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Yang W, Chandra M, Gordon NP, Darbinian JA, Drees JC, Park-Sigal J, Lee C, Lo JC. Prevalence of low vitamin D levels among older US Asian and Pacific Islander adults. Osteoporos Int 2024:10.1007/s00198-024-07197-z. [PMID: 39207531 DOI: 10.1007/s00198-024-07197-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/15/2024] [Indexed: 09/04/2024]
Abstract
While US Asian and Pacific Islander adults have lower 25-hydroxyvitamin D (25(OH)D) levels than White adults, ethnic subgroup data remain limited. In a large California population, the adjusted prevalence of 25(OH)D < 20 ng/mL (50 nmol/L) was 1.5- to 2.7-fold higher for Asian/Pacific Islander compared to White adults, with substantial variation by ethnicity. PURPOSE US Asian and Pacific Islander (PI) adults generally have lower 25-hydroxyvitamin D [25(OH)D] levels than non-Hispanic White (NHW) adults, but subgroup data remain limited. We compared sex- and ethnicity-specific prevalence of low 25(OH)D among older Asian/PI and NHW adults. METHODS Data from 102,556 Asian/PI and 381,724 NHW adults aged 50-89 years with measured 25(OH)D in 2012-2019 and body mass index (BMI, within ± 1 year) were examined in a California healthcare system. Low 25(OH)D < 20 ng/mL (50 nmol/L) was examined by race and ethnicity. Covariates included age, smoking, BMI, and season of measurement. Modified Poisson regression was used to estimate prevalence ratios (aPR), adjusting for covariates. RESULTS Among 31,287 Asian/PI men and 71,269 Asian/PI women, the prevalence of low 25(OH)D was 22.6% and 14.7%, respectively, significantly higher than observed for 122,162 NHW men (12.3%) and 259,562 NHW women (9.9%). Within Asian/PI subgroups, low 25(OH)D prevalence ranged from 17 to 18% (Korean, Japanese, Filipino), 22 to 24% (Chinese, Vietnamese), 28% (South Asian), and 35% (Native Hawaiian/PI) among men and 11 to 14% (Japanese, Filipina, Chinese, Korean), 17 to 18% (South Asian, Vietnamese), and 26% (Native Hawaiian/PI) among women. The corresponding aPRs (NHW reference) for men and women were as follows: Native Hawaiian/PI, 2.70 and 2.34; South Asian, 2.56 and 2.07; Vietnamese, 2.17 and 2.31; Chinese, 2.04 and 1.89; Korean, 1.60 and 1.85; Filipino, 1.58 and 1.52; and Japanese, 1.58 and 1.49 (p < 0.001). CONCLUSION In a large US healthcare population of older Asian/PI adults, low 25(OH)D prevalence was 1.5- to 2.7-fold higher for Asian/PI compared to NHW adults, with substantial variation by sex and ethnicity.
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Affiliation(s)
- Wei Yang
- Department of Endocrinology, Kaiser Permanente San Jose Medical Center, San Jose, CA, USA
- The Permanente Medical Group, Oakland, CA, USA
| | - Malini Chandra
- Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA
| | - Jeanne A Darbinian
- Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA
| | - Julia C Drees
- Department of Chemistry, The Permanente Medical Group Regional Laboratories, Richmond, CA, USA
| | - Jennifer Park-Sigal
- The Permanente Medical Group, Oakland, CA, USA
- Department of Endocrinology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, CA, USA
| | - Catherine Lee
- Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Joan C Lo
- The Permanente Medical Group, Oakland, CA, USA.
- Division of Research, Kaiser Permanente Northern California, Pleasanton, CA, USA.
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
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Akbari LN, Kheirollahi A, Vatannejad A, Hamidi H. Association of rs4588 polymorphism in vitamin D binding protein gene with polycystic ovarian syndrome in Iranian women: a case-control study. BMC Res Notes 2024; 17:207. [PMID: 39068475 PMCID: PMC11283716 DOI: 10.1186/s13104-024-06857-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/05/2024] [Indexed: 07/30/2024] Open
Abstract
OBJECTIVE Vitamin D deficiency and variations in the vitamin D binding protein (VDBP) gene may play a role in the development of Polycystic ovary syndrome (PCOS). This study aims to investigate the association of the rs4588 polymorphism with PCOS in Iranian women, as well as its association with infertility and recurrent pregnancy loss (RPL) in these patients. RESULTS The analysis revealed statistically significant differences in the distributions of genotypes and alleles of the rs4588 polymorphism among the three groups (p < 0.0001). The AC genotype and A allele showed an association with an elevated risk of PCOS and infertility. In this study, no association was found between genotypes and alleles of the rs4588 polymorphism and the risk of RPL in women with PCOS. Subjects with the AA or AC genotype exhibited significantly higher levels of LDL compared to those with the CC genotype.
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Affiliation(s)
- Leila Nazarpoor Akbari
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Asma Kheirollahi
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran.
| | - Akram Vatannejad
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Hediyeh Hamidi
- Department of Comparative Biosciences, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
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3
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Stroia CM, Ghitea TC, Vrânceanu M, Mureșan M, Bimbo-Szuhai E, Pallag CR, Pallag A. Relationship between Vitamin D3 Deficiency, Metabolic Syndrome and VDR, GC, and CYP2R1 Gene Polymorphisms. Nutrients 2024; 16:1272. [PMID: 38732523 PMCID: PMC11085312 DOI: 10.3390/nu16091272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/13/2024] Open
Abstract
The presence of vitamin D3 deficiency associated with the presence of metabolic syndrome (MS) has important public health effects. This study aims to investigate the relationship between vitamin D3 deficiency, MS and vitamin D3 receptor (VDR), GC Vitamin D binding protein (GC), and cytochrome P450 family 2 subfamily R member 1 (CYP2R1) gene polymorphisms, and genes whose encoded proteins are responsible for vitamin D3 metabolism and transport. A total of 58 participants were included in this study (age 39 ± 12 years) and were selected over a 12-month period. They were divided into four groups, depending on the presence of polymorphisms in VDR, GC, and CYP2R1 genes and their weight status. At baseline, in months 3, 6, and 12, biochemical parameters including 25(OH)D3, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and homeostatic model assessment (HOMA index), the insulin resistance indicator were measured. Our results show that all subjects in the polymorphism group supplemented with vitamin D3 reached an optimal level of vitamin D3 associated with high concentrations of 25(OH)D3. Weight loss was most significant in patients in the POW group (overweight patients).
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Affiliation(s)
- Carmina Mariana Stroia
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Timea Claudia Ghitea
- Pharmacy Department, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Maria Vrânceanu
- Department of Toxicology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj Napoca, 400012 Cluj-Napoca, Romania;
| | - Mariana Mureșan
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Erika Bimbo-Szuhai
- Department of Surgery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Csaba Robert Pallag
- MSc International Economy and Business Program of Study, Department of World Economy, Corvinus University of Budapest, 1093 Budapest, Hungary;
| | - Annamaria Pallag
- Doctoral School of Biomedical Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
- Pharmacy Department, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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4
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Du Y, Geng P, Chen Q, Han L, Liu L, Yang M, Tan M, Meng J, Sun X, Feng L. Associations of vitamin D receptor polymorphisms with risk of Alzheimer's disease, Parkinson's disease, and mild cognitive impairment: a systematic review and meta-analysis. Front Aging Neurosci 2024; 16:1377058. [PMID: 38681668 PMCID: PMC11047136 DOI: 10.3389/fnagi.2024.1377058] [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: 01/26/2024] [Accepted: 03/22/2024] [Indexed: 05/01/2024] Open
Abstract
Vitamin D is a lipid soluble steroid hormone, which plays a critical role in the calcium homeostasis, neuronal development, cellular differentiation, and growth by binding to vitamin D receptor (VDR). Associations between VDR gene polymorphism and Alzheimer's disease (AD), Parkinson's disease (PD), and mild cognitive impairment (MCI) risk has been investigated extensively, but the results remain ambiguous. The aim of this study was to comprehensively assess the correlations between four VDR polymorphisms (FokI, BsmI, TaqI, and ApaI) and susceptibility to AD, PD, and MCI. Crude odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the relationship of interest. Pooled analyses suggested that the ApaI polymorphism decreased the overall AD risk, and the TaqI increased the overall PD susceptibility. In addition, the BsmI and ApaI polymorphisms were significantly correlated with the overall MCI risk. Stratified analysis by ethnicity further showed that the TaqI and ApaI genotypes reduced the AD predisposition among Caucasians, while the TaqI polymorphism enhanced the PD risk among Asians. Intriguingly, carriers with the BB genotype significantly decreased the MCI risk in Asian descents, and the ApaI variant elevated the predisposition to MCI in Caucasians and Asians. Further studies are need to identify the role of VDR polymorphisms in AD, PD, and MCI susceptibility.
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Affiliation(s)
- Yanjun Du
- Department of Encephalopathy, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Peizhen Geng
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Qunqun Chen
- Department of Rehabilitation, Weifang Brain Hospital, Weifang, Shandong, China
| | - Laixi Han
- Department of Rehabilitation, Weifang Brain Hospital, Weifang, Shandong, China
| | - Lu Liu
- Department of Occupational Diseases, Weifang People’s Hospital, Weifang, Shandong, China
| | - Maoquan Yang
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Mingzhu Tan
- Department of Occupational Diseases, Weifang People’s Hospital, Weifang, Shandong, China
| | - Jun Meng
- Department of Occupational Diseases, Weifang People’s Hospital, Weifang, Shandong, China
| | - Xiaojuan Sun
- Department of Occupational Diseases, Weifang People’s Hospital, Weifang, Shandong, China
| | - Lidan Feng
- Department of Rehabilitation, Weifang People’s Hospital, Weifang, Shandong, China
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Ghiasvand R, Rashidian A, Abaj F, Rafiee M. Genetic variations of vitamin D receptor and vitamin D supplementation interaction in relation to serum vitamin D and metabolic traits: a systematic review and meta-analysis. INT J VITAM NUTR RES 2023; 93:535-558. [PMID: 35997204 DOI: 10.1024/0300-9831/a000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: It is now becoming increasingly recognized that the effects of vitamin D supplementation may vary by several factors including vitamin D deficiency status, ethnicity, and/or the presence of genetic variants, which affect individual responses to supplementation. This study investigates the interaction between metabolic traits and circulating 25-hydroxyvitamin-D (25OHD) concentration with 4 polymorphisms of vitamin D receptor (VDR) including BsmI, ApaI, TaqI, FokI, and vitamin D supplementation. Methods: A systematic review and meta-analysis of papers until August 2021 on PubMed, The Cochrane Library, Scopus, Web of Science, Google Scholar, ProQuest, Science Direct, and Embase about the association between functionally relevant VDR variants and vitamin D supplementation on circulating 25OHD and metabolic traits. Results: A total of 2994 cases from 16 randomized controlled trial (RCT) studies were included in meta-analyses. There were no significant changes in the serum concentrations of 25OHD and metabolic traits after vitamin D supplementation in different variants of BsmI, ApaI, TaqI, and FokI polymorphism in the VDR gene in the overall analysis (p>0.05). However, the results showed there is significant interaction between these above VDR polymorphisms and vitamin D supplement on serum 25OHD level after subgroup analyses based on the study duration, gender, age, BMI, health status, Hardy-Weinberg Equilibrium, PCR, and race (p<0.05). Conclusions: The present meta-analysis demonstrates that the effect of vitamin D supplementation on serum 25OHD and metabolic traits is independent of genetic variants of the VDR gene (BsmI, ApaI, TaqI, and FokI). However, future trials should consider inter-individual differences and, in particular, should aim to clarify whether certain subgroups of individuals may benefit from vitamin D supplementation in the context of metabolic health.
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Affiliation(s)
- Reza Ghiasvand
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Iran
| | - Ali Rashidian
- Department of Industrial Engineering, Sharif University of Technology, Tehran, Iran
| | - Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Iran
| | - Masoumeh Rafiee
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Almaghrbi H, Al-Shafai M, Al-Asmakh M, Bawadi H. Association of Vitamin D Genetic Risk Score with Noncommunicable Diseases: A Systematic Review. Nutrients 2023; 15:4040. [PMID: 37764823 PMCID: PMC10537716 DOI: 10.3390/nu15184040] [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: 08/18/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Background and Aims: The genetic risk score (GRS) is an important tool for estimating the total genetic contribution or susceptibility to a certain outcome of interest in an individual, taking into account their genetic risk alleles. This study aims to systematically review the association between the GRS of low vitamin D with different noncommunicable diseases/markers. Methods: The article was first registered in PROSPERO CRD42023406929. PubMed and Embase were searched from the time of inception until March 2023 to capture all the literature related to the vitamin D genetic risk score (vD-GRS) in association with noncommunicable diseases. This was performed using comprehensive search terms including "Genetic Risk Score" OR "Genetics risk assessment" OR "Genome-wide risk score" AND "Vitamin D" OR 25(HO)D OR "25-hydroxyvitamin D". Results: Eleven eligible studies were included in this study. Three studies reported a significant association between vD-GRS and metabolic parameters, including body fat percentage, body mass index, glycated hemoglobin, and fasting blood glucose. Moreover, colorectal cancer overall mortality and the risk of developing arterial fibrillation were also found to be associated with genetically deprived vitamin D levels. Conclusions: This systematic review highlights the genetic contribution of low-vitamin-D-risk single nucleotides polymorphisms (SNPs) as an accumulative factor associated with different non-communicable diseases/markers, including cancer mortality and the risk of developing obesity, type 2 diabetes, and cardiovascular diseases such as arterial fibrillation.
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Affiliation(s)
- Heba Almaghrbi
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (H.A.); (M.A.-S.); (M.A.-A.)
| | - Mashael Al-Shafai
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (H.A.); (M.A.-S.); (M.A.-A.)
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Maha Al-Asmakh
- Department of Biomedical Science, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar; (H.A.); (M.A.-S.); (M.A.-A.)
- Biomedical Research Center, Qatar University, Doha P.O. Box 2713, Qatar
| | - Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
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Shan X, Cao Y, Zhang H, Zhao X, Li S, Hu Y, Yang L. Free and bioavailable 25-hydroxyvitamin D thresholds for bone metabolism and their associations with metabolic syndrome in Chinese women of childbearing age. Front Nutr 2023; 10:1131140. [PMID: 37736136 PMCID: PMC10509557 DOI: 10.3389/fnut.2023.1131140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 08/18/2023] [Indexed: 09/23/2023] Open
Abstract
Objective The free hormone hypothesis suggests that free and bioavailable 25-hydroxyvitamin D [25(OH)D] may better reflect vitamin D bioactivity. This study aimed to determine the free and bioavailable 25(OH)D characteristics, estimate their thresholds based on parathyroid hormone (PTH) and bone turnover markers (BTMs), assess their associations with the risk of metabolic syndrome (MetS), and evaluate their potential advantages. Methods A cross-sectional study was conducted using a nationally representative database (n = 1,505, female, 18-45 years). Serum total 25(OH)D, vitamin D-binding protein, albumin, PTH, and BTMs [osteocalcin, β-CrossLaps of type 1 collagen containing cross-linked C-telopeptide (β-CTX), and procollagen type 1 N-terminal propeptide (P1NP)] were measured. Free 25(OH)D and bioavailable 25(OH)D were calculated. The threshold associations of 25(OH)D with PTH and BTMs were analyzed. The relationship between 25(OH)D and MetS risk was examined. An intervention study was then performed in 39 women (18-47 years) to assess the associations of increasing 25(OH)D with PTH and BTMs after vitamin D supplementation. Results In the cross-sectional study, the three forms of 25(OH)D were found to have similar distribution characteristics. Free and bioavailable 25(OH)D correlated well with total 25(OH)D. Significant total 25(OH)D cutoffs were observed for PTH (14.19 ng/mL and 18.03 ng/mL), osteocalcin (15.14 ng/mL), β-CTX (14.79 ng/mL), and P1NP (15.08 ng/mL). Free and bioavailable 25(OH)D cutoffs were only found for P1NP (3.47 pg/mL and 1.66 ng/mL, respectively). A total 25(OH)D of <15.14 ng/mL was marginally associated with a higher risk of reduced high-density lipoprotein cholesterol (HDL-C) [odd ratios (OR) = 1.371 (0.991-1.899)]. The ORs of higher versus lower free and bioavailable 25(OH)D levels for reduced HDL-C were 0.770 (0.621-0.956) and 0.772 (0.622-0.958), respectively. The results of the intervention study indicated that PTH and BTMs responded more sensitively to total 25(OH)D than to free or bioavailable 25(OH)D. Conclusion Free and bioavailable 25(OH)D only had a threshold effect on P1NP. The active 25(OH)D thresholds could be used for risk assessment of reduced HDL-C. However, no superiority of free or bioavailable 25(OH)D was found based on the response of PTH and BTMs to changes in 25(OH)D in Chinese women of childbearing age following vitamin D supplementation. Clinical trial registration http://www.chictr.org.cn, ChiCTR2200058290.
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Affiliation(s)
- Xiaoyun Shan
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
- Hunan Key Laboratory of Typical Environmental Pollution and Health Hazards, School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Yang Cao
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huidi Zhang
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiayu Zhao
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Siran Li
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yichun Hu
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lichen Yang
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China
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8
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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Struppe A, Schanda JE, Baierl A, Watzl P, Muschitz C. Impact of Intravenous Iron Substitution on Serum Phosphate Levels and Bone Turnover Markers-An Open-Label Pilot Study. Nutrients 2023; 15:2693. [PMID: 37375595 DOI: 10.3390/nu15122693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
The association between intravenous iron substitution therapy and hypophosphatemia was previously reported in patients with iron deficiency anemia. However, the extent of hypophosphatemia is thought to depend on the type of iron supplementation. We hypothesized that the intravenous application of ferric carboxymaltose and iron sucrose leads to a different longitudinal adaptation in serum phosphate levels. In this open-label pilot study, a total of 20 patients with inflammatory bowel diseases or iron deficiency anemia were randomly assigned to one of two study groups (group 1: ferric carboxymaltose, n = 10; group 2: iron sucrose, n = 10). Serum values were controlled before iron substitution therapy, as well as 2, 4, and 12 weeks after the last drug administration. The primary objective of the study was the longitudinal evaluation of serum phosphate levels after iron substitution therapy with ferric carboxymaltose and iron sucrose. The secondary objective was the longitudinal investigation of calcium, 25-hydroxyvitamin D (25(OH)D), intact parathyroid hormone, procollagen type 1 amino-terminal propeptide (P1NP), beta-CrossLaps (CTX), hemoglobin (Hb), iron, ferritin, and transferrin saturation levels. Two weeks after drug administration, phosphate levels were significantly lower (p < 0.001) in group 1 and ferritin levels were significantly higher (p < 0.001) in group 1. Phosphate levels (0.8-1.45 mmol/L) were below the therapeutic threshold and ferritin levels (10-200 ng/mL for women and 30-300 ng/mL for men) were above the therapeutic threshold in group 1. P1NP (15-59 µg/L) and CTX (<0.57 ng/mL) levels were above the therapeutic threshold in group 2. Four weeks after drug administration, significant differences were still observed between both study groups for phosphate (p = 0.043) and ferritin (p = 0.0009). All serum values except for Hb were within the therapeutic thresholds. Twelve weeks after drug administration, no differences were observed in all serum values between both study groups. Hb values were within the therapeutic threshold in both study groups. Serum 25(OH)D levels did not differ between both study groups throughout the whole study period and remained within the therapeutic threshold.
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Affiliation(s)
- Alexandra Struppe
- St. Vincent Hospital Vienna, II Medical Department-Gastroenterology, Hepatology, Metabolic, and Inflammation Medicine, Academic Teaching Hospital of the Medical University of Vienna, 1060 Vienna, Austria
| | - Jakob E Schanda
- AUVA Trauma Center Vienna-Meidling, Department for Trauma Surgery, 1120 Vienna, Austria
- Ludwig Boltzmann Institute for Traumatology, 1200 Vienna, Austria
- Austrian Cluster for Tissue Regeneration, 1200 Vienna, Austria
| | - Andreas Baierl
- Insitute for Statistics and Operations Research, University of Vienna, 1090 Vienna, Austria
| | - Paul Watzl
- St. Vincent Hospital Vienna, II Medical Department-Gastroenterology, Hepatology, Metabolic, and Inflammation Medicine, Academic Teaching Hospital of the Medical University of Vienna, 1060 Vienna, Austria
| | - Christian Muschitz
- St. Vincent Hospital Vienna, II Medical Department-Gastroenterology, Hepatology, Metabolic, and Inflammation Medicine, Academic Teaching Hospital of the Medical University of Vienna, 1060 Vienna, Austria
- HealthPi Medical Center, 1010 Vienna, Austria
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Hart MD, Girma M, Strong MD, Tadesse BT, Taddesse BM, Alemayehu FR, Stoecker BJ, Chowanadisai W. Vitamin D binding protein gene polymorphisms are associated with lower plasma 25-hydroxy-cholecalciferol concentrations in Ethiopian lactating women. Nutr Res 2022; 107:86-95. [PMID: 36206636 DOI: 10.1016/j.nutres.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 12/27/2022]
Abstract
Ethiopian women have been reported to have low plasma 25-hydroxy-cholecalciferol (25(OH)D) concentrations despite an abundance of sunshine. Low dietary vitamin D intake, limited skin exposure to sun, and genetics are among factors suggested to affect vitamin D status in this population. In this study (Clinical Trial NCT02210884), we hypothesized that polymorphisms in the vitamin D binding protein (VDBP) gene (rs7041, rs4588) are associated with reduced plasma 25(OH)D concentrations in Ethiopian women. Lactating Ethiopian women (n = 110) were randomly assigned to weekly administration of vitamin D3 (15,000 IU) or a placebo. Plasma 25(OH)D was measured at baseline (within 2 weeks of delivery, before supplementation) and at 3, 6, and 12 months after delivery. Associations between VDBP polymorphism status for rs7041 and rs4588 and plasma 25(OH)D were determined by analysis of variance and multiple linear and logistic regressions. Multiple linear regression with maternal age as a covariate revealed that rs7041 is associated with reduced plasma 25(OH)D (P = .021) and more risk alleles at rs7041 and rs4588 are associated with reduced plasma 25(OH)D (P = .017). Logistic regression models for vitamin D insufficiency showed that additional risk alleles for rs7041 and rs4588 are associated with increased odds ratios (OR = 1.66; 95% CI, 1.10-2.62; P = .019) for plasma 25(OH)D below 40 nmol/L. Supplementation increased plasma 25(OH)D at 3 months in women with fewer risk alleles and across all genotypes at 6 and 12 months. VDBP polymorphisms may contribute to vitamin D insufficiency in Ethiopian lactating women. Furthermore, VDBP polymorphisms may blunt short-term responses to vitamin D supplementation and require longer periods of intervention.
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Affiliation(s)
- Matthew D Hart
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | - Meron Girma
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA; School of Nutrition, Food Science, and Technology, Hawassa University, Hawassa, Ethiopia
| | - Morgan D Strong
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA
| | | | | | - Fikadu Reta Alemayehu
- School of Nutrition, Food Science, and Technology, Hawassa University, Hawassa, Ethiopia
| | - Barbara J Stoecker
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA.
| | - Winyoo Chowanadisai
- Department of Nutritional Sciences, Oklahoma State University, Stillwater, OK, 74078, USA.
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11
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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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12
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Wang F, Zheng J, Cheng J, Zou H, Li M, Deng B, Luo R, Wang F, Huang D, Li G, Zhang R, Ding X, Li Y, Du J, Yang Y, Kan J. Personalized nutrition: A review of genotype-based nutritional supplementation. Front Nutr 2022; 9:992986. [PMID: 36159456 PMCID: PMC9500586 DOI: 10.3389/fnut.2022.992986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Nutritional disorders have become a major public health issue, requiring increased targeted approaches. Personalized nutrition adapted to individual needs has garnered dramatic attention as an effective way to improve nutritional balance and maintain health. With the rapidly evolving fields of genomics and nutrigenetics, accumulation of genetic variants has been indicated to alter the effects of nutritional supplementation, suggesting its indispensable role in the genotype-based personalized nutrition. Additionally, the metabolism of nutrients, such as lipids, especially omega-3 polyunsaturated fatty acids, glucose, vitamin A, folic acid, vitamin D, iron, and calcium could be effectively improved with related genetic variants. This review focuses on existing literatures linking critical genetic variants to the nutrient and the ways in which these variants influence the outcomes of certain nutritional supplementations. Although further studies are required in this direction, such evidence provides valuable insights for the guidance of appropriate interventions using genetic information, thus paving the way for the smooth transition of conventional generic approach to genotype-based personalized nutrition.
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Affiliation(s)
| | | | - Junrui Cheng
- Department of Molecular and Structural Biochemistry, North Carolina State University, Kannapolis, NC, United States
| | - Hong Zou
- Sequanta Technologies Co., Ltd, Shanghai, China
| | | | - Bin Deng
- Nutrilite Health Institute, Guangzhou, China
| | - Rong Luo
- Nutrilite Health Institute, Guangzhou, China
| | - Feng Wang
- Nutrilite Health Institute, Guangzhou, China
| | | | - Gang Li
- Nutrilite Health Institute, Shanghai, China
| | - Rao Zhang
- School of Public Health, Institute of Nutrition and Health, Qingdao University, Qingdao, China
| | - Xin Ding
- School of Public Health, Institute of Nutrition and Health, Qingdao University, Qingdao, China
| | - Yuan Li
- Sequanta Technologies Co., Ltd, Shanghai, China
| | - Jun Du
- Nutrilite Health Institute, Shanghai, China
- Jun Du
| | - Yuexin Yang
- Chinese Center for Disease Control and Prevention, National Institute for Nutrition and Health, Beijing, China
- Yuexin Yang
| | - Juntao Kan
- Nutrilite Health Institute, Shanghai, China
- *Correspondence: Juntao Kan
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13
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Association of Serum 25(OH)D with Metabolic Syndrome in Chinese Women of Childbearing Age. Nutrients 2022; 14:nu14112301. [PMID: 35684100 PMCID: PMC9182986 DOI: 10.3390/nu14112301] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/01/2023] Open
Abstract
Objective: To analyze the associations between serum 25(OH)D levels and the risk of metabolic syndrome (MetS) and its components, and the related genetic and non-genetic factors in non-diabetic women of childbearing age in China. Methods: Subjects were randomly selected from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance. The data of sociodemographic characteristics and lifestyle factors were obtained through questionnaire survey. Anthropometry was measured by trained interviewers, and fasting blood was collected to test 25-hydroxyvitamin D [25(OH)D], total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), and other related parameters. Generalized linear mode and multivariate logistic analysis were performed to analyze the associations between serum 25(OH)D and MetS and its components, adjusting for the possible confounders. Results: Body mass index (BMI), serum alanine aminotransferase (ALT), hypersensitive C-reactive protein (hs-CRP), 25(OH)D, phosphorus (P), and parathyroid hormone (PTH) levels were associated with the number of MetS’s components. G allele carriers of GC rs2282679 had higher diastolic blood pressure (DBP) and FBG levels compared with the TT genotypes, while higher genetic risk score (GRS) seemed to be associated with reduced HDL-C level. The odds ratio (OR) for MetS in lowest group of 25(OH)D was 1.533 (0.980−2.399) after adjusting for season, district, area type, latitude, age, BMI, PTH, P, ALT, CRE, interleukin-6 (IL-6), and hs-CRP, compared with the median group, but the association was not significant. An insufficient 25(OH)D concentration (<14.22 ng/mL) was significantly related to the risk of elevated waist circumference (WC) (OR = 1.612 (1.014−2.561)) and TG (OR = 2.210 (1.318−3.706)), and reduced HDL-C (OR = 1.639 (1.206−2.229)) after adjusting for the confounders among these women. Moreover, these relationships were not affected by vitamin D metabolism-related gene polymorphisms. Conclusion: After comprehensively considering various influencing factors, significant associations between insufficient serum 25(OH)D and MetS‘s components, including elevated WC, TG, and reduced HDL-C, were observed. However, MetS, hypertension, and hyperglycemia were not found independently associated with 25(OH)D levels.
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14
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Dabas A, Dabas V, Dabla PK, Marwaha RK, Yadav S, Bharadwaj M, Tyagi V, Agrawal S. Daily v. weekly oral vitamin D 3 therapy for nutritional rickets in Indian children: a randomised controlled open-label trial. Br J Nutr 2022; 129:1-8. [PMID: 35550679 DOI: 10.1017/s0007114522001477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of the study was to compare the efficacy of daily v. weekly oral vitamin D3 therapy in radiological healing of nutritional rickets. Children 6 months to 12 years (n 132) diagnosed with nutritional rickets were randomised into three groups (n 44): group A - 2000 IU daily vitamin D3 for 12 weeks, B - 60 000 IU weekly for 3 weeks, C - 60 000 IU weekly for 6 weeks. Serum calcium, phosphorus, 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and X-ray score were estimated at baseline and 12 weeks (endline). The proportion of children who achieved complete radiological healing at endline was compared between three groups by χ2 and delta change in laboratory parameters by ANOVA (parametric data) or Kruskal Wallis test (non-parametric data), respectively. Baseline 25(OH)D ≤ 20 ng/ml was seen in 119 (90·2 %), hyperparathyroidism in 90 (68·8 %) and hypocalcaemia in 96 (72·7 %). A total of 120/132 children completed the study. Complete radiological healing seen in 30 (75 %) in group A, 23 (60·5 %) in group B and 26 (61·9 %) in group C; P = 0·15, with comparable endline X-ray scores; P = 0·31. The median (interquartile range (IQR)) delta X-ray score (baseline-endline) was 7 (4,9), 5 (2·25, 6) and 6 (4,7) in groups A, B and C, respectively; P = 0·019. Median (IQR) 25(OH)D endline levels in groups A, B and C were 50·0 (26·5, 66·5), 42·1 (28·4, 54·4) and 53·5 (33·7, 71·2) ng/ml, respectively; P = 0·045. Radiological scores were comparable at endline among daily and weekly vitamin D groups with greater change from baseline in daily supplemented group.
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Affiliation(s)
- Aashima Dabas
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Vineet Dabas
- Department of Orthopedics, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Pradeep Kumar Dabla
- Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
| | - Raman Kumar Marwaha
- Consultant Endocrinologist and President, Society for Endocrine Health of Elderly, Adolescents and Children, New Delhi, India
| | - Sangeeta Yadav
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Madhavi Bharadwaj
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Vernika Tyagi
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
| | - Shipra Agrawal
- Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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15
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Cashman KD, Ritz C, Carlin A, Kennedy M. Vitamin D biomarkers for Dietary Reference Intake development in children: a systematic review and meta-analysis. Am J Clin Nutr 2022; 115:544-558. [PMID: 34687199 DOI: 10.1093/ajcn/nqab357] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Circulating 25-hydroxyvitamin D [25(OH)D] has been the accepted vitamin D exposure/intake biomarker of choice within recent DRI exercises, but use of other vitamin D-related biomarkers as well as functional markers has been suggested. These may be of value in future vitamin D DRI exercises, such as the FAO/WHO's one for young children. OBJECTIVES To systematically review the usefulness of circulating 25(OH)D, parathyroid hormone (PTH), free and bioavailable 25(OH)D, C3-epimer of 25(OH)D, vitamin D3, 24,25-dihydroxyvitamin D [24,25(OH)2D], and bone turnover markers and calcium absorption as vitamin D biomarkers for DRI development in children. METHODS Methods included structured searches of published articles, full-text reviews, data extraction, quality assessment, meta-analysis, and random-effects meta-regression. RESULTS Fifty-nine vitamin D supplementation randomized controlled trials (RCTs) were included (39 in infants/children as the priority group and the remainder in adults since pediatric studies were absent/limited). Vitamin D supplementation significantly raised circulating 25(OH)D in infants and children, but the response was highly heterogeneous [weighted mean difference (WMD): 27.7 nmol/L; 95% CI: 22.9, 32.5; 27 RCTs; I2 = 93%]. Meta-regression suggested an increase by 1.7 nmol/L (95% CI: 0.7, 2.6) in serum 25(OH)D per each 100-IU increment in vitamin D intake (P = 0.0005). Vitamin D supplementation had a significant effect on circulating 24,25(OH)2D (WMD: 3.4 nmol/L; 95% CI: 2.4, 4.5; 13 RCTs; I2 = 95%), with a dose-response relation (+0.15 nmol/L per 100 IU; 95% CI: -0.01, 0.29). With circulating PTH, although there was a significant effect of vitamin D on WMD (P = 0.05), there was no significant dose-response relation (P = 0.32). Pediatric data were too limited in relation to the usefulness of the other biomarkers. CONCLUSIONS Circulating 25(OH)D may be a useful biomarker of vitamin D exposure/intake for DRI development in infants and children. Circulating 24,25(OH)2D also showed some promise, but further data are needed, especially in infants and children.
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Affiliation(s)
- Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Christian Ritz
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Aoife Carlin
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Mairead Kennedy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
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16
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Hu Y, Li S, Wang J, Zheng D, Zhang H, Yu W, Zhu L, Liu Z, Yang X, Yang L. Threshold for Relationship between Vitamin D and Parathyroid Hormone in Chinese Women of Childbearing Age. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13060. [PMID: 34948669 PMCID: PMC8702147 DOI: 10.3390/ijerph182413060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/04/2021] [Accepted: 12/08/2021] [Indexed: 12/25/2022]
Abstract
Background: The aim of this study was to assess the relationship between serum 25-hydroxyvitamin D [25(OH)D] and serum intact parathyroid hormone (PTH) in Chinese childbearing women, and to estimate the optimum threshold of 25(OH)D that maximally inhibits the PTH, which is considered to be the optimal status for vitamin D sufficiency. Methods: Serum samples were selected from the biological samples' bank of the Chinese Chronic Diseases and Nutrition Survey (CCDNS) 2015. The serum 25(OH)D concentration was determined by liquid chromatography tandem mass spectrometry and the serum PTH was determined by electronic chemiluminescence. Simple linear and partial correlation analysis, locally weighted regression smooth scatterplot (LOESS), nonlinear least squares estimation (NLS), and segmented regression (SR) were utilized to estimate the relationship of 25(OH)D and PTH, and to determine the threshold of 25(OH)D. Results: A total of 1568 serum samples of 25(OH)D concentration and PTH concentration were analyzed. A significant inverse relationship between 25(OH)D and PTH concentration was observed below 15.25 (14.22-16.28) ng/mL, and PTH decreased slowly with the increase of 25(OH)D above 16.75 (15.43-18.06) ng/mL after adjusting by age, latitude, city type, season, corrected calcium, and phosphorus. A very short plateau of PTH was found at 15.25 ng/mL and 16.75 ng/mL in terms of 25(OH)D according to LOESS, NLS, and SR. Conclusions: The serum 25(OH)D was negatively correlated with the serum PTH. The threshold of VitD sufficiency was found in the range of 14.22-18.06 ng/mL in terms of serum 25(OH)D concentration for Chinese childbearing women aged 18-44 years old.
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Affiliation(s)
- Yichun Hu
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
| | - Siran Li
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
| | - Jun Wang
- Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (J.W.); (W.Y.); (L.Z.)
| | - Deqiang Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing 100069, China;
| | - Huidi Zhang
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
| | - Wei Yu
- Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (J.W.); (W.Y.); (L.Z.)
| | - Lijia Zhu
- Physical and Chemical Laboratory, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; (J.W.); (W.Y.); (L.Z.)
| | - Zhen Liu
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
| | - Xiaoguang Yang
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
| | - Lichen Yang
- Key Laboratory of Trace Element Nutrition of National Health Committee, National Institute for Nutrition and Health, China CDC, Beijing 100050, China; (Y.H.); (S.L.); (H.Z.); (Z.L.); (X.Y.)
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17
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Kim YA, Yoon JW, Lee Y, Choi HJ, Yun JW, Bae E, Kwon SH, Ahn SE, Do AR, Jin H, Won S, Park DJ, Shin CS, Seo JH. Unveiling Genetic Variants Underlying Vitamin D Deficiency in Multiple Korean Cohorts by a Genome-Wide Association Study. Endocrinol Metab (Seoul) 2021; 36:1189-1200. [PMID: 34852423 PMCID: PMC8743587 DOI: 10.3803/enm.2021.1241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/19/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Epidemiological data have shown that vitamin D deficiency is highly prevalent in Korea. Genetic factors influencing vitamin D deficiency in humans have been studied in Europe but are less known in East Asian countries, including Korea. We aimed to investigate the genetic factors related to vitamin D levels in Korean people using a genome-wide association study (GWAS). METHODS We included 12,642 subjects from three different genetic cohorts consisting of Korean participants. The GWAS was performed on 7,590 individuals using linear or logistic regression meta- and mega-analyses. After identifying significant single nucleotide polymorphisms (SNPs), we calculated heritability and performed replication and rare variant analyses. In addition, expression quantitative trait locus (eQTL) analysis for significant SNPs was performed. RESULTS rs12803256, in the actin epsilon 1, pseudogene (ACTE1P) gene, was identified as a novel polymorphism associated with vitamin D deficiency. SNPs, such as rs11723621 and rs7041, in the group-specific component gene (GC) and rs11023332 in the phosphodiesterase 3B (PDE3B) gene were significantly associated with vitamin D deficiency in both meta- and mega-analyses. The SNP heritability of the vitamin D concentration was estimated to be 7.23%. eQTL analysis for rs12803256 for the genes related to vitamin D metabolism, including glutamine-dependent NAD(+) synthetase (NADSYN1) and 7-dehydrocholesterol reductase (DHCR7), showed significantly different expression according to alleles. CONCLUSION The genetic factors underlying vitamin D deficiency in Korea included polymorphisms in the GC, PDE3B, NADSYN1, and ACTE1P genes. The biological mechanism of a non-coding SNP (rs12803256) for DHCR7/NADSYN1 on vitamin D concentrations is unclear, warranting further investigations.
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Affiliation(s)
- Ye An Kim
- Division of Endocrinology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul,
Korea
| | - Ji Won Yoon
- Healthcare System Gangnam Center, Seoul National University Hospital, Seoul,
Korea
| | - Young Lee
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul,
Korea
| | - Hyuk Jin Choi
- Healthcare System Gangnam Center, Seoul National University Hospital, Seoul,
Korea
| | - Jae Won Yun
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul,
Korea
| | - Eunsin Bae
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul,
Korea
| | - Seung-Hyun Kwon
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul,
Korea
| | - So Eun Ahn
- Department of Public Health Science, Seoul National University, Seoul,
Korea
| | - Ah-Ra Do
- Department of Public Health Science, Seoul National University, Seoul,
Korea
| | - Heejin Jin
- Institute of Health and Environment, Seoul National University, Seoul,
Korea
| | - Sungho Won
- Department of Public Health Science, Seoul National University, Seoul,
Korea
- Institute of Health and Environment, Seoul National University, Seoul,
Korea
- RexSoft, Inc.,
Korea
| | - Do Joon Park
- Department of Internal Medicine, Seoul National University, Seoul,
Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University, Seoul,
Korea
| | - Je Hyun Seo
- Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul,
Korea
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18
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Karacan Küçükali G, Gülbahar Ö, Özalkak Ş, Dağlı H, Ceylaner S, Aycan Z, Savaş Erdeve Ş. Is Bioavailable Vitamin D Better Than Total Vitamin D to Evaluate Vitamin D Status in Obese Children? J Clin Res Pediatr Endocrinol 2021; 13:391-399. [PMID: 34013709 PMCID: PMC8638623 DOI: 10.4274/jcrpe.galenos.2020.2021.0230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Free hormones are biologically more active in target tissues. Thus, measurement of vitamin D taking into account bioavailability and free vitamin D may be preferable, especially when evidence is contradictory, as in obese children. In order to assess bioavailablity and free vitamin D, using a previously reported formula, vitamin D-binding protein (VDBP) level was measured and VDBP polymorphisms were also evaluated because of variations in binding affinity. METHODS Eighty-four obese and 78 healthy children were included. Anthropometry, calcium, phosphorus, alkaline-phosphatase, parathyroid hormone (PTH), 25 hydroxyvitamin D [25(OH)D], bioavailable-free vitamin D, and VDBP concentration and polymorphism were evaluated in the whole group. RESULTS Obese girls had significantly higher PTH than normal weight girls (p=0.001). Regardless of gender, obese children had significantly higher concentrations of VDBP (p=0.008) and PTH (p=0.002). When samples taken in winter were analyzed, PTH and VDBP were found to be higher and bioavailable and free vitamin D lower in the obese group. There was no difference in terms of total vitamin D between groups during the winter season. CONCLUSION While total, free, and bioavailable vitamin D in the obese group was similar to the control group in autumn, free and bioavailable vitamin D in the winter was lower in the obese than the control group. In addition, PTH was higher in the obese group in both autumn and winter. Therefore, more research is needed to evaluate the variability of free and bioavailable vitamin D according to body habitus, season and the effect any differences may have.
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Affiliation(s)
- Gülin Karacan Küçükali
- University of Health Science Turkey, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey,* Address for Correspondence: University of Health Science Turkey, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey Phone: +90 533 764 84 26 E-mail:
| | - Özlem Gülbahar
- Gazi University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey
| | - Şervan Özalkak
- University of Health Science Turkey, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Hasan Dağlı
- Gazi University Faculty of Medicine, Department of Clinical Biochemistry, Ankara, Turkey
| | | | - Zehra Aycan
- University of Health Science Turkey, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
| | - Şenay Savaş Erdeve
- University of Health Science Turkey, Dr. Sami Ulus Maternity, Child Health and Diseases Training and Research Hospital, Clinic of Pediatric Endocrinology, Ankara, Turkey
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19
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Vitamin D-related polymorphisms and vitamin D levels as risk biomarkers of COVID-19 disease severity. Sci Rep 2021; 11:20837. [PMID: 34675344 PMCID: PMC8531279 DOI: 10.1038/s41598-021-99952-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
Vitamin D is a fundamental regulator of host defences by activating genes related to innate and adaptive immunity. Previous research shows a correlation between the levels of vitamin D in patients infected with SARS-CoV-2 and the degree of disease severity. This work investigates the impact of the genetic background related to vitamin D pathways on COVID-19 severity. For the first time, the Portuguese population was characterized regarding the prevalence of high impact variants in genes associated with the vitamin D pathways. This study enrolled 517 patients admitted to two tertiary Portuguese hospitals. The serum concentration of 25 (OH)D, was measured in the hospital at the time of patient admission. Genetic variants, 18 variants, in the genes AMDHD1, CYP2R1, CYP24A1, DHCR7, GC, SEC23A, and VDR were analysed. The results show that polymorphisms in the vitamin D binding protein encoded by the GC gene are related to the infection severity (p = 0.005). There is an association between vitamin D polygenic risk score and the serum concentration of 25 (OH)D (p = 0.04). There is an association between 25 (OH)D levels and the survival and fatal outcomes (p = 1.5e−4). The Portuguese population has a higher prevalence of the DHCR7 RS12785878 variant when compared with its prevalence in the European population (19% versus 10%). This study shows a genetic susceptibility for vitamin D deficiency that might explain higher severity degrees in COVID-19 patients. These results reinforce the relevance of personalized strategies in the context of viral diseases. Trial registration: NCT04370808.
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Lu Q, Wan Z, Guo J, Liu L, Pan A, Liu G. Association Between Serum 25-hydroxyvitamin D Concentrations and Mortality Among Adults With Prediabetes. J Clin Endocrinol Metab 2021; 106:e4039-e4048. [PMID: 34089603 DOI: 10.1210/clinem/dgab402] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To investigate the association of circulating 25-hydroxyvitamin D [25(OH)D] levels with mortality among adults with prediabetes. METHODS This retrospective cohort study included 15,195 adults with prediabetes (aged ≥20 years) from the National Health and Nutrition Examination Survey (NHANES) III and NHANES 2001-2014. Mortality from all causes, cardiovascular disease (CVD), and cancer was linked to National Death Index mortality data. RESULTS The median (interquartile range) concentration of serum 25(OH)D was 60.5 (45.3, 77.4) nmol/L, and only 23.1% had sufficient vitamin D (≥75 nmol/L). Elevated serum 25(OH)D concentrations were significantly associated with lower levels of insulin, homeostasis model assessment of insulin resistance, triglyceride, and C-reactive protein, and higher levels of high-density lipoprotein at baseline (all Ptrend < 0.05). During a median follow up of 10.7 years, 3765 deaths (including 1080 CVD deaths and 863 cancer deaths) were identified. Compared with participants with 25(OH)D <30 nmol/L, the multivariate-adjusted hazard ratios and 95% confidence intervals for participants with 25(OH)D ≥ 75 nmol/L were 0.66 (0.53, 0.82) for all-cause mortality (Ptrend < 0.001), 0.66 (0.48, 0.89) for CVD mortality (Ptrend = 0.001), and 0.82 (0.49, 1.35) for cancer mortality (Ptrend = 0.32). For per-unit increment in ln-transformed 25(OH)D, there was a 27% lower risk of all-cause mortality and a 34% lower risk of CVD mortality (both P < 0.01). CONCLUSIONS These findings suggested that higher serum 25(OH)D concentrations were associated with lower all-cause and CVD mortality among individuals with prediabetes.
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Affiliation(s)
- Qi Lu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jingyu Guo
- Department of Health Toxicology, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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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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Berg AH, Tavasoli M, Lo AS, Burnett-Bowie SAM, Bhan I, Karumanchi SA, Kalim S, Zhang D, Zhao S, Thadhani RI. Development and analytical validation of a novel bioavailable 25-hydroxyvitamin D assay. PLoS One 2021; 16:e0254158. [PMID: 34242315 PMCID: PMC8270209 DOI: 10.1371/journal.pone.0254158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 06/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Bioavailable 25-hydroxyvitamin D (25OHD) may be a better indicator of vitamin D sufficiency than total 25OHD. This report describes a novel assay for measuring serum bioavailable 25OHD. METHODS We developed an assay for 25OHD % bioavailability based on competitive binding of 25OHD tracer between vitamin D-binding protein (DBP)-coated affinity chromatography beads and serum DBP. Bioavailable 25OHD, total 25OHD, albumin, and DBP protein concentrations were measured in 89 samples from hospitalized patients and 42 healthy controls to determine how the DBP binding assay responds to differences in concentrations of DBP and compares to calculated bioavailable 25OHD values. RESULTS DBP binding assay showed a linear relationship between DBP-bound 25OHD tracer recovered from bead supernatant and DBP calibrator concentrations (y = 0.0017x +0.731, R2 = 0.9961, p<0.001). Inversion of this relationship allowed interpolation of DBP binding equivalents based upon 25OHD tracer recovered. The relationship between DBP binding equivalents and % bioavailability fits a non-linear curve, allowing calculation of % bioavailable 25OHD from DBP binding equivalents (y = 10.625x-0.817, R2 = 0.9961, p<0.001). In hospitalized patient samples, there were linear relationships between DBP protein concentrations and DBP binding equivalents (y = 0.7905x + 59.82, R2 = 0.8597, p<0.001), between measured vs. calculated % bioavailability (y = 0.9528 + 0.0357, R2 = 0.7200, p<0.001), and between absolute concentrations of measured vs. calculated bioavailable 25OHD (y = 1.2403 + 0.1221, R2 = 0.8913, p<0.001). CONCLUSIONS The DBP-binding assay for bioavailable 25OHD shows expected changes in 25OHD % bioavailability in response to changes in DBP concentrations and concordance with calculated bioavailable 25OHD concentrations.
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Affiliation(s)
- Anders H. Berg
- Department of Pathology, Cedars Sinai Medical Center, Los Angeles, California, United States of America
| | - Mahtab Tavasoli
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Agnes S. Lo
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sherri-Ann M. Burnett-Bowie
- Endocrine Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Ishir Bhan
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - S. Ananth Karumanchi
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sahir Kalim
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Dongsheng Zhang
- Department of Medicine and Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California, United States of America
- Division of Nephrology and Center for Vascular Biology Research, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Sophia Zhao
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Ravi I. Thadhani
- Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
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Simpson CA, Zhang JH, Vanderschueren D, Fu L, Pennestri TC, Bouillon R, Cole DE, Carpenter TO. 25-OHD response to vitamin D supplementation in children: effect of dose but not GC haplotype. Eur J Endocrinol 2021; 185:333-342. [PMID: 34128826 PMCID: PMC8284876 DOI: 10.1530/eje-21-0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE GC/DBP effects on response to vitamin D supplementation have not been well-studied. Thus we assessed free and total 25-OHD after vitamin D treatment across the six common GC haplotypes. DESIGN This double-blind, randomized study compared two vitamin D3 doses in healthy, urban-dwelling 6-month to 10-year-old children at-risk for vitamin D deficiency. Randomization was stratified by GC haplotype. METHODS Children were randomized to receive 2800 or 7000 International Units of vitamin D3 weekly. 25-OHD and 1,25(OH)2D were sampled at baseline and after 1-6 months of supplementation. RESULTS AND CONCLUSIONS One hundred ninety-two of 225 enrolled subjects completed the study. After one month, total 25-OHD increased with both doses and were higher with 7000 IU/week (85.5 ± 22.8 nmol/L) compared to 2800 IU/week (76.8 ± 18.0 nmol/L), despite equivalent baseline levels. No further significant increase occurred at 6 months (89.8 ± 35.5 and 74.3 ± 18.3 nmol/L, respectively). Free 25-OHD similarly changed. 25-OHD differed among GC groups at baseline. Although no significant effects of individual GC haplotypes on incremental changes were evident, a trend toward an effect of combined 'at risk' GC alleles on response was evident (P = 0.06). Total 1,25(OH)2D showed modest increases, moreso with the larger dose. In urban-dwelling children at-risk for vitamin D deficiency, 1 month of vitamin D3 2800 IU/week increased 25-OHD across all GC haplotype groups, and somewhat enhanced with 7000 IU/week with no further significant increases after 6 months of supplementation. Free 25-OHD measures offer no monitoring advantage over total 25-OHD.
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Affiliation(s)
- Christine A. Simpson
- Departments of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Jane H. Zhang
- Veterans Administration Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT
| | - Dirk Vanderschueren
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Katholieke Universiteit Leuven, Belgium
| | - Lei Fu
- Department of Laboratory Medicine and Pathobiology, University of Toronto, and Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Katholieke Universiteit Leuven, Belgium
| | - David E.C. Cole
- Departments of Laboratory Medicine and Pathobiology, Medicine, and Genetics, University of Toronto, and Sunnybrook Health Center, Toronto, Ontario
| | - Thomas O. Carpenter
- Pediatrics (Endocrinology), Yale University School of Medicine, New Haven, CT
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Garand M, Toufiq M, Singh P, Huang SSY, Tomei S, Mathew R, Mattei V, Al Wakeel M, Sharif E, Al Khodor S. Immunomodulatory Effects of Vitamin D Supplementation in a Deficient Population. Int J Mol Sci 2021; 22:5041. [PMID: 34068701 PMCID: PMC8126205 DOI: 10.3390/ijms22095041] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 12/31/2022] Open
Abstract
In addition to its canonical functions, vitamin D has been proposed to be an important mediator of the immune system. Despite ample sunshine, vitamin D deficiency is prevalent (>80%) in the Middle East, resulting in a high rate of supplementation. However, the underlying molecular mechanisms of the specific regimen prescribed and the potential factors affecting an individual's response to vitamin D supplementation are not well characterized. Our objective is to describe the changes in the blood transcriptome and explore the potential mechanisms associated with vitamin D3 supplementation in one hundred vitamin D-deficient women who were given a weekly oral dose (50,000 IU) of vitamin D3 for three months. A high-throughput targeted PCR, composed of 264 genes representing the important blood transcriptomic fingerprints of health and disease states, was performed on pre and post-supplementation blood samples to profile the molecular response to vitamin D3. We identified 54 differentially expressed genes that were strongly modulated by vitamin D3 supplementation. Network analyses showed significant changes in the immune-related pathways such as TLR4/CD14 and IFN receptors, and catabolic processes related to NF-kB, which were subsequently confirmed by gene ontology enrichment analyses. We proposed a model for vitamin D3 response based on the expression changes of molecules involved in the receptor-mediated intra-cellular signaling pathways and the ensuing predicted effects on cytokine production. Overall, vitamin D3 has a strong effect on the immune system, G-coupled protein receptor signaling, and the ubiquitin system. We highlighted the major molecular changes and biological processes induced by vitamin D3, which will help to further investigate the effectiveness of vitamin D3 supplementation among individuals in the Middle East as well as other regions.
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Affiliation(s)
- Mathieu Garand
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Mohammed Toufiq
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Parul Singh
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Susie Shih Yin Huang
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Sara Tomei
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Rebecca Mathew
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Valentina Mattei
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
| | - Mariam Al Wakeel
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha 26999, Qatar;
| | - Elham Sharif
- Department of Biomedical Sciences, College of Health Sciences, Qatar University, Doha 26999, Qatar;
| | - Souhaila Al Khodor
- Research Department, Sidra Medicine, Doha 26999, Qatar; (M.T.); (P.S.); (S.S.Y.H.); (S.T.); (R.M.); (V.M.)
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Corpas M, Megy K, Mistry V, Metastasio A, Lehmann E. Whole Genome Interpretation for a Family of Five. Front Genet 2021; 12:535123. [PMID: 33763108 PMCID: PMC7982663 DOI: 10.3389/fgene.2021.535123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 02/15/2021] [Indexed: 12/19/2022] Open
Abstract
Although best practices have emerged on how to analyse and interpret personal genomes, the utility of whole genome screening remains underdeveloped. A large amount of information can be gathered from various types of analyses via whole genome sequencing including pathogenicity screening, genetic risk scoring, fitness, nutrition, and pharmacogenomic analysis. We recognize different levels of confidence when assessing the validity of genetic markers and apply rigorous standards for evaluation of phenotype associations. We illustrate the application of this approach on a family of five. By applying analyses of whole genomes from different methodological perspectives, we are able to build a more comprehensive picture to assist decision making in preventative healthcare and well-being management. Our interpretation and reporting outputs provide input for a clinician to develop a healthcare plan for the individual, based on genetic and other healthcare data.
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Affiliation(s)
- Manuel Corpas
- Cambridge Precision Medicine Limited, ideaSpace, University of Cambridge Biomedical Innovation Hub, Cambridge, United Kingdom.,Institute of Continuing Education Madingley Hall Madingley, University of Cambridge, Cambridge, United Kingdom.,Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, Madrid, Spain
| | - Karyn Megy
- Cambridge Precision Medicine Limited, ideaSpace, University of Cambridge Biomedical Innovation Hub, Cambridge, United Kingdom.,Department of Haematology, University of Cambridge & National Health Service (NHS) Blood and Transplant, Cambridge, United Kingdom
| | | | - Antonio Metastasio
- Cambridge Precision Medicine Limited, ideaSpace, University of Cambridge Biomedical Innovation Hub, Cambridge, United Kingdom.,Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Edmund Lehmann
- Cambridge Precision Medicine Limited, ideaSpace, University of Cambridge Biomedical Innovation Hub, Cambridge, United Kingdom
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Wan Z, Guo J, Pan A, Chen C, Liu L, Liu G. Association of Serum 25-Hydroxyvitamin D Concentrations With All-Cause and Cause-Specific Mortality Among Individuals With Diabetes. Diabetes Care 2021; 44:350-357. [PMID: 33168652 DOI: 10.2337/dc20-1485] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/22/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The evidence regarding vitamin D status and mortality among people with diabetes is scarce. This study aimed to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adults with diabetes. RESEARCH DESIGN AND METHODS This study included 6,329 adults with diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 2001-2014. Death outcomes were ascertained by linkage to National Death Index records through 31 December 2015. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% CIs for mortality from all causes, cardiovascular disease (CVD), and cancer. RESULTS The weighted mean (95% CI) level of serum 25(OH)D was 57.7 (56.6, 58.8) nmol/L, and 46.6% had deficient vitamin D (<50 nmol/L [20 ng/mL]). Higher serum 25(OH)D levels were significantly associated with lower levels of glucose, insulin, HOMA of insulin resistance, HbA1c, blood lipids, and C-reactive protein at baseline (all P trend < 0.05). During 55,126 person-years of follow-up, 2,056 deaths were documented, including 605 CVD deaths and 309 cancer deaths. After multivariate adjustment, higher serum 25(OH)D levels were significantly and linearly associated with lower all-cause and CVD mortality: there was a 31% reduced risk of all-cause mortality and a 38% reduced risk of CVD mortality per one-unit increment in natural log-transformed 25(OH)D (both P < 0.001). Compared with participants with 25(OH)D <25 nmol/L, the multivariate-adjusted HRs and 95% CI for participants with 25(OH)D >75 nmol/L were 0.59 (0.43, 0.83) for all-cause mortality (P trend = 0.003), 0.50 (0.29, 0.86) for CVD mortality (P trend = 0.02), and 0.49 (0.23, 1.04) for cancer mortality (P trend = 0.12). CONCLUSIONS Higher serum 25(OH)D levels were significantly associated with lower all-cause and CVD mortality. These findings suggest that maintaining adequate vitamin D status may lower mortality risk in individuals with diabetes.
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Affiliation(s)
- Zhenzhen Wan
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jingyu Guo
- Department of Health Toxicology, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chen Chen
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China .,State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China .,State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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27
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El Sabeh M, Ghanem P, Al-Shaar L, Rahme M, Baddoura R, Halaby G, Singh RJ, Vanderschueren D, Bouillon R, El-Hajj Fuleihan G. Total, Bioavailable, and Free 25(OH)D Relationship with Indices of Bone Health in Elderly: A Randomized Controlled Trial. J Clin Endocrinol Metab 2021; 106:e990-e1001. [PMID: 33280041 PMCID: PMC7823248 DOI: 10.1210/clinem/dgaa780] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Indexed: 12/20/2022]
Abstract
CONTEXT Questions regarding the superiority of free and bioavailable 25-hydroxyvitamin D [25(OH)D] in predicting health outcomes remain unresolved. OBJECTIVE This study investigates the impact of vitamin D variables-total, bioavailable, or free 25(OH)D-on indices of bone and mineral metabolism, at baseline and in response to 2 vitamin D doses. DESIGN Our objectives are implemented as exploratory analyses on data collected in a 1-year, double-blind, randomized controlled trial completed in July 2014. SETTING Participants were recruited from 3 major hospitals in an ambulatory setting. PARTICIPANTS Participants were >65 years of age, overweight, and had a baseline serum 25(OH)D between 10 and 30 ng/mL. A total of 221 participants completed the study. INTERVENTION Subjects were randomized to receive calcium and oral vitamin D3 (600 IU/day or 3750 IU/day) supplementation. RESULTS Participants who received the higher vitamin D dose had levels that were 1.3- to 1.4-fold higher than those taking the lower dose, for all variables (P value < 0.001). Serum values of bioavailable and free 25(OH)D were associated with total 25(OH)D, with r values of 0.942 and 0.943, respectively (P value < 0.001). Parathyroid hormone (PTH) was negatively associated with all vitamin D variables, with correlation coefficients ranging from -0.22 to -0.25, while calcium and bone turnover markers (carboxy-terminal collagen crosslinks and osteocalcin) did not. Only total 25(OH)D had a positive relationship with % change bone mineral density (BMD) at the femoral neck at 12 months, while only free and bioavailable 25(OH) had a positive relationship with % change total body BMD at 12 months. CONCLUSION Calculated free and bioavailable 25(OH)D do not appear to be superior to total 25(OH)D in predicting indices of bone health in an elderly population.
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Affiliation(s)
- Malak El Sabeh
- Scholars in Health Research Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Paola Ghanem
- Scholars in Health Research Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Laila Al-Shaar
- Scholars in Health Research Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Maya Rahme
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, Beirut, Lebanon
| | - Rafic Baddoura
- Department of Rheumatology, Hotel Dieu de France, Beirut, Lebanon
| | - Georges Halaby
- Department of Endocrinology, Hotel Dieu de France, Beirut, Lebanon
| | - Ravinder J Singh
- Division of Clinical Biochemistry and Immunology, Mayo Clinic, Rochester, Minnesota
| | - Dirk Vanderschueren
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), Laboratory of Clinical and Experimental Endocrinology, KU Leuven, Herestraat, Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, Herestraat, Leuven, Belgium
| | - Roger Bouillon
- Department of Internal Medicine, Division of Endocrinology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ghada El-Hajj Fuleihan
- Department of Internal Medicine, Division of Endocrinology, Calcium Metabolism and Osteoporosis Program, Beirut, Lebanon
- Correspondence and Reprint Requests: Ghada El-Hajj Fuleihan, MD, MPH, Professor of Medicine, Calcium Metabolism and Osteoporosis Program, American University of Beirut, Beirut, Lebanon. E-mail:
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Hu KL, Gan K, Wang R, Li W, Wu Q, Zheng B, Zou L, Zhang S, Liu Y, Wu Y, Chen R, Cao W, Yang S, Liu FT, Tian L, Zeng H, Xu H, Qiu S, Yang L, Chen X, Pan X, Wu X, Mol BW, Li R, Zhang D. Vitamin D supplementation prior to in vitro fertilisation in women with polycystic ovary syndrome: a protocol of a multicentre randomised, double-blind, placebo-controlled clinical trial. BMJ Open 2020; 10:e041409. [PMID: 33293396 PMCID: PMC7725097 DOI: 10.1136/bmjopen-2020-041409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Polycystic ovary syndrome (PCOS) is one of the leading causes of female infertility, affecting around 5% of women of childbearing age in China. Vitamin D insufficiency is common in women with PCOS and is associated with lower live birth rates. However, evidence regarding the effectiveness of vitamin D supplementation in women with PCOS is inconclusive. This multicentre randomised, double-blinded, placebo-controlled trial aims to evaluate the effectiveness of vitamin D supplementation prior to in vitro fertilisation (IVF) on the live birth rate in women with PCOS. METHODS AND ANALYSIS We plan to enrol women with PCOS scheduled for IVF. After informed consent, eligible participants will be randomised in a 1:1 ratio to receive oral capsules of 4000 IU vitamin D per day or placebo for around 12 weeks until the day of triggering. All IVF procedures will be carried out routinely in each centre. The primary outcome is live birth after the first embryo transfer. The primary analysis will be by intention-to-treat analysis. To demonstrate or refute that treatment with vitamin D results in a 10% higher live birth rate than treatment with placebo, we need to recruit 860 women (48% vs 38% difference, anticipating 10% loss to follow-up and non-compliance, significance level 0.05 and power 80%). ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee in Women's Hospital of Zhejiang University on 2 March 2020 (reference number: IRB-20200035-R). All participants will provide written informed consent before randomisation. The results of the study will be submitted to scientific conferences and a peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT04082650.
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Affiliation(s)
- Kai-Lun Hu
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kwanghann Gan
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Rui Wang
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Wentao Li
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Qiongfang Wu
- Reproductive Medicine Center, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Beihong Zheng
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Libo Zou
- Department of Reproductive Medicine, Jinhua People's Hospital, Jinhua, China
| | - Su Zhang
- Department of Obstetrics and Gynaecology, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
| | - Yifeng Liu
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yiqing Wu
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ruixue Chen
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wushuang Cao
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Shuo Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Fen-Ting Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Lifeng Tian
- Reproductive Medicine Center, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Han Zeng
- Reproductive Medicine Center, Jiangxi Maternal and Child Health Hospital, Nanchang, China
| | - Huiling Xu
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Shumin Qiu
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lihua Yang
- Department of Reproductive Medicine, Jinhua People's Hospital, Jinhua, China
| | - Xiao Chen
- Department of Reproductive Medicine, Jinhua People's Hospital, Jinhua, China
| | - Xiaoqin Pan
- Department of Obstetrics and Gynaecology, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
| | - Xiaoyun Wu
- Department of Obstetrics and Gynaecology, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
| | - Ben W Mol
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Peking University Third Hospital, Beijing, China
| | - Dan Zhang
- Department of Reproductive Endocrinology, Key Laboratory of Reproductive Genetics, Ministry of Education, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Fang A, Long J, Zhang Y, Liu Z, Li Q, Zhang D, Luo Y, Zhong R, Zhou Z, Xu Y, Xu X, Ling W, Chen M, Zhu H. Serum Bioavailable, Rather Than Total, 25-hydroxyvitamin D Levels Are Associated With Hepatocellular Carcinoma Survival. Hepatology 2020; 72:169-182. [PMID: 31677282 PMCID: PMC7496975 DOI: 10.1002/hep.31013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 10/27/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIMS Free and bioavailable 25-hydroxyvitamin D (25OHD) are emerging measurements of vitamin D status. It remains unclear whether circulating free or bioavailable 25OHD are relevant to hepatocellular carcinoma (HCC) prognosis. Our aim was to test the hypothesis that bioavailable 25OHD may be a better serum biomarker of vitamin D status than total 25OHD on the association with HCC survival. APPROACH AND RESULTS We included 1,031 newly diagnosed, previously untreated patients with HCC from the Guangdong Liver Cancer Cohort enrolled between September 2013 and April 2017. Serum total 25OHD levels were measured using an electrochemiluminescence immunoassay. Serum-free 25OHD levels were measured using a two-step enzyme-linked immunosorbent assay. Bioavailable 25OHD levels were calculated from measured free 25OHD and albumin using a previously validated equation. Primary outcomes were liver cancer-specific (LCSS) and overall survival (OS). Cox proportional hazards models were performed to calculate the multivariable hazard ratios (HRs) and 95% confidence intervals (CIs). During a median follow-up of 726 days, 430 patients had deceased, including 393 deaths from HCC. In multivariable analyses, higher bioavailable 25OHD levels were significantly associated with better survival, independent of nonclinical and clinical prognostic factors including serum C-reactive protein, Barcelona Clinic Liver Cancer stage, and cancer treatment. The multivariable-adjusted HRs in the highest versus lowest quartile of bioavailable 25OHD levels were 0.69 (95% CI: 0.51, 0.93; P for trend = 0.014) for LCSS and 0.71 (95% CI: 0.53, 0.94; P for trend = 0.013) for OS. In contrast, neither total nor free 25OHD levels were associated with LCSS or OS. CONCLUSIONS Higher bioavailable, rather than total, 25OHD levels were independently associated with improved survival in a population-based HCC cohort, suggesting a potential utility of bioavailable 25OHD in HCC prognosis.
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Affiliation(s)
- Ai‐Ping Fang
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina,Guangdong Provincial Key Laboratory of Food, Nutrition and HealthSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Jing‐An Long
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yao‐Jun Zhang
- Department of Hepatobiliary OncologySun Yat‐sen University Cancer CenterGuangzhouChina,State Key Laboratory of Oncology in South ChinaSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Zhao‐Yan Liu
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Qi‐Jiong Li
- Department of Hepatobiliary OncologySun Yat‐sen University Cancer CenterGuangzhouChina,State Key Laboratory of Oncology in South ChinaSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Dao‐Ming Zhang
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Yun Luo
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Rong‐Huan Zhong
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Zhong‐Guo Zhou
- Department of Hepatobiliary OncologySun Yat‐sen University Cancer CenterGuangzhouChina,State Key Laboratory of Oncology in South ChinaSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Yan‐Jun Xu
- Department of Chronic Noncommunicable Disease Prevention and ControlGuangdong Provincial Center for Disease Control and PreventionGuangzhouChina
| | - Xiao‐Jun Xu
- Department of Chronic Noncommunicable Disease Prevention and ControlGuangdong Provincial Center for Disease Control and PreventionGuangzhouChina
| | - Wen‐Hua Ling
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina,Guangdong Provincial Key Laboratory of Food, Nutrition and HealthSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
| | - Min‐Shan Chen
- Department of Hepatobiliary OncologySun Yat‐sen University Cancer CenterGuangzhouChina,State Key Laboratory of Oncology in South ChinaSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Hui‐Lian Zhu
- Department of NutritionSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina,Guangdong Provincial Key Laboratory of Food, Nutrition and HealthSchool of Public HealthSun Yat‐sen UniversityGuangzhouChina
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30
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Klahold E, Penna-Martinez M, Bruns F, Seidl C, Wicker S, Badenhoop K. Vitamin D in Type 2 Diabetes: Genetic Susceptibility and the Response to Supplementation. Horm Metab Res 2020; 52:492-499. [PMID: 32542627 PMCID: PMC7746514 DOI: 10.1055/a-1157-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Variants of vitamin D metabolism-genes may predispose to type 2 diabetes (T2D). This study investigated the impact of these variants on disease susceptibility, Vitamin D, parathyroid hormone, C-peptide and HbA1c levels before and after cholecalciferol supplementation in patients with T2D.Twelve polymorphisms within CYP2R1, CYP27B1, DBP, VDR and CYP24A1 were genotyped in 553 T2D patients and 916 controls. In addition 65 patients receiving either cholecalciferol or placebo were analyzed during 6 months intervention and 6 months follow-up.T2D risk alleles are VDR rs7975232 "G" (pc=0.031), rs1544410 "G" (pc=0.027) and CYP2R1 rs10741657 "A" (pc=0.016). Patients with genotypes CYP27B1 rs10877012 "CC" (pc=4x10-5), DBP rs7041 "GG" (pc=0.003), rs4588 "CC" (pc = 3x10-4), CYP24A1 rs2585426 "CG" (pc=0.006) and rs2248137 "CG" (pc=0.001) showed lower 25(OH)D3 and DBP rs4588 "CC" lower 1,25(OH)2D3 levels (pc=0.005). Whereas DBP rs4588 "CC" (pc=0.009), CYP27B1 rs10877012 "AC" (pc=0.059), VDR rs7975323 "AG" (pc=0.033) and rs1544410 "GG" (pc=0.013) are associated with higher 25(OH)D3 levels at 6 months' follow-up. Significant PTH suppression was detected for CYP2R1 "AG" (pc=0.002), DBP rs4588 "CC" (pc<0.001), VDR rs110735810 "CT" (pc<0.001) and CYP24A1 rs2248137 "GG" (pc=0.021).Genetic variants of the vitamin D system predispose to type 2 diabetes and regulate - partially - vitamin D metabolism, concentrations and the vitamin D status. Vitamin D insufficiency is a T2D risk factor. The response to cholecalciferol supplementation can be measured as 25(OH)D3 increment and PTH suppression. This process is regulated by genes of the vitamin D system conferring modest T2D risk.
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Affiliation(s)
- Edith Klahold
- Department of Internal Medicine I, Division of Endocrinology, Diabetes
and Metabolism, Goethe-University Hospital, Frankfurt/Main,
Germany
- Correspondence: Edith Klahold Department of Internal Medicine I, Division of
Endocrinology,Diabetes and Metabolism, Goethe-University HospitalTheodor-Stern-Kai 760590 Frankfurt/MainGermany+49 69 6301 83977+49 69 6301 83343
| | - Marissa Penna-Martinez
- Department of Internal Medicine I, Division of Endocrinology, Diabetes
and Metabolism, Goethe-University Hospital, Frankfurt/Main,
Germany
| | - Franziska Bruns
- Department of Internal Medicine I, Division of Endocrinology, Diabetes
and Metabolism, Goethe-University Hospital, Frankfurt/Main,
Germany
| | - Christian Seidl
- German Red Cross Blood Donor Service, Institute for Transfusion
Medicine and Immunohaematology, Frankfurt/Main, Germany
| | - Sabine Wicker
- Occupational Health Service, Goethe-University Hospital,
Frankfurt/Main, Germany
| | - Klaus Badenhoop
- Department of Internal Medicine I, Division of Endocrinology, Diabetes
and Metabolism, Goethe-University Hospital, Frankfurt/Main,
Germany
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Yao P, Bennett D, Mafham M, Lin X, Chen Z, Armitage J, Clarke R. Vitamin D and Calcium for the Prevention of Fracture: A Systematic Review and Meta-analysis. JAMA Netw Open 2019; 2:e1917789. [PMID: 31860103 PMCID: PMC6991219 DOI: 10.1001/jamanetworkopen.2019.17789] [Citation(s) in RCA: 178] [Impact Index Per Article: 35.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/27/2019] [Indexed: 12/14/2022] Open
Abstract
Importance Vitamin D and calcium supplements are recommended for the prevention of fracture, but previous randomized clinical trials (RCTs) have reported conflicting results, with uncertainty about optimal doses and regimens for supplementation and their overall effectiveness. Objective To assess the risks of fracture associated with differences in concentrations of 25-hydroxyvitamin D (25[OH]D) in observational studies and the risks of fracture associated with supplementation with vitamin D alone or in combination with calcium in RCTs. Data Sources PubMed, EMBASE, Cochrane Library, and other RCT databases were searched from database inception until December 31, 2018. Searches were performed between July 2018 and December 2018. Study Selection Observational studies involving at least 200 fracture cases and RCTs enrolling at least 500 participants and reporting at least 10 incident fractures were included. Randomized clinical trials compared vitamin D or vitamin D and calcium with control. Data Extraction and Synthesis Two researchers independently extracted data according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and assessed possible bias. Rate ratios (RRs) were estimated using fixed-effects meta-analysis. Data extraction and synthesis took place between July 2018 and June 2019. Main Outcomes and Measures Any fracture and hip fracture. Results In a meta-analysis of 11 observational studies (39 141 participants, 6278 fractures, 2367 hip fractures), each increase of 10.0 ng/mL (ie, 25 nmol/L) in 25 (OH)D concentration was associated with an adjusted RR for any fracture of 0.93 (95% CI, 0.89-0.96) and an adjusted RR for hip fracture of 0.80 (95% CI, 0.75-0.86). A meta-analysis of 11 RCTs (34 243 participants, 2843 fractures, 740 hip fractures) of vitamin D supplementation alone (daily or intermittent dose of 400-30 000 IU, yielding a median difference in 25[OH]D concentration of 8.4 ng/mL) did not find a reduced risk of any fracture (RR, 1.06; 95% CI, 0.98-1.14) or hip fracture (RR, 1.14; 95% CI, 0.98-1.32), but these trials were constrained by infrequent intermittent dosing, low daily doses of vitamin D, or an inadequate number of participants. In contrast, a meta-analysis of 6 RCTs (49 282 participants, 5449 fractures, 730 hip fractures) of combined supplementation with vitamin D (daily doses of 400-800 IU, yielding a median difference in 25[OH]D concentration of 9.2 ng/mL) and calcium (daily doses of 1000-1200 mg) found a 6% reduced risk of any fracture (RR, 0.94; 95% CI, 0.89-0.99) and a 16% reduced risk of hip fracture (RR, 0.84; 95% CI, 0.72-0.97). Conclusions and Relevance In this systematic review and meta-analysis, neither intermittent nor daily dosing with standard doses of vitamin D alone was associated with reduced risk of fracture, but daily supplementation with both vitamin D and calcium was a more promising strategy.
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Affiliation(s)
- Pang Yao
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Derrick Bennett
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Marion Mafham
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Xu Lin
- Chinese Academy of Sciences Key Laboratory of Nutrition, Metabolism, and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
- Shanghai Institute for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Jane Armitage
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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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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Francis I, AlAbdali N, Kapila K, John B, Al-Temaimi RA. Vitamin D pathway related polymorphisms and vitamin D receptor expression in breast cancer. INT J VITAM NUTR RES 2019; 91:124-132. [PMID: 31623531 DOI: 10.1024/0300-9831/a000615] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is an emerging risk factor for breast cancer suggesting its role in breast cancer pathogenesis. Recent evidence suggests vitamin D receptor (VDR) expression is a prognosis predictor in breast cancer. We set out to determine the status of VDR expression in histologically characterized breast cancers, and whether common genetic variants modify VDR expression in breast cancer. One-hundred and twenty Kuwaiti female breast cancer fixed tissues were assessed for VDR expression to identify the level and location of its expression by immunohistochemistry. VDR variants (rs731236, rs2228570), and vitamin D binding protein (VDBP) variants (rs4588, rs7041) genotypes were ascertained in breast cancer specimens using Taqman genotyping assays. VDR nuclear expression correlated with low grade tumors (p = 0.01), whereas cytoplasmic expression correlated with lymph node positive tumors (p = 0.03). Absence of VDR expression was a marker for high-grade dedifferentiated tumors (p = 0.01). VDBP rs7041 associated with breast cancer risk (OR 1.92, 95% CI: 1.34 - 2.73; p = 0.0004), and VDR rs2228570 correlated with increased VDR cytoplasmic expression (p < 0.0001). In conclusion, VDR expression is altered in breast cancer confirming its involvement in breast cancer progression. Genetic factors appear to play a role in breast cancer risk, and may modify tumor sensitization to vitamin D.
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Affiliation(s)
- Issam Francis
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Noora AlAbdali
- Postgraduate Medical Sciences Program, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Kusum Kapila
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
| | - Bency John
- Department of Pathology, Faculty of Medicine, Kuwait University, Jabriya, Kuwait
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34
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Holmes WL, Maish GO, Minard G, Croce MA, Dickerson RN. Hypercalcemia Without Hypervitaminosis D During Cholecalciferol Supplementation in Critically Ill Patients. Nutr Clin Pract 2019; 35:933-941. [PMID: 31605425 DOI: 10.1002/ncp.10407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Vitamin D deficiency during critical illness has been associated with worsened outcomes. Because most critically ill patients with severe traumatic injuries are vitamin D deficient, we investigated the efficacy and safety of cholecalciferol therapy for these patients. METHODS Fifty-three patients (>17 years of age) admitted to the trauma intensive care unit who had a serum 25-hydroxy vitamin D (25-OH vit D) concentration <20 ng/mL were given 10,000 IU of cholecalciferol daily. Efficacy was defined as achievement of a 25-OH vit D of 30-79.9 ng/mL. Safety was evaluated by the presence of hypercalcemia (serum ionized calcium [iCa] >1.32 mmol/L) or hypervitaminosis D (25-OH vit D >79.9 nmol/L). Patients were monitored for 2 weeks during cholecalciferol therapy. RESULTS Twenty-four patients (45%) achieved target 25-OH vit D. No patients experienced hypervitaminosis D. Hypercalcemia occurred in 40% (n = 21) of patients; 2 patients experienced an iCa >1.49 nmol/L. 25-OH vit D was significantly greater for those who developed hypercalcemia (37.2 + 11.2 vs 28.4 + 5.6 ng/mL, respectively, P < 0.001) by the second week of cholecalciferol. Of 24 patients who achieved target 25-OH vit D, 14 (58%) experienced hypercalcemia in contrast to 24% of patients (7 out of 29) who did not achieve target 25-OH vit D (P = 0.024). CONCLUSIONS Cholecalciferol normalized serum 25-OH vit D concentrations in less than half of patients yet was associated with a substantial proportion of patients with hypercalcemia without hypervitaminosis D.
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Affiliation(s)
- Whitney L Holmes
- Department of Pharmacy, Regional One Health, Memphis, Tennessee, USA
| | - George O Maish
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Gayle Minard
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Martin A Croce
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Roland N Dickerson
- Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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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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Al-Daghri NM, Mohammed AK, Bukhari I, Rikli M, Abdi S, Ansari MGA, Sabico S, Hussain SD, Alenad A, Al-Saleh Y, Alokail MS. Efficacy of vitamin D supplementation according to vitamin D-binding protein polymorphisms. Nutrition 2019; 63-64:148-154. [DOI: 10.1016/j.nut.2019.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/08/2019] [Accepted: 02/11/2019] [Indexed: 11/24/2022]
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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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A systematic review and meta-analysis of the response of serum 25-hydroxyvitamin D concentration to vitamin D supplementation from RCTs from around the globe. Eur J Clin Nutr 2019; 73:816-834. [PMID: 30872787 DOI: 10.1038/s41430-019-0417-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/10/2019] [Accepted: 02/18/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVES Optimal doses of vitamin D (VitD) supplement in different populations are unclear. We aim to evaluate the relationship between VitD supplementation and post-intervention serum 25-hydroxyvitamin D [25(OH)D] concentration, to provide a recommended dosage of VitD for achieving an optimal 25(OH)D concentration for different populations. SUBJECTS/METHODS Literature search was conducted in Embase, etc. Randomized controlled trials about VitD supplemental intakes and their effect on 25(OH)D concentration were enrolled. The effect on 25(OH)D concentration between different supplementation doses in each population group was compared by meta-analysis. Multivariate meta-regression model is utilized to establish reference intake dosage of VitD. RESULTS A total of 136 articles were included about children (3-17 years), adults (18-64 years), postmenopausal women, the elderly ( >64 years), pregnant, or lactating women. Overall, intervention groups obtained higher 25(OH)D concentration than controls and there was obvious dose-response effect between intake dose and 25(OH)D concentration. Baseline 25(OH)D concentration and age were significant indicators for 25(OH)D concentration. To reach sufficient 25(OH)D concentration (75 nmol/L), the recommended VitD supplemental intakes was 1340 and 2250 IU/day for children and pregnant women, 2519 and 797 IU/day for European adults aged 18-64 and 65-85 years, 729, 2026, and 1229 IU/day for adults in North America, Asia and Middle East and Africa, respectively. CONCLUSIONS Regional- and age-specific recommended dosages of VitD supplements for population to achieve optimal 25(OH)D concentrations have been suggested.
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Marquina C, Mousa A, Scragg R, de Courten B. Vitamin D and cardiometabolic disorders: a review of current evidence, genetic determinants and pathomechanisms. Obes Rev 2019; 20:262-277. [PMID: 30450683 DOI: 10.1111/obr.12793] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/13/2018] [Accepted: 09/20/2018] [Indexed: 12/14/2022]
Abstract
Vitamin D deficiency has been implicated in the pathophysiology of cardiometabolic disorders including obesity, type 2 diabetes mellitus, cardiovascular diseases and polycystic ovary syndrome. Despite a large number of experimental and observational studies supporting a role for vitamin D in these pathologies, randomized controlled trials have reported little to no effect of vitamin D supplementation in the prevention or treatment of these disorders, although some results remain ambiguous. Polymorphisms in genes related to vitamin D metabolism, particularly in the vitamin D receptor and binding protein and the metabolizing enzyme 1-α-hydroxylase, have emerged as potential contributors to these divergent results. It is now becoming increasingly recognized that the effects and potential benefits of vitamin D supplementation may vary by several factors including vitamin D deficiency status, ethnicity and/or the presence of genetic variants, which affect individual responses to supplementation. However, these factors have seldom been explored in the available literature. Future trials should consider inter-individual differences and, in particular, should aim to clarify whether certain subgroups of individuals may benefit from vitamin D supplementation in the context of cardiometabolic health.
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Affiliation(s)
- C Marquina
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - A Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Scragg
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - B de Courten
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Zhou JC, Zhu Y, Gong C, Liang X, Zhou X, Xu Y, Lyu D, Mo J, Xu J, Song J, Che X, Sun S, Huang C, Liu XL. The GC2 haplotype of the vitamin D binding protein is a risk factor for a low plasma 25-hydroxyvitamin D concentration in a Han Chinese population. Nutr Metab (Lond) 2019; 16:5. [PMID: 30651747 PMCID: PMC6332541 DOI: 10.1186/s12986-019-0332-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 01/02/2019] [Indexed: 02/08/2023] Open
Abstract
Background The GC haplotype of the vitamin D binding protein (encoded by the GC gene) might be a risk factor to the vitamin D (VD) nutritional status for many populations, while evidences from the Chinese Han population are sparse. We test the association between vitamin D binding protein genotypes and VD status as well as the metabolic parameters of glucose and lipids in a Han Chinese population. Methods In a cross-sectional study conducted at a health examination centre (registered in ClinicalTrials.gov as QLS2013), 2641 adults were included and grouped according to their plasma 25-hydroxyvitamin D (25OHD) concentrations as VD deficient (VDD), insufficient (VDI), or sufficient (VDS). The rs7041 and rs4588 genotypes were analysed with a molecular beacon-based qPCR method using blood samples. Results Plasma 25OHD concentrations were lower in the GC2/2, rs7041T/T, and rs4588A/A genotypes than the GC1f/1s, rs7041G/T, and rs4588C/C genotypes (P < 0.05). After adjusting for confounders, the GC2 haplotype increased the risk of low VD status (P < 0.05) in both genders. More genotypic models revealed the negative contributions of rs4588A than rs7041T to low VD status (P < 0.05). The combined rates of VDD and VDI were 80.2% in males and 86.1% in females. Compared with VDI, VDS, or both, VDD showed higher plasma concentrations of fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides in males (P < 0.05); however, no significant differences were found with regard to these parameters between the subgroups defined by the GC genotypes (P > 0.05). Conclusions In a Han Chinese population, the GC2 haplotype or more exactly rs4588A is a risk factor for low VD status but is not associated with glucose and lipid metabolic disorders, which are inversely correlated with the circulating 25OHD concentration in males. Trial registration The study was retrospectively registered in January 2018 as NCT03406234 in the ClinicalTrials.gov online system. Electronic supplementary material The online version of this article (10.1186/s12986-019-0332-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ji-Chang Zhou
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China.,2School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, 518100 Guangdong China
| | - Yumei Zhu
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Chunmei Gong
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Xiongshun Liang
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Xiaoying Zhou
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Yuanfei Xu
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Deliang Lyu
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Junluan Mo
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Jian Xu
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Jinping Song
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Xiaoling Che
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
| | - Shiqiang Sun
- Shenzhen Qilinshan Sanatorium, Shenzhen, 518055 Guangdong China
| | - Changhua Huang
- Shenzhen Qilinshan Sanatorium, Shenzhen, 518055 Guangdong China
| | - Xiao-Li Liu
- Shenzhen Centre for Chronic Disease Control, 2021 Buxin Road, Luohu District, Shenzhen, 518020 Guangdong China
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Gopal-Kothandapani JS, Evans LF, Walsh JS, Gossiel F, Rigby AS, Eastell R, Bishop NJ. Effect of vitamin D supplementation on free and total vitamin D: A comparison of Asians and Caucasians. Clin Endocrinol (Oxf) 2019; 90:222-231. [PMID: 30067874 DOI: 10.1111/cen.13825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/27/2018] [Accepted: 07/29/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVES It is well established that UK Asians typically have lower vitamin D levels than Caucasians. It is also known that vitamin D binding protein (DBP) is lower in some races than Caucasians. To investigate how ethnicity, skin colour and genetic variation affect the response to vitamin D (15000 IU) administered to young Asian and Caucasian men. DESIGN Prospective, single-centre clinical trial. PARTICIPANTS Sixty young men (18-25 year) of Asian (n = 30) and Caucasian (n = 30) origin. MEASUREMENTS We measured serum calcium, phosphate, magnesium, alkaline phosphatase, albumin, parathyroid hormone; total 25 hydroxyvitamin D (25OHD); calculated and directly measured free 25OHD; DBP at baseline and 4 weeks; DBP genotype, skin colour (Fitzpatrick scale), dietary vitamin D and calcium intake at baseline; and urine calcium:creatinine ratio at baseline, 1 and 4 weeks. RESULTS At baseline, Asians had lower serum total 25OHD (26.4 [13.7] vs 34.1 [12.3] nmol/L P = 0.0272) and DBP (6.7 [3.4] vs 9.6 [4.4] nmol/L; P = 0.0065) but similar free 25OHD (16.7 [10.4] vs 17.8 [7.5] pmol/L P = 0.6530). After dosing, total 25OHD rose similarly in each group (≈56 nmol/L), but measured free 25OHD rose more in Asians (18.1 [9.4] vs 12.2 [13.3] pmol/L P = 0.0464). Lower DBP at baseline, possibly reflecting genotype differences, was associated with a greater change in measured free 25OHD in Caucasians, but not in Asians. CONCLUSIONS Asian compared with Caucasian males had a larger increment in measured free 25OHD following 150 000 units vitamin D3, possibly reflecting differences in DBP affinity for 25OHD. Ethnicity should be considered when devising guidelines for the treatment of vitamin D deficiency.
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Affiliation(s)
| | - Lucy Faith Evans
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Jennifer S Walsh
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Fatma Gossiel
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Alan S Rigby
- Faculty of Health, Hull York Medical School, University of Hull, Hull, UK
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Nick J Bishop
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Wallace TC, Bultman S, D'Adamo C, Daniel CR, Debelius J, Ho E, Eliassen H, Lemanne D, Mukherjee P, Seyfried TN, Tian Q, Vahdat LT. Personalized Nutrition in Disrupting Cancer - Proceedings From the 2017 American College of Nutrition Annual Meeting. J Am Coll Nutr 2018; 38:1-14. [PMID: 30511901 DOI: 10.1080/07315724.2018.1500499] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cancer is a major public health problem and is the second leading cause of death in the United States and worldwide; nearly one in six deaths are attributable to cancer. Approximately 20% of all cancers diagnosed in the United States are attributable to unhealthy diet, excessive alcohol consumption, physical inactivity, and body fatness. Individual cancers are distinct disease states that are multifactorial in their causation, making them exceedingly cumbersome to study from a nutrition standpoint. Genetic influences are a major piece of the puzzle and personalized nutrition is likely to be most effective in disrupting cancer during all stages. Increasing evidence shows that after a cancer diagnosis, continuing standard dietary recommendations may not be appropriate. This is because powerful dietary interventions such as short-term fasting and carbohydrate restriction can disrupt tumor metabolism, synergizing with standard therapies such as radiation and drug therapy to improve efficacy and ultimately, cancer survival. The importance of identifying dietary interventions cannot be overstated, and the American College of Nutrition's commitment to advancing knowledge and research is evidenced by dedication of the 2017 ACN Annual Meeting to "Disrupting Cancer: The Role of Personalized Nutrition" and this resulting proceedings manuscript, which summarizes the meeting's findings.
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Affiliation(s)
- Taylor C Wallace
- a Department of Nutrition and Food Studies , George Mason University , Fairfax, VA , USA.,b Think Healthy Group, Inc , Washington, DC , USA
| | - Scott Bultman
- c Department of Genetics, University of North Carolina School of Medicine
| | - Chris D'Adamo
- d Departments of Family and Community Medicine and Epidemiology and Public Health , Center for Integrative Medicine, University of Maryland School of Medicine
| | - Carrie R Daniel
- e Department of Epidemiology, Division of Cancer Prevention and Population Sciences , The University of Texas MD Anderson Cancer Center
| | - Justine Debelius
- f Department of Medical Epidemiology and Biostatistics , Karolinska Institute , Stockholm , Sweden
| | - Emily Ho
- g Moore Family Center for Whole Grain Foods, Nutrition and Preventive Health, School of Biological and Population Health Sciences, Linus Pauling Institute, Oregon State University
| | - Heather Eliassen
- h Channing Division of Network Medicine , Brigham and Women's Hospital and Harvard Medical School.,i Harvard T.H. Chan School of Public Health
| | - Dawn Lemanne
- j Department of Medicine , University of Arizona , Tucson.,k National Institute of Integrative Medicine , Melbourne , Australia.,l Oregon Integrative Oncology , Ashland , Oregon
| | | | | | - Qiang Tian
- n Institute for Systems Biology, P4 Medicine Institute
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Szili B, Szabó B, Horváth P, Bakos B, Kirschner G, Kósa JP, Toldy E, Putz Z, Lakatos P, Tabák Á, Takács I. Impact of genetic influence on serum total- and free 25-hydroxyvitamin-D in humans. J Steroid Biochem Mol Biol 2018; 183:62-67. [PMID: 29792983 DOI: 10.1016/j.jsbmb.2018.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/09/2018] [Accepted: 05/20/2018] [Indexed: 01/17/2023]
Abstract
Serum 25-hydroxyvitamin D /25OHD/ levels in humans are determined primarily by environmental factors such as UV-B radiation and diet, including vitamin D intake. Although some genetic determinants of 25OHD levels have been shown, the magnitude of this association has not yet been clarified. The present study evaluates the genetic contribution to total- /t-25OHD/ and free-25OHD /f-25OHD/ in a representative sample of the Hungarian population (n = 462). The study was performed at the end of winter to minimize the effect of sunlight, which is a major determinant of serum vitamin D levels. Single nucleotide polymorphisms (SNPs) of five genes playing major roles in vitamin D metabolism were investigated (NADSYN1, DHCR7, GC, CYP2R1 and CYP24A1). The selected SNPs account for 13.1% of the variance of t-25OHD levels. More than half of the genetic effect on t-25OHD levels was explained by two polymorphisms (rs7935125 in NADSYN1 and rs2762941 in CYP24A1), which had not previously been investigated with respect to vitamin D metabolism. No SNPs exhibited association with f-25OHD levels. Unexpectedly, SNPs that showed univariate associations with vitamin D binding protein (DBP) levels were not associated with f-25OHD levels questioning the biological significance of these polymorphisms. The present study shows that t-25OHD levels are significantly influenced by genetic factors, however, the clinical significance of this observation remains to be defined, as variation in f-25OHD levels are marginally explained by genetic effects.
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Affiliation(s)
- Balázs Szili
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Boglárka Szabó
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Horváth
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Bakos
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Györgyi Kirschner
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - János P Kósa
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Erzsébet Toldy
- Institute of Diagnostics, Faculty of Health Science, University of Pécs, Pécs, Hungary; Central Laboratory, Markusovszky Teaching Hospital, Szombathely, Hungary
| | - Zsuzsanna Putz
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Lakatos
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ádám Tabák
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary; Department of Epidemiology and Public Health, University College London, London, UK
| | - István Takács
- Department of Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
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Tsuprykov O, Chen X, Hocher CF, Skoblo R, Hocher B. Why should we measure free 25(OH) vitamin D? J Steroid Biochem Mol Biol 2018; 180:87-104. [PMID: 29217467 DOI: 10.1016/j.jsbmb.2017.11.014] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 11/21/2022]
Abstract
Vitamin D, either in its D2 or D3 form, is essential for normal human development during intrauterine life, kidney function and bone health. Vitamin D deficiency has also been linked to cancer development and some autoimmune diseases. Given this huge impact of vitamin D on human health, it is important for daily clinical practice and clinical research to have reliable tools to judge on the vitamin D status. The major circulating form of vitamin D is 25-hydroxyvitamin D (25(OH)D), although it is not the most active metabolite, the concentrations of total 25-hydroxyvitamin D in the serum are currently routinely used in clinical practice to assess vitamin D status. In the circulation, vitamin D - like other steroid hormones - is bound tightly to a special carrier - vitamin D-binding protein (DBP). Smaller amounts are bound to blood proteins - albumin and lipoproteins. Only very tiny amounts of the total vitamin D are free and potentially biologically active. Currently used vitamin D assays do not distinguish between the three forms of vitamin D - DBP-bound vitamin D, albumin-bound vitamin D and free, biologically active vitamin D. Diseases or conditions that affect the synthesis of DBP or albumin thus have a huge impact on the amount of circulating total vitamin D. DBP and albumin are synthesized in the liver, hence all patients with an impairment of liver function have alterations in their total vitamin D blood concentrations, while free vitamin D levels remain mostly constant. Sex steroids, in particular estrogens, stimulate the synthesis of DBP. This explains why total vitamin D concentrations are higher during pregnancy as compared to non-pregnant women, while the concentrations of free vitamin D remain similar in both groups of women. The vitamin D-DBP as well as vitamin D-albumin complexes are filtered through the glomeruli and re-uptaken by megalin in the proximal tubule. Therefore, all acute and chronic kidney diseases that are characterized by a tubular damage, are associated with a loss of vitamin D-DBP complexes in the urine. Finally, the gene encoding DBP protein is highly polymorphic in different human racial groups. In the current review, we will discuss how liver function, estrogens, kidney function and the genetic background might influence total circulating vitamin D levels and will discuss what vitamin D metabolite is more appropriate to measure under these conditions: free vitamin D or total vitamin D.
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Affiliation(s)
- Oleg Tsuprykov
- IFLB, Institute for Laboratory Medicine, Berlin, Berlin, Germany; Institute of Nutritional Sciences, University of Potsdam, Potsdam, Germany
| | - Xin Chen
- Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Carl-Friedrich Hocher
- Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China; First Medical Faculty, Charles University of Prague, Prague, Czech Republic
| | - Roman Skoblo
- IFLB, Institute for Laboratory Medicine, Berlin, Berlin, Germany
| | - Berthold Hocher
- Institute of Nutritional Sciences, University of Potsdam, Potsdam, Germany; Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China.
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Berlanga-Taylor AJ, Plant K, Dahl A, Lau E, Hill M, Sims D, Heger A, Emberson J, Armitage J, Clarke R, Knight JC. Genomic Response to Vitamin D Supplementation in the Setting of a Randomized, Placebo-Controlled Trial. EBioMedicine 2018; 31:133-142. [PMID: 29685792 PMCID: PMC6013786 DOI: 10.1016/j.ebiom.2018.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/23/2018] [Accepted: 04/06/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been associated with multiple diseases, but the causal relevance and underlying processes are not fully understood. Elucidating the mechanisms of action of drug treatments in humans is challenging, but application of functional genomic approaches in randomized trials may afford an opportunity to systematically assess molecular responses. METHODS In the Biochemical Efficacy and Safety Trial of Vitamin D (BEST-D), a double-blind, placebo-controlled, dose-finding, randomized clinical trial, 305 community-dwelling individuals aged over 65 years were randomly allocated to treatment with vitamin D3 4000 IU, 2000 IU or placebo daily for 12 months. Genome-wide genotypes at baseline, and transcriptome and plasma levels of cytokines (IFN-γ, IL-10, IL-8, IL-6 and TNF-α) at baseline and after 12 months, were measured. The trial had >90% power to detect 1.2-fold changes in gene expression. FINDINGS Allocation to vitamin D for 12-months was associated with 2-fold higher plasma levels of 25-hydroxy-vitamin D (25[OH]D, 4000 IU regimen), but had no significant effect on whole-blood gene expression (FDR < 5%) or on plasma levels of cytokines compared with placebo. In pre-specified analysis, rs7041 (intron variant, GC) had a significant effect on circulating levels of 25(OH)D in the low dose, but not in the placebo or high dose vitamin D regimen. A gene expression quantitative trait locus analysis (eQTL) demonstrated evidence of 31,568 cis-eQTLs (unique SNP-probe pairs) among individuals at baseline and 34,254 after supplementation for 12 months (any dose). No significant associations involving vitamin D supplementation response eQTLs were found. INTERPRETATION We performed a comprehensive functional genomics and molecular analysis of vitamin D supplementation in a randomized, placebo-controlled trial. Although this study was limited to mostly Caucasian individuals aged over 65 years, the results differ from many previous studies and do not support a strong effect of vitamin D on long-term transcriptomic changes in blood or on plasma cytokine levels. The trial demonstrates the feasibility of applying functional genomic and genetic approaches in randomized trials to assess molecular and individual level responses. KEY RESULT Supplementation with high-dose vitamin D in older people for 12 months in a randomized, placebo-controlled trial had no significant effect on gene expression or on plasma concentrations of selected cytokines. TRIAL REGISTRATION SRCTN registry (Number 07034656) and the European Clinical Trials Database (EudraCT Number 2011-005763-24).
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Affiliation(s)
- Antonio J Berlanga-Taylor
- Computational Genomics Analysis and Training (CGAT), Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, UK; Wellcome Centre for Human Genetics (WHG), Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology & Biostatistics, School of Public Health, Faculty of Medicine, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Katharine Plant
- Wellcome Centre for Human Genetics (WHG), Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Andrew Dahl
- Wellcome Centre for Human Genetics (WHG), Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Evelyn Lau
- Wellcome Centre for Human Genetics (WHG), Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK
| | - Michael Hill
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK
| | - David Sims
- Computational Genomics Analysis and Training (CGAT), Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, UK
| | - Andreas Heger
- Computational Genomics Analysis and Training (CGAT), Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, University of Oxford, Oxford OX3 9DS, UK
| | - Jonathan Emberson
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK; MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Jane Armitage
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Roosevelt Drive, Oxford OX3 7LF, UK
| | - Julian C Knight
- Wellcome Centre for Human Genetics (WHG), Nuffield Department of Medicine, University of Oxford, Roosevelt Drive, Oxford OX3 7BN, UK.
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Yao P, Sun L, Xiong Q, Xu X, Li H, Lin X. Cholecalciferol Supplementation Promotes Bone Turnover in Chinese Adults with Vitamin D Deficiency. J Nutr 2018; 148:746-751. [PMID: 29897564 DOI: 10.1093/jn/nxy032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/10/2017] [Accepted: 01/30/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bone turnover markers (BTMs) are proposed as alternative indicators for bone mineral density in diagnosis and management of osteoporosis. However, little is known about the effects of vitamin D supplementation on BTMs in nonwhite populations. OBJECTIVE We aimed to investigate the responses in BTMs after vitamin D supplementation in Asians. METHODS In this secondary data analysis of a randomized, double-blind, placebo-controlled trial, 448 Chinese adults [mean ± SD age: 31.9 ± 8.0 y; mean ± SD body mass index (kg/m2): 22.1 ± 2.6; 69% were women] with vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] <50 nmol/L) received 2000 IU/d cholecalciferol or placebo for 20 wk. Serum concentrations of 25(OH)D, parathyroid hormone (PTH), calcium, and markers of bone formation and resorption were measured at weeks 0 and 20. Intention-to-treat analysis was applied, and between-group differences were compared by general linear models with adjustments. RESULTS Cholecalciferol supplementation increased the serum bone alkaline phosphatase (BALP) concentration (+1.7 ± 1.9 µg/L) significantly more than placebo (+1.1 ± 1.7 µg/L; P = 0.004), but not circulating concentrations of procollagen type I N-terminal propeptide (PINP), β-isomerized C-terminal telopeptide of type I collagen (β-CTX), or tartrate-resistant acid phosphatase 5b (TRAP5b) (P ≥ 0.53). Notably, a pooled analysis indicated that changes in serum 25(OH)D were positively associated with changes in serum BALP, PINP, and TRAP5b (r = 0.07-0.16, P ≤ 0.02), but inversely with changes in PTH (r = -0.15, P < 0.001). Among cholecalciferol-treated participants, individuals who achieved serum 25(OH)D ≥75 nmol/L had greater increases in serum β-CTX (224% compared with 146%; P = 0.02) and TRAP5b (22.2% compared with 9.1%; P = 0.007), but smaller decreases in serum calcium (-1.3% compared with -1.9%; P = 0.005) and calcium-phosphorus product (-2.6% compared with -3.3%; P = 0.02) compared with those with serum 25(OH)D <75 nmol/L. CONCLUSIONS Daily supplementation with 2000 IU cholecalciferol for 20 wk may promote bone formation in Chinese adults with vitamin D deficiency. More studies are needed to elucidate the potential clinical implications of BTMs.This trial was registered at clinicaltrials.gov as NCT01998763.
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Affiliation(s)
- Pang Yao
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
| | - Liang Sun
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
| | - Quan Xiong
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
| | - Xinming Xu
- Key Laboratory of Public Health Safety of the Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Huaixing Li
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
| | - Xu Lin
- Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences and University of the Chinese Academy of Sciences, Shanghai, China
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Association Between Vitamin D Metabolism Gene Polymorphisms and Risk of Tunisian Adults' Asthma. Lung 2018; 196:285-295. [PMID: 29502202 DOI: 10.1007/s00408-018-0101-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 02/19/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Several studies have shown a strong correlation between the serum vitamin D level and asthma severity and deficits in lung function. OBJECTIVE Study the relationship between vitamin D and the severity of asthma by targeting five SNPs of vitamin D metabolism gene pathway in a Tunisian adult asthmatics population. METHODS Our case-control study includes 154 adult asthmatic patients and 154 healthy Tunisian subjects. We genotyped many variants in three human genes encoding key components of the vitamin D metabolism, CYP2R1, CYP27B1, GC. The GC gene rs4588 and rs7041 polymorphisms were analysed using the PCR-RFLP method, while rs10741657 and rs12794714 for CYP2R1 gene and rs10877012 of CYP27B1 gene were investigated using TaqMan PCR genotyping techniques. RESULTS We found that the presence of at least one copy of the rs12794714 A, allele was associated with lower risk of developing asthma (OR 0.61). Further, the rs12794714 is a protector factor against asthma severity (OR 0.5). However, the presence of rs10877012 TG genotype is a risk factor related to asthma severity (OR 1.89). When we classified the population according to sex, our results showed that rs10877012 TT genotype was a risk factor for women subjects (OR 6.7). Moreover, the expression of TT genotype was associated with a higher risk of asthma in non-smoker patients (OR 7.13). We found a significant lower VD serum levels in asthmatics than controls but no impact of the polymorphisms on VD levels. CONCLUSIONS We found that rs12794714 and rs10877012 SNPs were associated with asthma risk.
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Banerjee S, Basu S, Sen A, Sengupta J. The effect of vitamin D and calcium supplementation in pediatric steroid-sensitive nephrotic syndrome. Pediatr Nephrol 2017; 32:2063-2070. [PMID: 28725977 DOI: 10.1007/s00467-017-3716-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2017] [Revised: 05/28/2017] [Accepted: 05/30/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Low serum levels of total 25-hydroxycholecalciferol (25(OH)D) occur in nephrotic syndrome (NS). We aimed to assess the effects of vitamin D3 and calcium supplementation on 25(OH)D levels, bone mineralization, and NS relapse rate in children with steroid-sensitive NS. METHODS A randomized controlled trial (RCT) was performed in children with steroid-sensitive NS. The treatment group received vitamin D3 (60,000 IU orally, weekly for 4 weeks) and calcium supplements (500 to 1,000 mg/day for 3 months) after achieving NS remission. Blood samples for bone biochemistry were taken during relapse (T0), after 6 weeks (T1) and 6 months (T2) of randomization, whereas a lumbar DXA scan was performed at T0 and T2. Renal ultrasound was performed after study completion in the treatment group and in all patients with hypercalciuria. RESULTS Of the 48 initial recruits, 43 patients completed the study. Post-intervention, 25(OH)D levels showed significant improvements in the treatment group compared with controls at T1 (p < 0.001) and T2 (p < 0.001). However, this was not associated with differences in bone mineral content (BMC) (p = 0.44) or bone mineral density (BMD) (p = 0.64) between the groups. Additionally, there was no reduction in relapse number in treated patients (p = 0.54). Documented hypercalciuria occurred in 52% of patients in the treatment group, but was not associated with nephrocalcinosis. CONCLUSIONS Although supplementation with calcium and vitamin D improved 25(OH)D levels significantly, there was no effect on BMC, BMD or relapse rate over a 6-month follow-up. Occurrence of hypercalciuria mandates caution and appropriate monitoring if using such therapy. Appropriate dosage of vitamin D3 remains uncertain and studies examining biologically active vitamin D may provide answers.
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Affiliation(s)
- Sushmita Banerjee
- Department of Paediatric Nephrology, Institute of Child Health and Calcutta Medical Research Institute, Kolkata, India.
| | - Surupa Basu
- Department of Biochemistry, Institute of Child Health, Kolkata, India
| | - Ananda Sen
- Department of Family Medicine and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Jayati Sengupta
- Department of Paediatric Nephrology, Institute of Child Health, Kolkata, India
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Pfeffer PE, Hawrylowicz CM. Vitamin D in Asthma: Mechanisms of Action and Considerations for Clinical Trials. Chest 2017; 153:1229-1239. [PMID: 28923762 DOI: 10.1016/j.chest.2017.09.005] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 08/15/2017] [Accepted: 09/06/2017] [Indexed: 12/17/2022] Open
Abstract
There is increasing interest in the therapeutic utility of vitamin D in asthma, which is supported by a significant body of evidence on epidemiologic associations between vitamin D insufficiency and worse asthma control. In support of a causal relationship, vitamin D beneficially modulates diverse immunologic pathways in heterogeneous asthma endotypes, regulating the actions of lymphocytes, mast cells, antigen-presenting cells, and structural cells to dampen excessive inflammatory responses. Allergic asthma is characterized by a failure of immune tolerance and the development of pathologic responses to inhaled aeroallergens, and vitamin D has been extensively shown to support immune regulation. Alarmin cytokines are increasingly implicated in nonallergic eosinophilic inflammation, which vitamin D also regulates. Steroid resistance and pathologic interleukin (IL)-17 responses are features of severe asthma, and vitamin D beneficially enhances the response to steroids in these individuals. Additionally, vitamin D enhances antimicrobial pathways, which is of relevance to infection-precipitated asthma exacerbations. These mechanisms support a role for vitamin D as secondary prevention to reduce exacerbations and inflammation in asthma. Similar mechanisms, and effects on fetal lung development, likely underlie a primary prevention therapeutic role in pregnancy for vitamin D to reduce the development of asthma in children. However, randomized controlled trials of variable design show inconsistent positive outcomes for vitamin D interventions in asthma. Increased understanding of the biological characteristics of vitamin D reveals methodological issues that might explain certain negative outcomes. Importantly, on systematic review of the trials to date, vitamin D is shown to be beneficial in asthma. The evidence discussed in this review supports the importance of optimizing vitamin D in holistic asthma care.
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Affiliation(s)
- Paul E Pfeffer
- William Harvey Research Institute, Queen Mary University of London, London, England; MRC and Asthma UK Centre for Allergic Mechanisms of Asthma, King's College London, Guy's Hospital, London, England
| | - Catherine M Hawrylowicz
- MRC and Asthma UK Centre for Allergic Mechanisms of Asthma, King's College London, Guy's Hospital, London, England.
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Barchetta I, Cimini FA, Cavallo MG. Vitamin D Supplementation and Non-Alcoholic Fatty Liver Disease: Present and Future. Nutrients 2017; 9:nu9091015. [PMID: 28906453 PMCID: PMC5622775 DOI: 10.3390/nu9091015] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 09/04/2017] [Accepted: 09/11/2017] [Indexed: 12/14/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic hepatic disease throughout the Western world and is recognized as the main cause of cryptogenic cirrhosis; however, the identification of an effective therapy for NAFLD is still a major challenge. Vitamin D deficiency is a wide-spread condition which reaches epidemic proportions in industrialized countries, mainly in relation to current lifestyle and limited dietary sources. Epidemiological studies point towards an association between hypovitaminosis D and the presence of NAFLD and steatohepatitis (NASH), independently of confounders such as obesity and insulin resistance. Furthermore, several pieces of experimental data have shown the anti-fibrotic, anti-inflammatory and insulin-sensitizing properties exerted by vitamin D on hepatic cells. However, results from trials evaluating the effects of oral vitamin D supplementation on liver damage in NAFLD and NASH are controversial. The aim of this review is to give an overview of the evidence currently available from clinical trials and to discuss possible shortcomings and new strategies to be considered in future investigations.
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Affiliation(s)
- Ilaria Barchetta
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome 00161, Italy.
| | - Flavia Agata Cimini
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome 00161, Italy.
| | - Maria Gisella Cavallo
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Rome 00161, Italy.
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