metabolic Complications of Home Parenteral Nutrition. Nutr Clin Pract 2017; 32:753-768. [DOI: 10.1177/0884533617735089] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Jamie Davila
- Center for Gut Rehabilitation and Transplantation Clinician, Cleveland Clinic, Cleveland, Ohio, USA
| | - Denise Konrad
- Home Nutrition Support Clinician, Cleveland Clinic, Cleveland, Ohio, USA
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12
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Napartivaumnuay N, Gramlich L. The Prevalence of Vitamin D Insufficiency and Deficiency and Their Relationship with Bone Mineral Density and Fracture Risk in Adults Receiving Long-Term Home Parenteral Nutrition. Nutrients 2017; 9:nu9050481. [PMID: 28489034 PMCID: PMC5452211 DOI: 10.3390/nu9050481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 04/20/2017] [Accepted: 05/05/2017] [Indexed: 01/10/2023] Open
Abstract
It has been demonstrated that low bone mass and vitamin D deficiency occur in adult patients receiving home parenteral nutrition (HPN). The aim of this study is to determine the prevalence of vitamin D insufficiency and deficiency and its relationship with bone mineral density (BMD) and fracture risk in long-term HPN patients. Methods: A retrospective chart review of all 186 patients in the HPN registry followed by the Northern Alberta Home Parenteral Nutrition Program receiving HPN therapy >6 months with a 25 (OH) D level and BMD reported were studied. Results: The mean age at the initiation of HPN was 53.8 (20–79) years and 23 (37%) were male. The mean HPN duration was 56 (6–323) months and the most common diagnosis was short bowel syndrome. Based on a total of 186 patients, 62 patients were categorized based on serum vitamin D status as follows: 1 (24.2%) sufficient, 31 (50%) insufficient and 16 (25.8%) deficient. Despite an average of 1891 IU/day orally and 181 IU/day intravenously vitamin D, the mean vitamin D level was 25.6 ng/mL (insufficiency) and 26.2 ± 11.9 ng/mL in patients with the highest 10-year fracture risk. Conclusion: Suboptimal vitamin D levels are common among patients on long-term HPN despite nutrient intake that should meet requirements.
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Affiliation(s)
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada.
- Nutrition Services, Alberta Health Services, Edmonton, AB T5J 3E4, Canada.
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13
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Outcomes of Vitamin D Supplementation in Adults Who are Deficient and Critically Ill: A Review of the Literature. Am J Ther 2017; 23:e1890-e1902. [PMID: 26164022 DOI: 10.1097/mjt.0000000000000281] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitamin D deficiency is known to be common in the general population and has been linked to all-cause mortality. The classically recognized role of vitamin D is its involvement in calcium and phosphorous homeostasis and bone health. Recent evidence suggests that vitamin D may also play a role in other nonskeletal processes, such as anti-proliferation, immunity, regulation of hormone section, and muscle strength. An extensive literature review of vitamin D and critical illness from 2000 to 2015 (PubMed and CINAL) produced multiple observational studies revealing a high prevalence of vitamin D deficiency in intensive care patients. Many of these studies have indicated that there is an association between vitamin D deficiency and clinical outcomes such as mortality, sepsis, duration of mechanical ventilation, and length of stay. This review article provides an overview of vitamin D physiology in adults, a summary of observational studies on vitamin D deficiency in critical illness, and an examination of the few clinical trials on vitamin D supplementation in intensive care patients.
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14
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Namjoshi SS, Muradian S, Bechtold H, Reyen L, Venick RS, Marcus EA, Vargas JH, Wozniak LJ. Nutrition Deficiencies in Children With Intestinal Failure Receiving Chronic Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2017; 42:427-435. [DOI: 10.1177/0148607117690528] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 12/22/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Shweta S. Namjoshi
- Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | | | | | - Laurie Reyen
- Department of Nursing, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
| | - Robert S. Venick
- Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Elizabeth A. Marcus
- Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- VA Greater Los Angeles Health Care System, Los Angeles, California, USA
| | - Jorge H. Vargas
- Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Laura J. Wozniak
- Pediatric Gastroenterology, Hepatology, and Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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Abstract
There are over 300 000 people in the UK affected by inflammatory bowel disease (IBD). Though vitamin D deficiency is common in patients with IBD, National Institute for Health and Care Excellence (NICE) guidance regarding vitamin D supplementation does not address the needs of patients with chronic inflammatory diseases. However, there is growing evidence that vitamin D plays an important role in the management of IBD. Nurses caring for patients with IBD should have an understanding of the causes and consequences of vitamin D deficiency in this patient group. This article looks at the role vitamin D plays in the body and the challenges of treating deficiency. Consideration is given to diet, sun exposure and supplementation as possible treatments and acknowledges the limitations of treatments for patients with IBD. With a lack of clear national guidance, it is hoped that raising awareness of these issues will inform nursing practice and ensure a holistic approach to care.
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Affiliation(s)
- Jane Fletcher
- Nutrition Nurse Team Leader, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust
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16
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Kim HJ, Sohn MS, Choi EY. Prevalence and Related Factors of Vitamin D Deficiency in Critically Ill Patients. Korean J Crit Care Med 2016. [DOI: 10.4266/kjccm.2016.00276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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17
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Fan S, Ni X, Wang J, Zhang Y, Tao S, Kong W, Li Y, Li J. High Prevalence of Suboptimal Vitamin D Status and Bone Loss in Adult Short Bowel Syndrome Even After Weaning Off Parenteral Nutrition. Nutr Clin Pract 2016; 32:258-265. [PMID: 27589260 DOI: 10.1177/0884533616665784] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Shengxian Fan
- Department of General Surgery, Drum Tower Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Xiaodong Ni
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Jian Wang
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Yongliang Zhang
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Shen Tao
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Wencheng Kong
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Yousheng Li
- Department of General Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jieshou Li
- Intestinal Rehabilitation and Transplant Center, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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18
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Abstract
Supplementation of micronutrients after burn injury is common practice in order to fight oxidative stress, support the immune system, and optimize wound healing. Assessing micronutrient status after burn injury is difficult because of hemodilution in the resuscitation phase, redistribution of nutrients from the serum to other organs, and decreases in carrier proteins such as albumin. Although there are many preclinical data, there are limited studies in burn patients. Promising research is being conducted on combinations of micronutrients, especially via the intravenous route.
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Aydogmus S, Kelekci S, Aydogmus H, Eriş S, Desdicioğlu R, Yilmaz B, Sağlam G. High prevalence of vitamin D deficiency among pregnant women in a Turkish population and impact on perinatal outcomes. J Matern Fetal Neonatal Med 2014; 28:1828-32. [PMID: 25260128 DOI: 10.3109/14767058.2014.969235] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Maternal vitamin D deficiency is a major public health problem. The aim of this study is to investigate the influence of vitamin D deficiency on perinatal results in primigravida. METHODS One-hundred fifty-two healthy nullipar women were included in the study. Pregnant women with serum vitamin D levels <15ng/ml were defined as Group I and ≥15 ng/dl were defined as Group II; data were evaluated retrospectively. Type of delivery, gestational age at birth, birth weight, intensive care of the newborn, peri-and postpartum complications were recorded. Statistical analyses were performed with SPSS for Windows (version 16.0 ). Categorical variables were assessed using chi-squared test. The numeric variables were analyzed using Student's t-test and one-way ANOVA. RESULTS 44.6% of pregnant women were found to have vitamin D deficiency. The mean serum vitamin D levels for Groups I and II were 10.8 ± 3.8 and 23.8 ± 13.3 ng/ml, respectively. SGA deliveries were detected in 16.66% and 4.87% of the primigravidas with and without vitamin D deficiency, respectively. CONCLUSIONS This study has shown that maternal vitamin D deficiency is related with an increased risk of SGA delivery. Further studies are needed to explain the relationship with vitamin D deficiency and poor perinatal outcomes.
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Affiliation(s)
- Serpil Aydogmus
- a Department of Obstetrics and Gynecology Izmi , School of Medicine
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Bharadwaj S, Gohel TD, Deen OJ, Coughlin KL, Corrigan ML, Fisher J, Lopez R, Shatnawei A, Kirby DF. Prevalence and Predictors of Vitamin D Deficiency and Response to Oral Supplementation in Patients Receiving Long-Term Home Parenteral Nutrition. Nutr Clin Pract 2014; 29:681-5. [DOI: 10.1177/0884533614539178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Affiliation(s)
| | | | - Omer J. Deen
- Torrance Memorial Medical Center, Torrance, California
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21
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Izadpanah M, Khalili H. Potential benefits of vitamin D supplementation in critically ill patients. Immunotherapy 2014; 5:843-53. [PMID: 23902554 DOI: 10.2217/imt.13.84] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To review potential benefits of vitamin D supplementation in critically ill patients. METHODS The data were collected by searching Scopus, PubMed/Medline, ScienceDirect, Clinical trials and Cochrane database systematic reviews. The keywords used as search terms were 'vitamin D', 'critically ill patients', 'ICU' and 'sepsis'. RESULTS & CONCLUSION Vitamin D deficiency is common in patients admitted to emergency departments, medical and surgical intensive care units. Positive effects of vitamin D on the immune system through decreasing inflammatory cytokines and increasing natural anti-infective molecules have been reported. Patients with low serum vitamin D concentrations experienced longer hospital stay and were more prone to nosocomial infections, including blood stream and respiratory infections. However, a correlation between vitamin D serum level and patients' mortality is not fully described. Limited studies have assessed effects of vitamin D supplementation on morbidity and mortality in critically ill patients. In the future, well-designed randomized clinical trials should describe the best dose, route and duration of vitamin D supplementation in critically ill patients.
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Affiliation(s)
- Mandana Izadpanah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Enghelab Avenue, postal code 1417614411, PO box 14155/6451, Tehran, Iran
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Arnson Y, Gringauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM 2012; 105:633-9. [PMID: 22331959 DOI: 10.1093/qjmed/hcs014] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Vitamin D plays a seminal role in many homeostatic mechanisms. In this study, we assessed the correlation between circulating vitamin D levels and mortality rates in critically ill patients. METHODS All patients admitted to the intensive care units (ICUs) and internal medicine wards in a university-based hospital that required mechanical ventilation were admitted. Data collected included the underlying disease, basic hematological and biochemical blood test results, APACHE II scores and serum 25-hydroxyvitamin D [25(OH)D] levels. The primary end point was defined as all-cause mortality within 60 days from admission or from acute deterioration. RESULTS Between December 2008 and June 2009, 130 patients were enrolled. Average vitamin D concentration was 14.04 ± 6.9 ng/ml; 107 patients were vitamin D deficient (< 20 ng/ml). Total mortality rate after 60 days was 44.3%. Vitamin D levels were correlated with white blood cell (WBC) count, but with no other measured variable. Among the deceased patients, survival curves indicated that survival of patients with vitamin D deficiency was significantly shorter than those whose vitamin D concentration was >20 ng/ml (P < 0.05); the average survival time was 15.3 ± 12.4 days for vitamin D deficient patients compared with 24.2 ± 16.5 days among those with normal vitamin D levels. CONCLUSION This study demonstrated that low vitamin D levels are common among patients admitted to ICU. We observed longer survival times among vitamin D sufficient patients. Our results indicate that vitamin D concentration may be either a biomarker of survival or a co-factor. We recommend assessing the effects of vitamin D supplementation in critically ill patients.
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Affiliation(s)
- Y Arnson
- Department of Medicine B, Sheba Medical Center, Tel-Hashomer 52621, Israel
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23
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Vanchinathan V, Lim HW. A dermatologist's perspective on vitamin D. Mayo Clin Proc 2012; 87:372-80. [PMID: 22425213 PMCID: PMC3498088 DOI: 10.1016/j.mayocp.2011.12.010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 12/12/2011] [Accepted: 12/21/2011] [Indexed: 12/19/2022]
Abstract
Vitamin D is a fat-soluble steroid hormone that is crucial for human health and has recently generated controversy regarding its role in human health and disease. In this Special Article, we discuss our dermatologic perspective on vitamin D in a question-and-answer format. We discuss methods of obtaining vitamin D, including cutaneous photobiosynthesis, diet, and supplements and include the recent US Institute of Medicine recommendations. Other reviewed topics include the associations among skin pigmentation, climate, photoprotection, and vitamin D levels. We also elaborate on the popular interest in sun exposure as a method of normalizing vitamin D levels in the context of the risks of solar and artificial radiation. We also discuss groups at risk for vitamin D inadequacy, the need for testing serum vitamin D levels, and the role of phototherapy in patients with malabsorption conditions and hypervitaminosis D, with a focus on patients with sarcoidosis. Finally, we summarize our recommendations on vitamin D.
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Key Words
- 25(oh)d, 25-hydroxyvitamin d
- 1,25(oh2)d, 1,25-dihydroxyvitamin d
- ai, allowable intake
- iom, institute of medicine
- iu, international units
- med, minimal erythema dose
- ng/ml, nanograms/milliliter
- nm, nanometer
- nmol/l, nanomoles/liter
- spf, sun protection factor
- rda, recommended dietary allowance
- uv, ultraviolet
- uv-a, ultraviolet a
- uv-b, ultraviolet b
- vbp, vitamin d binding protein
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Affiliation(s)
| | - Henry W. Lim
- Correspondence: Address to Henry W. Lim, MD, Department of Dermatology, Henry Ford Medical Center, New Center One, 3031 W Grand Blvd, Ste 800, Detroit, MI 48202
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Kumar PR, Fenton TR, Shaheen AA, Raman M. Prevalence of Vitamin D Deficiency and Response to Oral Vitamin D Supplementation in Patients Receiving Home Parenteral Nutrition. JPEN J Parenter Enteral Nutr 2012; 36:463-9. [DOI: 10.1177/0148607111416483] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Puja R. Kumar
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Tanis R. Fenton
- Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Abdel A. Shaheen
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Maitreyi Raman
- Division of Gastroenterology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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25
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Flynn L, Zimmerman LH, McNorton K, Dolman M, Tyburski J, Baylor A, Wilson R, Dolman H. Effects of vitamin D deficiency in critically ill surgical patients. Am J Surg 2011; 203:379-82; discussion 382. [PMID: 22206852 DOI: 10.1016/j.amjsurg.2011.09.012] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/25/2011] [Accepted: 09/25/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND The incidence of vitamin D deficiency in critically ill patients is reported to be up to 50%, with a 3-fold increase in predicted mortality, but limited data exist concerning vitamin D deficiency in critically ill surgical patients. METHODS Sixty-six adult surgical intensive care unit patients who had 25-hydroxyvitamin D serum levels evaluated from January 2010 to February 2011 were prospectively identified. Patients were divided into groups according to vitamin D level (<20 vs ≥20 ng/mL). RESULTS Of the 66 patients evaluated, 49 (74%) had vitamin D levels < 20 ng/mL, and 17 (26%) had vitamin D levels ≥ 20 ng/mL. Patients with vitamin D levels < 20 versus ≥ 20 ng/mL had longer lengths of hospital stay. Lengths of intensive care unit stay were clinically longer, although not significant. Infection rates tended to be higher (P = .09), and a higher incidence of sepsis was seen in the patients with vitamin D levels < 20 ng/mL. CONCLUSIONS Vitamin D levels < 20 ng/mL have a significant impact on length of stay, organ dysfunction, and infection rates. More data are needed on the value of supplementation to improve these outcomes.
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Affiliation(s)
- Lisa Flynn
- Department of Surgery, Wayne State University, School of Medicine, Detroit, MI, USA
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26
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Thomson P, Duerksen DR. Vitamin D deficiency in patients receiving home parenteral nutrition. JPEN J Parenter Enteral Nutr 2011; 35:499-504. [PMID: 21540352 DOI: 10.1177/0148607110381269] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In addition to its role in bone metabolism, vitamin D has important immunomodulatory and antineoplastic effects. Patients on home parenteral nutrition (HPN) receive most of their vitamin D from intravenous (IV) supplementation. Vitamin D deficiency is common in the general population, and the adequacy of vitamin D supplementation in HPN patients is unclear. The purpose of this study is to determine the vitamin D status of patients on HPN. METHODS Consecutive patients seen in a regional home nutrition program had their oral and IV vitamin D intakes determined. Plasma 25-hydroxyvitamin D levels were measured in all patients. Intake of calcium, magnesium, and phosphate were also determined. RESULTS The mean 25-hydroxyvitamin D level in 22 patients receiving HPN for a mean of 33.5 months (range, 1-177) was 42 nmol/L. Vitamin D deficiency was present in 15 (68%) patients and vitamin D insufficiency in 6 (27%) patients. The mean dietary vitamin D intake was 79.5 IU per day, while the mean IV supplementation was 166 IU per day. CONCLUSIONS In this study of a regional Canadian HPN program, there was a high prevalence of vitamin D deficiency/insufficiency affecting virtually all patients. All patients receiving HPN should be supplemented with vitamin D and have their 25-hydroxyvitamin D levels monitored. Further studies are required to determine optimal methods and dosing of vitamin D replacement using oral supplements or ultraviolet light therapy.
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Affiliation(s)
- Patti Thomson
- Department of Medicine, Division of Gastroenterology, C5120 409 Tache Ave, St Boniface Hospital, Winnipeg, Manitoba, Canada.
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Vitamin D—New Recommendations Worthy of Our Consideration. JPEN J Parenter Enteral Nutr 2011; 35:289-90. [DOI: 10.1177/0148607111406499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cytochromes P450 are essential players in the vitamin D signaling system. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2010; 1814:186-99. [PMID: 20619365 DOI: 10.1016/j.bbapap.2010.06.022] [Citation(s) in RCA: 192] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 06/15/2010] [Accepted: 06/28/2010] [Indexed: 12/13/2022]
Abstract
From earliest development on, the vitamin D receptor (VDR) is expressed in most cells of the mammalian body. The VDR is a nuclear, ligand-induced transcription factor that regulates in complex with hormonally active vitamin D the expression of more than 900 genes involved in a wide array of physiological functions (e.g. calcium homeostasis, growth control, differentiation, cognition, immune response, etc.). Accordingly, severe health problems are associated to vitamin deficiencies. Synthesis of the major active form 1α,25(OH)₂D₃ from vitamin D and subsequent metabolism are exclusively controlled by specific P450-forms. Synthesis, a two-step process, starts with a 25-hydroxylation primarily by CYP2R1 (CYP27A1, CYP2J2, and CYP3A4 may also contribute) and a subsequent 1α-hydroxylation via CYP27B1. Circulating in the bloodstream, 1α,25(OH)₂D₃ acts at sites of VDR expression (target sites) in an endocrine way. However, it is also capable of autocrine/paracrine functions since various target tissues are fully competent in 1α,25(OH)₂D₃ synthesis, as illustrated by three examples. 1α,25(OH)₂D₃ levels are short-lived: the hormone upregulates its rapid metabolism by CYP24A1 that attacks repeatedly the vitamin D C₂₀₋₂₇ side chain, thereby producing a complex cascade of transient metabolites with increasing polarity. Most of these metabolites still retain 1α,25(OH)₂D₃-like activities on the VDR, contributing to the overall effect that is commonly attributed to 1α,25(OH)₂D₃. As selective inhibitors of CYP24A1 increase the lifetime and thereby the function of vitamin D metabolites, they will help exploring whether and which intrinsic activities distinct metabolites possess. It appears likely that this strategy may unmask important regulators of new functions.
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Boullata JI. Vitamin D: getting to know you... again. JPEN J Parenter Enteral Nutr 2009; 34:96-8. [PMID: 19861530 DOI: 10.1177/0148607109344726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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