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Chan Y, Cai D, Guo R, Zhou X, He G, Li H, Geng Z, Guo Y, Lin J, Wang R, Jiang L, Zhu B. Evaluation of the deficiency status of 25-hydroxyvitamin D and associated factors in Southwest China: A hospital-based retrospective cross-sectional analysis of a low-latitude, high-altitude, multiracial region. NUTR BULL 2023; 48:535-545. [PMID: 37864477 DOI: 10.1111/nbu.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
Abstract
Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25-hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low-latitude, high-altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital-based participants (age, 1 day-96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital-based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0-6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = -0.53, 0.60, 0.31, -0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China.
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Affiliation(s)
- Ying Chan
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Dongling Cai
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Rongfen Guo
- Yunnan Meteorological Service Center, Kunming, China
| | - Xiaoyan Zhou
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Guangyu He
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Huiping Li
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Zibiao Geng
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Yan Guo
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Junyue Lin
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Ruihong Wang
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Lihong Jiang
- School of Medicine, Kunming University of Science and Technology, Kunming, China
- Department of Cardiothoracic Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Baosheng Zhu
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
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Hassan AA, Elbashir MI, Al-Nafeesah A, AlEed A, Adam I. Association between Serum 25-Hydroxyvitamin D Concentrations and Academic Performance among Adolescent Schoolchildren: A Cross-Sectional Study. Nutrients 2023; 15:4552. [PMID: 37960205 PMCID: PMC10650548 DOI: 10.3390/nu15214552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023] Open
Abstract
The level of association between 25-hydroxyvitamin D (25[OH]D) levels and students' academic performance has not yet been established. The current study aimed to investigate the association between serum 25(OH)D levels and academic performance among schoolchildren in Sudan. A cross-sectional study was conducted among schoolchildren during the 2021/2022 academic year from four randomly selected schools in Almatamah, River Nile State, northern Sudan. Sociodemographic data were collected using a questionnaire. Anthropometric measurements were performed in accordance with standard procedures. Academic performance was obtained from school records. Serum 25(OH)D levels were measured, and regression (multiple linear regression and multivariate logistic) analyses were performed. A total of 241 participants were enrolled in this study, of whom 129 (53.5%) were female. The mean standard deviation (SD) of the participants' ages was 15 ± 1.6 years. In multiple linear regression tests, being female, age, employment, and serum 25(OH)D level were positively associated with academic performance. The average overall academic score was 33.74%. Of the 241 participants, 95 (39.4%) and 149 (61.6%) had good and poor academic performances, respectively. In multivariable logistic regressions, age and 25(OH)D level were inversely associated with poor academic performance and vitamin D deficiency was associated with poor performance. The current study revealed a positive association between 25(OH)D levels and adolescents' academic performance. Effective interventional programs are needed to maintain sufficient vitamin D levels during childhood and adolescence and, as a consequence, to improve academic performance.
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Affiliation(s)
- Ahmed A. Hassan
- Faculty of Medicine, University of Khartoum, Khartoum 11115, Sudan; (A.A.H.)
| | - Mustafa I. Elbashir
- Faculty of Medicine, University of Khartoum, Khartoum 11115, Sudan; (A.A.H.)
| | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 51911, Saudi Arabia;
| | - Ashwaq AlEed
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 51911, Saudi Arabia;
- Department of Pediatrics, College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah 51911, Saudi Arabia;
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ALbuloshi T, Kamel AM, Spencer JPE. Factors Associated with Low Vitamin D Status among Older Adults in Kuwait. Nutrients 2022; 14:nu14163342. [PMID: 36014846 PMCID: PMC9414672 DOI: 10.3390/nu14163342] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/16/2022] Open
Abstract
Low vitamin D levels among older people represent a significant health problem worldwide. This study aimed to examine the factors associated with vitamin D deficiency in older people (aged ≥ 65) in the Kuwaiti population. A cross-sectional study was conducted in seven primary healthcare centers across Kuwait (November 2020 to June 2021). The participants (n = 237) had their serum vitamin D (25(OH)D) concentrations (analyzed using LC-MS) classified as sufficiency 75 nmol/L (30 ng/mL) or deficiency < 75 nmol/L (below 30 ng/mL). The data were collected using self-administered questionnaires and face-to-face interviews with participants in geriatric clinics. Binomial logistic regression analysis was applied to assess factors associated with vitamin D deficiency. Vitamin D deficiency was found to be present in two thirds of the participants (n = 150, 63%), with a higher prevalence of deficiency in participants who did not receive vitamin D supplements, compared to those who did (84% vs. 16%, p = 0.001). The results from the binary logistic regression showed that a low duration of sun exposure (OR = 0.24, 95% C.I. [0.08−0.7], p = 0.011), dark skin pigmentation (OR = 4.46, 95% [1.35−20.49], p = 0.026), and lower caloric intake (OR = 0.9, 95% C.I. [0.85−0.96], p = 0.001) were risk factors for vitamin D deficiency. Furthermore, a significant inverse relationship was found between vitamin D levels and parathyroid hormone (PTH) levels (OR = 1.16, 95% C.I. [1.04−1.31], p = 0.016). These findings support the recommendation that vitamin D supplementation and adequate sunlight exposure are necessary for raising low vitamin D levels in older people in Kuwait.
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Affiliation(s)
- Thurayya ALbuloshi
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Reading RG6 6AP, UK
- Palliative Care Center, Kuwait, Ministry of Health, Al Sabah Medical Area, P.O. Box 5, Kuwait City 13001, Kuwait
- Correspondence: (T.A.); (J.P.E.S.)
| | - Ahmed M. Kamel
- Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University|Kasr El-Aini, Cairo 11562, Egypt
| | - Jeremy P. E. Spencer
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Reading RG6 6AP, UK
- Correspondence: (T.A.); (J.P.E.S.)
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Lower Blood Vitamin D Levels Are Associated with Depressive Symptoms in a Population of Older Adults in Kuwait: A Cross-Sectional Study. Nutrients 2022; 14:nu14081548. [PMID: 35458111 PMCID: PMC9032782 DOI: 10.3390/nu14081548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/27/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Low serum vitamin D has been associated with an increased risk of neuropsychiatry disorders. This study aimed to examine the association between vitamin D deficiency and depression in adults aged 65 years and older. This cross-sectional study was conducted in seven primary healthcare centers across Kuwait (November 2020 to June 2021). The participants (n = 237) had their serum vitamin D 25-(OH)-D concentrations (analyzed by LC-MS) classified as sufficient, ≥75 nmol/L (30 ng/mL); insufficient, 50−75 nmol/L (20−30 ng/mL); or deficient, <50 nmol/L (20 ng/mL). Depressive symptoms were evaluated using the 15-Item Geriatric Depression Scale (15-item GDS). The mean serum 25-OH-D levels (nmol/L) in volunteers with normal, mild, moderate, and severe depression were 100.0 ± 31.7, 71.2 ± 38.6, 58.6 ± 30.1 and 49.0 ± 6.93, respectively (p < 0.001). The participants in the vitamin D sufficiency group were significantly less likely to exhibit depressive symptoms (88.2%) than patients with mild (36%) and moderate (21%) depression (p < 0.001). Ordinal logistic regression showed that vitamin D deficiency (OR = 19.7, 95% CI 5.60, 74.86, p < 0.001) and insufficiency (OR = 6.40, 95% CI 2.20, 19.91, p < 0.001) were associated with higher odds of having depressive symptoms. A low serum vitamin D level is a significant predictor of symptoms of depression among older individuals.
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Ladang A, Rousselle O, Huyghebaert L, Bekaert AC, Kovacs S, Le Goff C, Cavalier E. Parathormone, bone alkaline phosphatase and 25-hydroxyvitamin D status in a large cohort of 1200 children and teenagers. Acta Clin Belg 2022; 77:4-9. [PMID: 32441564 DOI: 10.1080/17843286.2020.1769285] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: 25-Hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone alkaline phosphatase (BALP) are biomarkers of calcium/phosphate metabolism and bone turnover. Although vitamin D deficiency is a well-known cause of secondary hyperparathyroidism, few studies have considered vitamin D status when establishing reference ranges. In this study, we report PTH levels according to the vitamin D status and BALP levels in a large cohort of 1200 children. Additionally, we provide PTH pediatric reference values according to 25(OH)D status as well as BALP pediatric reference ranges.Methods: Serum samples from 1200 children (equally distributed from 5 months to 20 years old) who underwent blood sampling for allergy exploration were used to quantify 25(OH)D, PTH and BALP.Results: The percentage of vitamin D deficient children (<20 ng/ml) progressively increased during childhood starting from 7% in the 0 to 2 year-old subgroup to a mean of at least 50% among teenagers. PTH levels inversely mirrored 25(OH)D concentrations for all age and gender subgroups, and 25(OH)D deficient subgroups presented higher PTH levels than their non-deficient counterparts. In the non-deficient 25(OH)D population, PTH levels were the highest at 11 years old for girls and 14 years old for boys. BALP results were slightly increased during childhood and showed a constant decrease during teenage years starting from 12 years old for girls and 14 years old for boys.Conclusion: Our results highlight the inverse relationship between PTH and 25(OH)D in children and the need for a well characterized 25(OH)D population to establish pediatric reference ranges for PTH.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU De Liège, Liège, Belgium
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Alawadhi F, Yavuz L. Signs and Symptoms of Vitamin D Deficiency in Children: A Cross-Sectional Study in a Tertiary Pediatric Hospital in the United Arab Emirates. Cureus 2021; 13:e18998. [PMID: 34820245 PMCID: PMC8607358 DOI: 10.7759/cureus.18998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study was conducted to estimate the common signs and symptoms present in patients with vitamin D deficiency at a children's specialty hospital in Dubai, United Arab Emirates (UAE). METHODS This descriptive cross-sectional study (n = 805) examined patients aged <18 years with a serum 25-hydroxy vitamin D concentration of <50 ng/mL and presenting to the hospital between 2017 and 2018. Variables (age, gender, nationality, vitamin D levels, signs and symptoms, and primary complaint) were described using frequencies and mean values (SD). Chi-square and Kruskal-Wallis tests were conducted. RESULTS Among the 805 patients, 315 (39.2%) had vitamin D deficiency (<20 ng/mL). Regarding the symptoms of these 315 patients, 26% (n = 82) of them were asymptomatic, 13.3% (n = 42) of them had endocrine symptoms and other/rare symptoms, and 11.7% (n = 37) of them had gastrointestinal symptoms. The least common symptoms were found in the mixed category (mixed symptoms of different body systems), consisting of 3.5% (n = 11) of patients. Vitamin D deficiency was more common among female patients (44.8%) and Emiratis (40.5%), and the average age for patients to have vitamin D deficiency was nine years. CONCLUSION To our knowledge, this is one of the first studies in the United Arab Emirates to focus on and examine patients with low vitamin D levels in detail. Determining the most frequent symptoms is helpful for healthcare practitioners because our results showed that most patients with the deficiency were asymptomatic. Hence, we recommend performing regular checkups for healthy and asymptomatic children to detect vitamin D deficiency before they show any symptoms.
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Affiliation(s)
- Fatma Alawadhi
- Pediatrics, Al Jalila Children's Hospital - Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, ARE
| | - Lemis Yavuz
- Pediatrics, Al Jalila Children's Hospital - Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, ARE
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Sherief LM, Ali A, Gaballa A, Abdellatif GM, Kamal NM, Afify MR, Abdelmalek DH, El-Emari SA, Soliman AS, Mokhtar WA. Vitamin D status and healthy Egyptian adolescents: Where do we stand? Medicine (Baltimore) 2021; 100:e26661. [PMID: 34398026 PMCID: PMC8294863 DOI: 10.1097/md.0000000000026661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 06/25/2021] [Indexed: 01/04/2023] Open
Abstract
Vitamin D deficiency is a worldwide public health problem. Low vitamin D and its consequences among children and adolescents could be considered as one of the most important health-related problems. This study aimed to estimate the prevalence of vitamin D deficiency in healthy Egyptian adolescents and investigate factors associated with vitamin D status.A cross-sectional study was conducted on 572 school children (270 males and 302 females) aged 14 to 18 years, who were randomly selected from high schools in one governorate in Egypt. Data were collected through a self-administered questionnaire. Vitamin D level, serum calcium, phosphorus, alkaline phosphates were measured.Vitamin D deficiency was almost present in all the studied Egyptian healthy adolescents (99%), 94.8% had vitamin D deficiency and 4.2% had vitamin D insufficiency. Girls had a higher prevalence of vitamin D deficiency than boys. There was a significant association between lack of physical activity, sun exposure, and vitamin D deficiency.Vitamin D deficiency and insufficiency are highly prevalent. In sunny countries, the special pattern of conservative clothing and the lack of outdoor physical activity might be the underlying factors for the high prevalence in females. Vitamin D supplementation seems to be mandatory to halt the problem.
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Affiliation(s)
| | - Adel Ali
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Gaballa
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | - Mona R. Afify
- Department of Medical Microbiology & Parasitology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia
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Nassar MF, Emam EK, Allam MF. Is There a Benefit of Vitamin D Supplementation in Deficient Children and Adolescents Suffering from Obesity? A Meta-Analysis. Glob Pediatr Health 2021; 8:2333794X211018352. [PMID: 34104694 PMCID: PMC8165875 DOI: 10.1177/2333794x211018352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/26/2021] [Indexed: 11/16/2022] Open
Abstract
This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Ten studies were retrieved, but only 6 were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the 2 studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the 6 retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation.
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Affiliation(s)
- May Fouad Nassar
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ehab Khairy Emam
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed Farouk Allam
- Department of Family Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Koyama S, Kubota T, Naganuma J, Arisaka O, Ozono K, Yoshihara S. Incidence rate of vitamin D deficiency and FGF23 levels in 12- to 13-year-old adolescents in Japan. J Bone Miner Metab 2021; 39:456-462. [PMID: 33206223 DOI: 10.1007/s00774-020-01173-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/21/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The incidence rate of vitamin D deficiency is increasing throughout the world. We measured the incidence rate of vitamin D deficiency and fibroblast growth factor 23 (FGF23) levels in 12- to 13-year-old adolescents in Japan. MATERIALS AND METHODS A total of 492 adolescents (247 boys and 245 girls) from Japanese community enrolled in this study. 25 hydroxyvitamin D (25(OH)D) was measured with radioimmunoassay. In the subjects with low 25(OH)D levels (≦ 20 ng/ml), intact parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), albumin (Alb), alkaline phosphatase (ALP) and FGF23 were measured. RESULTS 25(OH)D levels were significantly lower in girls (20.9 ± 3.1 ng/ml) than in boys (22.2 ± 3.3 ng/ml) (p < 0.0001). Fifty-five boys (22.3%) and 83 (33.9%) girls showed vitamin D deficiency (< 20 ng/ml). One-hundred eighty-six (75.3%) boys and 162 (66.1%) girls showed vitamin D insufficiency (≧ 20 ng/ml, < 30 ng/ml). In the subjects whose 25(OH)D levels were ≦ 20 ng/ml, the levels of iPTH, Ca, P, Alb, ALP and FGF23 were 22.3 ± 9.0 pg/ml, 9.5 ± 0.4 mg/dl, 4.7 ± 0.6 mg/dl, 4.6 ± 0.3 g/dl, 920.8 ± 339.3 U/l and 42.6 ± 26.0 pg/ml, respectively. There was a significant negative association between serum 25(OH)D levels and iPTH [r = - 0.290 (p < 0.0001)]. There was no significant association between serum 25(OH)D levels and FGF23. CONCLUSION We show that 28% of Japanese 12- to 13-year-old early adolescents suffer from vitamin D deficiency. Findings from this study indicate that vitamin D deficiency requires close oversight in public health during adolescence to ensure proper bone health.
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Affiliation(s)
- Satomi Koyama
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan.
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Junko Naganuma
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
| | - Osamu Arisaka
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
- Department of Pediatrics, Nasu Red Cross Hospital, Otawara, Tochigi, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shigemi Yoshihara
- Department of Pediatrics, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi, 321-0293, Japan
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Obesity, oxidative DNA damage and vitamin D as predictors of genomic instability in children and adolescents. Int J Obes (Lond) 2021; 45:2095-2107. [PMID: 34158611 PMCID: PMC8380542 DOI: 10.1038/s41366-021-00879-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/18/2021] [Accepted: 05/27/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND/OBJECTIVES Epidemiological evidence indicates obesity in childhood and adolescence to be an independent risk factor for cancer and premature mortality in adulthood. Pathological implications from excess adiposity may begin early in life. Obesity is concurrent with a state of chronic inflammation, a well-known aetiological factor for DNA damage. In addition, obesity has been associated with micro-nutritional deficiencies. Vitamin D has attracted attention for its anti-inflammatory properties and role in genomic integrity and stability. The aim of this study was to determine a novel approach for predicting genomic instability via the combined assessment of adiposity, DNA damage, systemic inflammation, and vitamin D status. SUBJECTS/METHODS We carried out a cross-sectional study with 132 participants, aged 10-18, recruited from schools and paediatric obesity clinics in London. Anthropometric assessments included BMI Z-score, waist and hip circumference, and body fat percentage via bioelectrical impedance. Inflammation and vitamin D levels in saliva were assessed by enzyme-linked immunosorbent assay. Oxidative DNA damage was determined via quantification of 8-hydroxy-2'-deoxyguanosine in urine. Exfoliated cells from the oral cavity were scored for genomic instability via the buccal cytome assay. RESULTS As expected, comparisons between participants with obesity and normal range BMI showed significant differences in anthropometric measures (p < 0.001). Significant differences were also observed in some measures of genomic instability (p < 0.001). When examining relationships between variables for all participants, markers of adiposity positively correlated with acquired oxidative DNA damage (p < 0.01) and genomic instability (p < 0.001), and negatively correlated with vitamin D (p < 0.01). Multiple regression analyses identified obesity (p < 0.001), vitamin D (p < 0.001), and oxidative DNA damage (p < 0.05) as the three significant predictors of genomic instability. CONCLUSIONS Obesity, oxidative DNA damage, and vitamin D deficiency are significant predictors of genomic instability. Non-invasive biomonitoring and predictive modelling of genomic instability in young patients with obesity may contribute to the prioritisation and severity of clinical intervention measures.
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Alyahya KO. Poor dietary consumption and limited sun exposure are risk factors for vitamin D deficiency in premenopausal Kuwaiti women: A cross-sectional study. Qatar Med J 2020; 2020:15. [PMID: 32391251 PMCID: PMC7198469 DOI: 10.5339/qmj.2020.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/11/2019] [Indexed: 11/03/2022] Open
Abstract
Background: Low serum vitamin D levels are reported constantly among females living in the Arabian Gulf countries, presumably due to their lifestyle, which limits direct sun exposure. Because Vitamin D deficiency has been implicated in a wide range of ailments, healthy females with the deficiency might be at risk for developing many health problems. Thus, the aim was to assess lifestyle risk factors for vitamin D deficiency in healthy women in Kuwait. Methods: A total of 104, disease-free, premenopausal women were recruited for assessment of their serum 25OHD and intact PTH levels. Physical examination, blood withdrawal and interviewer-administered questionnaires were used to collect the relevant data. Associations were detected statistically using nonparametric tests and logistic regression was used to identify risk factors for vitamin D deficiency. Results: Vitamin D deficiency ( < 25 nmol/L) occurred in 84.6%, and hyperparathyroidism ( ≥ 6.9 pmol/L) occurred in 25% of women, among which all were vitamin D deficient. Significant risk factors of vitamin D deficiency were nondaily milk intake (OR:25, CI%:4.2-147), no fish intake (OR:5, CI%:1-22.8), and no weekend sun exposure (OR:8.2, CI%:1.28-52.6). Having PTH ≥ 6 pmol/L was also associated with a higher likelihood of having vitamin D deficiency. Conclusion: Vitamin D deficiency is very common in disease-free, premenopausal Kuwaiti women and can be avoided by improving food consumption and obtaining more sun exposure.
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Affiliation(s)
- Khulood Othman Alyahya
- Science Department, College of Basic Education, Public Authority for Applied Education and Training (PAAET, Kuwait
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12
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The relation between circulating levels of vitamin D and parathyroid hormone in children and adolescents with overweight or obesity: Quest for a threshold. PLoS One 2019; 14:e0225717. [PMID: 31770397 PMCID: PMC6879169 DOI: 10.1371/journal.pone.0225717] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 11/11/2019] [Indexed: 12/31/2022] Open
Abstract
The level of serum 25-hydroxyvitamin D (25(OH)D) at which intact parathyroid hormone (iPTH) is maximally suppressed (suppression point) and below which PTH begins to rise (inflection point) has been used to define optimum 25(OH)D concentration. We aimed to study the association of circulating iPTH with 25(OH)D concentrations and to determine a 25(OH)D threshold associated with a significant iPTH suppression. This cross-sectional study was conducted on 198 boys and 180 girls, aged 6–13 years with BMI ≥ 1SD (WHO criteria) recruited from primary schools. Adjusted iPTH for BMI z-score, pubertal status, and dietary calcium was used. Nonlinear regression was used to model the relationship between 25(OH)D and iPTH and identify a suppression point for 25(OH)D at which iPTH reached a plateau. Piecewise regression analysis with a single knot for all possible values of 25(OH)D were fitted. Furthermore, 95% confidence intervals (95%CI) for those point had been calculated. The mean age (SD) of girls and boys was 9.1 (1.6) and 9.4 (1.7) years, respectively. Median 25(OH)D and iPTH were 13.8 ng/mL and 33.9 pg/mL in boys and 9.9 ng/mL and 47.8 ng/mL in girls, respectively. The equation in girls was: log-iPTH = 3.598+0.868 exp[(-0.190×25(OH)D. The point for near maximal suppression of iPTH by 25(OH)D for girls occurred at a 25(OH)D concentration of 20 ng/mL (95% CI: 7.1 to 32.2). No point of maximal suppression was found for boys. We also found a 25(OH)D threshold of 10 ng/mL (95% CI: 4.6 to 22.5) for girls (f: 9.8) by linear piecewise regression modeling of adjusted iPTH. No significant inflection point for boys was observed. In overweight/obese girls, when the concentration of 25(OH)D was higher than 20 ng/mL, an iPTH mean plateau level is reached, and when its concentrations approach 10 ng/mL, the slope of iPTH concentration has been accelerated.
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13
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Francis I, AlAbdali N, Kapila K, John B, Al-Temaimi RA. Vitamin D pathway related polymorphisms and vitamin D receptor expression in breast cancer. INT J VITAM NUTR RES 2019; 91:124-132. [PMID: 31623531 DOI: 10.1024/0300-9831/a000615] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is an emerging risk factor for breast cancer suggesting its role in breast cancer pathogenesis. Recent evidence suggests vitamin D receptor (VDR) expression is a prognosis predictor in breast cancer. We set out to determine the status of VDR expression in histologically characterized breast cancers, and whether common genetic variants modify VDR expression in breast cancer. One-hundred and twenty Kuwaiti female breast cancer fixed tissues were assessed for VDR expression to identify the level and location of its expression by immunohistochemistry. VDR variants (rs731236, rs2228570), and vitamin D binding protein (VDBP) variants (rs4588, rs7041) genotypes were ascertained in breast cancer specimens using Taqman genotyping assays. VDR nuclear expression correlated with low grade tumors (p = 0.01), whereas cytoplasmic expression correlated with lymph node positive tumors (p = 0.03). Absence of VDR expression was a marker for high-grade dedifferentiated tumors (p = 0.01). VDBP rs7041 associated with breast cancer risk (OR 1.92, 95% CI: 1.34 - 2.73; p = 0.0004), and VDR rs2228570 correlated with increased VDR cytoplasmic expression (p < 0.0001). In conclusion, VDR expression is altered in breast cancer confirming its involvement in breast cancer progression. Genetic factors appear to play a role in breast cancer risk, and may modify tumor sensitization to vitamin D.
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Affiliation(s)
- Issam Francis
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Noora AlAbdali
- Postgraduate Medical Sciences Program, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Kusum Kapila
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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14
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Hocaoğlu-Emre FS, Sarıbal D, Oğuz O. Vitamin D Deficiency and Insufficiency According to the Current Criteria for Children: Vitamin D Status of Elementary School Children in Turkey. J Clin Res Pediatr Endocrinol 2019; 11:181-188. [PMID: 30592191 PMCID: PMC6571535 DOI: 10.4274/jcrpe.galenos.2018.2018.0272] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE This study aimed to determine the ratio of seasonal vitamin D deficiency and insufficiency in elementary school children aged between 6-9 years old, living in one of the largest metropols of Europe, İstanbul. METHODS Serum 25(OH)D levels of 640 children aged 6-9 years old were scanned retrospectively from the hospital information system records between September 2017-August 2018 period. Vitamin D deficiency was defined as a serum 25(OH)D level less than 12 ng/mL (30 nmol/L) and insufficiency as levels between 12 and 20 ng/mL (30-50 nmol/L). RESULTS Serum 25(OH)D levels ranged from 3.90 to 64.60 ng/mL, the median value was 25.95 ng/mL for all subjects. Of all the primary school children, 485 (75.78%) had adequate levels of 25(OH)D. Vitamin D deficiency was observed in 36 of children (5.62%), whereas insufficient levels of 25(OH)D were found in 119 children (18.60%). The ratio of vitamin D insufficiency and deficiency together was highest in spring (31.87%) and lowest in summer (13.12%). CONCLUSION Vitamin D deficiency is a widely observed and preventable public health problem among children of different ages. It is necessary to increase the awareness among health professionals, and providing 25(OH)D supplements will yield generations with healthy bone structure and well growth.
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Affiliation(s)
- F. Sinem Hocaoğlu-Emre
- Beykent University School of Health Sciences, Department of Nutrition and Dietetics, İstanbul, Turkey,* Address for Correspondence: Beykent University School of Health Sciences, Department of Nutrition and Dietetics, İstanbul, Turkey Phone: +90 506 503 06 80 E-mail:
| | - Devrim Sarıbal
- İstanbul University Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Biophysics, İstanbul, Turkey
| | - Osman Oğuz
- İstanbul Training and Research Hospital, Department of Clinical Chemistry, İstanbul, Turkey
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15
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Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon R. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol 2019; 180:P23-P54. [PMID: 30721133 DOI: 10.1530/eje-18-0736] [Citation(s) in RCA: 369] [Impact Index Per Article: 73.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D <30 nmol/L or 12 ng/mL) is found in >10% of Europeans. The European Calcified Tissue Society (ECTS) advises that the measurement of serum 25(OH)D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defects and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non-Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficiency, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer.
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Affiliation(s)
- Paul Lips
- Endocrine Section, Department of Internal Medicine, Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, University College Cork, Cork, Ireland
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutritional Sciences, University of Helsinki, Helsinki, Finland
| | | | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | - Jan Stepan
- Institute of Rheumatology, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Roger Bouillon
- Clinic and Laboratory of Endocrinology, Gasthuisberg, KU Leuven, Leuven, Belgium
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16
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Alkazemi DUZ, Saleh A. Adequacy of dairy product intake among children in Kuwait using a short dietary assessment questionnaire. ACTA ACUST UNITED AC 2019. [DOI: 10.1108/nfs-04-2018-0120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper aims to assess the consumption of dairy products in Kuwaiti children, and develop and validate a semi-quantitative food frequency questionnaire to measure dairy product consumption.Design/methodology/approachThis cross-sectional study was based on a sample of child–parent dyads (n= 150). A dietary assessment questionnaire on local dairy products consumed by preschool and preadolescent children was developed. Serving and portion sizes were evaluated on the basis of the guidelines of the United States Department of Agriculture and the American Academy of Pediatrics to calculate median intake levels of three age groups (3-5, 6-8 and 9-11 years).FindingsAll children met or exceeded the recommended daily servings of dairy products for their age and sex. Dairy product intake was often from processed dairy including milk-based desserts, flavored milk and cheese. Compared to boys, girls consumed more yogurt (15.5 per cent vs 14.2 per cent,p= 0.001) and milk-based desserts (15.5 vs 14.3,p= 0.001). In boys, flavored milk contributed more to the total dairy intake than in girls, especially in 6-8-year-olds (21.8 per cent vs 18.9 per cent,p= 0.021). Weight status was not associated with dairy product intake in either sex.Originality/valueThis is the first study that quantifies dairy product consumption in Kuwaiti children and provides insight into sex-specific trends in dairy product selection. The findings of this study may help in investigating relationships between dairy product consumption in children and disease risk factors, and are important for the development of local dietary guidelines for children.
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