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Demay MB, Pittas AG, Bikle DD, Diab DL, Kiely ME, Lazaretti-Castro M, Lips P, Mitchell DM, Murad MH, Powers S, Rao SD, Scragg R, Tayek JA, Valent AM, Walsh JME, McCartney CR. Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2024; 109:1907-1947. [PMID: 38828931 DOI: 10.1210/clinem/dgae290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND Numerous studies demonstrate associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. Although a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain. OBJECTIVE To develop clinical guidelines for the use of vitamin D (cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the risk of disease in individuals without established indications for vitamin D treatment or 25(OH)D testing. METHODS A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials in general populations (without an established indication for vitamin D treatment or 25[OH]D testing), evaluating the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes). The panel defined "empiric supplementation" as vitamin D intake that (a) exceeds the Dietary Reference Intakes (DRI) and (b) is implemented without testing for 25(OH)D. Systematic reviews queried electronic databases for publications related to these 14 clinical questions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and guide recommendations. The approach incorporated perspectives from a patient representative and considered patient values, costs and resources required, acceptability and feasibility, and impact on health equity of the proposed recommendations. The process to develop this clinical guideline did not use a risk assessment framework and was not designed to replace current DRI for vitamin D. RESULTS The panel suggests empiric vitamin D supplementation for children and adolescents aged 1 to 18 years to prevent nutritional rickets and because of its potential to lower the risk of respiratory tract infections; for those aged 75 years and older because of its potential to lower the risk of mortality; for those who are pregnant because of its potential to lower the risk of preeclampsia, intra-uterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality; and for those with high-risk prediabetes because of its potential to reduce progression to diabetes. Because the vitamin D doses in the included clinical trials varied considerably and many trial participants were allowed to continue their own vitamin D-containing supplements, the optimal doses for empiric vitamin D supplementation remain unclear for the populations considered. For nonpregnant people older than 50 years for whom vitamin D is indicated, the panel suggests supplementation via daily administration of vitamin D, rather than intermittent use of high doses. The panel suggests against empiric vitamin D supplementation above the current DRI to lower the risk of disease in healthy adults younger than 75 years. No clinical trial evidence was found to support routine screening for 25(OH)D in the general population, nor in those with obesity or dark complexion, and there was no clear evidence defining the optimal target level of 25(OH)D required for disease prevention in the populations considered; thus, the panel suggests against routine 25(OH)D testing in all populations considered. The panel judged that, in most situations, empiric vitamin D supplementation is inexpensive, feasible, acceptable to both healthy individuals and health care professionals, and has no negative effect on health equity. CONCLUSION The panel suggests empiric vitamin D for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. Due to the scarcity of natural food sources rich in vitamin D, empiric supplementation can be achieved through a combination of fortified foods and supplements that contain vitamin D. Based on the absence of supportive clinical trial evidence, the panel suggests against routine 25(OH)D testing in the absence of established indications. These recommendations are not meant to replace the current DRIs for vitamin D, nor do they apply to people with established indications for vitamin D treatment or 25(OH)D testing. Further research is needed to determine optimal 25(OH)D levels for specific health benefits.
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Affiliation(s)
- Marie B Demay
- Department of Medicine, Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Anastassios G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Tufts Medical Center, Boston, MA 02111, USA
| | - Daniel D Bikle
- Departments of Medicine and Dermatology, University of California San Francisco, San Francisco VA Medical Center, San Francisco, CA 94158, USA
| | - Dima L Diab
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of Cincinnati, Cincinnati, OH 45267, USA
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences and INFANT Research Centre, University College Cork, Cork, T12 Y337, Ireland
| | - Marise Lazaretti-Castro
- Department of Internal Medicine, Division of Endocrinology, Universidade Federal de Sao Paulo, Sao Paulo 04220-00, Brazil
| | - Paul Lips
- Endocrine Section, Amsterdam University Medical Center, Internal Medicine, 1007 MB Amsterdam, Netherlands
| | - Deborah M Mitchell
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - M Hassan Murad
- Evidence-Based Practice Center, Mayo Clinic, Rochester, MN 55905, USA
| | - Shelley Powers
- Bone Health and Osteoporosis Foundation, Los Gatos, CA 95032, USA
| | - Sudhaker D Rao
- Division of Endocrinology, Diabetes and Bone & Mineral Disorders, Henry Ford Health, Detroit, MI 48202, USA
- College of Human Medicine, Michigan State University, Lansing, MI 48824, USA
| | - Robert Scragg
- School of Population Health, The University of Auckland, Auckland 1142, New Zealand
| | - John A Tayek
- Department of Internal Medicine, Harbor-UCLA Medical Center, Torrance, CA 90509, USA
- The Lundquist Institute, Torrance, CA 90502, USA
| | - Amy M Valent
- Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, OR 97239, USA
| | - Judith M E Walsh
- Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - Christopher R McCartney
- Department of Medicine, University of Virginia, Charlottesville, VA 22908, USA
- Department of Medicine, West Virginia University, Morgantown, WV 26506, USA
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Shah VP, Nayfeh T, Alsawaf Y, Saadi S, Farah M, Zhu Y, Firwana M, Seisa M, Wang Z, Scragg R, Kiely ME, Lips P, Mitchell DM, Demay MB, Pittas AG, Murad MH. A Systematic Review Supporting the Endocrine Society Clinical Practice Guidelines on Vitamin D. J Clin Endocrinol Metab 2024; 109:1961-1974. [PMID: 38828942 DOI: 10.1210/clinem/dgae312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Indexed: 06/05/2024]
Abstract
CONTEXT Low vitamin D status is common and is associated with various common medical conditions. OBJECTIVE To support the development of the Endocrine Society's Clinical Practice Guideline on Vitamin D for the Prevention of Disease. METHODS We searched multiple databases for studies that addressed 14 clinical questions prioritized by the guideline panel. Of the 14 questions, 10 clinical questions assessed the effect of vitamin D vs no vitamin D in the general population throughout the lifespan, during pregnancy, and in adults with prediabetes; 1 question assessed dosing; and 3 questions addressed screening with serum 25-hydroxyvitamin D (25[OH]D). The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess certainty of evidence. RESULTS Electronic searches yielded 37 007 citations, from which we included 151 studies. In children and adolescents, low-certainty evidence suggested reduction in respiratory tract infections with empiric vitamin D. There was no significant effect on select outcomes in healthy adults aged 19 to 74 years with variable certainty of evidence. There was a very small reduction in mortality among adults older than 75 years with high certainty of evidence. In pregnant women, low-certainty evidence suggested possible benefit on various maternal, fetal, and neonatal outcomes. In adults with prediabetes, moderate certainty of evidence suggested reduction in the rate of progression to diabetes. Administration of high-dose intermittent vitamin D may increase falls, compared to lower-dose daily dosing. We did not identify trials on the benefits and harms of screening with serum 25(OH)D. CONCLUSION The evidence summarized in this systematic review addresses the benefits and harms of vitamin D for the prevention of disease. The guideline panel considered additional information about individuals' and providers' values and preferences and other important decisional and contextual factors to develop clinical recommendations.
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Affiliation(s)
| | - Tarek Nayfeh
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Yahya Alsawaf
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Samer Saadi
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Magdoleen Farah
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Ye Zhu
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Mohammed Firwana
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Mohamed Seisa
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Zhen Wang
- Mayo Clinic Evidence-Based Practice Center, Rochester, MN 55905, USA
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland 1023, New Zealand
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences and INFANT Research Centre, University College Cork, Cork T12 Y337, Ireland
| | - Paul Lips
- Internal Medicine, Endocrine Section, Amsterdam University Medical Center, Amsterdam 1007 MB, The Netherlands
| | - Deborah M Mitchell
- Pediatric Endocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Marie B Demay
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Anastassios G Pittas
- Divisions of Endocrinology, Diabetes and Metabolism, Tufts-New England Medical Center, Boston, MA 02116, USA
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Al Refaie A, Baldassini L, Mondillo C, De Vita M, Giglio E, Tarquini R, Gonnelli S, Caffarelli C. Vitamin D and Dyslipidemia: Is There Really a Link? A Narrative Review. Nutrients 2024; 16:1144. [PMID: 38674837 PMCID: PMC11053479 DOI: 10.3390/nu16081144] [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: 02/24/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
Nowadays, the interest in the extraskeletal effects of vitamin D is growing. In the literature, its several possible actions have been confirmed. Vitamin D seems to have a regulatory role in many different fields-inflammation, immunity, and the endocrine system-and many studies would demonstrate a possible correlation between vitamin D and cardiovascular disease. In this paper, we deepened the relationship between vitamin D and dyslipidemia by reviewing the available literature. The results are not entirely clear-cut: on the one hand, numerous observational studies suggest a link between higher serum vitamin D levels and a beneficial lipid profile, while on the other hand, interventional studies do not demonstrate a significant effect. Understanding the possible relationship between vitamin D and dyslipidemia may represent a turning point: another link between vitamin D and the cardiovascular system.
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Affiliation(s)
- Antonella Al Refaie
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Leonardo Baldassini
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Caterina Mondillo
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Michela De Vita
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Elisa Giglio
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Roberto Tarquini
- Division of Internal Medicine I, San Giuseppe Hospital, 50053 Tuscany, Italy
| | - Stefano Gonnelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
| | - Carla Caffarelli
- Section of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy (S.G.)
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Jiang Q, Prabahar K, Saleh SAK, Adly HM, Velu P, Adi AR, Baradwan S, Hajkhalaf MI, Baredwan A, Gari F, Kord-Varkaneh H. The Effects of Vitamin D Supplementation on C-Reactive Protein and Systolic and Diastolic Blood Pressure in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. J Acad Nutr Diet 2024; 124:387-396.e5. [PMID: 38441080 DOI: 10.1016/j.jand.2023.10.013] [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: 03/15/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.
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Affiliation(s)
- Qidong Jiang
- Intensive Care Unit, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Saleh A K Saleh
- Department of Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Oncology Diagnostic Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M Adly
- Department of Community Medicine and Pilgrims Healthcare, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Periyannan Velu
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Chidambaram, Tamil Nadu, India
| | | | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | | | - Ahlam Baredwan
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Faris Gari
- Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hamed Kord-Varkaneh
- Department of Nutrition and Food Hygiene, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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5
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Habiba E, Ali S, Ghanem Y, Sharaki O, Hewedy W. Effect of oral versus parenteral vitamin D3 supplementation on nuclear factor-κB and platelet aggregation in type 2 diabetic patients. Can J Physiol Pharmacol 2023; 101:610-619. [PMID: 37721213 DOI: 10.1139/cjpp-2022-0359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
Platelet hyperactivity is one of the key factors implicated in the development and progression of diabetic vascular complications. Activated platelets mediate leukocyte recruitment that further enhances inflammatory responses in vascular wall ultimately resulting in atherosclerotic complications. Since vitamin D insufficiency is highly prevalent in diabetics, we aimed to evaluate the effect of three dosage forms of vitamin D supplementation on lipid profile, NF-κB, platelet aggregation, and platelet calcium content in type 2 diabetic patients. Type 2 diabetic patients were randomized to receive daily (4000 IU/day) or weekly (50 000 IU/week) oral vitamin D3 for 3 months. Another group received a single parenteral dose (300 000 IU) of vitamin D3, whereas the control group received their antidiabetic drug(s) alone. Serum 25(OH)D, total cholesterol, triglycerides, high- and low-density lipoprotein cholesterol, NF-κB, and platelet aggregation were measured at the beginning and 3 months after vitamin D supplementation. Platelet calcium content was evaluated by measuring the fluorescence intensity of Rhod-2-stained platelets by confocal fluorescence microscopy. Results showed that serum 25(OH)D3 levels significantly increased in all vitamin D3-treated groups. However, the mean level for parenteral treated group was significantly lower than oral-treated groups. Oral and parenteral treatment were also able to decrease NF-κB level, platelet aggregation, and platelet calcium content. However, both oral doses of vitamin D3 were superior to the single parenteral dose. In conclusion, restoring normal levels of vitamin D is an important determinant to maintain normal platelet function and reduce inflammation. Nevertheless, further long-term studies are still needed.
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Affiliation(s)
- Esraa Habiba
- Clinical Pharmacology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Samia Ali
- Clinical Pharmacology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yehia Ghanem
- Internal medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ola Sharaki
- Clinical Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Wafaa Hewedy
- Clinical Pharmacology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Behers BJ, Melchor J, Behers BM, Meng Z, Swanson PJ, Paterson HI, Mendez Araque SJ, Davis JL, Gerhold CJ, Shah RS, Thompson AJ, Patel BS, Mouratidis RW, Sweeney MJ. Vitamins and Minerals for Blood Pressure Reduction in the General, Normotensive Population: A Systematic Review and Meta-Analysis of Six Supplements. Nutrients 2023; 15:4223. [PMID: 37836507 PMCID: PMC10574336 DOI: 10.3390/nu15194223] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.
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Affiliation(s)
- Benjamin J. Behers
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Julian Melchor
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Brett M. Behers
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Zhuo Meng
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Palmer J. Swanson
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Hunter I. Paterson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Samuel J. Mendez Araque
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Joshua L. Davis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Cameron J. Gerhold
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Rushabh S. Shah
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Anthony J. Thompson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Binit S. Patel
- Internal Medicine Residency, Florida State University, 1700 South Tamiami Trail, Sarasota, FL 34239, USA;
| | - Roxann W. Mouratidis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Michael J. Sweeney
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
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Rupprecht M, Wagenpfeil S, Schöpe J, Vieth R, Vogt T, Reichrath J. Meta-Analysis of European Clinical Trials Characterizing the Healthy-Adult Serum 25-hydroxyvitamin D Response to Vitamin D Supplementation. Nutrients 2023; 15:3986. [PMID: 37764770 PMCID: PMC10537880 DOI: 10.3390/nu15183986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
To obtain reliable data that allow health authorities to re-evaluate recommendations for oral vitamin D uptake, we conducted a meta-analysis to investigate the impact of supplementation on serum 25-hydroxyvitamin D (25(OH)D) levels in healthy adults in Europe. Of the publications identified (n = 4005) in our literature search (PUBMED, through 2 January 2022), 49 primary studies (7320 subjects, 73 study arms) were eligible for inclusion in our meta-analysis. The risk of bias was assessed using the Cochrane RoB tool based on seven categories, according to which each study is rated using three grades, and overall was rated as rather low. The median duration of intervention was 136.78 days (range, 1088 days); the mean weighted baseline 25(OH)D concentration and mean age were 33.01 vs. 33.84 nmol/L and 46.8 vs. 44.8 years in the vitamin D and placebo groups, respectively. Using random-effects models, 25(OH)D levels were increased by 36.28 nmol/L (95% CI 31.97-40.59) in the vitamin D group compared to the placebo, with a relative serum increment of 1.77 nmol/L per 2.5 μg of vitamin D daily. Notably, the relative serum 25(OH)D increment was affected by various factors, including the dosage and baseline serum 25(OH)D concentration, decreasing with increasing vitamin D doses and with increasing baseline serum levels. We estimate that supplementation in all healthy adults in Europe with appr. 25 μg of vitamin D (1000 IU) daily would raise serum 25(OH)D levels in 95% of the population to ≥50 nmol/L. Our work provides health authorities with reliable data that can help to re-evaluate recommendations for oral vitamin D supplementation.
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Affiliation(s)
- Manuel Rupprecht
- Department of Dermatology, Saarland University Medical Center, 66421 Homburg, Germany
- Health Management, German University for Prevention and Health Management (DHfPG), 66123 Saarbruecken, Germany
| | - Stefan Wagenpfeil
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jakob Schöpe
- Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University Medical Center, 66421 Homburg, Germany
| | - Reinhold Vieth
- Department of Nutritional Sciences, Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Thomas Vogt
- Department of Dermatology, Saarland University Medical Center, 66421 Homburg, Germany
| | - Jörg Reichrath
- Department of Dermatology, Saarland University Medical Center, 66421 Homburg, Germany
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8
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Hao L, Lu A, Gao H, Niu J, Prabahar K, Seraj SS, Pan Y. The Effects of Vitamin D on Markers of Glucose and Obesity in Postmenopausal Women: A Meta-analysis of Randomized Controlled Trials. Clin Ther 2023; 45:913-920. [PMID: 37598056 DOI: 10.1016/j.clinthera.2023.07.009] [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: 02/01/2023] [Revised: 05/30/2023] [Accepted: 07/12/2023] [Indexed: 08/21/2023]
Abstract
PURPOSE The effect of vitamin D effect on glucose markers and obesity in postmenopausal women remains controversial. The current literature contains little information on vitamin D dosage and duration for optimal efficacy in postmenopausal women. This meta-analysis was undertaken to assess the impact of vitamin D on glucose markers and obesity in postmenopausal women. METHODS A number of databases were used dated up to January 5, 2023, with no language restrictions (PubMed/MEDLINE, Web of Science, EMBASE, and Scopus). Treatment response from baseline was estimated from the mean within-group analysis, and SDs were used to calculate the treatment response. FINDINGS Nine eligible articles with 12 comparisons qualified for the final quantitative analysis. An overall decrease was noted in fasting blood glucose (weighted mean difference [WMD], -3.56 mg/dL; 95% CI, -5.49 to -1.64; P < 0.001), homeostatic model assessment for insulin resistance (WMD, -1.168 mm; 95% CI, -2.001 to -0.33; P = 0.006), insulin (WMD, -2.26 units; 95% CI, -4.35 to -0.18; P = 0.033), and glycosylated hemoglobin (WMD, -0.41%; 95% CI, -0.54 to -0.29; P < 0.001) after vitamin D administration in postmenopausal women. In subgroup analyses, a notable decrease in fasting blood glucose was detected when the intervention course was ˃6 months and dosage ≤1000 IU/d (WMD, -3.48 mg/dL). The present study showed that vitamin D was not associated with body mass index, body weight, or waist circumference in postmenopausal women. IMPLICATIONS Vitamin D is beneficial for glucose markers but not obesity in postmenopausal women. An individualized dosage regimen of vitamin D should be followed depending on the clinical outcome target of postmenopausal women.
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Affiliation(s)
- Lei Hao
- Clinical Chinese Medicine Teaching and Research Office, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Aiyangzi Lu
- Clinical Chinese Medicine Teaching and Research Office, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Hui Gao
- Department of 2nd Nephrology, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
| | - Jianfei Niu
- Department of Acupuncture, Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Shaikh Sanjid Seraj
- Department of Surgery, Royal Shrewsbury Hospital, Shrewsbury and Telford NHS Trust, Shrewsbury, West Midlands, United Kingdom
| | - Yongmei Pan
- Huang Di Neijing Teaching and Research Office, Hebei University of Chinese Medicine, Shijiazhuang, China.
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9
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Ruiz-García A, Pallarés-Carratalá V, Turégano-Yedro M, Torres F, Sapena V, Martin-Gorgojo A, Martin-Moreno JM. Vitamin D Supplementation and Its Impact on Mortality and Cardiovascular Outcomes: Systematic Review and Meta-Analysis of 80 Randomized Clinical Trials. Nutrients 2023; 15:nu15081810. [PMID: 37111028 PMCID: PMC10146299 DOI: 10.3390/nu15081810] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/01/2023] [Accepted: 04/05/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The impact of vitamin D supplementation on cardiovascular outcomes and mortality risk reduction remains unclear due to conflicting study findings. METHODS We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), published between 1983 and 2022, that reported the effect of vitamin D supplementation in adults versus placebo or no treatment on all-cause mortality (ACM), cardiovascular mortality (CVM), non-cardiovascular mortality (non-CVM), and cardiovascular morbidities. Only studies with a follow-up period longer than one year were included. The primary outcomes were ACM and CVM. Secondary outcomes were non-CVM, myocardial infarction, stroke, heart failure, and major or extended adverse cardiovascular events. Subgroup analyses were performed according to low-, fair- and good-quality RCTs. RESULTS Eighty RCTs were assessed, including 82,210 participants receiving vitamin D supplementation and 80,921 receiving placebo or no treatment. The participants' mean (SD) age was 66.1 (11.2) years, and 68.6% were female. Vitamin D supplementation was associated with a lower risk of ACM (OR: 0.95 [95%CI 0.91-0.99] p = 0.013), was close to statistical significance for a lower risk of non-CVM (OR: 0.94 [95%CI 0.87-1.00] p = 0.055), and was not statistically associated with a lower risk of any cardiovascular morbi-mortality outcome. Meta-analysis of low-quality RCTs showed no association with cardiovascular or non-cardiovascular morbi-mortality outcomes. CONCLUSIONS The emerging results of our meta-analysis present evidence that vitamin D supplementation appears to decrease the risk of ACM (especially convincing in the fair- and good-quality RCTs), while not showing a decrease in the specific cardiovascular morbidity and mortality risk. Thus, we conclude that further research is warranted in this area, with well-planned and executed studies as the basis for more robust recommendations.
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Affiliation(s)
- Antonio Ruiz-García
- Lipids and Cardiovascular Prevention Unit, Pinto University Health Center, 28320 Madrid, Spain
- Department of Medicine, European University of Madrid, 28670 Madrid, Spain
| | - Vicente Pallarés-Carratalá
- Health Surveillance Unit, Castellón Mutual Insurance Union, 12003 Castellón, Spain
- Department of Medicine, Universitat Jaume I, 12006 Castellón, Spain
| | | | - Ferran Torres
- Biostatistics Unit, Medical School, Universitat Autònoma de Barcelona Bellaterra, 08193 Barcelona, Spain
| | - Víctor Sapena
- Biostatistics Unit, Medical School, Universitat Autònoma de Barcelona Bellaterra, 08193 Barcelona, Spain
| | | | - Jose M Martin-Moreno
- Department of Preventive Medicine and Public Health, University of Valencia, 46010 Valencia, Spain
- Biomedical Research Institute INCLIVA, Clinic University Hospital, 46010 Valencia, Spain
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10
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Ihekweazu C. Is Coffee the Cause or the Cure? Conflicting Nutrition Messages in Two Decades of Online New York Times' Nutrition News Coverage. HEALTH COMMUNICATION 2023; 38:260-274. [PMID: 34519247 DOI: 10.1080/10410236.2021.1950291] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Two-thirds of US adults report hearing news stories about diet and health relationships daily or a few times a week. These stories have often been labeled as conflicting. While public opinion suggests conflicting nutrition messages are widespread, there has been limited empirical research to support this belief. This study examined the prevalence of conflicting information in online New York Times' news articles discussing published nutrition research between 1996-2016. It also examined the contextual differences that existed between conflicting studies. The final sample included 375 news articles discussing 416 diet and health relationships (228 distinct relationships). The most popular dietary items discussed were alcoholic beverages (n = 51), vitamin D (n = 26), and B vitamins (n = 23). Over the 20-year study period, 12.7% of the 228 diet and health relationships had conflicting reports. Just under three-fourths of the conflicting reports involved changes in study design, 79% involved changes in study population, and 31% involved changes in industry funding. Conflicting nutrition messages can have negative cognitive and behavioral consequences for individuals. To help effectively address conflicting nutrition news coverage, a multi-pronged approach involving journalists, researchers, and news audiences is needed.
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11
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Hu Z, Zhi X, Li J, Li B, Wang J, Zhu J, Zhang Z. Effects of long-term vitamin D supplementation on metabolic profile in middle-aged and elderly patients with type 2 diabetes. J Steroid Biochem Mol Biol 2023; 225:106198. [PMID: 36181990 DOI: 10.1016/j.jsbmb.2022.106198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 02/01/2023]
Abstract
To evaluate the effects of long-term vitamin D supplementation on metabolic profiles in middle-aged to elderly patients with type 2 diabetes (T2D), a randomized controlled trial was conducted among patients with T2D aged 50-70 years. A total of 270 patients underwent randomization with 135 being allocated to the vitamin D group and 135 to the control group, and participants in the vitamin D group received oral vitamin D3 (800 IU/day) for 30 months. Serum 25(OH)D and metabolic variables were measured at baseline, and after 6, 12, 18, and 30 months of intervention. After 30 months, the vitamin D group showed a greater increase in serum 25(OH)D than the control group (12.39 ± 6.99 vs 5.35 ± 5.29 ng/ml, P < 0.001). Meanwhile, changes in the levels of fasting insulin, HOMA-IR, non-high-density-lipoprotein cholesterol (non-HDL-C), high-sensitivity C-reactive protein (hs-CRP), and uric acid differed significantly between the two groups (all P < 0.05). Stratified analysis indicated that change in uric acid differed significantly between the two groups in subgroup with baseline 25(OH)D ≥ 20 ng/ml (P = 0.042) or subgroup with female patients (P = 0.034). And the change in fasting blood glucose (FBG) differed significantly between the vitamin D group (-0.30 ± 2.52 mmol/L) and the control group (0.49 ± 1.78 mmol/L, P = 0.049) among patients achieving 25(OH)D concentrations of 30 ng/ml at the end of this trial. A significant difference in the change of triglyceride was observed between the two groups among patients with obesity at baseline [0.05(-0.59, 0.23) vs 0.41(-0.01, 0.80) mmol/L, P = 0.023]. These findings suggested that long-term vitamin D supplementation significantly reduced fasting insulin, HOMA-IR, and serum concentrations of non-HDL-C, hs-CRP, and uric acid among middle-aged to elderly patients with T2D. And vitamin D status, gender, and baseline obesity may modify the effects of vitamin D supplementation.
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Affiliation(s)
- Zhiyong Hu
- School of Public Health and Management, Binzhou Medical University, 346 Guanhai Road, Yantai 264003, China; Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Xueyuan Zhi
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Jiafu Li
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Bingyan Li
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China; Department of Nutrition and Food Hygiene, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China
| | - Jinxiu Wang
- School of Public Health and Management, Binzhou Medical University, 346 Guanhai Road, Yantai 264003, China
| | - Jianliang Zhu
- Lishui Center for Disease Control and Prevention, Lishui 323000, China
| | - Zengli Zhang
- Department of Occupational and Environmental Health, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, China.
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12
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Efficacy of vitamin D supplementation in reducing body mass index and lipid profile in healthy young adults in Colombia: a pilot randomised controlled clinical trial. J Nutr Sci 2023; 12:e29. [PMID: 36843975 PMCID: PMC9947753 DOI: 10.1017/jns.2022.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 02/24/2023] Open
Abstract
The objective of the present study was to evaluate the efficacy of oral administration of vitamin D supplementation in reducing BMI and lipid profile in adolescents and young adults from a cohort in Bucaramanga, Colombia. One hundred and one young adults were randomly assigned to one of two doses of vitamin D [1000 international units (IU) or 200 IU] administered daily for 15 weeks. The primary outcomes were serum 25(OH)D levels, BMI and lipid profile. The secondary outcomes were waist-hip ratio, skinfolds and fasting blood glucose. We found a mean ± sd plasma concentration of 25-hydroxyvitamin D [25(OH)D] was 25⋅0 ± 7⋅0 ng/ml at baseline, and after 15 weeks, it increased to 31⋅0 ± 10⋅0 ng/ml in the participants who received a daily dose of 1000 IU, (P < 0⋅0001). For the participants in the control group (200 IU), it went from 26⋅0 ± 8⋅0 ng/ml to 29⋅0 ± 8⋅0 ng/ml (P = 0⋅002). There were no differences between groups in body mass index. There was a statistically significant decrease in LDL-cholesterol between the intervention group v. the control group (mean difference -11⋅50 mg/dl (95 % CI -21⋅86 to -1⋅15; P = 0⋅030). The conclusions of the present study were two different doses of vitamin D supplementation (200 IU v. 1000 IU) produced changes in serum 25(OH)D levels over 15 weeks of administration in healthy young adults. No significant changes were found in the body mass index when the effect of the treatments was compared. A significant reduction in LDL-cholesterol was found when comparing the two intervention groups. Trial registration: NCT04377386.
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13
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Kittithaworn A, Toro-Tobon D, Sfeir JG. Cardiovascular benefits and risks associated with calcium, vitamin D, and antiresorptive therapy in the management of skeletal fragility. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231170059. [PMID: 37129172 PMCID: PMC10159251 DOI: 10.1177/17455057231170059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 03/08/2023] [Accepted: 03/30/2023] [Indexed: 05/03/2023]
Abstract
Osteoporosis affects one in every five women over the age of 50 worldwide. With a rapidly ageing population, the prevalence of fragility fractures, considered a largely preventable consequence of osteoporosis, is expected to increase. Age is also a major risk for cardiovascular disease and mortality, thus highlighting the importance of cardiovascular profiling of osteoporosis interventions. Although calcium and vitamin D are essential for a healthy bone metabolism, excessive supplementation may be associated with increased risk. Conversely, early pre-clinical data have suggested a possible cardiovascular benefit from bisphosphonate therapy. This review evaluates the evidence behind the cardiovascular benefits and risks that may be associated with osteoporosis therapy.
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Affiliation(s)
- Annop Kittithaworn
- Division of Endocrinology, Diabetes,
Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - David Toro-Tobon
- Division of Endocrinology, Diabetes,
Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Jad G Sfeir
- Division of Endocrinology, Diabetes,
Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
- Robert and Arlene Kogod Center on
Aging, Mayo Clinic, Rochester, MN, USA
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14
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Kuzmenko NV, Shchegolev BF. Dependence of Seasonal Dynamics in Healthy People's Circulating Lipids and Carbohydrates on Regional Climate: Meta-Analysis. Indian J Clin Biochem 2022; 37:381-398. [PMID: 36262777 PMCID: PMC9573834 DOI: 10.1007/s12291-022-01064-6] [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: 03/10/2022] [Accepted: 07/03/2022] [Indexed: 10/16/2022]
Abstract
We analyzed the seasonal dynamics of lipid profile, glucose, and insulin in healthy subjects from 29 studies conducted in 23 regions, located in different climate zones ranging from subarctic to tropical. Our meta-analysis showed that people have higher the level of TC (total cholesterol), LDL (low-density lipoprotein), HDL (high-density lipoprotein), FBG (fasting blood glucose) in winter than in summer regardless of gender. Regional climate had a significant impact on the seasonal dynamics of lipid profile and glucose. TC, HDL, FBG seasonal fluctuations were more prominent in a climate that had a marked increase in average monthly atmospheric pressure in winter compared with summer as opposed to a climate where atmospheric pressure did not vary significantly in winter and summer. In a climate with humid winters, TC seasonal changes were significantly greater than in the regions with humid summers, most likely due to LDL seasonal changes, since HDL seasonal dynamics with peaks in winter were more prominent in the regions with humid summers. The level of triglycerides had prominent seasonal dynamics with peak values in winter only in the regions with a large difference in winter and summer air temperatures. The results of our current and prior meta-analysis allow for the conclusion that the seasonal dynamics of circulating lipids and glucose are frequently linked to the seasonal dynamics of thyroid-stimulating hormone and hematocrit. Dependence of the seasonal changes in the biochemical parameters on annual fluctuations in air temperature, atmospheric pressure and relative humidity is more obvious than on photoperiod changes. Supplementary Information The online version contains supplementary material available at 10.1007/s12291-022-01064-6.
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Affiliation(s)
- N. V. Kuzmenko
- Almazov National Medical Research Centre of the Ministry of Health of the Russian Federation, 2 Akkuratova St., St. Petersburg, 197341 Russia
| | - B. F. Shchegolev
- Federal State Budgetary Institution of Science Pavlov Institute of Physiology, Russian Academy of Sciences, 6 Makarova Emb., St. Petersburg, 199034 Russia
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15
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Qorbani M, Zarei M, Moradi Y, Appannah G, Djalainia S, Pourrostami K, Ejtahed HS, Mahdavi-Gorabi A, Naderali EK, Khazdouz M. Effect of vitamin D supplementation on cardiac-metabolic risk factors in elderly: a systematic review and meta-analysis of clinical trials. Diabetol Metab Syndr 2022; 14:88. [PMID: 35752843 PMCID: PMC9233853 DOI: 10.1186/s13098-022-00859-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There has been a longstanding interest in the potential effect of vitamin D in preventing cardiac-metabolic diseases. However, there are divergent results regarding the impact of vitamin D supplementation (VDS) on managing cardiac-metabolic outcomes in the elderly population. MATERIAL AND METHOD We systematically searched electronic databases; Web of Science, PubMed, Scopus, EMBASE, Cochrane, and ProQuest. We included all trials that evaluated the effect of VDS on cardiac-metabolic risk factors in the elderly population, which were published until 30 September 2021. The effects of VDS on cardiac-metabolic outcomes were assessed using standardized mean difference (SMD). A random-effect model was used to pool the SMD and 95% confidence interval (CI). RESULT The literature search identified 4409 studies, of which 12 trials met inclusion criteria. Results of random effect meta-analysis indicated a significant reduction in total cholesterol (TC) (SMD: - 0.14 mg/dl; 95% CI: - 0.25, - 0.02) and triglyceride (TG) (SMD: - 0.45 mg/dl; 95% CI: - 0.86, - 0.04) with VDS compared to the placebo. The subgroup analyses revealed that the reduction of TG in patients with diabetes and vitamin D deficiency was significant. Furthermore, short-term intervention (≤ 6 months) induced a significantly lower level of TG and insulin in comparison to longer duration (> 6 months). CONCLUSION The study suggests that VDS could improve insulin concentration and dyslipidemia in the elderly population. The systematic review was registered in Alborz university of medical sciences with 2060-01-03-1397 number and the Ethics council IR.ABZUMS.REC.1397.207 number.
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Affiliation(s)
- Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Zarei
- Department of Nutrition Community, Deputy of Health affairs, Ministry of Health and Medical Education, Tehran, Iran
| | - Yousef Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Geeta Appannah
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor Malaysia
| | - Shirin Djalainia
- Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Kumars Pourrostami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Armita Mahdavi-Gorabi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | | | - Maryam Khazdouz
- Growth and Development Research Center, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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16
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O'Connor EA, Evans CV, Ivlev I, Rushkin MC, Thomas RG, Martin A, Lin JS. Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2022; 327:2334-2347. [PMID: 35727272 DOI: 10.1001/jama.2021.15650] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Cardiovascular disease and cancer are the 2 leading causes of death in the US, and vitamin and mineral supplementation has been proposed to help prevent these conditions. OBJECTIVE To review the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent cardiovascular disease and cancer to inform the US Preventive Services Task Force. DATA SOURCES MEDLINE, PubMed (publisher-supplied records only), Cochrane Library, and Embase (January 2013 to February 1, 2022); prior reviews. STUDY SELECTION English-language randomized clinical trials (RCTs) of vitamin or mineral use among adults without cardiovascular disease or cancer and with no known vitamin or mineral deficiencies; observational cohort studies examining serious harms. DATA EXTRACTION AND SYNTHESIS Single extraction, verified by a second reviewer. Quantitative pooling methods appropriate for rare events were used for most analyses. MAIN OUTCOMES AND MEASURES Mortality, cardiovascular disease events, cancer incidence, serious harms. RESULTS Eighty-four studies (N=739 803) were included. In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (odds ratio [OR], 0.93 [95% CI, 0.87-0.99]; 4 RCTs [n=48 859]; absolute risk difference [ARD] range among adequately powered trials, -0.2% to -1.2%) and lung cancer (OR, 0.75 [95% CI, 0.58-0.95]; 2 RCTs [n=36 052]; ARD, 0.2%). However, the evidence for multivitamins had important limitations. Beta carotene (with or without vitamin A) was significantly associated with an increased risk of lung cancer (OR, 1.20 [95% CI, 1.01-1.42]; 4 RCTs [n=94 830]; ARD range, -0.1% to 0.6%) and cardiovascular mortality (OR, 1.10 [95% CI, 1.02-1.19]; 5 RCTs [n=94 506] ARD range, -0.8% to 0.8%). Vitamin D use was not significantly associated with all-cause mortality (OR, 0.96 [95% CI, 0.91-1.02]; 27 RCTs [n=117 082]), cardiovascular disease (eg, composite cardiovascular disease event outcome: OR, 1.00 [95% CI, 0.95-1.05]; 7 RCTs [n=74 925]), or cancer outcomes (eg, any cancer incidence: OR, 0.98 [95% CI, 0.92-1.03]; 19 RCTs [n=86 899]). Vitamin E was not significantly associated with all-cause mortality (OR, 1.02 [95% CI, 0.97-1.07]; 9 RCTs [n=107 772]), cardiovascular disease events (OR, 0.96 [95% CI, 0.90-1.04]; 4 RCTs [n=62 136]), or cancer incidence (OR, 1.02 [95% CI, 0.98-1.08]; 5 RCTs [n=76 777]). Evidence for benefit of other supplements was equivocal, minimal, or absent. Limited evidence suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]). CONCLUSIONS AND RELEVANCE Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Corinne V Evans
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Ilya Ivlev
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan C Rushkin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
- Center for Evidence-based Policy, Oregon Health & Science University, Portland
| | - Rachel G Thomas
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Allea Martin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Jennifer S Lin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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17
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Zhang W, Yi J, Liu D, Wang Y, Jamilian P, Gaman MA, Prabahar K, Fan J. The effect of vitamin D on the lipid profile as a risk factor for coronary heart disease in postmenopausal women: a meta-analysis and systematic review of randomized controlled trials. Exp Gerontol 2022; 161:111709. [PMID: 35090975 DOI: 10.1016/j.exger.2022.111709] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 01/04/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023]
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18
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Guo Z, Huang M, Fan D, Hong Y, Zhao M, Ding R, Cheng Y, Duan S. Association between vitamin D supplementation and cancer incidence and mortality: A trial sequential meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr 2022; 63:8428-8442. [PMID: 35352965 DOI: 10.1080/10408398.2022.2056574] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Observational studies and clinical trials have evaluated the associations between vitamin D supplementation and cancer incidence/mortality and obtained mixed results. Previous meta-analyses have also yielded inconsistent conclusions. In this paper, we conduct an updated meta-analysis by including current randomized clinical trials (RCTs) to assess the association between vitamin D supplementation and cancer incidence and mortality. The PubMed, Scopus and Embase databases were systematically searched from their inception to 6 February 2022. Fixed-effects meta-analyses were conducted. Trial sequential analyses were performed using a risk ratio reduction threshold of 10% for cancer incidence and mortality. Twenty-six RCTs were eligible, and pooled results indicated that vitamin D supplementation, compared to placebo with/without calcium, was not associated with a reduction in total cancer incidence (risk ratio: 0.98, 95% CI: 0.94, 1.02; I2 = 0%). In contrast, vitamin D supplementation significantly reduced total cancer mortality (risk ratio: 0.88, 95% CI: 0.8, 0.96; I2 = 0%). Moreover, trial sequential analysis provided reliable evidence that supplementation with vitamin D lowered the relative risk of total cancer mortality by 10%. Our updated meta-analysis suggested that vitamin D supplementation did not reduce total cancer incidence but significantly lowered total cancer mortality.Supplemental data for this article is available online at https://doi.org/10.1080/10408398.2022.2056574 .
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Affiliation(s)
- Zhangyou Guo
- Yunnan Cancer Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Ming Huang
- Yunnan Cancer Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Dandan Fan
- Yunnan Cancer Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Yuan Hong
- Institute of Experimental Diagnostics of Yunnan Province, Key Laboratory of Laboratory Medicine of Yunnan Province, Medical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Min Zhao
- Department of Neonatology, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders (Chongqing), Chongqing, People's Republic of China
- International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, People's Republic of China
| | - Rong Ding
- Yunnan Cancer Center, Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, People's Republic of China
| | - Yao Cheng
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shigang Duan
- Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, People's Republic of China
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19
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JABEEN S, KHAN HF, ALI S, SIDDIQUE AH, MAJEED S, SAFDER S, SHAMSHAD F. Role of Vitamin D Supplementation in Improving Cytokine Profile in Patients of Non-ST-Elevation Acute Coronary Syndrome. J Nutr Sci Vitaminol (Tokyo) 2022; 68:1-7. [DOI: 10.3177/jnsv.68.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Sidra JABEEN
- Department of Physiology, Islamic International Medical College
| | | | - Shazia ALI
- Department of Physiology, Islamic International Medical College
| | - Abdul Hamid SIDDIQUE
- Head of Cardiology Department, Armed Forces Institute of Cardiology/National Institute of Heart Diseases
| | - Sana MAJEED
- Department of Physiology, Islamic International Medical College
| | - Saira SAFDER
- Department of Physiology, Islamic International Medical College
| | - Fozia SHAMSHAD
- Department of Physiology, Islamic International Medical College
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20
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Panahi Y, Namazi S, Rostami-Yalmeh J, Sahebi E, Khalili N, Jamialahmadi T, Sahebkar A. Effect of Vitamin D Supplementation on the Regulation of Blood Pressure in Iranian Patients with Essential Hypertension: A Clinical Trial. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1328:501-511. [PMID: 34981501 DOI: 10.1007/978-3-030-73234-9_35] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Low serum vitamin D level is associated with both high blood pressure and incidence of primary hypertension. Experimental studies suggest that vitamin D supplements may reduce blood pressure. OBJECTIVE The aim of this study was to investigate whether vitamin D supplementation reduces systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in Iranian patients with essential hypertension. METHOD A total of 173 patients with essential hypertension participated in this open-label clinical trial. SBP, DBP, and serum vitamin D levels were measured at baseline and at the end of the study. Vitamin D was administered at a dose of 50,000 IU/week, and 1000 IU/day in patients with serum vitamin D levels <20 ng/mL and 20-30 ng/mL, respectively, for 8 weeks. RESULTS Based on serum vitamin D levels, 45.1%, 17.3%, and 29.5% of patients were deficient, insufficient, and sufficient for vitamin D intake, respectively. Baseline serum levels of vitamin D were not correlated with SBP, DBP, and MAP at the beginning of the study (p = ns). Multiple logistic regression analysis revealed that the risk of vitamin D deficiency was 2.5-fold times higher in women than in men (p = 0.03). After 8 weeks of supplementation with vitamin D, mean SBP and MAP were significantly reduced by 5.5 ± 16.16 (p = 0.01) and 3.7 ± 9.24 (p = 0.004) mmHg, respectively. Neither sex nor age could significantly predict BP response to vitamin D supplementation. CONCLUSION Vitamin D supplementation may significantly reduce SBP and MAP but not DBP in patients with essential hypertension.
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Affiliation(s)
- Yunes Panahi
- Faculty of Pharmacy, Pharmacotherapy Department, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Soha Namazi
- Department of Pharmacotherapy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Javad Rostami-Yalmeh
- Department of Pharmacotherapy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ebrahim Sahebi
- Department of Pharmacotherapy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Khalili
- Department of Endocrinology, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Tannaz Jamialahmadi
- Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran.,Faculty of Medicine, Department of Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. .,Applied Biomedical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,School of Medicine The University of Western Australia, Perth, Australia. .,School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.
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21
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Role and Treatment of Insulin Resistance in Patients with Chronic Kidney Disease: A Review. Nutrients 2021; 13:nu13124349. [PMID: 34959901 PMCID: PMC8707041 DOI: 10.3390/nu13124349] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 01/11/2023] Open
Abstract
Patients with chronic kidney disease (CKD) and dialysis have higher mortality than those without, and cardiovascular disease (CVD) is the main cause of death. As CVD is caused by several mechanisms, insulin resistance plays an important role in CVD. This review summarizes the importance and mechanism of insulin resistance in CKD and discusses the current evidence regarding insulin resistance in patients with CKD and dialysis. Insulin resistance has been reported to influence endothelial dysfunction, plaque formation, hypertension, and dyslipidemia. A recent study also reported an association between insulin resistance and cognitive dysfunction, non-alcoholic fatty liver disease, polycystic ovary syndrome, and malignancy. Insulin resistance increases as renal function decrease in patients with CKD and dialysis. Several mechanisms increase insulin resistance in patients with CKD, such as chronic inflammation, oxidative stress, obesity, and mineral bone disorder. There is the possibility that insulin resistance is the potential future target of treatment in patients with CKD.
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22
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Radkhah N, Shabbidar S, Zarezadeh M, Safaeiyan A, Barzegar A. Effects of vitamin D supplementation on apolipoprotein A1 and B100 levels in adults: Systematic review and meta-analysis of controlled clinical trials. J Cardiovasc Thorac Res 2021; 13:190-197. [PMID: 34630965 PMCID: PMC8493225 DOI: 10.34172/jcvtr.2021.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/10/2021] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of death around the world. According to the studies, apolipoproteins A1 and B100 play crucial role in CVD development and progression. Also, findings have indicated the positive role of vitamin D on these factors. Thus, we conducted the present meta-analysis of randomized controlled trials (RCTs) to demonstrate the impact of vitamin D supplementation on apolipoproteins A1 and B100 levels in adults. PubMed and Scopus databases and Google Scholar were searched up to 21 December 2020. Relevant articles were screened, extracted, and assessed for quality based on the Cochrane collaboration's risk of bias tool. Data analysis conducted by random-effect model and expressed by standardized mean difference (SMD). The heterogeneity between studies was assessed by I-squared (I2) test. Subgroups and sensitivity Analyses were also conducted. Seven RCTs were identified investigating the impact of vitamin D on Apo A1 levels and six on Apo B100 levels. The findings showed the insignificant effect of vitamin D supplementation on Apo A1 (SMD=0.26 mg/dL; 95% confidence interval (CI), -0.10, 0.61; P = 0.155) and Apo B100 (standardized mean difference (SMD)=-0.06 mg/dL; 95% CI, -0.24, 0.12; P = 0.530) in adults. There was a significant between-study heterogeneity in Apo A1 (I2=89.3%, P < 0.001) and Apo B100 (I2 = 57.1%, P = 0.030). However, significant increase in Apo A1 in daily dosage of vitamin D (SMD=0.56 mg/dL; 95% CI, 0.02, 1.11; P = 0.044) and ≤12 weeks of supplementation duration (SMD=0.71 mg/dL; 95% CI, 0.08, 1.34; P = 0.028) was observed. No significant effects of vitamin D on Apo A1 and Apo B100 levels after subgroup analysis by mean age, gender, study population, dosage and duration of study. Overall, daily vitamin D supplementation and ≤12 weeks of supplementation might have beneficial effects in increasing Apo A1 levels, however, future high-quality trials considering these a primary outcome are required.
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Affiliation(s)
- Nima Radkhah
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Shabbidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolrasoul Safaeiyan
- Department of Vital Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Barzegar
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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23
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Rajaie H, Rabiee MR, Bellissimo N, Faghih S. Independent and Combined Effects of Calcium and Vitamin D Supplementation on Blood Lipids in Overweight or Obese Premenopausal Women: A Triple-Blind Randomized Controlled Clinical Trial. Int J Prev Med 2021; 12:52. [PMID: 34447494 PMCID: PMC8356995 DOI: 10.4103/ijpvm.ijpvm_294_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/04/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Dyslipidemia is often associated with obesity and contributes to the increased risk of atherosclerosis, heart disease, and stroke. This study was designed to evaluate the independent or combined effect of calcium and vitamin D (Ca + Vit D) supplementation on blood lipid profile in overweight or obese premenopausal women. Methods: This study is a triple-blind, randomized, parallel, placebo-controlled trial. About 100 overweight or obese (body mass index (BMI) of 25–40 kg/m2) premenopausal (aged 30–50 years) women, recruited from Shiraz University of Medical Sciences (SUMS) clinics, were allocated into 4 groups: (1) calcium (Ca) supplementation (2 tablets per day; each containing 500 mg calcium carbonate), (2) vitamin D (Vit D) supplementation (2 tablets per day; each containing 200 IU vitamin D3), (3) Ca + Vit D supplementation (2 tablets per day; each containing 500 mg calcium carbonate plus 200 IU vitamin D3), (4) placebo supplementation (2 tablets per day, containing micro-cellulose). All participants received a 500 kcal energy-restricted diet. Blood lipids, serum vitamin D, and anthropometric indices were measured at baseline and after 8 weeks. Physical activity and 3-day dietary records were taken at baseline and every 4 weeks during the intervention. Results: At 8 weeks, triglyceride levels were significantly decreased in the Ca group (P = 0.002). Low-density lipoprotein (LDL) levels were decreased in the Ca + Vit D group (P = 0.04) and high-density lipoprotein (HDL) levels decreased in both the Ca and Ca + Vit D groups (P = 0.006, P = 0.004, respectively). The results of one-way ANOVA indicated that changes in the serum lipid profile levels were not significantly different among the four groups (P = 0.90, P = 0.86, P = 0.61, P = 0.27, and P = 0.19, respectively for TG, TC, LDL, HDL, and LDL/HDL). The results were not significant even after adjusting for potential covariates. Conclusions: Although the results were not significantly different among the four treated groups at 8 weeks, within-group changes like the reduction in triglyceride and LDL levels, respectively in the Ca group and Ca + Vit D group, and HDL levels in both the Ca and Ca + Vit D groups were significant. These changes may have potentially significant public health implications.
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Affiliation(s)
- Hamideh Rajaie
- Research Center of Nutrition and Food Sciences, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Rabiee
- Department of Physical Education and Sport Physiology, Shiraz University, Shiraz, Iran
| | - Nick Bellissimo
- Faculty of Community Services, School of Nutrition, Ryerson University, Toronto, ON, Canada
| | - Shiva Faghih
- Research Center of Nutrition and Food Sciences, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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24
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Maboshe W, Macdonald HM, Wassall H, Fraser WD, Tang JCY, Fielding S, Barker RN, Vickers MA, Ormerod A, Thies F. Low-Dose Vitamin D 3 Supplementation Does Not Affect Natural Regulatory T Cell Population but Attenuates Seasonal Changes in T Cell-Produced IFN-γ: Results From the D-SIRe2 Randomized Controlled Trial. Front Immunol 2021; 12:623087. [PMID: 34262557 PMCID: PMC8275124 DOI: 10.3389/fimmu.2021.623087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 06/02/2021] [Indexed: 01/01/2023] Open
Abstract
Background Seasonal variations have been reported for immune markers. However, the relative contributions of sunlight and vitamin D variability on such seasonal changes are unknown. Objective This double-blind, randomized, placebo-controlled trial tested whether daily 400 IU vitamin D3 supplementation affected short-term (12 weeks) and long-term (43 weeks) natural regulatory T cell (nTreg) populations in healthy participants. Design 62 subjects were randomized equally to vitamin D versus placebo in March and assessed at baseline, April (4w), June (12w), September (25w) and January (43w). Circulating nTregs, ex vivo proliferation, IL-10 and IFN-γ productions were measured. Vitamin D metabolites and sunlight exposure were also assessed. Results Mean serum 25-hydroxyvitamin D (25(OH)D) increased from 35.8(SD 3.0) to 65.3(2.6) nmol/L in April and remained above 75 nmol/L with vitamin D supplementation, whereas it increased from 36.4(3.2) to 49.8(3.5) nmol/L in June to fall back to 39.6(3.5) nmol/L in January with placebo. Immune markers varied similarly between groups according to the season, but independently of 25(OH)D. For nTregs, the mean (%CD3+CD4+CD127lo cells (SEM)) nadir observed in March (2.9(0.1)%) peaked in September at 4.0(0.2)%. Mean T cell proliferation peaked in June (33156(1813) CPM) returning to the nadir in January (17965(978) CPM), while IL-10 peaked in June and reached its nadir in September (median (IQR) of 262(283) to (121(194) pg/ml, respectively). Vitamin D attenuated the seasonal increase in IFN-γ by ~28% with mean ng/ml (SEM) for placebo vs vitamin D, respectively, for April 12.5(1.4) vs 10.0(1.2) (p=0.02); June 13.9(1.3) vs 10.2(1.7) (p=0.02) and January 7.4(1.1) vs 6.0(1.1) (p=0.04). Conclusions Daily low dose Vitamin D intake did not affect the nTregs population. There were seasonal variation in nTregs, proliferative response and cytokines, suggesting that environmental changes influence immune response, but the mechanism seems independent of vitamin D status. Vitamin D attenuated the seasonal change in T cell-produced IFN-γ, suggesting a decrease in effector response which could be associated with inflammation. Clinical Trial Registration https://www.isrctn.com, identifier (ISRCTN 73114576).
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Affiliation(s)
- Wakunyambo Maboshe
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Helen M Macdonald
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Heather Wassall
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - William D Fraser
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Jonathan C Y Tang
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Shona Fielding
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Robert N Barker
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Mark A Vickers
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Anthony Ormerod
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
| | - Frank Thies
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, United Kingdom
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25
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Kahwati LC, LeBlanc E, Weber RP, Giger K, Clark R, Suvada K, Guisinger A, Viswanathan M. Screening for Vitamin D Deficiency in Adults: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2021; 325:1443-1463. [PMID: 33847712 DOI: 10.1001/jama.2020.26498] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Low serum vitamin D levels have been associated with adverse clinical outcomes; identifying and treating deficiency may improve outcomes. OBJECTIVE To review the evidence about screening for vitamin D deficiency in adults. DATA SOURCES PubMed, EMBASE, the Cochrane Library, and trial registries through March 12, 2020; bibliographies from retrieved articles, outside experts, and surveillance of the literature through November 30, 2020. STUDY SELECTION Fair- or good-quality, English-language randomized clinical trials (RCTs) of screening with serum 25-hydroxyvitamin D (25[OH]D) compared with no screening, or treatment with vitamin D (with or without calcium) compared with placebo or no treatment conducted in nonpregnant adults; nonrandomized controlled intervention studies for harms only. Treatment was limited to studies enrolling or analyzing participants with low serum vitamin D levels. DATA EXTRACTION AND SYNTHESIS Two reviewers assessed titles/abstracts and full-text articles, extracted data, and assessed study quality; when at least 3 similar studies were available, meta-analyses were conducted. MAIN OUTCOMES AND MEASURES Mortality, incident fractures, falls, diabetes, cardiovascular events, cancer, depression, physical functioning, and infection. RESULTS Forty-six studies (N = 16 205) (77 publications) were included. No studies directly evaluated the health benefits or harms of screening. Among community-dwelling populations, treatment was not significantly associated with mortality (pooled absolute risk difference [ARD], 0.3% [95% CI, -0.6% to 1.1%]; 8 RCTs, n = 2006), any fractures (pooled ARD, -0.3% [95% CI, -2.1% to 1.6%]; 6 RCTs, n = 2186), incidence of diabetes (pooled ARD, 0.1% [95% CI, -1.3% to 1.6%]; 5 RCTs, n = 3356), incidence of cardiovascular disease (2 RCTs; hazard ratio, 1.00 [95% CI, 0.74 to 1.35] and 1.09 [95% CI, 0.68 to 1.76]), incidence of cancer (2 RCTs; hazard ratio, 0.97 [95% CI, 0.68 to 1.39] and 1.01 [95% CI, 0.65 to 1.58], or depression (3 RCTs, various measures reported). The pooled ARD for incidence of participants with 1 or more falls was -4.3% (95% CI, -11.6% to 2.9%; 6 RCTs). The evidence was mixed for the effect of treatment on physical functioning (2 RCTs) and limited for the effect on infection (1 RCT). The incidence of adverse events and kidney stones was similar between treatment and control groups. CONCLUSIONS AND RELEVANCE No studies evaluated the direct benefits or harms of screening for vitamin D deficiency. Among asymptomatic, community-dwelling populations with low vitamin D levels, the evidence suggests that treatment with vitamin D has no effect on mortality or the incidence of fractures, falls, depression, diabetes, cardiovascular disease, cancer, or adverse events. The evidence is inconclusive about the effect of treatment on physical functioning and infection.
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Affiliation(s)
- Leila C Kahwati
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- RTI International, Research Triangle Park, North Carolina
| | - Erin LeBlanc
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Rachel Palmieri Weber
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill
| | - Kayla Giger
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- RTI International, Research Triangle Park, North Carolina
| | - Rachel Clark
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- RTI International, Research Triangle Park, North Carolina
| | - Kara Suvada
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- RTI International, Research Triangle Park, North Carolina
| | - Amy Guisinger
- Gillings School of Global Public Health and Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
| | - Meera Viswanathan
- RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center, Chapel Hill, North Carolina
- RTI International, Research Triangle Park, North Carolina
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26
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Li Z, Wu L, Zhang J, Huang X, Thabane L, Li G. Effect of Vitamin D Supplementation on Risk of Breast Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Nutr 2021; 8:655727. [PMID: 33869269 PMCID: PMC8049142 DOI: 10.3389/fnut.2021.655727] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
Objective: Laboratory findings indicated that vitamin D might have a potent protective effect on breast cancer, but epidemiology studies reported conflicting results. The aim of the study was to conduct a systematic review and meta-analysis to clarify the efficacy of vitamin D supplementation on risk of breast cancer. Methods: MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and abstracts of three major conferences were searched (up to December 8, 2020). Parallel randomized controlled trials (RCTs) examining the efficacy of vitamin D supplementation on risk of breast cancer or change of mammography compared with placebo in females were included. Data were meta-analyzed using a random-effects model. Bayesian meta-analysis was conducted to synthesize the results using data from observational studies as priors. Results: Seven RCTs were identified for effect of vitamin D on risk of breast cancer, with 19,137 females included for meta-analysis. No statistically significant effect of vitamin D on risk of breast cancer was found in classical random-effects meta-analysis (risk ratio = 1.04, 95% confidence interval: 0.84–1.28, p = 0.71). When Bayesian meta-analyses were conducted, results remained non-significant. There was no statistically significant effect of vitamin D on mammography density observed: mean difference = 0.46, 95% confidence interval: −2.06 to 2.98, p = 0.72. Conclusion: There is insufficient evidence to support the efficacy of vitamin D supplementation in breast cancer risk and change of mammography density. The protective effect of vitamin D on risk of breast cancer from previous observational studies may be overestimated. Systematic Review Registration: PROSPERO, identifier CRD42019138718.
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Affiliation(s)
- Ziyi Li
- Centre for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Liangzhi Wu
- Department of Gynecology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Junguo Zhang
- Centre for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Xin Huang
- Centre for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Guowei Li
- Centre for Clinical Epidemiology and Methodology, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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27
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Liu W, Wu Z, Zhu D, Chen G, Yan G, Zhang S, Chen F, Khan BA, Hou K. Vitamin D and Lipid Profiles in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. Front Mol Biosci 2021; 8:799934. [PMID: 34977158 PMCID: PMC8719197 DOI: 10.3389/fmolb.2021.799934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/19/2021] [Indexed: 02/05/2023] Open
Abstract
Background and Aim: It is known that hyperlipidemia and low vitamin D level are risk factors associated with cardiovascular disease (CVD). However, the effect of vitamin D administration on lipid profiles in postmenopausal women remains unclear. This study aims to evaluate the effect of vitamin D on lipid profiles in postmenopausal women based on meta-analysis and systemic review. Methods: The literature search was performed in multiple databases (Scopus, PubMed/Medline, Web of Science, and Embase) from 1997 to 2021. The statistical analysis was performed using the Stata software version 14 (Stata Corp. College Station, Texas, United States). The effects of vitamin D administration of the lipid profiles, including Triacylglycerol (TG), LDL-Cholesterol (LDL-C), HDL-Cholesterol (HDL-C), and Total Cholesterol (TC) were evaluated by the Der Simonian and Laird random effects model. The weighted mean difference (WMD) and 95% confidence intervals (CI) were calculated. Results: The level of TG changed significantly by -3.76 mg/dl (CI: -6.12 to -1.39, p = 0.004) and HDL-C by 0.48 mg/dl (CI: -0.80 to -0.15, p = 0.004) in vitamin D administration group [11 eligible trials (placebo = 505 participants, vitamin D intervention = 604 participants)] compared to the control group in the postmenopausal women. Taking into account this comparison between groups, in contrast, the level of LDL-Cholesterol (LDL-C) (WMD: 0.73 mg/dl, 95% CI: -1.88, 3.36, p = 0.583) and TC (WMD: 0.689 mg/dl, CI: -3.059 to 4.438, p = 0.719) did not change significantly. Conclusion: In conclusion, the vitamin D administration in postmenopausal women, decreased the concentrations of TG, and HDL-C, but have no effects on LDL-C and TC.
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Affiliation(s)
- Weiting Liu
- School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Zezhen Wu
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Dan Zhu
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Genben Chen
- Department of Endocrine and Metabolic Diseases, Chaoan District People’s Hospital, Chaozhou, China
| | - Guiming Yan
- School of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Shuo Zhang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
| | - Fengwu Chen
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
- Department of Endocrine and Metabolic Diseases, the First Affiliated Hospital of Medical College of Shantou University, Shantou, China
| | - Barkat Ali Khan
- Drug Delivery and Cosmetics Lab (DDCL), GCPS, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Kaijian Hou
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Endocrine and Metabolic Diseases, Longhu People’s Hospital, Shantou, China
- *Correspondence: Kaijian Hou,
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28
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Effects of Vitamin D Supplementation on Omentin-1 and Spexin Levels, Inflammatory Parameters, Lipid Profile, and Anthropometric Indices in Obese and Overweight Adults with Vitamin D Deficiency under Low-Calorie Diet: A Randomized Placebo Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3826237. [PMID: 33224249 PMCID: PMC7673929 DOI: 10.1155/2020/3826237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/13/2020] [Accepted: 10/28/2020] [Indexed: 11/17/2022]
Abstract
Background and Aims Improved vitamin D levels can have a favorable effect on some metabolic variables. The objective of the current study was to determine the effects of vitamin D supplementation during a weight-loss intervention on the levels of omentin-1, spexin, lipid profiles, and inflammatory factors in obese and overweight participants. Methods and Materials In this double-blind placebo-controlled randomized clinical trial, 70 overweight and obese participants with vitamin D deficiency (25(OH)D ≤ 20 nmol/L) were assigned into the intervention (a daily dose of 2,000 IU vitamin D + low-calorie diet) and placebo (placebo + low-calorie diet) groups for 8 weeks. Anthropometric parameters, serum levels of 25-hydroxy vitamin D (25(OH)D), lipid profiles, omentin-1 and spexin levels, high-sensitivity C-reactive protein (hs-CRP), and soluble intercellular adhesion molecule-1 (sICAM-1) concentrations were assessed before and after the intervention. Results Vitamin D supplementation after the intervention led to a significant decrease in triglycerides (TG) (P = 0.02), very-low-density lipoprotein-cholesterol (VLDL-C) (P = 0.02), and hs-CRP (P = 0.03) concentrations and a significant increase in the serum vitamin D level (P < 0.001). Furthermore, after adjusting for baseline values, age, and baseline BMI, the levels of serum high-density lipoprotein-cholesterol (HDL-C) (P = 0.01) increased significantly, and a significant reduction was observed in the concentration of sICAM-1 (P = 0.01) in the intervention group. However, we did not find any significant difference in serum omentin-1 and spexin concentrations between the groups after intervention. Conclusions Vitamin D supplementation along with a low-calorie diet (LCD) program for 8 weeks significantly decreased the inflammatory markers in obese individuals, while it did not alter serum omentin-1 and spexin concentrations.
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Duan L, Han L, Liu Q, Zhao Y, Wang L, Wang Y. Effects of Vitamin D Supplementation on General and Central Obesity: Results from 20 Randomized Controlled Trials Involving Apparently Healthy Populations. ANNALS OF NUTRITION AND METABOLISM 2020; 76:153-164. [DOI: 10.1159/000507418] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/21/2020] [Indexed: 11/19/2022]
Abstract
Background: The obesity pandemic has been paralleled by a high prevalence of vitamin D deficiency (VDD). There is growing epidemiological evidence linking low vitamin D status with obesity events. In addition, observational studies also show that obesity may increase the risk of VDD. However, there is insufficient knowledge to understand whether there is a causality between the two. Moreover, the impact of vitamin D supplementation on obesity indices has shown inconsistent outcomes. Objective: This meta-analysis aimed to assess whether vitamin D supplementation modified general and central obesity indices in apparently healthy populations. Methods: A systematic retrieval of relevant randomized controlled trials (RCTs) was undertaken using Pubmed, Embase, Web of Knowledge and Chinese National Knowledge Infrastructure databases. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were used to assess the changes in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and 25-hydroxyvitamin D (25[OH]D) from baseline. Results: Twenty RCTs involving 3,153 participants reporting either BMI, WC, WHR or 25(OH)D met the inclusion criteria. When compared with placebo, vitamin D supplementation had no significant decreases in BMI (WMD = –0.09 kg/m2, 95% CI –0.19 to 0.01, p = 0.08), WC (WMD = –0.71 cm, 95% CI –1.58 to 0.16, p = 0.112) or WHR (WMD = 0.00, 95% CI –0.01 to 0.01, p = 0.749). However, in the subgroups of females, Asia region studies and intervention duration ≥6 months, a beneficial and significant reduction in BMI and WC was noted (all p < 0.026). On the other hand, pooled results showed that there was a significant increase in serum 25(OH)D levels (WMD = 13.20 ng/mL, 95% CI 9.83–16.58, p < 0.001) after vitamin D intervention. No publication bias was found in our study. Conclusions: Overall, supplementation with vitamin D produced no significant effect on the BMI, WC or WHR of healthy adults.
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Pramono A, Jocken JWE, Blaak EE, van Baak MA. The Effect of Vitamin D Supplementation on Insulin Sensitivity: A Systematic Review and Meta-analysis. Diabetes Care 2020; 43:1659-1669. [PMID: 33534727 DOI: 10.2337/dc19-2265] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 03/02/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Vitamin D has been suggested to affect peripheral insulin sensitivity. Evidence regarding the effect of vitamin D supplementation on insulin sensitivity is still conflicting. PURPOSE This meta-analysis aimed to assess the effect of vitamin D supplementation on insulin sensitivity in humans with or at risk for insulin resistance. DATA SOURCES AND STUDY SELECTION PubMed, Web of Science, Embase, CINAHL, and Cochrane Library were systematically searched for randomized controlled trials (RCTs) from 1980 until 31 December 2018 reporting treatment effects of vitamin D supplementation on insulin sensitivity. DATA EXTRACTION The main outcome of interest was the change in insulin sensitivity, derived from the gold standard hyperinsulinemic-euglycemic clamp or the Matsuda index derived from the oral glucose tolerance test and insulin sensitivity index from intravenous glucose tolerance test. We extracted data on the standardized mean difference between the vitamin D treatment and placebo groups in change from baseline insulin sensitivity. DATA SYNTHESIS Eighteen RCTs were included in this meta-analysis comparing vitamin D supplementation (n = 612) with placebo (n = 608). Vitamin D supplementation had no effect on insulin sensitivity (standardized mean difference -0.01, 95% CI -0.12, 0.10; P = 0.87, I 2 = 0%). Visual inspection of funnel plot symmetry did not suggest potential publication bias. LIMITATIONS The number of individuals who participated in the included studies was relatively small, possibly due to the invasive character of the measurement (e.g., clamp). CONCLUSIONS This meta-analysis provides no evidence that vitamin D supplementation has a beneficial effect on peripheral insulin sensitivity in people with or at risk for insulin resistance.
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Affiliation(s)
- Adriyan Pramono
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands.,Department of Nutrition, Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia
| | - Johan W E Jocken
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
| | - Marleen A van Baak
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, the Netherlands
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Farapti F, Fadilla C, Yogiswara N, Adriani M. Effects of vitamin D supplementation on 25(OH)D levels and blood pressure in the elderly: a systematic review and meta-analysis. F1000Res 2020; 9:633. [PMID: 32968483 PMCID: PMC7489275 DOI: 10.12688/f1000research.24623.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 03/30/2024] Open
Abstract
Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) levels and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D level changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21-17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = -4.01; 95% CI = -7.45 to -0.57; P = 0.02 and MD = -1.91; 95% CI = -3.48 to -0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = -2.22; 95% CI = -4.1 to -0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D levels and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.
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Affiliation(s)
- Farapti Farapti
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Chusnul Fadilla
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
| | - Niwanda Yogiswara
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia
| | - Merryana Adriani
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
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Farapti F, Fadilla C, Yogiswara N, Adriani M. Effects of vitamin D supplementation on 25(OH)D levels and blood pressure in the elderly: a systematic review and meta-analysis. F1000Res 2020; 9:633. [PMID: 32968483 PMCID: PMC7489275 DOI: 10.12688/f1000research.24623.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2020] [Indexed: 03/30/2024] Open
Abstract
Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) levels and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D level changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21-17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = -4.01; 95% CI = -7.45 to -0.57; P = 0.02 and MD = -1.91; 95% CI = -3.48 to -0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = -2.22; 95% CI = -4.1 to -0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D levels and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.
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Affiliation(s)
- Farapti Farapti
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Chusnul Fadilla
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
| | - Niwanda Yogiswara
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia
| | - Merryana Adriani
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
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Farapti F, Fadilla C, Yogiswara N, Adriani M. Effects of vitamin D supplementation on 25(OH)D concentrations and blood pressure in the elderly: a systematic review and meta-analysis. F1000Res 2020; 9:633. [PMID: 32968483 PMCID: PMC7489275 DOI: 10.12688/f1000research.24623.3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 12/18/2022] Open
Abstract
Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) concentrations and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D concentrations changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21-17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = -4.01; 95% CI = -7.45 to -0.57; P = 0.02 and MD = -1.91; 95% CI = -3.48 to -0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = -2.22; 95% CI = -4.1 to -0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D concentrations and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.
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Affiliation(s)
- Farapti Farapti
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
- Post Graduate Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Chusnul Fadilla
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
| | - Niwanda Yogiswara
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, 60132, Indonesia
| | - Merryana Adriani
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, East Java, 60115, Indonesia
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Association of Hypovitaminosis D with Metabolic Syndrome in Postmenopausal Women. J Obstet Gynaecol India 2020; 70:184-188. [PMID: 32476763 DOI: 10.1007/s13224-020-01314-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 04/04/2020] [Indexed: 10/24/2022] Open
Abstract
The prevalence of vitamin D deficiency and metabolic syndrome is spreading like a pandemic globally; postmenopausal women are particularly vulnerable population. Hypovitaminosis D is reported to predispose to various components of metabolic syndrome like dyslipidemia, hypertension, diabetes and obesity. The purpose of this review is to highlight the recently published evidence, evaluating the association of vitamin D deficiency with metabolic syndrome in postmenopausal women. Besides, it emphasizes the long-term risks involved with low vitamin D levels and importance of vitamin D supplementation. Data were obtained from PubMed, Google Scholar and individual searches.
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Oliveira PWC, Couto MR, de Sousa GJ, Peixoto P, Moraes FSA, de Andrade TU, Bissoli NS. Effects of Drugs, Phytoestrogens, Nutrients and Probiotics on Endothelial Dysfunction in the Estrogen-Deficient State. Curr Pharm Des 2020; 26:3711-3722. [PMID: 32228420 DOI: 10.2174/1381612826666200331084338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/22/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Endothelial dysfunction is commonly present in estrogen-deficient states, e.g., after menopause. In the search for alternatives to hormone replacement therapy (HRT), treatments based on phytoestrogens or in non-hormonal mechanisms have been under evaluation. OBJECTIVE Here we aim to present an overview of innovative potential treatments for endothelial dysfunction in estrogen-deficient states, introducing our own preliminary data about the probiotic kefir. METHODS We conducted a review based on a PubMed database search for keywords of interest (Menopause, Ovariectomy, Vascular dysfunction, Hot flashes, Metformin, Statins, Phytoestrogens, Omega-3, Vitamin D, Probiotics). RESULTS Vascular parameters were found to be improved by both metformin and statins through pleiotropic effects, being related to a decrease in oxidative stress and restoration of the nitric oxide pathway. Phytoestrogens such as genistein and resveratrol have also been shown to improve vascular dysfunction, which seems to involve their estrogenic-like actions. Omega-3, vitamin D and its analogues, as well as probiotics, have shown similar vascular beneficial effects in both postmenopausal women and an animal model of ovariectomy (OVX), which could be related to antioxidant and/or anti-inflammatory effects. Moreover, our preliminary data on the probiotic kefir treatment in OVX rats suggested a vascular antioxidant effect. In particular, some evidence points to statins and vitamin D having anti-atherogenic effects. CONCLUSION Pleiotropic effects of common medications and natural compounds could have therapeutic potential for endothelial dysfunction in estrogen-deficient states. They could, therefore, work as future complementary or alternative treatments to HRT.
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Affiliation(s)
- Phablo Wendell C Oliveira
- Department of Physiological Sciences, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Mariana R Couto
- Department of Physiological Sciences, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Glauciene J de Sousa
- Department of Physiological Sciences, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Pollyana Peixoto
- Department of Physiological Sciences, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
| | - Flávia S A Moraes
- Department of Pharmacy, University Vila Velha, Vila Velha, ES, Brazil
| | | | - Nazaré S Bissoli
- Department of Physiological Sciences, Universidade Federal do Espirito Santo, Vitoria, Espirito Santo, Brazil
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Dibaba DT. Effect of vitamin D supplementation on serum lipid profiles: a systematic review and meta-analysis. Nutr Rev 2020; 77:890-902. [PMID: 31407792 DOI: 10.1093/nutrit/nuz037] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
CONTEXT Vitamin D deficiency is highly prevalent across the world. The existing evidence suggests vitamin D may have beneficial effects on serum lipid profiles and thus cardiovascular health. OBJECTIVE The objective of this systematic review and meta-analysis was to examine the effect of vitamin D supplementation on serum lipid profiles. DATA SOURCE Original randomized controlled trials (RCTs) examining the effect of vitamin D supplementation on serum lipid profiles and published before July 2018 were identified by searching online databases, including PubMed, Google Scholar, and ScienceDirect, using a combination of relevant keywords. DATA EXTRACTION Data on study characteristics, effect size, measure of variation, type of vitamin D supplementation, and duration of follow-up were extracted by the author. DATA ANALYSIS PRISMA guidelines for systematic reviews were followed. Random effects (DerSimonian and Laird [D-V)] models were used to pool standardized mean differences in total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides between the active and the placebo arms of RCT studies. Between-study heterogeneities were assessed using Cochrane Q and I2, and publication bias was assessed using Begg's test, Egger's test, and funnel plot. RESULTS A total of 41 RCTs comprising 3434 participants (n = 1699 in the vitamin D supplementation arm and n = 1735 in the placebo arm) were identified and included in the meta-analysis. Approximately 63.4% of study participants were women, with 14 studies conducted entirely among women. Approximately 24% of the trials had follow-up duration >6 months, whereas the remaining 76% had follow-up duration of <6 months. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) for comparing the change from baseline to follow-up between the vitamin D supplementation arm and the placebo (control) arm were as follows: total cholesterol = -0.17 (-0.28 to -0.06); LDL cholesterol = -0.12 (-0.23 to -0.01); triglycerides = -0.12 (-0.25 to 0.01); and HDL cholesterol = -0.19 (-0.44 to 0.06). After removing a trial that was an outlier based on the magnitude of the effect size, the SMD for triglycerides was -0.15 (-0.24 to -0.06) and that for HDL cholesterol was -0.10 (-0.28 to 0.09). The improvements in total cholesterol and triglycerides were more pronounced in participants with baseline vitamin D deficiency. CONCLUSIONS Vitamin D supplementation appeared to have a beneficial effect on reducing serum total cholesterol, LDL cholesterol, and triglyceride levels but not HDL cholesterol levels. Vitamin D supplementation may be useful in hypercholesterolemia patients with vitamin D insufficiency who are at high risk of cardiovascular diseases.
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Affiliation(s)
- Daniel T Dibaba
- TN-Clinical and Translational Science Institute, University of Tennessee, Health Science Center, Memphis, Tennessee, USA; and the Department of Epidemiology, College of Public Health, and the Markey Cancer Center, University of Kentucky, Lexington, Kentucky, USA
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Zhang D, Cheng C, Wang Y, Sun H, Yu S, Xue Y, Liu Y, Li W, Li X. Effect of Vitamin D on Blood Pressure and Hypertension in the General Population: An Update Meta-Analysis of Cohort Studies and Randomized Controlled Trials. Prev Chronic Dis 2020; 17:E03. [PMID: 31922371 PMCID: PMC6977781 DOI: 10.5888/pcd17.190307] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The effect of vitamin D supplementation on blood pressure has been explored in previous meta-analyses, but whether the association is causal in the general population is still unknown. We evaluated the association comprehensively and quantitatively. Methods We searched PubMed and Embase for relevant cohort studies and randomized controlled trials (RCTs). We used a 2-step generalized least-squares method to assess the dose–response association of circulating 25-hydroxyvitamin D (25[OH]D) and hypertension and a fixed-effects model to pool the weighted mean differences (WMDs) and corresponding 95% confidence intervals (95% CIs) of blood pressure across RCTs. Results We identified 11 cohort studies and 27 RCTs, with 43,320 and 3,810 participants, respectively. The dose–response relationship between circulating 25(OH)D levels and hypertension risk was approximately L-shaped (Pnonlinearity = .04), suggesting that the risk of hypertension increased substantially below 75 nmol/L as 25(OH)D decreased, but it remained significant over the range of 75–130 nmol/L. However, pooled results of RCTs showed that there was no significant reduction in systolic blood pressure (WMD, −0.00 mm Hg; 95% CI, −0.71 to 0.71) or diastolic blood pressure (WMD, 0.19 mm Hg; 95% CI, −0.29 to 0.67) after vitamin D intervention. Conclusions The results of this meta-analysis indicate that supplementation with vitamin D does not lower blood pressure in the general population. RCTs with long-term interventions and a sufficient number of participants who have low levels of vitamin D are needed to validate these findings.
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Affiliation(s)
- Dongdong Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Yan Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Hualei Sun
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Songcheng Yu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Yuan Xue
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Yiming Liu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhengzhou, 450001 Henan, China.
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
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Chen C, Chen Y, Weng P, Xia F, Li Q, Zhai H, Wang N, Lu Y. Association of 25-hydroxyvitamin D with cardiometabolic risk factors and metabolic syndrome: a mendelian randomization study. Nutr J 2019; 18:61. [PMID: 31660975 PMCID: PMC6819483 DOI: 10.1186/s12937-019-0494-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/14/2019] [Indexed: 12/17/2022] Open
Abstract
Background Low circulating vitamin D levels have been associated with increased risk of metabolic syndrome (MS) and cardiometabolic risk factors in multiple epidemiology studies. However, whether this association is causal is still unclear. We aimed to test whether genetically lowered vitamin D levels were associated with MS and its metabolic traits, using mendelian randomization (MR) methodology. Methods Ten thousand six hundred fifty-five participants were enrolled from the SPECT-China study, which was performed in 23 sites in East China during 2014 to 2016. Using four single-nucleotide polymorphisms (SNPs) in the DHCR7, CYP2R1, GC and CYP24A1 genes with known effects on 25(OH) D concentrations, we created a genetic risk score (GRS) as instrumental variable (IV) to estimate the effect of genetically lowered 25(OH) D on MS and cardiometabolic risk factors. MS was defined according to the International Diabetes Federation criteria. Results Lower measured 25(OH)D levels were associated with MS (OR 0.921, 95% CI 0.888, 0.954) after multivariable adjustment. However, the MR-derived odds ratio of genetically determined 25(OH) D for risk of MS was 0.977 (95% CI 0.966, 1.030). The MR-derived estimates for raised fasting plasma glucose was 0.578 (95% CI 0.321, 0.980) per 10 nmol/L GRSsynthesis determined increase of 25(OH) D levels. Conclusions We found no evidence that genetically determined reduction in 25(OH)D conferred an increased risk of MS and its metabolic traits. However, we created our GRS only on the basis of common variants, which represent limited amount of variance in 25(OH)D. MR studies using rare variants, and large-scale well-designed RCTs about the effect of vitamin D supplementation on MS are warranted to further validate the findings.
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Affiliation(s)
- Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Pan Weng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
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Isolated vitamin D supplementation improves the immune-inflammatory biomarkers in younger postmenopausal women: a randomized, double-blind, placebo-controlled trial. Menopause 2019; 25:897-903. [PMID: 29738417 DOI: 10.1097/gme.0000000000001106] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of vitamin D (VitD) supplementation on immune-inflammatory biomarkers in younger postmenopausal women. METHODS In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50 to 65 years with amenorrhea ≥12 months were randomized into two groups: VitD group, oral supplementation with 1000 IU VitD3/day (n = 80) or placebo group (n = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Serum levels of interleukins (ILs)-1β, IL-5, IL-6, IL-10, IL-12ρ70, IL-17α, tumor necrosis factor-alpha, and interferon-gamma were determined by immunoassay. Plasma concentrations of 25-hydroxyvitamin D [25(OH)D] were measured by high-performance liquid chromatography. Per-protocol analysis was adopted as the statistical method using a gamma distribution and repeated measures design, followed by Wald's multiple comparisons test. RESULTS The two groups were similar at baseline in terms of clinical and laboratory parameters. After 9 months, there was a significant increase of 25(OH)D levels in the VitD group (+45.4%, P < 0.001) and a decrease (-18.5%, P = 0.049) in the placebo group. A significant decrease in IL-5, IL-12p70, IL-17α, tumor necrosis factor-alpha, and interferon-gamma levels was observed in the VitD group (P < 0.05). IL-5 and IL-6 levels were significantly lower in the VitD group compared to the placebo group (P < 0.05). There were no significant intervention effects on serum IL-1β or IL-10 levels in either group (P > 0.05). CONCLUSIONS In younger postmenopausal women, isolated supplementation with 1000 IU of VitD3 for 9 months was associated with a reduction in proinflammatory biomarkers.
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Vitamin D supplementation and inflammatory and metabolic biomarkers in patients with knee osteoarthritis: post hoc analysis of a randomised controlled trial. Br J Nutr 2019; 120:41-48. [PMID: 29936918 DOI: 10.1017/s0007114518001174] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aim of this study was to determine whether vitamin D supplementation and maintaining vitamin D sufficiency are associated with changes in inflammatory and metabolic biomarkers in patients with knee osteoarthritis (OA) and vitamin D deficiency. A total of 413 participants with symptomatic knee OA and vitamin D deficiency were enrolled in a randomised, placebo-controlled trial and received 1·25 mg vitamin D3 or placebo monthly for 24 months across two sites. In this post hoc analysis, 200 participants from one site (ninety-four from the placebo group and 106 from the vitamin D group; mean age 63·1 (sd 7·3) years, 53·3 % women) were randomly selected for measurement of serum levels of inflammatory and metabolic biomarkers at baseline and 24 months using immunoassays. In addition, participants were classified into two groups according to serum 25-hydroxyvitamin D (25(OH)D) levels at months 3 and 24: (1) not consistently sufficient (25(OH)D≤50 nmol/l at either month 3 or 24, n 61), and (2) consistently sufficient (25(OH)D>50 nmol/l at both months 3 and 24, n 139). Compared with placebo, vitamin D supplementation had no significant effect on change in serum high-sensitive C-reactive protein, IL-6, IL-8, IL-10, leptin, adiponectin, resistin, adipsin and apelin. Being consistently vitamin D sufficient over 2 years was also not associated with changes in these biomarkers compared with not being consistently sufficient. Vitamin D supplementation and maintaining vitamin D sufficiency did not alter serum levels of inflammatory and metabolic biomarkers over 2 years in knee OA patients who were vitamin D insufficient, suggesting that they may not affect systemic inflammation in knee OA patients.
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Thirteen weeks of supplementation of vitamin D and leucine-enriched whey protein nutritional supplement attenuates chronic low-grade inflammation in sarcopenic older adults: the PROVIDE study. Aging Clin Exp Res 2019; 31:845-854. [PMID: 31049877 PMCID: PMC6583678 DOI: 10.1007/s40520-019-01208-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/16/2019] [Indexed: 12/15/2022]
Abstract
Background A chronic low-grade inflammatory profile (CLIP) is associated with sarcopenia in older adults. Protein and Vitamin (Vit)D have immune-modulatory potential, but evidence for effects of nutritional supplementation on CLIP is limited. Aim To investigate whether 13 weeks of nutritional supplementation of VitD and leucine-enriched whey protein affected CLIP in subjects enrolled in the PROVIDE-study, as a secondary analysis. Methods Sarcopenic adults (low skeletal muscle mass) aged ≥ 65 years with mobility limitations (Short Physical Performance Battery 4–9) and a body mass index of 20–30 kg/m2 were randomly allocated to two daily servings of active (n = 137, including 20 g of whey protein, 3 g of leucine and 800 IU VitD) or isocaloric control product (n = 151) for a double-blind period of 13 weeks. At baseline and after 13 weeks, circulating interleukin (IL)-8, IL-1 receptor antagonist (RA), soluble tumor-necrosis-factor receptor (sTNFR)1, IL-6, high-sensitivity C-reactive protein, pre-albumin and 25-hydroxyvitamin(OH)D were measured. Data-analysis included repeated measures analysis of covariance (corrected for dietary VitD intake) and linear regression. Results IL-6 and IL-1Ra serum levels showed overall increases after 13 weeks (p = 0.006 and p < 0.001, respectively). For IL-6 a significant time × treatment interaction (p = 0.046) was observed, with no significant change over time in the active group (p = 0.155) compared to control (significant increase p = 0.012). IL-8 showed an overall significant decrease (p = 0.03). The change in pre-albumin was a significant predictor for changes in IL-6 after 13 weeks. Conclusions We conclude that 13 weeks of nutritional supplementation with VitD and leucine-enriched whey protein may attenuate the progression of CLIP in older sarcopenic persons with mobility limitations. Electronic supplementary material The online version of this article (10.1007/s40520-019-01208-4) contains supplementary material, which is available to authorized users.
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Ferreira PP, Cangussu L, Bueloni-Dias FN, Orsatti CL, Schmitt EB, Nahas-Neto J, Nahas EAP. Vitamin D supplementation improves the metabolic syndrome risk profile in postmenopausal women. Climacteric 2019; 23:24-31. [PMID: 31134822 DOI: 10.1080/13697137.2019.1611761] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Objective: This study aimed to evaluate the effect of isolated vitamin D (VD) supplementation on the metabolic syndrome (MetS) risk profile in postmenopausal women.Methods: In this double-blind, placebo-controlled trial, 160 postmenopausal women aged 50-65 years were randomized into two groups: VD group, supplementation with 1000 IU vitamin D3/day (n = 80); or placebo group (n = 80). The intervention time was 9 months, and the women were assessed at baseline and endpoint. Clinical and anthropometric data were collected. Biochemical parameters, including total cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides, glucose, and insulin, were measured. The plasma concentration of 25-hydroxyvitamin D (25(OH)D) was measured by high-performance liquid chromatography.Results: After 9 months, there was a significant increase in the 25(OH)D levels for VD group (+45.4%, p < 0.001), and a decrease (-18.5%, p = 0.049) in the placebo group. In the VD group, a significant reduction was observed in triglycerides (-12.2%, p = 0.001), insulin (-13.7%, p = 0.008), and the homeostasis model assessment of insulin resistance (-17.9%, p = 0.007). In the placebo group, there was an increase in glucose (+6.2%, p = 0.009). Analysis of the risk adjusted for age, time since menopause, and body mass index showed that women supplemented with VD had a lower risk of MetS (odds ratio [OR] 0.42; 95% confidence interval [CI] 0.21-0.83), hypertriglyceridemia (OR 0.43; 95% CI 0.22-0.85), and hyperglycemia (OR 0.23; 95% CI 0.10-0.52) compared to the placebo group (p < 0.05).Conclusions: In postmenopausal women with VD deficiency, isolated supplementation with 1000 IU vitamin D3 for 9 months was associated with a reduction in the MetS risk profile. Women undergoing VD supplementation had a lower risk of MetS, hypertriglyceridemia, and hyperglycemia.
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Affiliation(s)
- P P Ferreira
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - L Cangussu
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - F N Bueloni-Dias
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - C L Orsatti
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - E B Schmitt
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - J Nahas-Neto
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
| | - E A P Nahas
- Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil
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He S, Hao X. The effect of vitamin D3 on blood pressure in people with vitamin D deficiency: A system review and meta-analysis. Medicine (Baltimore) 2019; 98:e15284. [PMID: 31083159 PMCID: PMC6531166 DOI: 10.1097/md.0000000000015284] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate the effect of vitamin D3 on blood pressure in people with vitamin D deficiency. METHODS Randomized controlled trials (RCTs) were electronically searched databases including CNKI, VIP, WanFang Data, the Cochrane Library, PubMed, and EMbase which were about oral vitamin D3 among people with vitamin D deficiency from inception to December 2017. Two reviewers independently screened literature according to the inclusion and extracted data; meta-analysis was performed using RevMan5.3. RESULTS A total of 17 RCTs with 22 arms involving 1687 participants were included. The results of meta-analysis showed that, there were no significant differences between the vitamin D deficiency group and the control group on the level of change in systolic pressure (ΔSBP) [weighted mean difference (WMD) = -1.94, 95% confidence interval (CI) (-3.93,0.04) P = .06] and on the level of change in diastolic pressure (ΔDBP) [WMD = -0.50, 95% CI (-1.17, 0.17) P = .14]. The results of subgroups showed that, there were statistically significant differences in the age of >50 years subgroup on ΔSBP [WMD = -2.32, 95% CI (-4.39, -0.25) P = .03]; there were statistically significant differences in the hypertension subgroup on ΔSBP [WMD = -6.58, 95% CI (-8.72, -4.44) P <.00001]; there were statistically significant differences in the hypertension subgroup on ΔDBP [WMD = -3.07, 95% CI (-4.66, -1.48) P = .0002]; there were statistically significant differences in the body mass index (BMI) >30 subgroup on ΔSBP [WMD = -3.51, 95% CI (-5.96, -1.07) P = .005]. CONCLUSION Oral vitamin D3 has no significant effect on blood pressure in people with vitamin D deficiency. It reduces systolic blood pressure in people with vitamin D deficiency that was older than 50 years old or obese. It reduces systolic blood pressure and diastolic pressure in people with both vitamin D deficiency and hypertension.
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Durgarao Y, Manjrekar PA, Adhikari P, Chakrapani M, Rukmini MS. Comprehensive Review on Diabetes Associated Cardiovascular Complications - The Vitamin D Perspective. Cardiovasc Hematol Disord Drug Targets 2019; 19:139-153. [PMID: 30648528 DOI: 10.2174/1871529x19666190114155302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/14/2018] [Accepted: 11/28/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D, a steroid hormone is primarily known for its role in calcium and bone mineral homeostasis. Over the years, vitamin D has been implicated in various non-skeletal diseases. The extraskeletal phenomenon can be attributed to the presence of vitamin D receptors (VDRs) in almost all cells and identification of 1-α hydroxylase in extrarenal tissues. The vitamin D deficiency (VDD) pandemic was globally reported with increasing evidence and paralleled the prevalence of diabetes, obesity and cardiovascular diseases (CVDs). A dependent link was proposed between hypovitaminosis D glycemic status, insulin resistance and also the other major factors associated with type 2 diabetes leading to CVDs. Insulin resistance plays a central role in both type 2 diabetes and insulin resistance syndrome. These 2 disorders are associated with distinct etiologies including hypertension, atherogenic dyslipidemia, and significant vascular abnormalities that could lead to endothelial dysfunction. Evidence from randomised clinical trials and meta-analysis, however, yielded conflicting results. This review summarizes the role of vitamin D in the regulation of glucose homeostasis with an emphasis on insulin resistance, blood pressure, dyslipidaemia, endothelial dysfunction and related cardiovascular diseases and also underline the plausible mechanisms for all the documented effects.
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Affiliation(s)
- Y Durgarao
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Poornima A Manjrekar
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Prabha Adhikari
- Department of Internal Medicine, Yenepoya University, Mangalore, Karnataka, India
| | - M Chakrapani
- Department of Internal Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - M S Rukmini
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
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Khosravi ZS, Kafeshani M, Tavasoli P, Zadeh AH, Entezari MH. Effect of Vitamin D Supplementation on Weight Loss, Glycemic Indices, and Lipid Profile in Obese and Overweight Women: A Clinical Trial Study. Int J Prev Med 2018; 9:63. [PMID: 30123437 PMCID: PMC6071442 DOI: 10.4103/ijpvm.ijpvm_329_15] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 12/15/2017] [Indexed: 12/26/2022] Open
Abstract
Introduction Vitamin D (vit D) deficiency has defined as a health problem worldwide. World Health Organization (WHO) has declared that obesity is an epidemic of the 21st century. Previous studies have shown that obesity may increase the risk of Vit D deficiency. Furthermore, other studies have demonstrated that vit D insufficiency was accompanied with higher risk of type 2 diabetes, cardiovascular diseases, hypertension, and obesity. The aim of this study was to survey the effect of vit D supplementation on weight loss among overweight and obese women aged 20-40 years in Isfahan. Methods This double-blind clinical trial was done on 50 overweight and obese women who were divided into two groups, in which one group received vit D supplements and the other group received placebo. Intervention group received vit D with dozes 50,000 IU/w for 6 weeks. The levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting blood sugar (FBS), insulin (ins), homeostasis model assessment of ins resistance (IR), C-reactive protein (CRP), height, weight (WT), waist circumference (WC), hip circumference (HC), and blood pressure (BP) were measured before and after intervention. Results After using vit D supplementation for 6 weeks, WT, WC, and body mass index (BMI) were decreased significantly and serum vit D increased significantly compared to control group (P < 0.001). Other factors including TC, TG, LDL-c, HDL-c, FBS, CRP, ins, IR, and waist to hip ratio (WHR) did not change significantly (P > 0.05). Conclusions After 6 weeks of intervention, the means of WT, BMI, WC, and HC decreased significantly. Previous studies have shown that vit D deficiency was more prevalence in obese people and there was an inverse association among vit D with BMI and WC. The relationship between vit D and lipid profiles such as glycemic indexes, anthropometric indexes, CRP, and BP is not clear and needs more study in the future.
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Affiliation(s)
- Zahra Sadat Khosravi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Kafeshani
- Clinical Nutrition/Community Nutrition/Food Science and Technology, Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parastoo Tavasoli
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Akbar Hassan Zadeh
- Department of Epidemiology and Biostatic, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Entezari
- Clinical Nutrition/Community Nutrition/Food Science and Technology, Food Security Research Center, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Mirhosseini N, Rainsbury J, Kimball SM. Vitamin D Supplementation, Serum 25(OH)D Concentrations and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2018; 5:87. [PMID: 30050908 PMCID: PMC6052909 DOI: 10.3389/fcvm.2018.00087] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Cardiovascular disease (CVD) risk factors are associated with low serum 25 hydroxyvitamin D (25(OH)D) concentrations in observational studies; however, clinical trial findings are inconsistent. Objective: We assessed the effect of vitamin D supplementation and increased serum 25(OH)D concentrations on CVD risk factors in a systemic review and meta-analysis of randomized controlled trials (RCTs). Design: MEDLINE, CINAHL, EMBASE, and Google Scholar were searched for RCTs that evaluated vitamin D supplementation and cardiovascular outcomes [blood pressure, parathyroid hormone (PTH), serum high-sensitivity C-reactive protein (hs-CRP), total cholesterol, high and low density lipoprotein (HDL and LDL, respectively), triglycerides, peak wave velocity (PWV) and Augmentation Index (AI)] from 1992 through 2017. Meta-analysis was based on a random-effects model and inverse variance method to calculate standardized mean difference (SMD) as effect sizes, followed by a leave-one-out method for sensitivity analysis. Risk of publication bias was assessed using Cochrane checklist and Begg funnel plots. The systematic review is registered as CRD42015025346. Results: We identified 2341 studies from which 81 met inclusion criteria. The meta-analysis indicated a significant reduction in systolic blood pressure (SMD = −0.102 ± 0.04 mmHg, 95% confidence interval (CI), −0.20 to −0.03), diastolic blood pressure (SMD = −0.07 ± 0.03 mmHg, 95% CI, −0.14 to −0.006), serum PTH (SMD = −0.66 ± 0.08 ng/L, 95% CI, −0.82 to −0.49), hs-CRP (SMD = −0.20 ± 0.07 mg/L, 95% CI, −0.34 to −0.06), total cholesterol (SMD = −0.15 ± 0.06 mmol/L, 95% CI, −0.25 to −0.04), LDL (SMD = −0.10 ± 0.05 mmol/L, 95% CI, −0.20 to −0.003), triglycerides (SMD = −0.12 ± 0.06 mmol/L, 95% CI, −0.23 to −0.003) and a significant increase in HDL (SMD = 0.09 ± 0.04 mmol/L, 95% CI, 0.00 to 0.17) with vitamin D supplementation. These findings remained significant in sensitivity analyses for blood pressure, lipid profile, serum PTH, and serum hs-CRP. There was no significant effect of vitamin D supplementation on PWV (SMD = −0.20 ± 0.13 m/s, 95% CI, −0.46 to 0.06, p = 0.14) and AI (SMD = −0.09 ± 0.14%, 95% CI, −0.37 to 0.19, p = 0.52) for vitamin D supplemented groups. Conclusion: These findings suggest that vitamin D supplementation may act to protect against CVD through improving risk factors, including high blood pressure, elevated PTH, dyslipidemia, and inflammation.
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Affiliation(s)
| | | | - Samantha M Kimball
- Pure North S'Energy Foundation, Calgary, AB, Canada.,St. Mary's University, Calgary, AB, Canada
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Mirhosseini N, Vatanparast H, Mazidi M, Kimball SM. Vitamin D Supplementation, Glycemic Control, and Insulin Resistance in Prediabetics: A Meta-Analysis. J Endocr Soc 2018; 2:687-709. [PMID: 29951596 PMCID: PMC6016617 DOI: 10.1210/js.2017-00472] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/22/2018] [Indexed: 12/15/2022] Open
Abstract
Diabetes prevention is a public health priority. Vitamin D supplementation may help prevent the development of diabetes in persons at increased risk. We performed a meta-analysis of controlled clinical trials that assessed glycemic outcome measures among adults at risk for type 2 diabetes, including prediabetes, overweight, or obesity. We searched PUBMED/ MEDLINE, CINAHL, and Google Scholar databases for trials published prior to April 2017. Placebo-controlled clinical trials with random allocation to vitamin D with or without calcium supplementation were selected. Data collection included country, study design, inclusion criteria, sample size, form, and dose of vitamin D, supplementation interval, control group, duration, participant characteristics, comorbidities, baseline and follow-up serum 25-hydroxyvitamin D [25(OH)D] concentration, and available outcome measures [glycosylated hemoglobin (HbA1c), fasting plasma glucose, plasma glucose after 2-hour oral glucose tolerance test, and homeostatic model assessment of insulin resistance (HOMA-IR)]. Data synthesis was conducted using random-effect models (PROSPERO registration no. CRD42017055326). Twenty-eight trials, representing 3848 participants, met the eligibility criteria. Compared with the control group, vitamin D supplementation significantly reduced HbA1c level by -0.48% (95% CI, -0.79 to -0.18), fasting plasma glucose level by -0.46 mmol/L (95% CI, -0.74 to -0.19), and HOMA-IR level by -0.39 (95% CI, -0.68 to -0.11). Subgroup analysis revealed that the effects of vitamin D supplementation on different glycemic measures were influenced by age, calcium coadministration, vitamin D deficiency, serum 25(OH)D level after supplementation, and duration of supplementation. Vitamin D supplementation and improved vitamin D status improved glycemic measures and insulin sensitivity and may be useful as part of a preventive strategy for type 2 diabetes.
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Affiliation(s)
| | - Hassanali Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Mohsen Mazidi
- Key State Laboratory of Molecular Developmental Biology, Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China
- Institute of Genetics and Developmental Biology, International College, University of Chinese Academy of Sciences, Beijing, China
| | - Samantha M Kimball
- Pure North S’Energy Foundation, Calgary, Alberta, Canada
- St. Mary’s University, Calgary, Alberta, Canada
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Relationship of vitamin D and parathyroid hormone with the nocturnal blood pressure decline in hypertension. Blood Press Monit 2018; 22:322-327. [PMID: 28926360 DOI: 10.1097/mbp.0000000000000286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Vitamin D deficiency and high parathyroid hormone (PTH) levels have been linked with hypertension. Nondipper hypertension is associated with increased morbidity and mortality. We aimed to investigate the relationship of vitamin D and PTH levels with nondipper hypertension and nocturnal decline in untreated hypertensive patients. PATIENTS AND METHODS This cross-sectional study included a total of 73 hypertensive and 34 normotensive participants. Each patient underwent 24-hour ambulatory blood pressure monitoring, routine biochemical tests, vitamin D, and PTH analysis. RESULTS The study population was divided into three groups according to ambulatory blood pressure monitoring records: 40 nondippers (mean age; 59.8±10.8 years, 24 women and 16 men), 33 dipper hypertensives (mean age; 58±11.8 years, 13 women and 20 men), and 34 normotensives (mean age; 56.9±11.7 years, 19 women and 15 men). Nondipper hypertensives showed lower levels of vitamin D than dippers and normotensives (9.7±6.1 vs. 14.9±10.1 vs. 16.4±9.5 ng/ml, P=0.001, for both) and higher levels of PTH than dippers (74.8±34.7 vs. 53.3±19.9 ng/ml, P=0.001). A significant positive correlation was observed between vitamin D and nocturnal decline (r=0.34, P=0.001), whereas a significant negative correlation was present between PTH and nocturnal decline(r=-0.26, P=0.006). In multivariate analysis, PTH level was correlated independently with nocturnal decline (β=-0.07, 95% confidence interval: -0.114-0.025, P=0.003). CONCLUSION In this study, vitamin D levels were significantly lower and PTH levels were significantly higher in nondippers. The vitamin D level was correlated positively and the PTH level was correlated negatively with nocturnal decline. In addition, PTH level was associated independently with nocturnal decline in hypertension.
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He S, Yu S, Zhou Z, Wang C, Wu Y, Li W. Effect of vitamin D supplementation on fasting plasma glucose, insulin resistance and prevention of type 2 diabetes mellitus in non-diabetics: A systematic review and meta-analysis. Biomed Rep 2018; 8:475-484. [PMID: 29725526 PMCID: PMC5920274 DOI: 10.3892/br.2018.1074] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 02/06/2018] [Indexed: 12/29/2022] Open
Abstract
Increasing epidemiological studies suggest that there is an association between vitamin D deficiency and risk of type 2 diabetes mellitus (T2DM). Therefore, randomized clinical trials (RCTs) have been performed to observe the effect of vitamin D supplementation on preventing T2DM, decreasing fasting plasma glucose (FPG) and improving insulin resistance to confirm the association between vitamin D and T2DM. However, the results of RCTs on controlling FPG level, improving insulin resistance and preventing T2DM in non-diabetics are inconsistent. In the present study, a systematic meta-analysis considering individual variation and intervention strategy was conducted to establish an objective and definitive conclusion. The results suggested that vitamin D supplementation had no significant effect on controlling FPG level, improving insulin resistance or preventing T2DM in non-diabetics in a pooled meta-analysis of 23 articles (containing 28 RCTs). However, stratified analysis indicated that supplementation of vitamin D had differential effects on FPG control, insulin sensitivity improvement and T2DM prevention in individuals with different baseline states: FPG was decreased for those with BMI <25 (P=0.048) or 20≤ 25(OH)D <30 ng/ml (P=0.002); insulin resistance was improved for those with 25(OH)D ≥30 ng/ml (P=0.021); and risk of T2DM was lower for pre-diabetic individuals (P=0.047) or for those with 25≤ BMI <30 (P=0.032). Additionally, the effect on T2DM prevention was improved when the supplement dose was >2,000 IU/day (P=0.047) and with intervention without calcium (P=0.047). Thus, further trials should focus on individual baselines and the supplementation strategy of vitamin D in the prevention of T2DM.
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Affiliation(s)
- Sitian He
- Department of Sanitary Chemistry, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Songcheng Yu
- Department of Sanitary Chemistry, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Zonglei Zhou
- Department of Sanitary Chemistry, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Chongjian Wang
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Yongjun Wu
- Department of Sanitary Chemistry, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, Henan 450001, P.R. China
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Reyes-Garcia R, Mendoza N, Palacios S, Salas N, Quesada-Charneco M, Garcia-Martin A, Fonolla J, Lara-Villoslada F, Muñoz-Torres M. Effects of Daily Intake of Calcium and Vitamin D-Enriched Milk in Healthy Postmenopausal Women: A Randomized, Controlled, Double-Blind Nutritional Study. J Womens Health (Larchmt) 2018; 27:561-568. [PMID: 29676968 DOI: 10.1089/jwh.2017.6655] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To determine the effect of the daily intake of calcium and vitamin D-enriched milk (with or without fructooligosaccharides [FOS]) on vitamin D, bone metabolism, and cardiovascular risk factors. MATERIALS AND METHODS Two-year randomized controlled study, including 500 healthy postmenopausal women, assigned to 500 mL/day of skimmed milk to one of three groups: Low-dose (L): (120 mg/100 mL calcium, vitamin D3 30 UI/100 mL), group A: calcium and vitamin D (180 mg/100 mL and 120 UI/100 mL), and group B: calcium and vitamin D (180 mg/100 mL and 120 UI/100 mL) and FOS (5 g/L). We evaluated serum 25(OH)D, bone mineral density (BMD) by Dual Energy X-ray Absorptiometry, and biochemical data of glucose and lipid metabolism. RESULTS After 24 months, vitamin D concentrations did not change in the control group, but increased in group A and group B, p < 0.001. We observed an increase in femoral neck BMD and an improvement in fasting plasma glucose, HbA1c, total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B 100. CONCLUSIONS Daily intake of milk enriched with calcium and vitamin D in postmenopausal healthy women induces a significant improvement in vitamin D status, a significant increase in BMD at femoral neck, and also favorable effects on glucose and lipid profile.
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Affiliation(s)
- Rebeca Reyes-Garcia
- 1 Bone Metabolic Unit (CIBERFES), UGC Endocrinología y Nutrición, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitario de Granada (Ibs. Granada) , Granada, Spain .,2 Unidad de Endocrinología y Nutrición, Complejo Hospitalario Torrecardenas , Almeria, Spain
| | - Nicolas Mendoza
- 3 Department of Obstetrics and Gynecology, University of Granada , Granada, Spain
| | | | - Nancy Salas
- 4 Palacios Institute of Women's Health , Madrid, Spain
| | - Miguel Quesada-Charneco
- 1 Bone Metabolic Unit (CIBERFES), UGC Endocrinología y Nutrición, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitario de Granada (Ibs. Granada) , Granada, Spain
| | - Antonia Garcia-Martin
- 1 Bone Metabolic Unit (CIBERFES), UGC Endocrinología y Nutrición, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitario de Granada (Ibs. Granada) , Granada, Spain
| | | | | | - Manuel Muñoz-Torres
- 1 Bone Metabolic Unit (CIBERFES), UGC Endocrinología y Nutrición, Hospital Universitario San Cecilio, Instituto de Investigación Biosanitario de Granada (Ibs. Granada) , Granada, Spain
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