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Delanghe JR, Speeckaert MM, Maenhout T. Factors to take into account when interpreting 25-hydroxy-vitamin D serum levels. Acta Clin Belg 2024; 79:97-102. [PMID: 38454315 DOI: 10.1080/17843286.2024.2327218] [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: 12/25/2023] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Assessing vitamin D status, typically evaluated using serum or plasma 25-hydroxy vitamin D [25(OH)D] concentration, is complex because of various influencing factors. METHODS Seasonality significantly affects intra-individual variability in 25(OH)D levels. This variation can be addressed by employing cosinor functions that are tailored to the geographical location of the patient to correct for seasonal effects. In addition to seasonality, genetic factors, such as DBP polymorphism and body composition, particularly adiposity, play crucial roles. Dialysis patients with DBP 2-2 phenotype exhibit higher vitamin D requirements. Genotyping/phenotyping of DBP allows for better tailored vitamin D supplementation. The lipid-soluble nature of vitamin D also interacts with plasma components such as serum triglycerides, which can influence vitamin D measurements. Adiposity, which is negatively correlated with vitamin D concentration, necessitates body mass-based mathematical adjustments for accurate vitamin D assessment in subjects with extreme BMI values. CONCLUSIONS Accordingly, vitamin D replacement therapy must be personalized, taking into account factors such as body size and seasonal variations, to effectively reach the target serum 25(OH)D concentrations.
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Affiliation(s)
| | - Marijn M Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium
- Research Foundation-Flanders (FWO), Brussels, Belgium
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Determinants and Effects of Vitamin D Supplementation in Postmenopausal Women: A Systematic Review. Nutrients 2023; 15:nu15030685. [PMID: 36771392 PMCID: PMC9919965 DOI: 10.3390/nu15030685] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
Hormonal fluctuations, excessive clothing covering, sunscreen use, changes in body fat composition, a vitamin D-deficient diet, and a sedentary lifestyle can all predispose postmenopausal women to vitamin D deficiency. An effective supplementation plan requires a thorough understanding of underlying factors to achieve the desired therapeutic concentrations. The objective of this study was to conduct a systematic review of the predictors that affect vitamin D status in postmenopausal women. From inception to October 2022, we searched MEDLINE, Embase, Web of Science, Scopus, and clinical trial registries. Randomized clinical trials of postmenopausal women taking supplements of vitamin D with serum 25-hydroxyvitamin D (25(OH)D) measurement as the trial outcome were included. Two independent reviewers screened selected studies for full-text review. The final assessment covered 19 trials within 13 nations with participants aged 51 to 78. Vitamin D supplementation from dietary and pharmaceutical sources significantly increased serum 25(OH)D to optimal levels. Lower baseline serum 25(OH)D, lighter skin color, longer treatment duration, and prolonged skin exposure were all associated with a better response to vitamin D supplementation in postmenopausal women.
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Asghari G, Yuzbashian E, Nikparast A, Najd Hassan Bonab L, Mahdavi M, Daneshpour MS, Hosseinpanah F, Mirmiran P. Impact of daily vitamin D 3 supplementation on the risk of vitamin D deficiency with the interaction of rs2282679 in vitamin D binding protein gene (GC) among overweight and obese children and adolescents: A one-year randomized controlled trial. Front Nutr 2022; 9:1061496. [PMID: 36579074 PMCID: PMC9792175 DOI: 10.3389/fnut.2022.1061496] [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: 10/04/2022] [Accepted: 11/11/2022] [Indexed: 12/14/2022] Open
Abstract
Background The rs2282679 polymorphism in the vitamin D binding protein (DBP) gene may influence the response to vitamin D supplementation. Therefore, we examine the effect of 1-year vitamin D supplementation on vitamin D deficiency (VDD) with the interaction of rs2282679 polymorphism in overweight and obese children and adolescents. Materials and methods The participants (n = 300) were part of a randomized controlled trial who received a daily supplement of either 1,000 or 2,000 IU or four supplements of 1,000 IU weekly (equal to 600 IU daily) of vitamin D3 for 12 months. Genotyping was performed using amplification refractory mutation system polymerase chain reaction (ARMS-PCR). Results The mean of 25(OH)D values at baseline for participants with the TT, TG, and GG genotypes were 15.4, 14.4, and 10.8 ng/mL, respectively, and were not different between the three genotype groups (P = 0.062). A significant reduction in VDD was observed after vitamin D supplementation with dosages of 1,000 or 2,000 IU compared to 600 IU. No significant association of genotypes with risk of VDD was observed in each intervention group after vitamin D supplementation, except, that individuals with TG genotype showed a higher risk of VDD compared to those with TT genotype in the 2,000 IU group after 6 months of supplementation [odds ratio (95% CI): 6.94; 1.30-37.02]. We observed no interaction between time duration, three genotypes, and dosages with serum 25(OH)D, calcium, phosphorus, alkaline phosphatase, and parathyroid hormone levels. Conclusion Response to vitamin D supplementation by three doses of 600, 1,000, and 2,000 IU could not be affected by rs2282679 polymorphism during 12 months in overweight and obese children and adolescents.
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Affiliation(s)
- Golaleh Asghari
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Emad Yuzbashian
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
| | - Ali Nikparast
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Najd Hassan Bonab
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam S. Daneshpour
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Farhad Hosseinpanah,
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran,*Correspondence: Parvin Mirmiran, ;
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4
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Variability in response to vitamin D supplementation according to vitamin D metabolism related gene polymorphisms in healthy adults. Eur J Clin Nutr 2022; 77:189-194. [PMID: 36167979 PMCID: PMC9514197 DOI: 10.1038/s41430-022-01218-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/23/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The aim of this study was to determine the influence of polymorphisms in some key gene actors of the vitamin D (vitD) metabolic pathway on supplementation efficacy. METHODS In total, 245 healthy participants were recruited from occupational medicine service in Sahloul University Hospital with vitD deficiency [25(OH)D ≤ 30 ng/ml]. After giving an informed consent, all participants were asked to complete a generalized questionnaire and to follow a detailed personalized supplementation protocol. Genetic study was performed by PCR-RFLP for 15 single nucleotide polymorphisms (SNPs) belonging to DBP, CYP2R1, CYP27B14, CYP24A1 and VDR genes. Statistical study was carried out with SPSS23.0. RESULTS Among the studied SNPs, non-response was significantly associated with variant alleles of rs4588 (OR* = 11.51; p < 0.001), rs10766197 (OR* = 6.92; p = 0.008) and rs12794714 (OR* = 5.09; p = 0.004). These three SNPs contributed in 18.8% in response variability with rs4588 being the most influential (10.3%). There was a significant linear negative correlation between baseline 25(OH)D and post supplementation 25(OH)D concentration (r = -0.437; p < 0.001) as well as a linear negative association between the increase in 25(OH)D concentration and GRS (GRS: genetic risk score = the sum of risk alleles) (r = -0.149; p = 0.033). CONCLUSIONS DBP-rs4588, CYP2R1-rs10766197 and rs12794714 variants are associated with variations in serum 25(OH)D concentrations and efficacy of response to vitD supplementation in Tunisian adults. Taking into account these variations can help to better adapt vitD intake to ensure a higher response to supplementation.
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5
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McCourt AF, Mulrooney SL, O'Neill GJ, O'Riordan ED, O'Sullivan AM. Postprandial 25-hydroxyvitamin D response varies according to the lipid composition of a vitamin D3 fortified dairy drink. Int J Food Sci Nutr 2021; 73:396-406. [PMID: 34615419 DOI: 10.1080/09637486.2021.1984400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In-vitro evidence suggests that the lipid component of foods alters vitamin D absorption. This single-blinded, cross-over postprandial study examined the effect of changing the lipid component of a 20 µg vitamin D3 fortified dairy drink on postprandial 25(OH)D concentrations. Participants consumed one dairy drink per visit: a non-lipid, a pre-formed oleic acid micelle, an olive oil and a fish oil dairy drink. There was a significant time*drink*baseline status effect on 25(OH)D concentrations (p = 0.039). There were no time*drink, time or drink effects on 25(OH)D in vitamin D sufficient participants (>50nmol/L). However, there was an effect of time on changes in 25(OH)D concentrations after the olive oil dairy drink (p = 0.034) in vitamin D insufficient participants (<50nmol/L). There were no effects after the other diary drinks. Olive oil may improve vitamin D absorption from fortified foods. Further research is needed to examine the practical implications of changing the lipid component of fortified foods.
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Affiliation(s)
- Aislinn F McCourt
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Steven L Mulrooney
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Graham J O'Neill
- TUD School of Food Science and Environmental Health, Technological University Dublin (TUD), Dublin, Ireland
| | - E Dolores O'Riordan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
| | - Aifric M O'Sullivan
- UCD Institute of Food and Health, UCD School of Agriculture and Food Science, University College Dublin (UCD), Dublin, Ireland
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Krasniqi E, Boshnjaku A, Wagner KH, Wessner B. Association between Polymorphisms in Vitamin D Pathway-Related Genes, Vitamin D Status, Muscle Mass and Function: A Systematic Review. Nutrients 2021; 13:3109. [PMID: 34578986 PMCID: PMC8465200 DOI: 10.3390/nu13093109] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/27/2021] [Accepted: 09/02/2021] [Indexed: 12/13/2022] Open
Abstract
An association between vitamin D level and muscle-related traits has been frequently reported. Vitamin D level is dependent on various factors such as sunlight exposure and nutrition. But also on genetic factors. We, therefore, hypothesize that single nucleotide polymorphisms (SNPs) within the vitamin D pathway-related genes could contribute to muscle mass and function via an impact on vitamin D level. However, the integration of studies investigating these issues is still missing. Therefore, this review aimed to systematically identify and summarize the available evidence on the association between SNPs within vitamin D pathway-related genes and vitamin D status as well as various muscle traits in healthy adults. The review has been registered on PROSPERO and was conducted following PRISMA guidelines. In total, 77 studies investigating 497 SNPs in 13 different genes were included, with significant associations being reported for 59 different SNPs. Variations in GC, CYP2R1, VDR, and CYP24A1 genes were reported most frequently, whereby especially SNPs in the GC (rs2282679, rs4588, rs1155563, rs7041) and CYP2R1 genes (rs10741657, rs10766197, rs2060793) were confirmed to be associated with vitamin D level in more than 50% of the respective studies. Various muscle traits have been investigated only in relation to four different vitamin D receptor (VDR) polymorphisms (rs7975232, rs2228570, rs1544410, and rs731236). Interestingly, all of them showed only very low confirmation rates (6-17% of the studies). In conclusion, this systematic review presents one of the most comprehensive updates of the association of SNPs in vitamin D pathway-related genes with vitamin D status and muscle traits in healthy adults. It might be used for selecting candidate SNPs for further studies, but also for personalized strategies in identifying individuals at risk for vitamin D deficiency and eventually for determining a potential response to vitamin D supplementation.
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Affiliation(s)
- Ermira Krasniqi
- Research Platform Active Ageing, University of Vienna, Althanstraße 14, 1090 Vienna, Austria; (E.K.); (K.-H.W.)
- Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria;
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090 Vienna, Austria
| | - Arben Boshnjaku
- Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria;
- Faculty of Medicine, University “Fehmi Agani” in Gjakova, Ismail Qemali n.n., 50000 Gjakovë, Kosovo
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, Althanstraße 14, 1090 Vienna, Austria; (E.K.); (K.-H.W.)
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090 Vienna, Austria
| | - Barbara Wessner
- Research Platform Active Ageing, University of Vienna, Althanstraße 14, 1090 Vienna, Austria; (E.K.); (K.-H.W.)
- Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria;
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Ganji V, Shi Z, Alshami H, Ajina S, Albakri S, Jasim Z. Serum 25-hydroxyvitamin D concentrations are inversely associated with body adiposity measurements but the association with bone mass is non-linear in postmenopausal women. J Steroid Biochem Mol Biol 2021; 212:105923. [PMID: 34089833 DOI: 10.1016/j.jsbmb.2021.105923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/03/2021] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
Vitamin D deficiency has been linked to increased adiposity and decreased bone density. It is not known if vitamin D is linked to adiposity measures and bone mass in postmenopausal Qatar women. We investigated an association between serum vitamin D [25-hydroxyvitmain D (25(OH)D)] and adiposity measurements in postmenopausal women using Qatar Biobank data (n = 935). The post-menopausal status was self-reported by participants. Multivariate adjusted regression was applied to determine the association between serum 25(OH)D and body adiposity markers and bone mass. Serum 25(OH)D was significantly, inversely associated with body mass index (p < 0.0005), waist circumference (0.044), fat mass (p < 0.003), gynoid fat (p < 0.001), and android fat (p < 0.009). Serum 25(OH)D appeared to have an inverse 'U' association with several adiposity measures. Overall, body adiposity markers were the lowest in the 4th quartile serum 25(OH)D and significantly lower compared to the 1st quartile serum 25(OH)D. In multivariable adjusted analysis, no association was found between serum 25(OH)D concentration and bone mass when serum 25(OH)D was categorized. In a continuous variable analysis, the association between 25(OH)D and bone mass was significant, non-linear, inverse 'U'. In conclusion, serum 25-hydroxyvitamin D was inversely associated with adiposity measures and non-linearly associated to bone mass in postmenopausal Qatari women.
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Affiliation(s)
- Vijay Ganji
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | - Zumin Shi
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Hanadi Alshami
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Sarah Ajina
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Shayma Albakri
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Zahra Jasim
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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8
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Sallinen RJ, Dethlefsen O, Ruotsalainen S, Mills RD, Miettinen TA, Jääskeläinen TE, Lundqvist A, Kyllönen E, Kröger H, Karppinen JI, Lamberg-Allardt C, Viljakainen H, Kaunisto MA, Kallioniemi O. Genetic Risk Score for Serum 25-Hydroxyvitamin D Concentration Helps to Guide Personalized Vitamin D Supplementation in Healthy Finnish Adults. J Nutr 2021; 151:281-292. [PMID: 33382404 DOI: 10.1093/jn/nxaa391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/26/2020] [Accepted: 11/13/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Genetic factors modify serum 25-hydroxyvitamin D [25(OH)D] concentration and can affect the optimal intake of vitamin D. OBJECTIVES We aimed to personalize vitamin D supplementation by applying knowledge of genetic factors affecting serum 25(OH)D concentration. METHODS We performed a genome-wide association study of serum 25(OH)D concentration in the Finnish Health 2011 cohort (n = 3339) using linear regression and applied the results to develop a population-matched genetic risk score (GRS) for serum 25(OH)D. This GRS was used to tailor vitamin D supplementation for 96 participants of a longitudinal Digital Health Revolution (DHR) Study. The GRS, serum 25(OH)D concentrations, and personalized supplementation and dietary advice were electronically returned to participants. Serum 25(OH)D concentrations were assessed using immunoassays and vitamin D intake using FFQs. In data analyses, cross-sectional and repeated-measures statistical tests and models were applied as described in detail elsewhere. RESULTS GC vitamin D-binding protein and cytochrome P450 family 2 subfamily R polypeptide 1 genes showed genome-wide significant associations with serum 25(OH)D concentration. One single nucleotide polymorphism from each locus (rs4588 and rs10741657) was used to develop the GRS. After returning data to the DHR Study participants, daily vitamin D supplement users increased from 32.6% to 60.2% (P = 6.5 × 10-6) and serum 25(OH)D concentration from 64.4 ± 20.9 nmol/L to 68.5 ± 19.2 nmol/L (P = 0.006) between August and November. Notably, the difference in serum 25(OH)D concentrations between participants with no risk alleles and those with 3 or 4 risk alleles decreased from 20.7 nmol/L to 8.0 nmol/L (P = 0.0063). CONCLUSIONS We developed and applied a population-matched GRS to identify individuals genetically predisposed to low serum 25(OH)D concentration. We show how the electronic return of individual genetic risk, serum 25(OH)D concentrations, and factors affecting vitamin D status can be used to tailor vitamin D supplementation. This model could be applied to other populations and countries.
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Affiliation(s)
- Riitta J Sallinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.,Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Olga Dethlefsen
- National Bioinformatics Infrastructure Sweden, Science for Life Laboratory, Stockholm University, Stockholm, Sweden
| | - Sanni Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Robert D Mills
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Timo A Miettinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tuija E Jääskeläinen
- Finnish Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland
| | - Annamari Lundqvist
- Finnish Institute for Health and Welfare, Department of Public Health Solutions, Helsinki, Finland
| | - Eero Kyllönen
- Physical and Rehabilitation Medicine Division, Oulu University Hospital, Oulu, Finland
| | - Heikki Kröger
- Department of Orthopaedics, Traumatology and Handsurgery, Kuopio University Hospital, Kuopio, Finland.,Kuopio Musculoskeletal Research Unit, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaro I Karppinen
- Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | | | - Heli Viljakainen
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Mari A Kaunisto
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Olli Kallioniemi
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.,Science for Life Laboratory, Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
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9
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Gkouskou KK, Grammatikopoulou MG, Vlastos I, Sanoudou D, Eliopoulos AG. Genotype-guided dietary supplementation in precision nutrition. Nutr Rev 2020; 79:1225-1235. [PMID: 33367884 DOI: 10.1093/nutrit/nuaa132] [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] [Indexed: 12/11/2022] Open
Abstract
Achieving adequate micronutrient status, while avoiding deficiencies, represents a challenge for people globally. Consequently, many individuals resort to oral nutrient supplementation (ONS) in order to correct suboptimal dietary intakes. Advances in the fields of nutrigenetics and nutritional genomics have identified differences in response to micronutrient supplementation according to genetic makeup, adding dietary supplement use to the clinician's toolkit in the precision nutrition era. This review focuses on published evidence linking genetic variants to the responses associated with some of the most popular dietary supplements. With an increasing number of health professionals becoming involved in the prescription of ONS, identifying and matching individuals to the appropriate dietary supplement according to their genotype is important for achieving optimal health benefits and micronutrient equilibrium, while reducing the adverse events and financial costs often associated with excessive ONS.
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Affiliation(s)
- Kalliopi K Gkouskou
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Embiodiagnostics, Biology Research Company, Heraklion, Crete, Greece
| | - Maria G Grammatikopoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Ioannis Vlastos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Sanoudou
- Clinical Genomics and Pharmacogenomics Unit, 4th Department of Internal Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Aristides G Eliopoulos
- Department of Biology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center for New Biotechnologies and Precision Medicine, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Center of Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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10
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Personalized Nutrition for Management of Micronutrient Deficiency-Literature Review in Non-bariatric Populations and Possible Utility in Bariatric Cohort. Obes Surg 2020; 30:3570-3582. [PMID: 32564308 PMCID: PMC7378102 DOI: 10.1007/s11695-020-04762-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 02/07/2023]
Abstract
Background Bariatric surgery can effectively treat morbid obesity; however, micronutrient deficiencies are common despite recommendations for high-dose supplements. Genetic predisposition to deficiencies underscores necessary identification of high-risk candidates. Personalized nutrition (PN) can be a tool to manage these deficiencies. Methods Medline, PubMed, and Google Scholar were searched. Articles involving genetic testing, micronutrient metabolism, and bariatric surgery were included. Results Studies show associations between genetic variants and micronutrient metabolism. Research demonstrates genetic testing to be a predictor for outcomes among obesity and bariatric surgery populations. There is limited research in bariatric surgery and micronutrient genetic variants. Conclusion Genotype-based PN is becoming feasible to provide an effective treatment of micronutrient deficiencies associated with bariatric surgery. The role of genomic technology in micronutrient recommendations needs further investigation.
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11
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Martineau AR, Jolliffe DA, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Janssens W, Jensen ME, Kerley CP, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Trilok Kumar G, Urashima M, Camargo CA, Griffiths CJ, Hooper RL. Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis. Health Technol Assess 2020; 23:1-44. [PMID: 30675873 DOI: 10.3310/hta23020] [Citation(s) in RCA: 174] [Impact Index Per Article: 43.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Randomised controlled trials (RCTs) exploring the potential of vitamin D to prevent acute respiratory infections have yielded mixed results. Individual participant data (IPD) meta-analysis has the potential to identify factors that may explain this heterogeneity. OBJECTIVES To assess the overall effect of vitamin D supplementation on the risk of acute respiratory infections (ARIs) and to identify factors modifying this effect. DATA SOURCES MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, ClinicalTrials.gov and the International Standard Randomised Controlled Trials Number (ISRCTN) registry. STUDY SELECTION Randomised, double-blind, placebo-controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration having incidence of acute respiratory infection as a prespecified efficacy outcome were selected. STUDY APPRAISAL Study quality was assessed using the Cochrane Collaboration Risk of Bias tool to assess sequence generation, allocation concealment, blinding of participants, personnel and outcome assessors, completeness of outcome data, evidence of selective outcome reporting and other potential threats to validity. RESULTS We identified 25 eligible RCTs (a total of 11,321 participants, aged from 0 to 95 years). IPD were obtained for 10,933 out of 11,321 (96.6%) participants. Vitamin D supplementation reduced the risk of ARI among all participants [adjusted odds ratio (aOR) 0.88, 95% confidence interval (CI) 0.81 to 0.96; heterogeneity p < 0.001]. Subgroup analysis revealed that protective effects were seen in individuals receiving daily or weekly vitamin D without additional bolus doses (aOR 0.81, 95% CI 0.72 to 0.91), but not in those receiving one or more bolus doses (aOR 0.97, 95% CI 0.86 to 1.10; p = 0.05). Among those receiving daily or weekly vitamin D, protective effects of vitamin D were stronger in individuals with a baseline 25-hydroxyvitamin D [25(OH)D] concentration of < 25 nmol/l (aOR 0.30, 95% CI 0.17 to 0.53) than in those with a baseline 25(OH)D concentration of ≥ 25 nmol/l (aOR 0.75, 95% CI 0.60 to 0.95; p = 0.006). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (aOR 0.98, 95% CI 0.80 to 1.20; p = 0.83). The body of evidence contributing to these analyses was assessed as being of high quality. LIMITATIONS Our study had limited power to detect the effects of vitamin D supplementation on the risk of upper versus lower respiratory infection, analysed separately. CONCLUSIONS Vitamin D supplementation was safe, and it protected against ARIs overall. Very deficient individuals and those not receiving bolus doses experienced the benefit. Incorporation of additional IPD from ongoing trials in the field has the potential to increase statistical power for analyses of secondary outcomes. STUDY REGISTRATION This study is registered as PROSPERO CRD42014013953. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Adrian R Martineau
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Asthma UK Centre for Applied Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - David A Jolliffe
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Lauren Greenberg
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - John F Aloia
- Bone Mineral Research Center, Winthrop University Hospital, Mineola, NY, USA
| | - Peter Bergman
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gal Dubnov-Raz
- Deptartment of Exercise, Lifestyle and Nutrition Clinic, Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel
| | - Susanna Esposito
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Emma C Goodall
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Wim Janssens
- Universitaire ziekenhuizen Leuven, Leuven, Belgium
| | - Megan E Jensen
- Centre for Asthma and Respiratory Diseases, University of Newcastle, Newcastle, NSW, Australia
| | | | - Ilkka Laaksi
- Centre for Military Medicine, Finnish Defense Forces, University of Tampere, Tampere, Finland
| | - Semira Manaseki-Holland
- Department of Public Health, Epidemiology and Biostatistics, Institute of Applied Health Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - David Mauger
- Department of Statistics, The Pennsylvania State University, Hershey, PA, USA
| | - David R Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Rachel Neale
- Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Judy R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Steve Simpson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Iwona Stelmach
- Department of Pediatrics and Allergy, Medical University of Łódź, Łódź, Poland
| | | | - Mitsuyoshi Urashima
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Christopher J Griffiths
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Asthma UK Centre for Applied Research, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Medical Research Council and Asthma UK Centre in Allergic Mechanisms of Asthma, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Richard L Hooper
- Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Markers Indicating Body Vitamin D Stores and Responses of Liver and Adipose Tissues to Changes in Vitamin D Intake in Male Mice. Nutrients 2020; 12:nu12051391. [PMID: 32413956 PMCID: PMC7284563 DOI: 10.3390/nu12051391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 01/22/2023] Open
Abstract
Circulating 25-hydroxyvitamin D (25(OH)D) is regarded as the most reliable biomarker of vitamin D status. However, limited data exist concerning the suitability of 25(OH)D as an indicator of body vitamin D stores and the ability of adipose tissue to mobilize vitamin D. In the first study, in which male mice received different vitamin D3 doses for three weeks, we found strong linear response relationships between vitamin D3 intake and levels of vitamin D3 in the plasma (p < 0.001), liver (p < 0.001) and adipose tissues (p < 0.001), and strong positive correlations between plasma and tissue stores of vitamin D3 (p < 0.001). Plasma levels of 25(OH)D3 and 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) showed weak or no correlations with tissue vitamin D3 stores. Data from a second study demonstrate a strong and rapid response of plasma 25(OH)D3 in vitamin D3-treated mice with a low vitamin D status. Additionally, mice fed a vitamin D-free diet showed a strong and rapid decline in vitamin D3 in the liver, whereas the decline in different adipose tissues was distinctly lower than that in the liver. To conclude, tissue stores of vitamin D3 were best reflected by plasma vitamin D3. In contrast to the liver, adipose tissues responded less sensitively to an absence of vitamin D intake.
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13
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Vitamin D Deficiency Aggravates Hepatic Oxidative Stress and Inflammation during Chronic Alcohol-Induced Liver Injury in Mice. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2020; 2020:5715893. [PMID: 32184917 PMCID: PMC7063183 DOI: 10.1155/2020/5715893] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/06/2020] [Accepted: 02/12/2020] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency has been reported in alcoholics. This study is aimed at evaluating the effects of vitamin D deficiency on chronic alcohol-induced liver injury in mice. Mice were fed with modified Lieber-DeCarli liquid diets for 6 weeks to establish an animal model of chronic alcohol-induced liver injury. In the VDD+EtOH group, mice were fed with modified diets, in which vitamin D was depleted. Vitamin D deficiency aggravated alcohol-induced liver injury. Furthermore, vitamin D deficiency aggravated hepatocyte apoptosis during alcohol-induced liver injury. Although it has a little effect on hepatic TG content, vitamin D deficiency promoted alcohol-induced hepatic GSH depletion and lipid peroxidation. Further analysis showed that vitamin D deficiency further increased alcohol-induced upregulation of hepatic inducible nitric oxide synthase (inos), two NADPH oxidase subunits p47phox and gp91phox, and heme oxygenase- (HO-) 1. By contrast, vitamin D deficiency attenuated alcohol-induced upregulation of hepatic antioxidant enzyme genes, such as superoxide dismutase (sod) 1 and gshpx. In addition, vitamin D deficiency significantly elevated alcohol-induced upregulation of hepatic proinflammatory cytokines and chemokines. Taken together, these results suggest that vitamin D deficiency aggravates hepatic oxidative stress and inflammation during chronic alcohol-induced liver injury.
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14
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Trummer O, Schweighofer N, Haudum CW, Trummer C, Pilz S, Theiler-Schwetz V, Keppel MH, Grübler M, Pieber TR, Renner W, Obermayer-Pietsch B, Lerchbaum E. Genetic Components of 25-Hydroxyvitamin D Increase in Three Randomized Controlled Trials. J Clin Med 2020; 9:jcm9020570. [PMID: 32093012 PMCID: PMC7074051 DOI: 10.3390/jcm9020570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 12/30/2022] Open
Abstract
The 25-Hydroxyvitamin D (25[OH)D) serum concentration depends on vitamin D intake, endogenous vitamin D production and genetic factors. The latter have been demonstrated in large genome-wide association studies indicating that single nucleotide polymorphisms (SNPs) in genes related to the vitamin D metabolism are as important for serum 25(OH)D levels as the influence of season. The mechanism on how these SNPs influence serum 25(OH)D levels are still unclear. The aim of the present study was to investigate the genetic effects of ten selected SNPs related to vitamin D metabolism on 25-hydroxyvitamin D increase (∆25(OH)D) after vitamin D supplementation in three randomized controlled trials. Genotypes of SNPs related to vitamin D metabolism were determined in 411 participants with 25(OH)D concentrations < 75 nmol/l receiving 20,000 IU cholecalciferol per week for 8 or 12 weeks after study inclusion. For the vitamin D receptor (VDR) rs10783219 polymorphism, the minor A-allele was associated with lower ∆25(OH)D values in the entire study population (p = 0.022), which was not consistent in all three cohorts when analysed separately. VDR rs10783219 might therefore be a genetic modulator of increasing 25-hydroxyvitamin D concentrations. Considering the wide-spread use of vitamin D supplementation, future large and well-designed randomized controlled trials (RCTs) should investigate the clinical impact of this polymorphism.
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Affiliation(s)
- Olivia Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
- Correspondence: ; Tel.: +43-316-385-72935
| | - Natascha Schweighofer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
- Center for Biomarker Research in Medicine, CBmed, 8010 Graz, Austria
| | - Christoph W. Haudum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
- Center for Biomarker Research in Medicine, CBmed, 8010 Graz, Austria
| | - Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
| | - Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
| | - Verena Theiler-Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
| | - Martin H. Keppel
- Department of Laboratory Medicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;
| | - Martin Grübler
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
| | - Thomas R. Pieber
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
- Center for Biomarker Research in Medicine, CBmed, 8010 Graz, Austria
| | - Wilfried Renner
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria;
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria; (N.S.); (C.W.H.); (C.T.); (S.P.); (V.T.-S.); (M.G.); (T.R.P.); (B.O.-P.); (E.L.)
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15
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Effect of genetic factors on the response to vitamin D 3 supplementation in the VIDARIS randomized controlled trial. Nutrition 2020; 75-76:110761. [PMID: 32289634 DOI: 10.1016/j.nut.2020.110761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/09/2019] [Accepted: 12/18/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Supplementation provides the best means of improving vitamin D status; however, individual responses vary partly owing to genetics. The aim of this study was to determine whether 28 single nucleotide polymorphisms (SNPs) in six key vitamin D pathway genes (GC, DHCR7, CYP2 R1, CYP24 A1, CYP27 B1, VDR) were associated with differences in response to supplementation. METHODS Participants (N = 313; n = 160 vitamin D, n = 153 placebo) were part of VIDARIS (Vitamin D and Acute Respiratory Infections Study), a double-blind, randomized controlled trial involving oral monthly supplementation of either vitamin D3 (200 000 IU each for the first 2 mo, thereafter 100 000 IU monthly) or placebo for 18 mo. Circulating 25-hydroxyvitamin D (25[OH]D) concentrations at baseline and 2, 6, 12, and 18 mo, and vitamin D binding protein (Gc-globulin) and calculated free 25(OH)D concentrations at baseline and 2 mo were obtained. Multiple regression was used to model associations between genetic variants and 25(OH)D, Gc-globulin, and free 25(OH)D concentrations. RESULTS SNPs within GC, CYP2 R1, and CYP27 B1 were associated with 25(OH)D concentrations following supplementation. However, only two GC gene SNPs (rs2282679, rs1155563) were significant after adjustment for multiple testing. This effect disappeared after more than 2 mo of supplementation. None of the SNPs were significantly associated with Gc-globulin concentrations; however, there was a significant interaction with one SNP in DHCR7 (rs12785878), which was associated with reduced free 25(OH)D concentrations in the supplemented arm. CONCLUSION Only variants of GC were associated with 25(OH)D concentrations after supplementation. This effect was modest and disappeared after >2 mo of supplementation, suggesting it may be time/dose-dependent and saturable.
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16
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Factors Predicting the Response to a Vitamin D-Fortified Milk in Healthy Postmenopausal Women. Nutrients 2019; 11:nu11112641. [PMID: 31689902 PMCID: PMC6893628 DOI: 10.3390/nu11112641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 10/24/2019] [Accepted: 10/25/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Milk products fortified with vitamin D may constitute an alternative to pharmacological supplements for reaching the optimal levels of serum 25-hydroxyvitamin D [25(OH)D]. Our aim was to analyze the response of serum 25(OH)D and its predictive factors in postmenopausal healthy women after a dietary intervention with a milk fortified with vitamin D and calcium. Methods: We designed a prospective study including 305 healthy postmenopausal women who consumed a fortified milk with calcium (900 mg/500 mL) and vitamin D3 (600 IU/500 mL) daily for 24 months. Results: The 25(OH)D concentrations at 24 months were correlated to weight, to body mass index, to the percentage of fat, triglycerides and to baseline 25(OH)D levels. We found significant differences in the levels of 25(OH)D at 24 months according to baseline 25(OH)D levels (p < 0.001) and body mass index (p = 0.019) expressed at quartiles. Multivariate analysis showed an association between levels of 25(OH)D after the intervention and at baseline 25(OH)D (Beta = 0.47, p < 0.001) and percentage of body fat (Beta = −0.227, p = 0.049), regardless of the body mass index. Conclusions: In healthy postmenopausal women, the improvement in 25(OH)D after an intervention with a fortified milk for 24 months depends mainly on the baseline levels of serum 25(OH)D and on the percentage of body fat.
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17
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Baur AC, Kühn J, Brandsch C, Hirche F, Stangl GI. Intake of ergosterol increases the vitamin D concentrations in serum and liver of mice. J Steroid Biochem Mol Biol 2019; 194:105435. [PMID: 31352023 DOI: 10.1016/j.jsbmb.2019.105435] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/18/2019] [Accepted: 07/24/2019] [Indexed: 12/26/2022]
Abstract
Factors that can modify the bioavailability of orally administered vitamin D are not yet widely known. Ergosterol is a common fungal sterol found in food which has a chemical structure comparable to that of vitamin D. This study aimed to investigate the effect of ergosterol on vitamin D metabolism. Therefore, 36 male wild type-mice were randomly subdivided into three groups (n = 12) and received a diet containing 25 μg vitamin D3 and either 0 mg (control), 2 mg or 7 mg ergosterol per kg diet for 6 weeks. To elucidate the impact of ergosterol on hepatic hydroxylation of vitamin D, human hepatoma cells (HepG2) were treated with different concentrations of ergosterol. Concentrations of vitamin D3 and 25-hydroxyvitamin D3 (25(OH)D3) in cells, livers and kidneys of mice and additionally 24,25-dihydroxyvitamin D3 (24,25(OH)2D3) in serum were quantified by LC-MS/MS. The concentration of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) in serum was analyzed by commercially-available enzyme immuno assay. The concentrations of cholesterol and triglycerides were analyzed in livers of mice by photometric assays. Analyses revealed that mice receiving 7 mg/kg ergosterol with their diet had 1.3-, 1.7- and 1.5-times higher concentrations of vitamin D3 in serum, liver and kidney, respectively, than control mice (P < 0.05), whereas no significant effects were observed in mice fed 2 mg/kg ergosterol. The hydroxylation of vitamin D remained unaffected by dietary ergosterol, since the concentration of 25-hydroxyvitamin D3 in serum and tissues and the concentrations of 1,25(OH)2D3 and 24,25(OH)2D3 in serum were not different between the three groups of mice. The lipid concentrations in liver were also not affected by dietary ergosterol. Data from the cell culture studies showed that ergosterol did not influence the conversion of vitamin D3 to 25(OH)D3. To conclude, ergosterol appears to be a modulator of vitamin D3 concentrations in the body of mice, without modulating the hydroxylation of vitamin D3 in liver.
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Affiliation(s)
- Anja C Baur
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany.
| | - Julia Kühn
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany.
| | - Corinna Brandsch
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany.
| | - Frank Hirche
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany.
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany; Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig, Germany.
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18
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Enlund-Cerullo M, Koljonen L, Holmlund-Suila E, Hauta-Alus H, Rosendahl J, Valkama S, Helve O, Hytinantti T, Viljakainen H, Andersson S, Mäkitie O, Pekkinen M. Genetic Variation of the Vitamin D Binding Protein Affects Vitamin D Status and Response to Supplementation in Infants. J Clin Endocrinol Metab 2019; 104:5483-5498. [PMID: 31365099 DOI: 10.1210/jc.2019-00630] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/25/2019] [Indexed: 02/04/2023]
Abstract
CONTEXT Single nucleotide polymorphisms (SNPs) of the vitamin D binding protein encoding the GC (group component) gene affect 25-hydroxyvitamin D (25OHD) concentrations, but their influence on vitamin D status and response to vitamin D supplementation in infants is unknown. OBJECTIVE To study GC genotype-related differences in 25OHD concentrations and the response to supplementation during a vitamin D intervention study in infants. DESIGN In this randomized controlled trial, healthy term infants received vitamin D3 (10 or 30 μg/d) from 2 weeks to 24 months of age. GC SNPs rs2282679, rs4588, rs7041, and rs1155563 were genotyped. rs4588/7041 diplotype and haplotypes of rs2282679, rs4588, and rs7041 (Haplo3SNP) and of all four SNPs (Haplo4SNP) were determined. MAIN OUTCOME MEASURES 25OHD measured in cord blood at birth and at 12 and 24 months during intervention. RESULTS A total of 913 infants were included. Minor allele homozygosity of all studied GC SNPs, their combined haplotypes, and rs4588/rs7041 diplotype 2/2 were associated with lower 25OHD concentrations at all time points in one or both intervention groups [analysis of covariance (ANCOVA) P < 0.043], with the exception of rs7041, which did not affect 25OHD at birth. In the high-dose supplementation group receiving 30 μg/d vitamin D3, but not in those receiving 10 µg/d, genotype of rs2282679, rs4588, and rs7041; diplotype; and Haplo3SNP significantly affected intervention response (repeated measurement ANCOVA Pinteraction < 0.019). Minor allele homozygotes had lower 25OHD concentrations and smaller increases in 25OHD throughout the intervention. CONCLUSIONS In infants, vitamin D binding protein genotype affects 25OHD concentration and efficiency of high-dose vitamin D3 supplementation.
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Affiliation(s)
- Maria Enlund-Cerullo
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Laura Koljonen
- Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Elisa Holmlund-Suila
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Helena Hauta-Alus
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jenni Rosendahl
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Saara Valkama
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Otto Helve
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo Hytinantti
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Heli Viljakainen
- Folkhälsan Research Center, Helsinki, Finland
- The Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Sture Andersson
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Center for Molecular Medicine, Karolinska Institutet, and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Minna Pekkinen
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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19
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Gonoodi K, Tayefi M, Bahrami A, Amirabadi Zadeh A, Ferns GA, Mohammadi F, Eslami S, Ghayour Mobarhan M. Determinants of the magnitude of response to vitamin D supplementation in adolescent girls identified using a decision tree algorithm. Biofactors 2019; 45:795-802. [PMID: 31355993 DOI: 10.1002/biof.1540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 06/13/2019] [Indexed: 12/23/2022]
Abstract
Vitamin D (VitD) supplementation is an inexpensive and effective approach for improving VitD insufficiency/deficiency. However, the response to supplementation, with respect to the increase in serum 25(OH)D level varies between individuals. In this study, we have assessed the factors associated with the response to VitD supplementation using a decision-tree algorithm. Serum VitD levels, pre- and post-VitD supplementation was used as the determinant of responsiveness. The model was validated by constructing a receiver operating characteristic curve. Serum VitD at baseline levels was at the apex of the tree in our model, followed by serum low-density lipoprotein cholesterol and triglyceride, age, waist-hip ratio, and high-density lipoprotein cholesterol. Our model suggests that these determinants of responsiveness to VitD supplementation had sensitivity, specificity, and accuracy, 59.4, 75.8 and 69.3%, respectively. The decision tree model appears to be a relatively accurate, specific, and sensitive approach for identifying the factors associated with response to VitD supplementation.
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Affiliation(s)
- Kayhan Gonoodi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Norwegian Center for e-health Research, University hospital of North Norway, Tromsø, Norway
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Alireza Amirabadi Zadeh
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences, Birjand, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Sussex, UK
| | - Farzaneh Mohammadi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Eslami
- Pharmaceutical Research Center, Mashhad University of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour Mobarhan
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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20
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Hu CQ, Xu M, Yang BB, Liu XJ, Bo QL, Zhang C, Xu DX. Vitamin D Deficiency Attenuates Acute Alcohol-Induced Hepatic Lipid Accumulation in Mice. Lipids 2019; 54:651-663. [PMID: 31463983 DOI: 10.1002/lipd.12188] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency has been frequently reported in chronic liver disease. However, its influence on hepatic lipid accumulation in alcoholic liver disease remains unclear. The present study investigated the effects of vitamin D deficiency on acute alcohol-induced hepatic lipid metabolism in mice. Mice were fed with vitamin D deficient diet, in which vitamin D was depleted for 12 weeks to establish an animal model of vitamin D deficiency. Some mice were administered a single gavage of alcohol (4 g/kg bodyweight) before they were euthanized. Results show that feeding mice with vitamin D deficient diet did not induce hepatic lipid accumulation. In contrast, vitamin D deficiency markedly reduced alcohol-induced triacylglycerol (TAG) content and prevented hepatic lipid accumulation. Moreover, vitamin D deficiency significantly attenuated alcohol-induced sterol-regulated element-binding protein (SREBP)-1c activation, which regulates genes for hepatic fatty acid (FA) and TAG synthesis, and the expression of its target genes fatty acid synthase (Fasn) and acetyl-coenzyme- A carboxylase (Acc). In addition, vitamin D deficiency alleviated alcohol-induced downregulation of hepatic nuclear peroxisome proliferator-activated receptor (PPAR)α, which governs FA transport and β-oxidation, and the expression of Carnitine palmitoyltransferase (Cpt)-1α, cytochrome P450, family 4, subfamily a, polypeptide (Cyp4a)10, and Cyp4a14, which are key enzymes for hepatic fatty acids β-oxidation and ω-oxidation. Taken together, these results suggest that vitamin D deficiency is not a direct risk factor for hepatic lipid accumulation. Vitamin D deficiency alleviates acute alcohol-induced hepatic lipid accumulation through inhibiting hepatic de novo fatty acid syntheses and promoting fatty acid β-oxidation and ω-oxidation.
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Affiliation(s)
- Chun-Qiu Hu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Department of Nutrition and Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Meng Xu
- Department of Nutrition and Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Bing-Bing Yang
- Department of Gastroenterology, Fourth Affiliated Hospital, Anhui Medical University, Hefei, 230012, China
| | - Xiao-Jing Liu
- Department of Paediatrics, First Affiliated Hospital, Anhui Medical University, Hefei, 230022, China
| | - Qing-Li Bo
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China.,Department of Nutrition and Hygiene, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Cheng Zhang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - De-Xiang Xu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
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21
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Borel P, Desmarchelier C. Bioavailability of Fat-Soluble Vitamins and Phytochemicals in Humans: Effects of Genetic Variation. Annu Rev Nutr 2019; 38:69-96. [PMID: 30130464 DOI: 10.1146/annurev-nutr-082117-051628] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent data have shown that interindividual variability in the bioavailability of vitamins A (β-carotene), D, and E, and carotenoids (lutein and lycopene), as well as that of phytosterols, is modulated by single nucleotide polymorphisms (SNPs). The identified SNPs are in or near genes involved in intestinal uptake or efflux of these compounds, as well as in genes involved in their metabolism and transport. The phenotypic effect of each SNP is usually low, but combinations of SNPs can explain a significant part of the variability. Nevertheless, results from these studies should be considered preliminary since they have not been validated in other cohorts. Guidelines for future studies are provided to ensure that sound associations are elucidated that can be used to build consolidated genetic scores that may allow recommended dietary allowances to be tailored to individuals or groups by taking into account the multiloci genotypic signature of people of different ethnic origin or even of individuals.
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Affiliation(s)
- Patrick Borel
- C2VN, INRA, INSERM, Aix Marseille Université, 13005 Marseille, France; ,
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22
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Ghaly S, Bliuc D, Center JR, Clarke MW, Jones AP, Trend S, Kermode AG, Neale RE, Hart PH. Vitamin D C3-epimer levels are proportionally higher with oral vitamin D supplementation compared to ultraviolet irradiation of skin in mice but not humans. J Steroid Biochem Mol Biol 2019; 186:110-116. [PMID: 30296587 DOI: 10.1016/j.jsbmb.2018.10.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/30/2018] [Accepted: 10/04/2018] [Indexed: 12/22/2022]
Abstract
A proportion of circulating 25-hydroxy vitamin D3 (25(OH)D3)) undergoes epimerization to form C3-epi 25(OH)D3 and C3-epi 1,25(OH)2D3. These epimers have less calcaemic activity than non-epimerized metabolites and are not differentiated by many immunoassays when reporting total 25(OH)D3 levels. This study aimed to compare the effect of exposure to ultraviolet radiation (UVR) and oral vitamin D3 supplementation on vitamin D C3-epimer levels. C57Bl/6 female mice were fed either vitamin D-sufficient (vitamin D3 2000 IU/kg) or -deficient diets (no vitamin D3) for 4 weeks. Among the vitamin D-deficient group, the shaved backs of half were irradiated daily for 4 days with 1 kJ/m2 UVR, followed by twice weekly irradiation for 4 weeks. Despite similar 25(OH)D3 levels, the UV-irradiated group had a lower proportion of C3-epi 25(OH)D3 at week 7 (p < 0.05) and week 9 (p < 0.01). C3-epimer concentrations and %C3-epi 25(OH)D3 were also analysed in serum samples from two human clinical trials. These trials investigated the effect of high dose oral vitamin D3 supplementation and narrowband UVB phototherapy, respectively. Serum 25(OH)D3 and the %C3-epi 25(OH)D3 levels measured at 12 months after oral vitamin D3 supplementation were not significantly different to those measured at the time of maximal effect of phototherapy (2 months). Thus, the proportion of 25(OH)D3 that undergoes epimerization is greater with oral vitamin D3 supplementation than exposure to UVR in mice, but not in humans. This important difference between human and murine vitamin D metabolism warrants consideration when interpreting animal studies.
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Affiliation(s)
- Simon Ghaly
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia; School of Medicine and Pharmacology, The University of Western Australia, Perth, WA, Australia; Department of Gastroenterology and Hepatology, St. Vincent's Hospital, Sydney, NSW, Australia.
| | - Dana Bliuc
- Clinical Studies and Epidemiology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Jacqueline R Center
- Clinical Studies and Epidemiology, Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, The University of Western Australia, Perth, WA 6009, Australia
| | - Anderson P Jones
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Stephanie Trend
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Allan G Kermode
- Centre for Neuromuscular and Neurological Disorders, Perron Institute for Neurological and Translational Science, University of Western Australia, Perth, WA, Australia; Institute for Immunology and Infectious Disease, Murdoch University, Perth, Australia
| | - Rachel E Neale
- Cancer Aetiology and Prevention Group, QIMR Berghofer, Brisbane, QLD, Australia
| | - Prue H Hart
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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23
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Hammami MM, Abuhdeeb K, Hammami S, Yusuf A. Vitamin-D2 treatment-associated decrease in 25(OH)D3 level is a reciprocal phenomenon: a randomized controlled trial. BMC Endocr Disord 2019; 19:8. [PMID: 30658603 PMCID: PMC6339397 DOI: 10.1186/s12902-019-0337-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 01/09/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Vitamin-D2 (D2) treatment has been associated with a decrease in 25-hydroxy (25(OH)) vitamin-D3 (D3) level, suggesting that D3 treatment would be preferred to raise total 25(OH) vitamin-D (D) level. We postulated that D2 treatment-associated decrease in 25(OH)D3 level is related to the increase in 25(OH)D level rather than being D2-specific, and thus there would be a similar D3 treatment-associated decrease in 25(OH)D2 level. METHODS Fifty volunteers were block-randomized to 50,000 IU D2 or placebo orally once (study-1) and fifty volunteers received 50,000 IU D2 orally once and 4 days later block-randomized to 50,000 IU D3 or placebo orally once (study-2). Interventions were concealed from volunteers and research coordinators and blindly-administered. Serum 25(OH)D2 and 25(OH)D3 levels were blindly-determined at baseline and days 14, 28, 42, and 56, post-randomization by high performance liquid chromatography assay. Results of 97 participants were analyzed. Primary outcome measure was day-28 D2-associated change in 25(OH)D3 level in study-1 and D3-associated change in 25(OH)D2 level in study-2, adjusted for baseline levels. RESULTS Mean (95% confidence interval) difference between the active and placebo arms in the decrease in day-28 25(OH)D3 (study-1) and 25(OH)D2 (study-2) levels was 13.2 (9.7 to 16.6) and 9.8 (5.2 to 14.4) nmol/L, respectively. Corresponding differences at day-56 were 10.8 (6.8 to 14.8) and 1.7 (- 7.6 to 11.1) nmol/L, respectively. The difference between the placebo and active arms in area-under-the-curve at day-28 (AUC28) and day-56 (AUC56) were 262.3 (197.8 to 326.7) and 605.1 (446.3 to 784.0) for 25(OH)D3 (study-1) and 282.2 (111.2 to 453.3) and 431.2 (179.3 to 683.2) nmol.d/L for 25(OH)D2 (study-2), respectively. There were significant correlations between day-28 changes in 25(OH)D2 and 25(OH)D3 levels in study-1 (rho = - 0.79, p < 0.001) and study-2 (rho = - 0.36, p = 0.01), and between day-28 changes in 25(OH)D2 level and baseline 25(OH)D level in study-2 (rho = - 0.42, p = 0.003). CONCLUSIONS Compared to placebo, D3 treatment is associated with a decrease in 25(OH)D2 level similar in magnitude to D2-treatment associated decrease in 25(OH)D3 level; however, the D3-placebo difference in 25(OH)D2 level is shorter-lasting. Changes in 25(OH)D2 and 25(OH)D3 levels are correlated with each other and with baseline 25 (OH) D levels, suggesting a common regulatory mechanism. TRIAL REGISTRATION ClinicalTrial.gov identifier: NCT03035084 (registered January 27, 2017).
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Affiliation(s)
- Muhammad M. Hammami
- Department King Faisal Specialist Hospital and Research Center, Clinical Studies and Empirical Ethics, P O Box # 3354, Riyadh, 11211 Saudi Arabia
- Alfaisal University College of Medicine, Riyadh, Saudi Arabia
| | - Kafa Abuhdeeb
- Department King Faisal Specialist Hospital and Research Center, Clinical Studies and Empirical Ethics, P O Box # 3354, Riyadh, 11211 Saudi Arabia
| | - Safa Hammami
- St. Mary Medical Center, San Francisco, California USA
| | - Ahmed Yusuf
- Department King Faisal Specialist Hospital and Research Center, Clinical Studies and Empirical Ethics, P O Box # 3354, Riyadh, 11211 Saudi Arabia
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Kühn J, Trotz P, Stangl GI. Prevalence of vitamin D insufficiency and evidence for disease prevention in the older population. Z Gerontol Geriatr 2018; 51:567-572. [PMID: 29666919 DOI: 10.1007/s00391-018-1390-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 03/05/2018] [Accepted: 03/27/2018] [Indexed: 12/20/2022]
Abstract
The prevalence of vitamin D insufficiency, usually assessed by the analysis of circulating 25-hydroxyvitamin D (25[OH])D), is very high in the aging German population. An important factor that reduces endogenous vitamin D synthesis in older persons is physical inactivity or care-dependency that limits the time spent outside. Additionally, it has been suggested that the age-dependent decline in the glomerular filtration rate is associated with a reduced production of bioactive calcitriol. As this phenomenon is not detectable by the assessment of 25(OH)D, it is necessary to analyze the level of parathyroid hormone as a marker of calcitriol function. Because 25(OH)D levels are highly correlated with an active and healthy life style, data from epidemiological studies are not necessarily suitable to elucidate the role of vitamin D in disease prevention. Recently published meta-analyses of randomized controlled trials (RCTs) showed moderate effects of vitamin D supplementation on fracture risk and found that vitamin D was more effective when administered in combination with calcium. The role of vitamin D in the prevention of falls and frailty remains unclear. Much evidence has demonstrated the beneficial effects of vitamin D on respiratory tract infections and asthma, which are very relevant health issues in the older population. To conclude, vitamin D, particularly combined with calcium, has moderately beneficial effects on the skeletal system and is useful for the prevention of respiratory tract infections.
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Affiliation(s)
- Julia Kühn
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany.,Competence Cluster of Cardiovascular Health and Nutrition (nutriCARD), Halle-Jena-Leipzig, Germany
| | - Paula Trotz
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Von-Danckelmann-Platz 2, 06120, Halle (Saale), Germany. .,Competence Cluster of Cardiovascular Health and Nutrition (nutriCARD), Halle-Jena-Leipzig, Germany.
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25
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Malihi Z, Wu Z, MM Lawes C, Scragg R. Noncalcemic adverse effects and withdrawals in randomized controlled trials of long-term vitamin D2 or D3 supplementation: a systematic review and meta-analysis. Nutr Rev 2017; 75:1007-1034. [DOI: 10.1093/nutrit/nux059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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26
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Benson KA, Chand S, Maxwell AP, Smyth LJ, Kilner J, Borrows R, McKnight AJ. Design and implementation of a custom next generation sequencing panel for selected vitamin D associated genes. BMC Res Notes 2017; 10:348. [PMID: 28754147 PMCID: PMC5534126 DOI: 10.1186/s13104-017-2664-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 07/21/2017] [Indexed: 12/12/2022] Open
Abstract
Background Biologically active vitamin D has an important regulatory role within the genome. It binds the vitamin D receptor (VDR) in order to control the expression of a wide range of genes as well as interacting with the epigenome to modify chromatin and methylation status. Vitamin D deficiency is associated with several human diseases including end-stage renal disease. Methods This article describes the design and testing of a custom, targeted next generation sequencing (NGS) panel for selected vitamin D associated genes. Sequencing runs were used to determine the effectiveness of the panel for variant calling, to compare efficiency and data across different sequencers, and to perform representative, proof of principle association analyses. These analyses were underpowered for significance testing. Amplicons were designed in two pools (163 and 166 fragments respectively) and used to sequence two cohorts of renal transplant recipients on the Ion Personal Genome Machine (PGM)™ and Ion S5™ XL desktop sequencers. Results Coverage was provided for 43.8 kilobases across seven vitamin D associated genes (CYP24A1, CUBN, VDR, GC, NADSYN1, CYP27B1, CYP2R1) as well as 38 prioritised SNPs. Sequencing runs provided sufficient sequencing quality, data output and validated the effective library preparation and panel design. Conclusions This novel, custom-designed, validated panel provides a fast, cost effective, and specific approach for the analysis of vitamin D associated genes in a wide range of patient cohorts. This article does not report results from a controlled health-care intervention. Electronic supplementary material The online version of this article (doi:10.1186/s13104-017-2664-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katherine Angela Benson
- Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT9 7AB, UK.
| | - Sourabh Chand
- Department of Renal Medicine, Royal Shrewsbury Hospital, Shropshire, UK
| | - Alexander Peter Maxwell
- Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT9 7AB, UK
| | - Laura Jane Smyth
- Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT9 7AB, UK
| | - Jill Kilner
- Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT9 7AB, UK
| | - Richard Borrows
- Department of Nephrology and Kidney Transplantation, Queen Elizabeth Hospital Birmingham, Birmingham, UK
| | - Amy Jayne McKnight
- Nephrology Research Group, Centre for Public Health, Queen's University Belfast, Belfast, BT9 7AB, UK
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27
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Hammami MM, Yusuf A. Differential effects of vitamin D2 and D3 supplements on 25-hydroxyvitamin D level are dose, sex, and time dependent: a randomized controlled trial. BMC Endocr Disord 2017; 17:12. [PMID: 28231782 PMCID: PMC5324269 DOI: 10.1186/s12902-017-0163-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/17/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D (D) supplements are indispensable for its world-wide deficiency. Controversy continues on ergocalciferol (D2) and cholecalciferol (D3) relative potency as well as on dosing-schedule and sex role in raising 25-hydroxy D (25(OH)D) level, the best indicator of D status. METHODS We randomized 279 adults to daily D2, D3, D2/D3, or placebo; 2-weekly D2 or D3; or 4-weekly D2 or D3 (250,000 IU over/140 days). Randomization sequence, stratified by body-mass-index (BMI) and sex, was concealed from study coordinators and participants who were then blinded to capsules' content. D2, D3, 25(OH)D2, and 25(OH)D3 Serum levels were determined blindly on days 0,1,2,3,4,7,14, and 2-weekly thereafter by high performance liquid chromatography assay. The results of 269 participants were available for analysis. Primary endpoint was area-under-the-curve (AUC) of 25(OH)D (25(OH)D2 + 25(OH)D3) adjusted for sex, BMI, and baseline 25(OH)D level. RESULTS Mean(SD) age was 33.0(8.5) year, 41% were males, and 85% completed follow-up. Baseline 25(OH)D level was 39.8(11.9) and increased by 3.3(11.6) and 28.6(16.3) nmol/L, in the placebo and active-treatment groups, respectively. AUC from day 0 to 140 (AUC140) of 25(OH)D was 40% (D3 daily) to 55% (D3 2-weekly) higher with active-treatment than placebo (p < 0.001). 25(OH)D2 AUC140 was higher in daily than 2-weekly (17%, p = 0.006) and 4-weekly (20%, p = 0.001) D2-treated groups. 25(OH)D3 AUC140 was lower in daily than 2-weekly (11%, p = 0.002) and 4-weekly D3-treated groups (10%, p = 0.008). In D2-treated groups, there was 16.4 nmol/L decrease in 25(OH)D3 level that correlated (p < 0.001) with 25(OH)D2 level increase (r = 0.48) and baseline 25(OH)D level (r = 0.58), in one participant with measurable baseline 25(OH)D2 level, D3 caused a similar decrease in 25(OH)D2 level, while in the D2/D3-treated group, 25(OH)D3 level didn't increase. Incremental AUC from day 0 to 7 (AUC7) of D3 and 25(OH)D3 in D3-treated groups were 118-243% higher and 31-39% lower, respectively, than incremental AUC7 of D2 and 25(OH)D2 in D2-treated groups. Incremental AUC7 of D3 and 25(OH)D3 in D3-treated groups and D2 and 25(OH)D2 in D2-treated groups were higher in females than males (55, 13, 64, and 28%, respectively). Baseline 25(OH)D level predicted response to D2 and D3 (p < 0.001), whereas, BMI was significant predictor only for early response to D2. CONCLUSIONS Effects of D2 and D3 supplements on 25 (OH)D level may be dosing-schedule and sex-dependent. D2-associated reduction in 25(OH)D3 level may be related to total 25(OH)D level rather than being D2-specific. D2 may be 25-hydroxylated faster than D3. TRIAL REGISTRATION ClinicalTrial.gov identifier: NCT01170494 (registered July 25, 2010).
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Affiliation(s)
- Muhammad M. Hammami
- Clinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Center, P O Box # 3354 (MBC 03), Riyadh, 11211 Saudi Arabia
- Alfaisal University College of Medicine, Riyadh, Saudi Arabia
| | - Ahmed Yusuf
- Clinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Center, P O Box # 3354 (MBC 03), Riyadh, 11211 Saudi Arabia
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Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, Dubnov-Raz G, Esposito S, Ganmaa D, Ginde AA, Goodall EC, Grant CC, Griffiths CJ, Janssens W, Laaksi I, Manaseki-Holland S, Mauger D, Murdoch DR, Neale R, Rees JR, Simpson S, Stelmach I, Kumar GT, Urashima M, Camargo CA. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356:i6583. [PMID: 28202713 PMCID: PMC5310969 DOI: 10.1136/bmj.i6583] [Citation(s) in RCA: 1120] [Impact Index Per Article: 160.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objectives To assess the overall effect of vitamin D supplementation on risk of acute respiratory tract infection, and to identify factors modifying this effect.Design Systematic review and meta-analysis of individual participant data (IPD) from randomised controlled trials.Data sources Medline, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, ClinicalTrials.gov, and the International Standard Randomised Controlled Trials Number registry from inception to December 2015.Eligibility criteria for study selection Randomised, double blind, placebo controlled trials of supplementation with vitamin D3 or vitamin D2 of any duration were eligible for inclusion if they had been approved by a research ethics committee and if data on incidence of acute respiratory tract infection were collected prospectively and prespecified as an efficacy outcome.Results 25 eligible randomised controlled trials (total 11 321 participants, aged 0 to 95 years) were identified. IPD were obtained for 10 933 (96.6%) participants. Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (adjusted odds ratio 0.88, 95% confidence interval 0.81 to 0.96; P for heterogeneity <0.001). In subgroup analysis, protective effects were seen in those receiving daily or weekly vitamin D without additional bolus doses (adjusted odds ratio 0.81, 0.72 to 0.91) but not in those receiving one or more bolus doses (adjusted odds ratio 0.97, 0.86 to 1.10; P for interaction=0.05). Among those receiving daily or weekly vitamin D, protective effects were stronger in those with baseline 25-hydroxyvitamin D levels <25 nmol/L (adjusted odds ratio 0.30, 0.17 to 0.53) than in those with baseline 25-hydroxyvitamin D levels ≥25 nmol/L (adjusted odds ratio 0.75, 0.60 to 0.95; P for interaction=0.006). Vitamin D did not influence the proportion of participants experiencing at least one serious adverse event (adjusted odds ratio 0.98, 0.80 to 1.20, P=0.83). The body of evidence contributing to these analyses was assessed as being of high quality.Conclusions Vitamin D supplementation was safe and it protected against acute respiratory tract infection overall. Patients who were very vitamin D deficient and those not receiving bolus doses experienced the most benefit.Systematic review registration PROSPERO CRD42014013953.
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Affiliation(s)
- Adrian R Martineau
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
- Asthma UK Centre for Applied Research, Blizard Institute, Queen Mary University of London, London, UK
| | - David A Jolliffe
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Richard L Hooper
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - Lauren Greenberg
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
| | - John F Aloia
- Bone Mineral Research Center, Winthrop University Hospital, Mineola, NY, USA
| | - Peter Bergman
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gal Dubnov-Raz
- Department of Exercise, Lifestyle and Nutrition Clinic, Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel
| | - Susanna Esposito
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Emma C Goodall
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Cameron C Grant
- Department of Paediatrics: Child & Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AB, UK
- Asthma UK Centre for Applied Research, Blizard Institute, Queen Mary University of London, London, UK
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Blizard Institute, Queen Mary University of London, London, UK
| | | | - Ilkka Laaksi
- Tampere School of Public Health, University of Tampere, Tampere, Finland
| | - Semira Manaseki-Holland
- Department of Public Health, Epidemiology and Biostatistics, Institute of Applied Health Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - David Mauger
- Department of Statistics, The Pennsylvania State University, Hershey, PA, USA
| | - David R Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | - Rachel Neale
- QIMR Berghofer Medical Research Institute, Queensland, Australia
| | - Judy R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Steve Simpson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Iwona Stelmach
- Department of Pediatrics and Allergy, Medical University of Lodz, Lodz, Poland
| | | | - Mitsuyoshi Urashima
- Division of Molecular Epidemiology, Jikei University School of Medicine, Tokyo, Japan
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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29
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SNP rs11185644 of RXRA gene is identified for dose-response variability to vitamin D3 supplementation: a randomized clinical trial. Sci Rep 2017; 7:40593. [PMID: 28079136 PMCID: PMC5228186 DOI: 10.1038/srep40593] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 12/07/2016] [Indexed: 12/28/2022] Open
Abstract
The level of serum 25-Hydroxyvitamin D [25(OH)D] has high heritability, suggesting that genes may contribute to variations in serum 25(OH)D level and vitamin D dose-response. As vitamin D deficiency has been linked to numerous diseases, understanding how genetic variation contributes to vitamin D dose-response is important for personalized vitamin D treatment and cost-effective disease prevention. To identify genetic variants responsible for vitamin D status and dose-response, we performed two vitamin D3 and calcium clinical supplementation trials in 2,207 postmenopausal Caucasian women. We examined the association of 291 SNPs with baseline serum 25(OH)D levels and 25(OH)D dose-response. Five SNPs, rs10500804 (P = 4.93 × 10−7), rs2060793 (P = 6.63 × 10−7), rs10741657 (P = 1.49 × 10−6), rs10766197 (P = 1.05 × 10−5) and rs11023380 (P = 7.67 × 10−5) in the CYP2R1 gene, as well as 6 SNPs, rs4588 (P = 7.86 × 10−7), rs2298850 (P = 1.94 × 10−6), rs1155563 (P = 6.39 × 10−6), rs705119 (P = 2.80 × 10−5), rs705120 (P = 1.08 × 10−4) and rs222040 (P = 1.59 × 10−4) in the GC gene were associated with baseline serum 25(OH)D levels. SNP rs11185644 near the RXRA was significantly associated with 25(OH)D dose-response (P = 1.01 × 10−4). Our data suggest that polymorphisms in the CYP2R1 and GC gene may contribute to variation in baseline serum 25(OH)D concentration, and that polymorphism rs11185644 may contribute to variation in 25(OH)D dose-response in healthy postmenopausal Caucasian women.
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Kokturk N, Baha A, Oh YM, Young Ju J, Jones PW. Vitamin D deficiency: What does it mean for chronic obstructive pulmonary disease (COPD)? a compherensive review for pulmonologists. CLINICAL RESPIRATORY JOURNAL 2017; 12:382-397. [PMID: 27925404 DOI: 10.1111/crj.12588] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 11/15/2016] [Accepted: 11/23/2016] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Vitamin D deficiency and Chronic Obstructive Pulmonary Disease (COPD) are both under-recognized health problems, world-wide. Although Vitamin D has long been known for calcemic effects it also has less known noncalcemic effects. Recent data have shown that Vitamin D deficiency is highly prevalent in patients with COPD and correlates with forced expiratory volume in one second (FEV1 ) and FEV1 decline. The objective of this work was to review the current literature on vitamin D deficiency in relation with COPD. DATA SOURCE A literature search, using the words "vitamin D" and "COPD", was undertaken in Pubmed database. RESULTS The noncalcemic effects of vitamin D relating with COPD may be summarised as increasing antimicrobial peptide production, regulation of inflammatory response and airway remodelling. Vitamin D inhibits the production of several proinflammatory cytokines and leads to suppression Th1 and Th17 responses which may be involved in the pathogenesis of COPD. Vitamin D insufficiency may also contribute to chronic respiratory infections and airway colonization so returning vitamin D concentrations to an optimal range in patients with COPD might reduce bacterial load and concomitant exacerbations.Vitamin D is also important for COPD-related comorbodities such as osteoporosis, muscle weakness and cardiovascular diseases. Data about the effect of Vitamin D supplementation on those comorbidities in relation with COPD are been scarce. CONCLUSION Improving the blood level of Vitamin D into the desired range may have a beneficial effect bones and muscles, but more studies are needed to test to test that hypothesis.
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Affiliation(s)
- Nurdan Kokturk
- Department of Pulmonary Medicine, School of Medicine, Gazi University, Ankara, Turkey.,Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ayse Baha
- Department of Pulmonary Medicine, School of Medicine, Gazi University, Ankara, Turkey
| | - Yeon-Mok Oh
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jung Young Ju
- Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asian Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Paul W Jones
- Department of Pulmonology, School of Medicine, Clinical Science Center, St George University, London, UK
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Yao P, Sun L, Lu L, Ding H, Chen X, Tang L, Xu X, Liu G, Hu Y, Ma Y, Wang F, Jin Q, Zheng H, Yin H, Zeng R, Chen Y, Hu FB, Li H, Lin X. Effects of Genetic and Nongenetic Factors on Total and Bioavailable 25(OH)D Responses to Vitamin D Supplementation. J Clin Endocrinol Metab 2017; 102:100-110. [PMID: 27768857 DOI: 10.1210/jc.2016-2930] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 10/17/2016] [Indexed: 01/10/2023]
Abstract
CONTEXT Little is known about how genetic and nongenetic factors modify responses of vitamin D supplementation in nonwhite populations. OBJECTIVE To investigate factors modifying 25-hydroxyvitamin D [25(OH)D] and bioavailable 25(OH)D [25(OH)DBio] responses after vitamin D3 supplementation. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTION In this 20-week, randomized, double-blinded, placebo-controlled trial, 448 Chinese with vitamin D deficiency received 2000 IU/d vitamin D3 or placebo. MAIN OUTCOME MEASURES Serum 25(OH)D, vitamin D-binding protein (VDBP), parathyroid hormone (PTH) and calcium were measured, and 25(OH)DBio was calculated based on VDBP levels. Six common polymorphisms in vitamin D metabolism genes were genotyped. RESULTS Between-arm net changes were +30.6 ± 1.7 nmol/L for 25(OH)D, +2.7 ± 0.2 nmol/L for 25(OH)DBio, and -5.2 ± 1.2 pg/mL for PTH, corresponding to 70% [95% confidence interval (CI), 62.8% to 77.2%] net reversion rate for vitamin D deficiency at week 20 (P < 0.001). Only 25(OH)DBio change was positively associated with calcium change (P < 0.001). Genetic factors (GC-rs4588/GC-rs7041, VDR-rs2228570, and CYP2R1-rs10741657; P ≤ 0.04) showed stronger influences on 25(OH)D or 25(OH)DBio responses than nongenetic factors, including baseline value, body mass index, and sex. An inverse association of PTH-25(OH)D was demonstrated only at 25(OH)D of <50.8 (95% CI, 43.6 to 59.0) nmol/L. CONCLUSIONS Supplemented 2000 IU/d vitamin D3 raised 25(OH)D and 25(OH)DBio but was unable to correct deficiency in 25% of Chinese participants, which might be partially attributed to the effect of genetic modification. More studies are needed to elucidate appropriate vitamin D recommendations for Asians and the potential clinical implications of 25(OH)DBio.
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Affiliation(s)
- Pang Yao
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Liang Sun
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Ling Lu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Hong Ding
- Department of Nutrition and Food Hygiene, School of Public Health, Xinjiang Medical University, Urumqi 830011, China
| | - Xiafei Chen
- Huadong Hospital Affiliated with Fudan University, Shanghai 200040, China
| | - Lixin Tang
- Huadong Hospital Affiliated with Fudan University, Shanghai 200040, China
| | - Xinming Xu
- High School Affiliated to Fudan University, Shanghai 200433, China; and
| | - Gang Liu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Yao Hu
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Yiwei Ma
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Feijie Wang
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Qianlu Jin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - He Zheng
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Huiyong Yin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Rong Zeng
- Key Laboratory of Systems Biology, Institute of Biochemistry and Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai 200031, China
| | - Yan Chen
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115
| | - Huaixing Li
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
| | - Xu Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, and
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Rees JR, Mott LA, Barry EL, Baron JA, Bostick RM, Figueiredo JC, Bresalier RS, Robertson DJ, Peacock JL. Lifestyle and Other Factors Explain One-Half of the Variability in the Serum 25-Hydroxyvitamin D Response to Cholecalciferol Supplementation in Healthy Adults. J Nutr 2016; 146:2312-2324. [PMID: 27683872 PMCID: PMC5086794 DOI: 10.3945/jn.116.236323] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 08/29/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Many factors have been associated with serum 25-hydroxyvitamin D [25(OH)D] concentrations in observational studies, with variable consistency. However, less information is available on factors affecting the magnitude of changes in serum 25(OH)D resulting from vitamin D supplementation. OBJECTIVE This study aimed to identify factors associated with the serum 25(OH)D response to supplementation with 1000 IU cholecalciferol/d during the first year of a large, multicenter, randomized, placebo-controlled colorectal adenoma chemoprevention trial. METHODS Eligible older adults who were not vitamin D-deficient [serum 25(OH)D ≥12 ng/mL] were randomly assigned in a modified 2 × 2 factorial design to 1 of 4 groups: daily 1000 IU cholecalciferol, 1200 mg Ca as carbonate, both, or placebo. Women could elect 2-group (calcium ± cholecalciferol) random assignment. In secondary analyses, we used multivariable models to assess factors associated with serum 25(OH)D concentrations in all enrollees (n = 2753) and with relative changes in serum 25(OH)D after 1 y cholecalciferol supplementation among those randomly assigned (n = 2187). RESULTS In multivariable models, 8 factors accounted for 50% of the variability of proportional change in serum 25(OH)D after cholecalciferol supplementation. Larger increases were associated with being female (34.5% compared with 20.5%; P < 0.001) and with lower baseline serum 25(OH)D (P < 0.0001), optimal adherence to study pill intake (P = 0.0002), wearing long pants and sleeves during sun exposure (P = 0.0002), moderate activity level (P = 0.01), use of extra vitamin D-containing supplements during the trial (P = 0.03), and seasons of blood draw (P ≤ 0.002). Several genetic polymorphisms were associated with baseline serum 25(OH)D and/or serum response, but these did not substantially increase the models' R2 values. Other factors, including body mass index, were associated with serum 25(OH)D at baseline but not with its response to supplemental cholecalciferol. CONCLUSIONS The factors that most affected changes in serum 25(OH)D concentrations in response to cholecalciferol supplementation included sex, baseline serum 25(OH)D, supplement intake adherence, skin-covering clothes, physical activity, and season. Genetic factors did not play a major role. This trial was registered at www.clinicaltrials.gov as NCT00153816.
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Affiliation(s)
| | | | | | - John A Baron
- Departments of Epidemiology and,Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
| | - Roberd M Bostick
- Department of Epidemiology, Rollins School of Public Health,,Winship Cancer Institute, Emory University, Atlanta, GA
| | - Jane C Figueiredo
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center,,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Robert S Bresalier
- Department of Gastroenterology, Hepatology and Nutrition, the University of Texas MD Anderson Cancer Center, Houston, TX
| | - Douglas J Robertson
- Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH;,VA Medical Center, White River Junction, VT; and
| | - Janet L Peacock
- Departments of Epidemiology and,Division of Health and Social Care Research, King's College London, London, United Kingdom
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Pharmacokinetics and effects of demographic factors on blood 25(OH)D3 levels after a single orally administered high dose of vitamin D3. Acta Pharmacol Sin 2016; 37:1509-1515. [PMID: 27569392 DOI: 10.1038/aps.2016.82] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 04/22/2016] [Indexed: 01/12/2023] Open
Abstract
AIM To examine the biological consequences and demographic factors that might affect the pharmacokinetics of vitamin D3 after a single high dose intervention in a young Chinese population with vitamin D insufficiency status. METHODS A total of 28 young subjects (25 to 35 years old) with vitamin D insufficiency status [serum 25(OH)D <30 ng/mL] was recruited in Shanghai, China. The subjects were orally administered a single high dose of vitamin D3 (300 000 IU). Baseline characteristics and blood samples were collected at d 0, 1, 2, 3, 7, 28, 56, 84 and 112 after the intervention. The blood biomarker levels were determined with standardized methods. RESULTS The intervention markedly increased the blood 25(OH)D3 levels within the first five days (mean Tmax=5.1±2.1 d) and sustained an optimal circulating level of 25(OH)D3 (≥30 ng/mL) for 56 d. After the intervention, body weight and baseline 25(OH)D3 levels were significantly correlated with circulating 25(OH)D3 levels. No adverse events and no consistently significant changes in serum calcium, creatinine, glucose, parathyroid hormone, vitamin D binding protein, or the urinary calcium/reatinine ratio were observed. However, there was a significant increase in phosphorus after the vitamin D3 intervention. Total cholesterol and triglyceride levels were decreased at the end of the trial. CONCLUSION The pharmacokinetics of vitamin D after intervention were influenced by baseline 25(OH)D3 levels and the body weight of the subjects. The results suggest that a single high oral vitamin D3 intervention is safe and efficient for improving the vitamin D status of young Chinese people with vitamin D insufficiency.
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Desmarchelier C, Borel P, Goncalves A, Kopec R, Nowicki M, Morange S, Lesavre N, Portugal H, Reboul E. A Combination of Single-Nucleotide Polymorphisms Is Associated with Interindividual Variability in Cholecalciferol Bioavailability in Healthy Men. J Nutr 2016; 146:2421-2428. [PMID: 27798339 DOI: 10.3945/jn.116.237115] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/10/2016] [Accepted: 09/19/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Most people require dietary vitamin D to achieve the recommended concentration of 25-hydroxyvitamin D [25(OH)D] in the blood. However, the response to vitamin D supplementation is highly variable among individuals. OBJECTIVE We assessed whether the variability in cholecalciferol bioavailability was associated with single-nucleotide polymorphisms (SNPs) in candidate genes. METHODS In a single-group design, 39 healthy adult men with a mean ± SD age of 33 ± 2 y and mean ± SD body mass index (in kg/m2) of 22.9 ± 0.3 were genotyped with the use of whole-genome microarrays. After an overnight fast, plasma 25(OH)D status was measured, and the subjects then consumed a meal that provided 5 mg cholecalciferol as a supplement. Plasma chylomicron cholecalciferol concentration was measured over 8 h, and cholecalciferol response was assessed by calculating the postprandial area under the curve. Partial least squares regression was used to test the association of SNPs in or near candidate genes (61 genes representing 3791 SNPs) with the postprandial cholecalciferol response. RESULTS The postprandial chylomicron cholecalciferol concentration peaked at 5.4 h. The cholecalciferol response was extremely variable among individuals (CV: 47%). It correlated with the chylomicron triglyceride (TG) response (r = 0.60; P < 0.001) but not with the fasting plasma 25(OH)D concentration (r = 0.04; P = 0.83). A significant (P = 1.32 × 10-4) partial least squares regression model that included 17 SNPs in 13 genes (including 5 that have been associated with chylomicron TG response) was associated with the variance in the cholecalciferol response. CONCLUSION In healthy men, there is a high interindividual variability in cholecalciferol bioavailability that is associated with a combination of SNPs located in or near genes involved in both vitamin D and lipid metabolism. This trial was registered at clinicaltrials.gov as NCT02100774.
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Affiliation(s)
- Charles Desmarchelier
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Patrick Borel
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France;
| | | | - Rachel Kopec
- National Institute for Agricultural Research, Avignon, France.,Security and Quality of Plant Products, University of Avignon, Avignon, France
| | - Marion Nowicki
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Sophie Morange
- Clinical Investigation Centre, Conception Hospital, Marseille, France; and
| | - Nathalie Lesavre
- Clinical Investigation Centre, North Hospital, Marseille, France
| | - Henri Portugal
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
| | - Emmanuelle Reboul
- NORT Nutrition Obesity and Thrombotic Risk, Aix-Marseille University, INRA National Institute for Agricultural Research, INSERM National Institute of Health and Medical Research, Marseille, France
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Malihi Z, Wu Z, Stewart AW, Lawes CM, Scragg R. Hypercalcemia, hypercalciuria, and kidney stones in long-term studies of vitamin D supplementation: a systematic review and meta-analysis. Am J Clin Nutr 2016; 104:1039-1051. [PMID: 27604776 DOI: 10.3945/ajcn.116.134981] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 08/03/2016] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Vitamin D supplementation is increasingly being used in higher doses in randomized controlled trials (RCTs). However, adverse events from very large annual doses of vitamin D have been shown in 2 RCTs, whereas in a third RCT, low-dose vitamin D, with calcium supplements, was shown to increase kidney stone risk. OBJECTIVE We analyzed the side effects related to calcium metabolism in RCTs, specifically hypercalcemia, hypercalciuria, and kidney stones, in participants who were given vitamin D supplements for ≥24 wk compared with in subjects in the placebo arm. DESIGN The following 3 main online databases were searched: Ovid Medline (PubMed), EMBASE, and the Cochrane Library. Software was used for the meta-analysis. RESULTS A total of 48 studies with 19,833 participants were identified, which reported ≥1 of the following side effects: hypercalcemia, hypercalciuria, or kidney stones. Of these studies, kidney stones were reported in only 9 trials with a tendency for fewer subjects reporting stones in the vitamin D arm than in the placebo arm (RR: 0.66, 95% CI: 0.41, 1.09; P = 0.10). In 37 studies, hypercalcemia was shown with increased risk shown for the vitamin D group (RR: 1.54; 95% CI: 1.09, 2.18; P = 0.01). Similar increased risk of hypercalciuria was shown in 14 studies for the vitamin D group (RR: 1.64; 95% CI: 1.06, 2.53; P = 0.03). In subgroup analyses, it was shown that the effect of vitamin D supplementation on risk of hypercalcemia, hypercalciuria, or kidney stones was not modified by baseline 25-hydroxyvitamin D, vitamin D dose and duration, or calcium co-supplementation. CONCLUSIONS Long-term vitamin D supplementation resulted in increased risks of hypercalcemia and hypercalciuria, which were not dose related. However, vitamin D supplementation did not increase risk of kidney stones. Additional large RCTs of long-term vitamin D supplementation are required to confirm these findings.
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Affiliation(s)
- Zarintaj Malihi
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Zhenqiang Wu
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Alistair W Stewart
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Carlene Mm Lawes
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
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Alizadeh N, Khalili H, Mohammadi M, Abdollahi A, Ala S. Effect of vitamin D on stress-induced hyperglycaemia and insulin resistance in critically ill patients. Int J Clin Pract 2016; 70:396-405. [PMID: 27091752 DOI: 10.1111/ijcp.12795] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
AIM Effects of vitamin D supplementation on the glycaemic indices and insulin resistance in diabetic and non-diabetic patients were studied. In this study, effects of vitamin D supplementation on stress-induced hyperglycaemia and insulin resistance were evaluated in non-diabetic surgical critically ill patients. METHODS Adult surgical patients with stress-induced hyperglycaemia within the first 24 h of admission to the ICU were recruited. The patients randomly assigned to receive either vitamin D or placebo. Patients in the vitamin D group received a single dose of 600,000 IU vitamin D3 as intramuscular injection at time of recruitment. Besides demographic and clinical characteristics of the patients, plasma glucose, insulin, 25(OH) D and adiponectin levels were measured at the time of ICU admission and day 7. Homoeostasis model assessment for insulin resistance (HOMA-IR) and homestasis model assessment adiponectin (HOMA-AD) ratio were considered at the times of assessment. RESULTS Comparing with the baseline, plasma 25(OH) D level significantly increased in the subjects who received vitamin D (p = 0.04). Improvement in fasting plasma glucose levels was detected in day 7 of the study compared with the baseline status in both groups. HOMA-IR showed a decrement pattern in vitamin D group (p = 0.09). Fasting plasma adiponectin levels increased significantly in the vitamin D group (p = 0.007), but not in the placebo group (p = 0.38). Finally, changes in HOMA-AD ratio were not significant in the both groups. CONCLUSION Vitamin D supplementation showed positive effect on plasma adiponectin level, as a biomarker of insulin sensitivity in surgical critically ill patients with stress-induced hyperglycaemia. However, effects of vitamin D supplementation on HOMA-IR and HOMA-AD as indicators of insulin resistance were not significant.
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Affiliation(s)
- N Alizadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - H Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | - M Mohammadi
- Department of Intensive Care Unit, Faculty of Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | - A Abdollahi
- Department of Pathology, Faculty of Medicine, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Iran
| | - S Ala
- Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Mazandaran, Iran
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Vitamin D deficiency and its role in neurological conditions: A review. Rev Neurol (Paris) 2016; 172:109-22. [DOI: 10.1016/j.neurol.2015.11.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/25/2015] [Accepted: 11/02/2015] [Indexed: 12/14/2022]
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Alavi NM, Madani M, Taghizadeh M, Sharif MR. VITAMIN D SUPPLEMENTATION IN FEMALE NURSES: THE EFFECTS ON SERUM 25-HYDROXYVITAMIN D, AND NON-SPECIFIC MUSCULOSKELETAL PAIN. ACTA ACUST UNITED AC 2015. [DOI: 10.1142/s0218957715500086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: To investigate the effect of weekly single high dose vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D], and non-specific musculoskeletal pain in female nurses. Methods: In this prospective study in Kashan/Iran, from April 1, 2014, through September 30, 2014, the 150 nurses with vitamin D deficiency received the weekly pearls of 50,000 units of vitamin D3 for 10 weeks. The serum level of 25(OH)D was measured before and after supplement therapy. The subjects were also asked to complete the Extended Nordic Musculoskeletal Questionnaire. All analyses were conducted with SPSS version 16. Results: After 10 weeks of intervention there was [Formula: see text][Formula: see text]ng/mL increase in 25(OH)D. The 82 nurses (54.7%) had 25(OH)D in normal range, while the 68 nurses (45.3%) were still vitamin D deficient. Weight could explain 15.4% increase in 25(OH)D. Before intervention 135 (90%), of nurses reported musculoskeletal pain in at least one region, after intervention this number decreased to 72.7%. There was a statistically significant improvement in musculoskeletal pain in neck, shoulders, upper back, lower back, hips/tights, knees, and ankles/feet after intervention. Conclusions: The weekly single high dose of vitamin D for 10 weeks could resolve vitamin D deficiency in about half of the patients. Patients with non-specific musculoskeletal pain might benefit from vitamin D supplementation.
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Affiliation(s)
- Negin Masoudi Alavi
- Trauma Nursing Research Center, Department of Medical Surgical Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Mahla Madani
- Student Research Committee, Department of Medical Surgical Nursing, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohsen Taghizadeh
- Research Center for Biochemistry and Nutrition in Metabolic Disease, Department of Nutrition, Kashan University of Medical Sciences, Kashan, Iran
| | - Mohammad Reza Sharif
- The Center of Clinical, Research Kashan University of Medical Sciences, Kashan, Iran
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Chang B, Schlussel Y, Sukumar D, Schneider SH, Shapses SA. Influence of vitamin D and estrogen receptor gene polymorphisms on calcium absorption: BsmI predicts a greater decrease during energy restriction. Bone 2015; 81:138-144. [PMID: 26165414 PMCID: PMC4641000 DOI: 10.1016/j.bone.2015.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 06/25/2015] [Accepted: 07/07/2015] [Indexed: 12/19/2022]
Abstract
Low calcium absorption is associated with low bone mass and fracture. In this study, we use gold standard methods of fractional calcium absorption (FCA) to determine whether polymorphisms of intestinal receptors, vitamin D receptor (VDR) and estrogen receptor α (ESR1), influence the response to energy restriction. Fractional calcium absorption was measured using dual stable isotopes ((42)Ca and (43)Ca) in women given adequate calcium and vitamin D and examined at baseline and after 6 weeks of energy restriction or no intervention. After genotyping, the relationship between VDR and ESR1 genotypes/haplotypes and FCA response was assessed using several genetic models. One-hundred and sixty-eight women (53 ± 11 years of age) were included in this analysis. The ESR1 polymorphisms, PvuII and XbaI and VDR polymorphisms (TaqI, ApaI) did not significantly influence FCA. The BB genotype of the VDR polymorphism, BsmI, was associated with a greater decrease in FCA than the Bb/bb genotype. Multiple linear regression showed that the BsmI polymorphism or the VDR haplotype, BAt, in addition to changes in weight and vitamin D intake explained ~16% of the variation in changes in FCA. In conclusion, the reduction in calcium absorption due to energy restriction is greatest for those with the BB genotype. Previous candidate gene studies show that VDR polymorphisms are associated with higher risk for osteoporosis, and the current study supports the notion that the BsmI polymorphism in intestinal VDR may be contributing to alterations in bone health.
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Affiliation(s)
- B Chang
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - Y Schlussel
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA
| | - D Sukumar
- Drexel University, Philadelphia, PA, USA
| | - S H Schneider
- Department of Medicine, Rutgers-Robert Wood Johnson University Hospital, USA
| | - S A Shapses
- Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ, USA.
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Silva MC, Faulhauber GAM, Leite ÉN, Goulart KR, Ramirez JMA, Cocolichio FM, Furlanetto TW. Impact of a cholesterol membrane transporter's inhibition on vitamin D absorption: A double-blind randomized placebo-controlled study. Bone 2015. [PMID: 26208795 DOI: 10.1016/j.bone.2015.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Oral supplements are important to prevent and treat vitamin D deficiency. Despite the growing number of prescriptions, vitamin D's absorptive mechanisms are not clearly elucidated. By evaluating the effect of ezetimibe on vitamin D absorption, we aim to determine if the cholesterol transporter Niemann-Pick C1-Like 1 transporter contributes to it. This randomized, double-blind, placebo-controlled trial (ClinicalTrials.govNCT02234544) was developed in a South Brazilian University Hospital. Fifty-one medical students were randomized to ezetimibe 10mg/day or placebo for 5 days. On the fifth and 19th days, blood samples for 25-hydroxycholecalciferol (25OHD), parathyroid hormone (PTH), calcium, and albumin were collected. After the first blood sample collection, all participants received a single oral 50,000 IU cholecalciferol dose during a 15 g-fat meal. Serum 25OHD levels were measured by the immunoassay Diasorin Liaison®. Measurements were compared in a general linear model adjusted for multiple comparisons by the Bonferroni test. Before cholecalciferol administration, 25OHD was <30 ng/mL and <20 ng/mL, respectively, in all and in 82.3% of the participants. Fourteen days after a single 50,000 IU oral dose of cholecalciferol, mean (SD) changes in serum 25OHD were similar in both groups, after adjustment to BMI and 25OHD levels before cholecalciferol administration (p=0.26): 8.7 (3.7) ng/mL in the ezetimibe group, versus 10.0 (3.8) ng/mL in the placebo group. Mean serum 25OHD, PTH, calcium and albumin levels remained similar in both groups. We conclude that ezetimibe had no effect on the mean change in serum 25OHD after a single oral dose of cholecalciferol, in these healthy and young adults.
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Affiliation(s)
- Mariana Costa Silva
- Postgraduation Program in Medicine, Medical Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Gustavo Adolpho Moreira Faulhauber
- Postgraduation Program in Medicine, Medical Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Internal Medicine Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Érica Neves Leite
- Internal Medicine Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | | | | | | | - Tania Weber Furlanetto
- Postgraduation Program in Medicine, Medical Science, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; Internal Medicine Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil.
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Abstract
BACKGROUND The accuracy and utility of electronic health record (EHR)-derived phenotypes in replicating genotype-phenotype relationships have been infrequently examined. Low circulating vitamin D levels are associated with severe outcomes in inflammatory bowel disease (IBD); however, the genetic basis for vitamin D insufficiency in this population has not been examined previously. METHODS We compared the accuracy of physician-assigned phenotypes in a large prospective IBD registry to that identified by an EHR algorithm incorporating codified and structured data. Genotyping for IBD risk alleles was performed on the Immunochip and a genetic risk score calculated and compared between EHR-defined patients and those in the registry. Additionally, 4 vitamin D risk alleles were genotyped and serum 25-hydroxy vitamin D [25(OH)D] levels compared across genotypes. RESULTS A total of 1131 patients captured by our EHR algorithm were also included in our prospective registry (656 Crohn's disease, 475 ulcerative colitis). The overall genetic risk score for Crohn's disease (P = 0.13) and ulcerative colitis (P = 0.32) was similar between EHR-defined patients and a prospective registry. Three of the 4 vitamin D risk alleles were associated with low vitamin D levels in patients with IBD and contributed an additional 3% of the variance explained. Vitamin D genetic risk score did not predict normalization of vitamin D levels. CONCLUSIONS EHR cohorts form valuable data sources for examining genotype-phenotype relationships. Vitamin D risk alleles explain 3% of the variance in vitamin D levels in patients with IBD.
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Rinne P, Ahola-Olli A, Nuutinen S, Koskinen E, Kaipio K, Eerola K, Juonala M, Kähönen M, Lehtimäki T, Raitakari OT, Savontaus E. Deficiency in Melanocortin 1 Receptor Signaling Predisposes to Vascular Endothelial Dysfunction and Increased Arterial Stiffness in Mice and Humans. Arterioscler Thromb Vasc Biol 2015; 35:1678-86. [DOI: 10.1161/atvbaha.114.305064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 04/16/2015] [Indexed: 12/11/2022]
Abstract
Objective—
The melanocortin 1 receptor (MC1-R) is expressed by vascular endothelial cells and shown to enhance nitric oxide (NO) availability and vasodilator function on pharmacological stimulation. However, the physiological role of MC1-R in the endothelium and its contribution to vascular homeostasis remain unresolved. We investigated whether a lack of functional MC1-R signaling carries a phenotype with predisposition to vascular abnormalities.
Approach and Results—
Recessive yellow mice (MC1R
e/e
), deficient in MC1-R signaling, and their wild-type littermates were studied for morphology and functional characteristics of the aorta. MC1R
e/e
mice showed increased collagen deposition and arterial stiffness accompanied by an elevation in pulse pressure. Contractile capacity and NO-dependent vasodilatation were impaired in the aorta of MC1R
e/e
mice supported by findings of decreased NO availability. These mice also displayed elevated levels of systemic and local cytokines. Exposing the mice to high-sodium diet or acute endotoxemia revealed increased susceptibility to inflammation-driven vascular dysfunction. Finally, we investigated whether a similar phenotype can be found in healthy human subjects carrying variant
MC1-R
alleles known to attenuate receptor function. In a longitudinal analysis of 2001 subjects with genotype and ultrasound data (The Cardiovascular Risk in Young Finns Study), weak MC1-R function was associated with lower flow-mediated dilatation response of the brachial artery and increased carotid artery stiffness.
Conclusions—
The present study demonstrates that deficiency in MC1-R signaling is associated with increased arterial stiffness and impairment in endothelium-dependent vasodilatation, suggesting a physiological role for MC1-R in the regulation of arterial tone.
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Affiliation(s)
- Petteri Rinne
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Ari Ahola-Olli
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Salla Nuutinen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Emilia Koskinen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Katja Kaipio
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Kim Eerola
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Markus Juonala
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Mika Kähönen
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Terho Lehtimäki
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Olli T. Raitakari
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
| | - Eriika Savontaus
- From the Department of Pharmacology, Drug Development and Pharmaceutics (P.R., S.N., E.K., K.E.,E.S.), the Research Centre of Applied and Preventive Cardiovascular Medicine (A.A-O., O.T.R.), and Department of Pathology (K.K), University of Turku, Turku, Finland; Division of Medicine (M.J.), Department of Clinical Physiology and Nuclear Medicine (O.T.R), and the Unit of Clinical Pharmacology (E.S.), Turku University Hospital, Turku, Finland; Department of Clinical Physiology, University of Tampere
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Fuleihan GEH, Bouillon R, Clarke B, Chakhtoura M, Cooper C, McClung M, Singh RJ. Serum 25-Hydroxyvitamin D Levels: Variability, Knowledge Gaps, and the Concept of a Desirable Range. J Bone Miner Res 2015; 30:1119-33. [PMID: 25952470 DOI: 10.1002/jbmr.2536] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 04/09/2015] [Accepted: 04/16/2015] [Indexed: 12/21/2022]
Abstract
Hypovitaminosis D is prevalent worldwide but proportions vary widely between regions, depending on genetic and lifestyle factors, the threshold to define deficiency, and accuracy of 25-hydroxyvitamin D (25OHD) assays used. Latitude, pollution, concealing clothing, sun exposure, gender, dietary habits, and lack of government regulation account for up to 50% in variations in serum 25OHD levels, whereas genetic polymorphisms in the vitamin D pathway account for less than 5%. Organizations/societies have developed guidelines for recommended desirable 25OHD levels and vitamin D doses to reach them, but their applicability across age groups and populations are still debated. This article and the accompanying online Supporting Information highlight sources of variations in circulating 25OHD levels, uncertainties and knowledge gaps, and analytical problems facing 25OHD assays, while keeping efficacy and safety data as the dominant factors when defining a desirable range for 25OHD levels. We propose a desirable range of 20 to 40 ng/mL (50 to 100 nmol/L), provided precise and accurate assays are used. Although slightly lower levels, 15 to 20 ng/mL, may be sufficient for some infants and adults, higher levels, 40 to 60 ng/mL, may still be safe. This desirable range allows physicians to tailor treatment while taking season, lifestyle, vitamin D intake, and other sources of variation into account. We reserve 25OHD measurements for at-risk patients, defined by disease or lifestyle, and the use of 25OHD assays calibrated against the recommended international standards. Most target groups reach desirable target levels by a daily intake of 400 to 600 IU for children and 800 IU for adults. A total daily allowance of vitamin D of up to 1000 IU in the pediatric age groups, and up to 2000 IU in adults, tailored to an individual patient risk profile, is probably safe over long durations. Additional data are needed to validate the proposed range and vitamin D doses, especially in children, pregnant women, and non-white populations.
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Affiliation(s)
- Ghada El-Hajj Fuleihan
- Department of Internal Medicine, Calcium Metabolism and Osteoporosis Program, American University of Beirut, Beirut, Lebanon
| | - Roger Bouillon
- Department of Endocrinology and Laboratory Medicine, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Bart Clarke
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Foundation, Rochester, MN, USA
| | - Marlene Chakhtoura
- Department of Internal Medicine, Calcium Metabolism and Osteoporosis Program, American University of Beirut, Beirut, Lebanon
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | | | - Ravinder J Singh
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic Foundation, Rochester, MN, USA
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45
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Factors Affecting 25-Hydroxyvitamin D Concentration in Response to Vitamin D Supplementation. Nutrients 2015; 7:5111-42. [PMID: 26121531 PMCID: PMC4516990 DOI: 10.3390/nu7075111] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/05/2015] [Accepted: 06/12/2015] [Indexed: 12/27/2022] Open
Abstract
Sun exposure is the main source of vitamin D. Due to many lifestyle risk factors vitamin D deficiency/insufficiency is becoming a worldwide health problem. Low 25(OH)D concentration is associated with adverse musculoskeletal and non-musculoskeletal health outcomes. Vitamin D supplementation is currently the best approach to treat deficiency and to maintain adequacy. In response to a given dose of vitamin D, the effect on 25(OH)D concentration differs between individuals, and it is imperative that factors affecting this response be identified. For this review, a comprehensive literature search was conducted to identify those factors and to explore their significance in relation to circulating 25(OH)D response to vitamin D supplementation. The effect of several demographic/biological factors such as baseline 25(OH)D, aging, body mass index(BMI)/body fat percentage, ethnicity, calcium intake, genetics, oestrogen use, dietary fat content and composition, and some diseases and medications has been addressed. Furthermore, strategies employed by researchers or health care providers (type, dose and duration of vitamin D supplementation) and environment (season) are other contributing factors. With the exception of baseline 25(OH)D, BMI/body fat percentage, dose and type of vitamin D, the relative importance of other factors and the mechanisms by which these factors may affect the response remains to be determined.
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46
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Lehmann U, Riedel A, Hirche F, Brandsch C, Girndt M, Ulrich C, Seibert E, Henning C, Glomb MA, Dierkes J, Stangl GI. Vitamin D3 supplementation: Response and predictors of vitamin D3 metabolites - A randomized controlled trial. Clin Nutr 2015; 35:351-358. [PMID: 26037521 DOI: 10.1016/j.clnu.2015.04.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS Large parts of the population are insufficiently supplied with vitamin D, in particular when endogenous synthesis is absent. Therefore many health care providers recommend the use of vitamin D supplements. The current study aimed to investigate the efficacy of an once-daily oral dose of 20 μg vitamin D3 to improve the vitamin D status and to evaluate predictors of response. METHODS The study was conducted as a double-blind, randomized, placebo-controlled parallel trial from January till April 2013. In total, 105 subjects (20-71 years) were allocated to receive either a vitamin D3 supplement (20 μg/d) or a placebo for 12 weeks. Circulating levels of vitamin D3 metabolites such as the 25(OH)D3 and the 24,25(OH)2D3, and biomarkers of calcium and phosphate metabolism were quantified. RESULTS The 25(OH)D3 serum concentrations in the placebo group decreased from 38 ± 15 nmol/L at baseline to 32 ± 14 nmol/L and 32 ± 13 nmol/L at weeks 8 and 12 of the study, respectively (p < 0.01). In the vitamin D3 group, the serum 25(OH)D3 concentration increased from 38 ± 14 nmol/L at baseline to 70 ± 15 nmol/L and 73 ± 16 nmol/L at weeks 8 and 12 of vitamin D3 supplementation (p < 0.001), respectively. As a result, 94% of the vitamin D3-supplemented participants reached 25(OH)D3 concentrations of ≥50 nmol/L and thereof 46% attained 25(OH)D3 levels of ≥75 nmol/L until the end of the study. The extent of the 25(OH)D3 increase upon vitamin D3 supplementation depended on 25(OH)D3 baseline levels, age, body weight and circulating levels of triglycerides. In contrast to 25(OH)D3, the response of 24,25(OH)2D3 to the vitamin D3 treatment was affected only by baseline levels of 24,25(OH)2D3 and age. CONCLUSIONS The average improvement of 25(OH)D3 levels in individuals who received 20 μg vitamin D3 per day during the winter months was 41 nmol/L compared to individuals without supplementation. As a result almost all participants with the vitamin D3 supplementation attained 25(OH)D3 concentrations of 50 nmol/L and higher. The suitability of 24,25(OH)2D3 as a marker of vitamin D status needs further investigation. Clinical trial registration number at clinicaltrials.gov: NCT01711905.
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Affiliation(s)
- Ulrike Lehmann
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Germany
| | - Annett Riedel
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Germany
| | - Frank Hirche
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Germany
| | - Corinna Brandsch
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Germany
| | - Christof Ulrich
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Germany
| | - Eric Seibert
- Department of Internal Medicine II, Martin Luther University Halle-Wittenberg, Germany
| | - Christian Henning
- Institute of Chemistry, Food Chemistry, Martin Luther University Halle-Wittenberg, Germany
| | - Marcus A Glomb
- Institute of Chemistry, Food Chemistry, Martin Luther University Halle-Wittenberg, Germany
| | - Jutta Dierkes
- Department of Clinical Medicine, University of Bergen, Norway
| | - Gabriele I Stangl
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Germany.
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47
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Whiting SJ, Bonjour JP, Payen FD, Rousseau B. Moderate amounts of vitamin D3 in supplements are effective in raising serum 25-hydroxyvitamin D from low baseline levels in adults: a systematic review. Nutrients 2015; 7:2311-23. [PMID: 25835074 PMCID: PMC4425146 DOI: 10.3390/nu7042311] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 03/20/2015] [Accepted: 03/26/2015] [Indexed: 01/01/2023] Open
Abstract
There is controversy surrounding the designation of vitamin D adequacy as defined by circulating levels of the metabolite 25-hydroxyvitamin D (25(OH)D). Depending on the cutoff level chosen, dietary intakes of vitamin D may or may not provide sufficient impact upon vitamin D status measured as improvement in serum levels of 25(OH)D. We sought to examine whether modest daily doses (5-20 μg) as found in fortified foods or multivitamin supplements had a measureable impact on vitamin D status, defined as moving from below to above 50 nmol/L, or from less than 30 nmol/L to above 30 nmol/L. Published literature was searched for relevant articles describing randomized controlled trials. Exclusion criteria were: studies not involving humans; review articles; studies lacking blood level data pre- and post-treatment; no control group; bolus treatments (weekly, monthly, yearly); vitamin D < 5 μg or > 20 μg; baseline 25(OH)D ≥ 75 nmol/L; subjects not defined as healthy; studies < 8 weeks; and age < 19 years. Of the 127 studies retrieved, 18 publications with 25 separate comparisons met criteria. The mean rate constant, defined as change in 25(OH)D in nmol/L per μg vitamin D administered, was calculated as 2.19 ± 0.97 nmol/L per μg. There was a significant negative correlation (r = -0.65, p = 0.0004) between rate constant and administered dose. To determine impact of the dose reflecting the Estimated Average Requirement (EAR) of 10 μg administered in nine studies (10 comparisons), in every case mean 25(OH)D status rose either from "insufficient" (30-50 nmol/L) to "sufficient" (> 50 nmol/L) or from "deficient" (< 30 nmol/L) to "insufficient" (> 30 but < 50 nmol/L). Our study shows that when baseline levels of groups were < 75 nmol/L, for every microgram of vitamin D provided, 25(OH)D levels can be raised by 2 nmol/L; and further, when groups were deficient or insufficient in vitamin D, there was significant value in providing additional 10 μg per day of vitamin D.
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Affiliation(s)
- Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan S7N 2Z4 Canada..
| | - Jean-Philippe Bonjour
- Division of Bone Disease, University Hospitals and Faculty of Medicine, Geneva 14, Switzerland.
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Hartley M, Hoare S, Lithander FE, Neale RE, Hart PH, Gorman S, Gies P, Sherriff J, Swaminathan A, Beilin LJ, Mori TA, King L, Black LJ, Marshall K, Xiang F, Wyatt C, King K, Slevin T, Pandeya N, Lucas RM. Comparing the effects of sun exposure and vitamin D supplementation on vitamin D insufficiency, and immune and cardio-metabolic function: the Sun Exposure and Vitamin D Supplementation (SEDS) Study. BMC Public Health 2015; 15:115. [PMID: 25884724 PMCID: PMC4391331 DOI: 10.1186/s12889-015-1461-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 01/23/2015] [Indexed: 12/22/2022] Open
Abstract
Background Adults living in the sunny Australian climate are at high risk of skin cancer, but vitamin D deficiency (defined here as a serum 25-hydroxyvitamin D (25(OH)D) concentration of less than 50 nmol/L) is also common. Vitamin D deficiency may be a risk factor for a range of diseases. However, the optimal strategies to achieve and maintain vitamin D adequacy (sun exposure, vitamin D supplementation or both), and whether sun exposure itself has benefits over and above initiating synthesis of vitamin D, remain unclear. The Sun Exposure and Vitamin D Supplementation (SEDS) Study aims to compare the effectiveness of sun exposure and vitamin D supplementation for the management of vitamin D insufficiency, and to test whether these management strategies differentially affect markers of immune and cardio-metabolic function. Methods/Design The SEDS Study is a multi-centre, randomised controlled trial of two different daily doses of vitamin D supplementation, and placebo, in conjunction with guidance on two different patterns of sun exposure. Participants recruited from across Australia are aged 18–64 years and have a recent vitamin D test result showing a serum 25(OH)D level of 40–60 nmol/L. Discussion This paper discusses the rationale behind the study design, and considers the challenges but necessity of data collection within a non-institutionalised adult population, in order to address the study aims. We also discuss the challenges of participant recruitment and retention, ongoing engagement of referring medical practitioners and address issues of compliance and participant retention. Trial registration Australia New Zealand Clinical Trials Registry: ACTRN12613000290796 Registered 14 March 2013.
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Affiliation(s)
- Mica Hartley
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Samuel Hoare
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Department of Health and Human Services, Hobart, Tasmania, Australia.
| | - Fiona E Lithander
- University of Canberra, Canberra, Australian Capital Territory, Australia.
| | - Rachel E Neale
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
| | - Prue H Hart
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Shelley Gorman
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Peter Gies
- Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
| | - Jill Sherriff
- Curtin University, Perth, Western Australia, Australia.
| | - Ashwin Swaminathan
- The Canberra Hospital, Canberra, Australian Capital Territory, Australia.
| | - Lawrence J Beilin
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.
| | - Trevor A Mori
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.
| | - Laura King
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Lucinda J Black
- Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Kushani Marshall
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Fan Xiang
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia.
| | - Candy Wyatt
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
| | - Kerryn King
- Australian Radiation Protection and Nuclear Safety Agency, Melbourne, Victoria, Australia.
| | - Terry Slevin
- Cancer Council of Western Australia, Perth, Western Australia, Australia.
| | | | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2600, Australia. .,Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.
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Abstract
Vitamin D deficiency has been linked to an increased risk of a wide range of adverse health outcomes. The active form of vitamin D has an important role in calcium metabolism and in bone mineralisation, but the evidence for other health outcomes is mixed, with the strongest effects seen in the weakest epidemiological study designs. There are plausible pathways whereby vitamin D deficiency can impair immune function, resulting in both overactivity and increased risk of autoimmune disease, as well as immune suppression with poorer resistance to infection. Vitamin D status may influence the bacterial flora that constitute the microbiome and affect immune function through this route. Exposure of the skin to ultraviolet radiation causes the production of a range of chemicals, including vitamin D, and new research is exploring possible vitamin D-independent immunomodulatory pathways.
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Affiliation(s)
- Robyn M. Lucas
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
- National Centre for Epidemiology and Population Health, The Australian National UniversityCanberraAustralia 0200
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
| | - Sian Geldenhuys
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
| | - Prue H. Hart
- Telethon Kids Institute, University of Western Australia100 Roberts Road, Subiaco, PerthAustralia 6008
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Abstract
In recent years, new functional roles of vitamin D beyond its traditional role in calcium homoeostasis and bone metabolism have emerged linking the fat-soluble vitamin to various non-communicable diseases. Vitamin D deficiency (25-hydroxyvitamin D (25(OH)D) < 25-30 nmol/l) and sub-optimal status (25(OH)D < 50-100 nmol/l) are increasingly associated with unfavourable metabolic phenotypes, including insulin resistance, type 2 diabetes and CVD; conditions also commonly linked with overweight and obesity. Early studies reported poor vitamin D status in the morbidly obese. More recently, it has been observed that a graded relationship between vitamin D status and BMI, or specifically adiposity, exists in the general population. A number of hypotheses have been proposed to explain the potential mechanisms whereby alterations in the vitamin D endocrine system occur in the obese state. Plausible explanations include sequestration in adipose tissue, volumetric dilution or negative feedback mechanisms from increased circulating 1,25-dihydroxyvitamin D3. Others hypothesise that heavier individuals may partake in less outdoor activity, may also cover-up and wear more clothing than leaner individuals, thus decreasing sun exposure and limiting endogenous production of cholecalciferol in the skin. Moreover, in some but not all studies, BMI and adiposity have been negatively associated with the change in vitamin D status following vitamin D supplementation. It therefore remains unclear if body size and/or adiposity should be taken into account when determining the dietary requirements for vitamin D. This review will evaluate the current evidence linking vitamin D status and supplementation to overweight and obesity, and discuss the implications for setting dietary requirements.
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