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The interplay of pineal hormones and socioeconomic status leading to colorectal cancer disparity. Transl Oncol 2022; 16:101330. [PMID: 34990909 PMCID: PMC8741600 DOI: 10.1016/j.tranon.2021.101330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/21/2021] [Indexed: 12/12/2022] Open
Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths in the United States. Despite increased screening options and state-of-art treatments offered in clinics, racial differences remain in CRC. African Americans (AAs) are disproportionately affected by the disease; the incidence and mortality are higher in AAs than Caucasian Americans (CAs). At the time of diagnosis, AAs more often present with advanced stages and aggressive CRCs, primarily accounting for the racial differences in therapeutic outcomes and mortality. The early incidence of CRC in AAs could be attributed to race-specific gene polymorphisms and lifestyle choices associated with socioeconomic status (SES). Altered melatonin-serotonin signaling, besides the established CRC risk factors (age, diet, obesity, alcoholism, and tobacco use), steered by SES, glucocorticoid, and Vitamin D status in AAs could also account for the early incidence in this racial group. This review focuses on how the lifestyle factors, diet, allelic variants, and altered expression of specific genes could lead to atypical serotonin and melatonin signaling by modulating the synthesis, secretion, and signaling of these pineal hormones in AAs and predisposing them to develop more aggressive CRC earlier than CAs. Crosstalk between gut microbiota and pineal hormones and its impact on CRC pathobiology is addressed from a race-specific perspective. Lastly, the status of melatonin-focused CRC treatments, the need to better understand the perturbed melatonin signaling, and the potential of pineal hormone-directed therapeutic interventions to reduce CRC-associated disparity are discussed.
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TIO Associated with Hyperparathyroidism: A Rarity, a Rule, or a Novel HPT-PMT Syndrome-A Case Study with Literature Review. Case Rep Endocrinol 2021; 2021:5172131. [PMID: 34354845 PMCID: PMC8331317 DOI: 10.1155/2021/5172131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/19/2022] Open
Abstract
Objective Association of primary hyperparathyroidism (pHPT) with phosphaturic mesenchymal tumors (PMT) is rarely reported. This report entertains the hypothesis of the causal association of HPT with tumor-induced osteomalacia (TIO) and of the existence of HPT-PMT syndrome. Case Presentation. A 49-year-old man presented with fragility rib fractures, generalized bone pain, and muscle weakness worsening over the past 3 years. Initial tests demonstrated hypophosphatemia and high PTH. The diagnosis of pHPT was entertained, but parathyroid scan was negative. During a 2-year follow-up, the patient reported minimal improvement of symptoms after intermittent treatment with calcitriol and phosphate. Biochemical evaluation showed persistent hypophosphatemia with renal phosphate wasting, elevated FGF23, and osteopenia on DXA scan. TIO was suspected. Multiple MRIs and whole-body FDG-PET scans were inconclusive. The patient subsequently underwent 68Ga-DOTATATE PET-CT, which revealed a somatostatin receptor-positive lesion in the lung. The resected mass was confirmed as PMT. The patient had dramatically improved symptoms, normal phosphate, calcium, and FGF23. During follow-up over 3 years postsurgery, the patient had slowly rising calcium and persistently elevated PTH. Conclusion The debate whether the patient had pHPT or tertiary HPT prompted literature review showing that aberrant genes including FGFR1, FGF1, fibronectin 1, and Klotho were mechanistically involved in the HPT-PMT association. This case highlights the pitfalls contributing to delayed diagnosis and treatment of TIO and hypothesizes the association between pHPT and PMT.
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Palmer ND, Lu L, Register TC, Lenchik L, Carr JJ, Hicks PJ, Smith SC, Xu J, Dimitrov L, Keaton J, Guan M, Ng MCY, Chen YDI, Hanley AJ, Engelman CD, Norris JM, Langefeld CD, Wagenknecht LE, Bowden DW, Freedman BI, Divers J. Genome-wide association study of vitamin D concentrations and bone mineral density in the African American-Diabetes Heart Study. PLoS One 2021; 16:e0251423. [PMID: 34014961 PMCID: PMC8136717 DOI: 10.1371/journal.pone.0251423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 04/26/2021] [Indexed: 12/29/2022] Open
Abstract
Relative to European Americans, African Americans have lower 25-hydroxyvitamin D (25OHD) and vitamin D binding protein (VDBP) concentrations, higher 1,25-dihydroxyvitamin D (1,25(OH)2D3) concentrations and bone mineral density (BMD), and paradoxically reduced burdens of calcified atherosclerotic plaque (subclinical atherosclerosis). To identify genetic factors contributing to vitamin D and BMD measures, association analysis of >14M variants was conducted in a maximum of 697 African American-Diabetes Heart Study participants with type 2 diabetes (T2D). The most significant association signals were detected for VDBP on chromosome 4; variants rs7041 (β = 0.44, SE = 0.019, P = 9.4x10-86) and rs4588 (β = 0.17, SE = 0.021, P = 3.5x10-08) in the group-specific component (vitamin D binding protein) gene (GC). These variants were found to be independently associated. In addition, rs7041 was also associated with bioavailable vitamin D (BAVD; β = 0.16, SE = 0.02, P = 3.3x10-19). Six rare variants were significantly associated with 25OHD, including a non-synonymous variant in HSPG2 (rs116788687; β = -1.07, SE = 0.17, P = 2.2x10-10) and an intronic variant in TNIK (rs143555701; β = -1.01, SE = 0.18, P = 9.0x10-10), both biologically related to bone development. Variants associated with 25OHD failed to replicate in African Americans from the Insulin Resistance Atherosclerosis Family Study (IRASFS). Evaluation of vitamin D metabolism and bone mineral density phenotypes in an African American population enriched for T2D could provide insight into ethnic specific differences in vitamin D metabolism and bone mineral density.
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Affiliation(s)
- Nicholette D. Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail: (NDP); (BIF)
| | - Lingyi Lu
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Thomas C. Register
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Leon Lenchik
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - J. Jeffrey Carr
- Department of Radiology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Pamela J. Hicks
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - S. Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Jianzhao Xu
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Latchezar Dimitrov
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Jacob Keaton
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Molecular Genetics and Genomics Program, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Meijian Guan
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Maggie C. Y. Ng
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Yii-der I. Chen
- Department of Pediatrics, The Institute for Translational Genomics and Population Sciences, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Anthony J. Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America
| | - Jill M. Norris
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO, United States of America
| | - Carl D. Langefeld
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Lynne E. Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Donald W. Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - Barry I. Freedman
- Center for Precision Medicine, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- Department of Internal Medicine-Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
- * E-mail: (NDP); (BIF)
| | - Jasmin Divers
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
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Mansouri S, Safabakhsh M, Forooshani AR, Shab-Bidar S. The Prevalence of Vitamin D and Calcium Supplement use and Association with Serum 25-Hydroxy-vitamin D (25(OH)D) and Demographic and Socioeconomic Variables in Iranian Elderly. Int J Prev Med 2021; 12:36. [PMID: 34249285 PMCID: PMC8218808 DOI: 10.4103/ijpvm.ijpvm_379_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/10/2020] [Indexed: 11/23/2022] Open
Abstract
Aims: The objective of this study was to determine the prevalence of vitamin D and calcium supplement use, and association with serum 25-hydroxy-vitamin D(25(OH)D) and demographic and socioeconomic variables in Iranian elderly. Settings and Design: This cross-sectional study was conducted in health centers of Tehran, capital of Iran. Methods: A total of 600 men and women were recruited using a two-stage cluster sampling method from 60 health centers. Participant's inclusion criteria included enrolling older adults over 60 years old who able to answer questions. We used valid and reliable questionnaires to record dietary intake of vitamin D and calcium. Any dietary supplements which included vitamin D/calcium were recorded. 25(OH)D level was measured. Participants were categorized as supplement users if they had taken supplements during last month. Results: The mean age of participants was 67.16 ± 6.07 years. Vitamin D supplements were used more often by females (OR = 11.89, 95% confidence interval (CI): 4.82–29.34), high educated subjects (OR = 3.49, 95% CI: 1.45–8.44), participants who did more physical activities (OR = 2.75, 95% CI: 1.52–5.00), and subjects who took antiosteoporosis medications (OR = 6.90, 95% CI: 2.84‑16.78). Calcium supplements were used more often by females (OR = 13.05, 95% CI: 5.19–32.81), more physical activities participants (OR = 2.17, 95% CI: 1.20–3.92), and antiosteoporosis users (OR = 8.31, 95% CI: 3.43–20.14). Significant positive associations were seen between 25(OH) D levels and osteoporosis (P = 0.020), vitamin D supplement use (P < 0.0001), and sun exposure (P = 0.093). Conclusion: In this population of Tehranian adults, the prevalence of vitamin D and calcium supplement use may be attributed to educational level and underlying disease. Vitamin D supplementation, osteoporosis, and sun exposure were the strong predictors of vitamin D status.
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Affiliation(s)
- Sara Mansouri
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Safabakhsh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Rahimi Forooshani
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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Ibrahimovic M, Franzmann E, Mondul AM, Weh KM, Howard C, Hu JJ, Goodwin WJ, Kresty LA. Disparities in Head and Neck Cancer: A Case for Chemoprevention with Vitamin D. Nutrients 2020; 12:E2638. [PMID: 32872541 PMCID: PMC7551909 DOI: 10.3390/nu12092638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 12/13/2022] Open
Abstract
Blacks experience disproportionate head and neck cancer (HNC) recurrence and mortality compared to Whites. Overall, vitamin D status is inversely associated to HNC pointing to a potential protective linkage. Although hypovitaminosis D in Blacks is well documented it has not been investigated in Black HNC patients. Thus, we conducted a prospective pilot study accessing vitamin D status in newly diagnosed HNC patients stratified by race and conducted in vitro studies to investigate mechanisms associated with potential cancer inhibitory effects of vitamin D. Outcome measures included circulating levels of vitamin D, related nutrients, and risk factor characterization as well as dietary and supplemental estimates. Vitamin D-based in vitro assays utilized proteome and microRNA (miR) profiling. Nineteen patients were enrolled, mean circulating vitamin D levels were significantly reduced in Black compared to White HNC patients, 27.3 and 20.0 ng/mL, respectively. Whites also supplemented vitamin D more frequently than Blacks who had non-significantly higher vitamin D from dietary sources. Vitamin D treatment of HNC cell lines revealed five significantly altered miRs regulating genes targeting multiple pathways in cancer based on enrichment analysis (i.e., negative regulation of cell proliferation, angiogenesis, chemokine, MAPK, and WNT signaling). Vitamin D further altered proteins involved in cancer progression, metastasis and survival supporting a potential role for vitamin D in targeted cancer prevention.
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Affiliation(s)
- Mirela Ibrahimovic
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Elizabeth Franzmann
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Otolaryngology, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Alison M. Mondul
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Katherine M. Weh
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
| | - Connor Howard
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
| | - Jennifer J. Hu
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL 33136, USA
| | - W. Jarrard Goodwin
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA; (E.F.); (J.J.H.); (W.J.G.)
- Department of Public Health Sciences, University of Miami School of Medicine, Miami, FL 33136, USA
| | - Laura A. Kresty
- The Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; (M.I.); (A.M.M.); (K.M.W.); (C.H.)
- Department of Surgery, Thoracic Surgery Section, University of Michigan, Ann Arbor, MI 48109, USA
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Crane-Godreau MA, Clem KJ, Payne P, Fiering S. Vitamin D Deficiency and Air Pollution Exacerbate COVID-19 Through Suppression of Antiviral Peptide LL37. Front Public Health 2020; 8:232. [PMID: 32671009 PMCID: PMC7326088 DOI: 10.3389/fpubh.2020.00232] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/18/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D deficiency and insufficiency (VDD) are widely recognized as risk factors for respiratory tract infections. Vitamin D influences expression of many genes with well-established relevance to airway infections and relevant to immune system function. Recently, VDD has been shown to be a risk factor for acquisition and severity of COVID-19. Thus, treating VDD presents a safe and inexpensive opportunity for modulating the severity of the disease. VDD is common in those over 60 years of age, many with co-morbid conditions and in people with skin pigmentation sufficient to reduce synthesis of vitamin D. Exposure to fine particulate air pollution is also associated with worse outcomes from COVID19. Vitamin D stimulates transcription of cathelicidin which is cleaved to generate LL37. LL37 is an innate antimicrobial with demonstrated activity against a wide range of microbes including envelope viruses. LL37 also modulates cytokine signaling at the site of infections. Fine particles in air pollution can interfere with LL37 destruction of viruses and may reduce effective immune signaling modulation by LL37. While vitamin D influences transcription of many immune related genes, the weakened antimicrobial response of those with VDD against SARS-CoV-2 may be in part due to reduced LL37. Conclusion: Vitamin D plays an important role reducing the impact of viral lung disease processes. VDD is an acknowledged public health threat that warrants population-wide action to reduce COVID-19 morbidity and mortality. While vitamin D influences transcription of many immune related genes, the weakened antimicrobial response of those with VDD against SARS-CoV-2 may be in part due to reduced LL37. Action is needed to address COVID-19 associated risks of air pollution from industry, transportation, domestic sources and from primary and second hand tobacco smoke.
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Affiliation(s)
- Mardi A. Crane-Godreau
- Department of Immunology and Microbiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Bodymind Science, LLC, Arlington, VT, United States
| | - Kathleen J. Clem
- Department of Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Peter Payne
- Department of Immunology and Microbiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Bodymind Science, LLC, Arlington, VT, United States
| | - Steven Fiering
- Department of Immunology and Microbiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Martín Giménez VM, Ferder L, Inserra F, García J, Manucha W. Differences in RAAS/vitamin D linked to genetics and socioeconomic factors could explain the higher mortality rate in African Americans with COVID-19. Ther Adv Cardiovasc Dis 2020; 14:1753944720977715. [PMID: 33283618 PMCID: PMC7724257 DOI: 10.1177/1753944720977715] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
COVID-19 is said to be a pandemic that does not distinguish between skin color or ethnic origin. However, data in many parts of the world, especially in the United States, begin to show that there is a sector of society suffering a more significant impact from this pandemic. The Black population is more vulnerable than the White population to infection and death by COVID-19, with hypertension and diabetes mellitus as probable predisposing factors. Over time, multiple disparities have been observed between the health of Black and White populations, associated mainly with socioeconomic inequalities. However, some mechanisms and pathophysiological susceptibilities begin to be elucidated that are related directly to the higher prevalence of multiple diseases in the Black population, including infection and death by COVID-19. Plasma vitamin D levels and evolutionary adaptations of the renin-angiotensin-aldosterone system (RAAS) in Black people differ considerably from those of other races. The role of these factors in the development and progression of hypertension and multiple lung diseases, among them SARS-CoV-2 infection, is well established. In this sense, the present review attempts to elucidate the link between vitamin D and RAAS ethnic disparities and susceptibility to infection and death by COVID-19 in Black people, and suggests possible mechanisms for this susceptibility.
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Affiliation(s)
- Virna Margarita Martín Giménez
- Instituto de Investigaciones en Ciencias
Químicas, Facultad de Ciencias Químicas y Tecnológicas, Universidad Católica
de Cuyo, San Juan, Argentina
| | - León Ferder
- Universidad Maimónides, Buenos Aires,
Argentina
| | | | - Joxel García
- AMBITNA, Ambitious Solutions for Health Cures,
Chevy Chase, MD, USA
| | - Walter Manucha
- Instituto de Medicina y Biología Experimental de
Cuyo (IMBECU), Consejo Nacional de Investigaciones Científicas y
Tecnológicas (CONICET), Mendoza, Argentina
- Departamento de Patología, Facultad de Ciencias
Médicas, Área de Farmacología, Universidad Nacional de Cuyo, Libertador 80,
Mendoza, 5500, Argentina
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Sakpal M, Satsangi S, Mehta M, Duseja A, Bhadada S, Das A, Dhiman RK, Chawla YK. Vitamin D supplementation in patients with nonalcoholic fatty liver disease: A randomized controlled trial. JGH OPEN 2017; 1:62-67. [PMID: 30483536 PMCID: PMC6207029 DOI: 10.1002/jgh3.12010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 08/12/2017] [Indexed: 01/10/2023]
Abstract
Background and Aim Deficiency of vitamin D may be related to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The aim of the present study was to evaluate the effect of vitamin D supplementation in patients with NAFLD. Methods A total of 81 patients with NAFLD with normal or raised (n = 47) serum alanine aminotransferase (ALT) having vitamin D deficiency were randomized prospectively. Group 1 (n = 51) received lifestyle modifications and a single injection of vitamin D (600 000 U) (standard medical treatment [SMT] + vitamin D) and group 2 (n = 30) received lifestyle modifications (SMT) for 6 months. The primary objective of this study was to assess the improvement in insulin resistance (IR) and serum ALT (in patients with raised ALT) and the secondary objective was to assess the change in cytokine profile in the SMT + vitamin D group. Results After 6 months, significant improvement in serum levels of ALT was observed in the SMT + vitamin D group when compared to the SMT group (ALT [87 ± 48 and 59 ± 32 IU/mL, P < 0.001] vs [64 ± 35 and 62 ± 24 IU/mL, P = 0.70]). Mean insulin levels and homeostasis model assessment‐IR remained unchanged at 6 months in the SMT + vitamin D group while there was a significant increase in mean insulin and homeostasis model assessment‐IR in the SMT group. SMT + vitamin D group had significant increase in mean serum levels of adiponectin (836 ± 309 and 908 ± 312 (pg/mL), P = 0.018) compared with the baseline; tumor necrosis factor‐α levels decreased from baseline but the change was not significant. Conclusion Patients with NAFLD given vitamin D in addition to lifestyle modifications have significant improvement in serum ALT and serum adiponectin levels.
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Affiliation(s)
- Mallikarjun Sakpal
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sandeep Satsangi
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Manu Mehta
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Ajay Duseja
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sanjay Bhadada
- Department of Endocrinology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Ashim Das
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Radha K Dhiman
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Yogesh K Chawla
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
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Matsuura K, Sugimoto I, Kuroda Y, Kadowaki K, Matsusaki M, Akashi M. Development of Microfluidic Systems for Fabricating Cellular Multilayers. ANAL SCI 2016; 32:1171-1176. [PMID: 27829621 DOI: 10.2116/analsci.32.1171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
We designed a microfluidic system comprising microfluidic channels, pumps, and valves to enable the fabrication of cellular multilayers in order to reduce labor inputs for coating extracellular matrices onto adhesive cells (e.g., centrifugation). Our system was used to fabricate nanometer-sized, layer-by-layer films of the extracellular matrices on a monolayer of C2C12 myoblasts. The use of this microfluidic system allowed the fabrication of cellular multilayers in designed microfluidic channels and on commercial culture dishes. The thickness of the fabricated multilayer using this microfluidic system was higher than that of the multilayer that was formed by centrifugation. Because cellular multilayer fabrication is less laborious and the mechanical force to the cell is reduced, this novel system can be applied to tissue modeling for cell biology studies, pharmaceutical assays, and quantitative analyses of mechanical or chemical stimuli applied to multilayers.
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Affiliation(s)
- Koji Matsuura
- Research Core for Interdisciplinary Sciences, Okayama University
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10
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Dhibar DP, Sharma YP, Bhadada SK, Sachdeva N, Sahu KK. Association of Vitamin D Deficiency with Coronary Artery Disease. J Clin Diagn Res 2016; 10:OC24-OC28. [PMID: 27790488 DOI: 10.7860/jcdr/2016/22718.8526] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 08/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Coronary Artery Disease (CAD) is a major global health problem. Recent studies demonstrated that lower vitamin D level (<30ng/ml) is associated with higher blood pressure and directly or indirectly with CAD, due to vascular endothelial damage. However the results are inconsistent. AIM To find the association of vitamin D deficiency with CAD. MATERIALS AND METHODS In this cross-sectional observational study, serum vitamin D level was measured in 315 patients who underwent coronary angiography. RESULT The mean (±SD) vitamin D was 13.40ng/ml (±10.40). However, the patients with normal coronary artery had much lower mean vitamin D (11.30ng/ml±9.50) as compared to the patients with CAD (14.10ng/ml±10.70). The mean (±SD) vitamin D levels were 19.00ng/ml (±16.50), 14.10ng/ml (±11.10) and 13.20ng/ml (±8.80) in patients with CAD with 50%-70%, >70%-90% and >90% stenosis respectively (p= 0.46) and 15.20ng/ml (±13.00), 15.50ng/ml (±11.30) and 11.80ng/ml (±7.00) in patients with CAD with single, double and triple vessels disease respectively (p= 0.14). The frequency of vitamin D deficiency were 66.70%, 83.20 % and 83.10% in patients with CAD with 50% -70%, >70%-90% and >90% stenosis respectively and 81.40%, 80.00% and 83.50% in patients with single, double and triple vessel disease respectively, as compared to 89.30% in patients with normal coronary artery (p= 0.41 and 0.075). So, all the study groups of CAD had low serum vitamin D level and high frequency of vitamin D deficiency, which was statistically insignificant. CONCLUSION Prevalence of vitamin D deficiency is very high in CAD, but it does not correlate with the angiographic severity of CAD.
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Affiliation(s)
- Deba Prasad Dhibar
- Senior Resident, Department of Internal Medicine, PGIMER , Chandigarh, India
| | - Yash Paul Sharma
- Professor & Head, Department of Cardiology, PGIMER , Chandigarh, India
| | | | - Naresh Sachdeva
- Associate Professor, Department of Endocrinology, PGIMER , Chandigarh, India
| | - Kamal Kant Sahu
- Senior Resident, Department of Internal Medicine, PGIMER , Chandigarh, India
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Palmer ND, Divers J, Lu L, Register TC, Carr JJ, Hicks PJ, Smith SC, Xu J, Judd SE, Irvin MR, Gutierrez OM, Bowden DW, Wagenknecht LE, Langefeld CD, Freedman BI. Admixture mapping of serum vitamin D and parathyroid hormone concentrations in the African American-Diabetes Heart Study. Bone 2016; 87:71-7. [PMID: 27032714 PMCID: PMC4862915 DOI: 10.1016/j.bone.2016.01.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/17/2015] [Accepted: 01/19/2016] [Indexed: 10/22/2022]
Abstract
Vitamin D and intact parathyroid hormone (iPTH) concentrations differ between individuals of African and European descent and may play a role in observed racial differences in bone mineral density (BMD). These findings suggest that mapping by admixture linkage disequilibrium (MALD) may be informative for identifying genetic variants contributing to these ethnic disparities. Admixture mapping was performed for serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, vitamin D-binding protein (VDBP), bioavailable vitamin D, and iPTH concentrations and computed tomography measured thoracic and lumbar vertebral volumetric BMD in 552 unrelated African Americans with type 2 diabetes from the African American-Diabetes Heart Study. Genotyping was performed using a custom Illumina ancestry informative marker (AIM) panel. For each AIM, the probability of inheriting 0, 1, or 2 copies of a European-derived allele was determined. Non-parametric linkage analysis was performed by testing for association between each AIM using these probabilities among phenotypes, accounting for global ancestry, age, and gender. Fine-mapping of MALD peaks was facilitated by genome-wide association study (GWAS) data. VDBP levels were significantly linked in proximity to the protein coding locus (rs7689609, LOD=11.05). Two loci exhibited significant linkage signals for 1,25-dihydroxyvitamin D on 13q21.2 (rs1622710, LOD=3.20) and 12q13.2 (rs11171526, LOD=3.10). iPTH was significantly linked on 9q31.3 (rs7854368, LOD=3.14). Fine-mapping with GWAS data revealed significant known (rs7041 with VDBP, P=1.38×10(-82)) and novel (rs12741813 and rs10863774 with VDBP, P<6.43×10(-5)) loci with plausible biological roles. Admixture mapping in combination with fine-mapping has focused efforts to identify loci contributing to ethnic differences in vitamin D-related traits.
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Affiliation(s)
- Nicholette D Palmer
- Department of Biochemistry, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Diabetes Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Jasmin Divers
- Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Department of Biostatistical Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Lingyi Lu
- Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Department of Biostatistical Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Thomas C Register
- Department of Pathology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - J Jeffrey Carr
- Department of Radiology, Vanderbilt University School of Medicine, 2525 West End Ave, Suite 300-B, Nashville, TN 37203, USA.
| | - Pamela J Hicks
- Department of Biochemistry, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - S Carrie Smith
- Department of Biochemistry, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Jianzhao Xu
- Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA.
| | - Marguerite R Irvin
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA.
| | - Orlando M Gutierrez
- Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA; Department of Medicine, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL, 35294, USA.
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Diabetes Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Lynne E Wagenknecht
- Division of Public Health Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Carl D Langefeld
- Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Department of Biostatistical Sciences, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| | - Barry I Freedman
- Center for Diabetes Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Genomics and Personalized Medicine Research, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Center for Public Health Genomics, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA; Department of Internal Medicine-Section on Nephrology, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
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Jemielita TO, Leonard MB, Baker J, Sayed S, Zemel BS, Shults J, Herskovitz R, Denburg MR. Association of 25-hydroxyvitamin D with areal and volumetric measures of bone mineral density and parathyroid hormone: impact of vitamin D-binding protein and its assays. Osteoporos Int 2016; 27:617-26. [PMID: 26359185 PMCID: PMC4924926 DOI: 10.1007/s00198-015-3296-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 08/14/2015] [Indexed: 11/29/2022]
Abstract
UNLABELLED A comparison of the association of different forms of 25-hydroxyvitamin D [25(OH)D] with parathyroid hormone (PTH) and with areal and volumetric bone mineral density (BMD) demonstrated that bioavailable and free 25(OH)D do not provide a better index of vitamin D status in terms of bone health compared to total 25(OH)D. INTRODUCTION This study aims to compare measures of vitamin D-binding protein (DBP) using a monoclonal versus polyclonal ELISA and assess correlations of total versus estimated free and bioavailable 25(OH)D with BMD and PTH concentrations. METHODS DXA and peripheral quantitative CT (pQCT) scans were obtained in 304 adults (158 black, 146 white), ages 21-80 years. Free and bioavailable 25(OH)D were calculated from total 25(OH)D, DBP, and albumin concentrations. Multivariable linear regression with standardized beta coefficients was used to evaluate associations of bone measures and PTH with total, free, and bioavailable 25(OH)D. RESULTS Measures of DBP obtained using a monoclonal versus polyclonal ELISA were not correlated (r s = 0.02, p = 0.76). Free and bioavailable 25(OH)D based on the polyclonal assay were lower in black versus white participants (p < 0.0001); this race difference was not evident using the monoclonal assay. Adjusted for age, sex, calcium intake, and race, all forms of 25(OH)D were negatively associated with PTH, but the absolute coefficient was greatest for total 25(OH)D (-0.34, p < 0.001) versus free/bioavailable 25(OH)D (-0.18/-0.24 depending on DBP assay, p ≤ 0.003). In analyses stratified on race, none of the measures of 25(OH)D were associated with BMD across DXA and pQCT sites. CONCLUSIONS The monoclonal versus polyclonal ELISA yielded highly discrepant measures of DBP, particularly among black individuals, likely related to established race differences in DBP polymorphisms. Contrary to prior studies, our findings indicate that using DBP to estimate bioavailable and free 25(OH)D does not provide a better index of vitamin D status in terms of bone health.
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Affiliation(s)
- T O Jemielita
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - M B Leonard
- Stanford University School of Medicine, Stanford, CA, USA
| | - J Baker
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Philadelphia VA Medical Center, Philadelphia, PA, USA
| | - S Sayed
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B S Zemel
- The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - J Shults
- The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - R Herskovitz
- The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M R Denburg
- The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA.
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Fabricant PD, Dy CJ, McLaren SH, Rauck RC, Ipp LS, Doyle SM. Low Vitamin D Levels in Children with Fractures: a Comparative Cohort Study. HSS J 2015; 11:249-57. [PMID: 26981060 PMCID: PMC4773687 DOI: 10.1007/s11420-015-9447-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 04/22/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The currently accepted ranges for "normal" serum vitamin D have recently been challenged in adults on the basis that healthy bone metabolism requires higher levels of vitamin D than previously thought. PURPOSE The purpose of this study was to evaluate whether a new "biologically based" classification based on 25(OH)vitamin D levels that invoke an endocrine biomarker response (<20 ng/mL for deficiency and <32 ng/mL for insufficiency) is more appropriate for children with fractures than historical criteria. METHODS Serum 25(OH)vitamin D levels were collected from 58 children with acute low-energy fractures from an outpatient orthopedic clinic from 2009 to 2012. These vitamin D levels were compared with a cohort of 103 children with chronic kidney disease (CKD) from an adjacent clinic, a condition with acknowledged low levels of vitamin D. Then, the prevalence of vitamin D sufficiency in the fracture cohort was evaluated and compared using both historical guidelines and newer biologically based criteria. RESULTS 25(OH)vitamin D levels in the fracture cohort did not differ from levels in the CKD cohort (27.5 vs. 24.6 ng/mL) indicating a similar distribution of vitamin D levels. This finding was consistent when controlling for significant covariables using linear regression analyses. In the fracture cohort, there was a discrepancy between historical and biologically based criteria in 64% of children. CONCLUSIONS The results of the current study suggest that fracture patients are more frequently vitamin D deficient than previously thought. This finding is more readily apparent when newer biologically based criteria for vitamin D sufficiency are used.
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Affiliation(s)
- Peter D. Fabricant
- />Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
| | - Christopher J. Dy
- />Washington University in St. Louis, 660 S. Euclid Ave, Box 8233, St. Louis, MO 63310 USA
| | - Son H. McLaren
- />New York Presbyterian Hospital/Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065 USA
| | - Ryan C. Rauck
- />The Ohio State University College of Medicine, 338 W 10th Ave, Columbus, OH 43210 USA
| | - Lisa S. Ipp
- />Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
- />New York Presbyterian Hospital/Weill Cornell Medical Center, 1300 York Ave, New York, NY 10065 USA
| | - Shevaun M. Doyle
- />Department of Pediatric Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA
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Schenk JM, Till CA, Tangen CM, Goodman PJ, Song X, Torkko KC, Kristal AR, Peters U, Neuhouser ML. Serum 25-hydroxyvitamin D concentrations and risk of prostate cancer: results from the Prostate Cancer Prevention Trial. Cancer Epidemiol Biomarkers Prev 2015; 23:1484-93. [PMID: 25085836 DOI: 10.1158/1055-9965.epi-13-1340] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Epidemiologic studies have reported inconsistent associations of vitamin D and prostate cancer risk; however, few have adequately controlled for detection bias related to prostate-specific antigen (PSA) screening, and the results of many studies may be affected by occult prostate cancers among controls. METHODS Data for this nested case-control analysis (n = 1,695 cases/1,682 controls) are from the Prostate Cancer Prevention Trial. Baseline serum was analyzed for 25-hydroxyvitamin D [25(OH)D]. The presence or absence of cancer was subsequently determined by prostate biopsy. Polytomous logistic regression models were used to estimate associations of 25(OH)D with risk of total, Gleason 2-6, Gleason 7, and Gleason 8-10 prostate cancer. Results are presented for placebo and finasteride arms separately and combined. RESULTS There were no associations of serum 25(OH)D with total prostate cancer risk. For Gleason 2-6 cancers, results were inconsistent across treatment arms with a suggestion of increased risk in the placebo arm only; however, there was no dose-response relationship. For Gleason 8-10 prostate cancers, 25(OH)D concentrations were associated with a linear decrease in risk among combined treatment arms [quartile 4 vs. 1: OR, 0.55; 95% confidence interval (CI), 0.32-0.94; P(trend) = 0.04]. These findings were somewhat stronger among men ≥65 versus 55-64 years at baseline (quartile 4 vs. 1: OR, 0.40; 95% CI, 0.18-0.88 vs. OR, 0.73; 95% CI, 0.35-1.52, respectively; P(interaction) = 0.52). CONCLUSIONS Higher serum 25(OH)D may modestly increase risk of Gleason 2-6 disease and more substantially reduce risk of Gleason 8-10 prostate cancer. IMPACT Vitamin D may have different effects for different stages of prostate cancers.
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Affiliation(s)
| | | | | | | | - Xiaoling Song
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program
| | - Kathleen C Torkko
- Department of Pathology, University of Colorado Denver, Aurora, Colorado
| | - Alan R Kristal
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program; Department of Epidemiology, University of Washington, Seattle, Washington; and
| | - Ulrike Peters
- Fred Hutchinson Cancer Research Center, Cancer Prevention Program
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15
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Hansen JG, Tang W, Hootman KC, Brannon PM, Houston DK, Kritchevsky SB, Harris TB, Garcia M, Lohman K, Liu Y, de Boer IH, Kestenbaum BR, Robinson-Cohen C, Siscovick DS, Cassano PA. Genetic and environmental factors are associated with serum 25-hydroxyvitamin D concentrations in older African Americans. J Nutr 2015; 145:799-805. [PMID: 25716552 PMCID: PMC4381765 DOI: 10.3945/jn.114.202093] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 02/03/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Low circulating 25-hydroxyvitamin D [25(OH)D] is prevalent in African Americans, but predictors of vitamin D status are understudied compared to Caucasian populations. OBJECTIVE We investigated whether certain environmental and genetic factors are predictors of circulating 25(OH)D in 989 elderly African Americans participating in the Health, Aging, and Body Composition (Health ABC) Study. METHODS Regression analysis estimated the cross-sectional association of nongenetic (environmental) factors with 25(OH)D. Single nucleotide polymorphisms (SNPs) associated with 25(OH)D in Caucasian genome-wide association studies (GWASs) were analyzed for association with serum 25(OH)D, including analyses of all imputed SNPs in identified genomic regions. Genome-wide complex trait analysis (GCTA) evaluated the association of all (genome-wide) genotyped SNPs with serum 25(OH)D in the Health ABC Study with replication in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. RESULTS Gender, study site, season of blood draw, body mass index, dietary supplement use, dairy and cereal consumption, Healthy Eating Index score, and walking >180 min/wk were associated with 25(OH)D (P < 0.05), jointly explaining 25% of the variation in circulating 25(OH)D. Multivitamin supplement use was the strongest predictor of circulating 25(OH)D, and supplement users had a 6.3-μg/L higher serum 25(OH)D concentration compared with nonusers. Previous GWAS-identified gene regions were not replicated in African Americans, but the nonsynonymous rs7041 SNP in group-specific component (vitamin D binding protein) was close to significance thresholds (P = 0.08), and there was evidence for an interaction between this SNP and use of multivitamin supplements in relation to serum 25(OH)D concentration (P = 0.04). Twenty-three percent (95% CI: 0%, 52%) of the variation in serum 25(OH)D was explained by total genetic variation in a pooled GCTA of 2087 Health ABC Study and MESA African-American participants, but population substructure effects could not be separated from other genetic influences. CONCLUSIONS Modifiable dietary and lifestyle predictors of serum 25(OH)D were identified in African Americans. GCTA confirms that a proportion of 25(OH)D variability is attributable to genetic variation, but genomic regions associated with the 25(OH)D phenotype identified in prior GWASs of European Americans were not replicated in the Health ABC Study in African Americans.
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Affiliation(s)
- Joyanna G Hansen
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Wenbo Tang
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Katie C Hootman
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Patsy M Brannon
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | | | | | - Tamara B Harris
- Intramural Research Program, Laboratory of Epidemiology and Population Science, National Institute on Aging, NIH, Bethesda, MD
| | - Melissa Garcia
- Intramural Research Program, Laboratory of Epidemiology and Population Science, National Institute on Aging, NIH, Bethesda, MD
| | | | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Ian H de Boer
- Division of Nephrology, Department of Medicine, and,Kidney Research Institute, University of Washington, Seattle, WA
| | - Bryan R Kestenbaum
- Division of Nephrology, Department of Medicine, and,Kidney Research Institute, University of Washington, Seattle, WA
| | - Cassianne Robinson-Cohen
- Division of Nephrology, Department of Medicine, and,Kidney Research Institute, University of Washington, Seattle, WA
| | | | - Patricia A Cassano
- Division of Nutritional Sciences, Cornell University, Ithaca, NY; Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, NY
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Orces CH. Vitamin D Status among Older Adults Residing in the Littoral and Andes Mountains in Ecuador. ScientificWorldJournal 2015; 2015:545297. [PMID: 26301259 PMCID: PMC4537767 DOI: 10.1155/2015/545297] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 07/15/2015] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and its determinants among older adults in Ecuador. METHODS 25(OH)D deficiency and insufficiency prevalence rates were examined among participants in the National Survey of Health, Wellbeing, and Aging. Logistic regression models were used to evaluate demographic characteristics associated with 25(OH)D deficiency. RESULTS Of 2,374 participants with a mean age of 71.0 (8.3) years, 25(OH)D insufficiency and deficiency were present in 67.8% (95% CI, 65.3-70.2) and 21.6% (95% CI, 19.5-23.7) of older adults in Ecuador, respectively. Women (OR, 3.19; 95% CI, 3.15-3.22), self-reported race as Indigenous (OR, 2.75; 95% CI, 2.70-2.80), and residents in rural (OR, 4.49; 95% CI, 4.40-4.58) and urban (OR, 2.74; 95% CI, 2.69-2.80) areas of the Andes Mountains region were variables significantly associated with 25(OH)D deficiency among older adults. CONCLUSIONS Despite abundant sunlight throughout the year in Ecuador, 25(OH)D deficiency was significantly prevalent among older women, Indigenous subjects, and subjects residing in the Andes Mountains region of the country. The present findings may assist public health authorities to implement policies of vitamin D supplementation among older adults at risk for this condition.
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Affiliation(s)
- Carlos H. Orces
- Department of Medicine, Laredo Medical Center, 1700 East Saunders, Laredo, TX 78041, USA
- *Carlos H. Orces:
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Racial differences in the burden of coronary artery calcium and carotid intima media thickness between Blacks and Whites. Neth Heart J 2014; 23:44-51. [PMID: 25342280 PMCID: PMC4268220 DOI: 10.1007/s12471-014-0610-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background Identification of racial differences in the burden and correlates of carotid intima media thickness (CIMT) and coronary artery calcium (CAC) may provide the basis for the development of race-specific cardiovascular disease (CVD) risk prediction algorithms. Methods In the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study, CIMT was measured by carotid ultrasonography in 792 individuals (35 % Black). CIMT >1 mm was considered significant. CAC was quantified by electron beam computed tomography in 776 individuals (46 % Black). CAC was considered significant if the Agatston score was >100. Cross-sectional associations between race, CIMT and CAC were assessed using logistic regression models. Results Blacks had greater CIMT (mean difference 0.033 mm, 95 % CI 0.005–0.06 mm; p = 0.02) and 1.5-fold (95 % CI 1.0–2.3) higher odds of having significant CIMT than Whites. Blacks had less CAC than Whites (mean Agatston score difference 66, [11–122]; p = 0.02) and 50 % lower odds of a significant CAC score compared with Whites (0.5 [0.3–0.7]). These associations were virtually unchanged after adjustment for CVD risk factors. Of the novel CVD risk markers assessed, small-dense low-density lipoprotein was independently associated with increased odds of significant CIMT, with the association being similar among Blacks and Whites (odds ratio [95 % CI]: 1.7 [1.2–2.5] and 1.4 [1.0–1.8] per 1-SD higher level, respectively). Interleukin-6 was significantly associated with CAC among Blacks (1.4 [1.0–2.0]). Conclusion Black race is independently associated with greater CIMT but less CAC than White race. CVD risk stratification strategies that incorporate these measures of subclinical atherosclerosis should consider race-specific algorithms. Electronic supplementary material The online version of this article (doi:10.1007/s12471-014-0610-4) contains supplementary material, which is available to authorized users.
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Common vitamin D pathway gene variants reveal contrasting effects on serum vitamin D levels in African Americans and European Americans. Hum Genet 2014; 133:1395-405. [PMID: 25085266 PMCID: PMC4185105 DOI: 10.1007/s00439-014-1472-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/18/2014] [Indexed: 01/06/2023]
Abstract
Vitamin D deficiency is more common among African Americans (AAs) than among European Americans (EAs), and epidemiologic evidence links vitamin D status to many health outcomes. Two genome-wide association studies (GWAS) in European populations identified vitamin D pathway gene single-nucleotide polymorphisms (SNPs) associated with serum vitamin D [25(OH)D] levels, but a few of these SNPs have been replicated in AAs. Here, we investigated the associations of 39 SNPs in vitamin D pathway genes, including 19 GWAS-identified SNPs, with serum 25(OH)D concentrations in 652 AAs and 405 EAs. Linear and logistic regression analyses were performed adjusting for relevant environmental and biological factors. The pattern of SNP associations was distinct between AAs and EAs. In AAs, six GWAS-identified SNPs in GC, CYP2R1, and DHCR7/NADSYN1 were replicated, while nine GWAS SNPs in GC and CYP2R1 were replicated in EAs. A CYP2R1 SNP, rs12794714, exhibited the strongest signal of association in AAs. In EAs, however, a different CYP2R1 SNP, rs1993116, was the most strongly associated. Our models, which take into account genetic and environmental variables, accounted for 20 and 28 % of the variance in serum vitamin D levels in AAs and EAs, respectively.
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Ng K, Scott JB, Drake BF, Chan AT, Hollis BW, Chandler PD, Bennett GG, Giovannucci EL, Gonzalez-Suarez E, Meyerhardt JA, Emmons KM, Fuchs CS. Dose response to vitamin D supplementation in African Americans: results of a 4-arm, randomized, placebo-controlled trial. Am J Clin Nutr 2014; 99:587-98. [PMID: 24368437 PMCID: PMC3927692 DOI: 10.3945/ajcn.113.067777] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/10/2013] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Association studies have suggested that lower circulating 25-hydroxyvitamin D [25(OH)D] in African Americans may partially underlie higher rates of cardiovascular disease and cancer in this population. Nonetheless, the relation between vitamin D supplementation and 25(OH)D concentrations in African Americans remains undefined. OBJECTIVE Our primary objective was to determine the dose-response relation between vitamin D and plasma 25(OH)D. DESIGN A total of 328 African Americans in Boston, MA, were enrolled over 3 winters from 2007 to 2010 and randomly assigned to receive a placebo or 1000, 2000, or 4000 IU vitamin D₃/d for 3 mo. Subjects completed sociodemographic and dietary questionnaires, and plasma samples were drawn at baseline and 3 and 6 mo. RESULTS Median plasma 25(OH)D concentrations at baseline were 15.1, 16.2, 13.9, and 15.7 ng/mL for subjects randomly assigned to receive the placebo or 1000, 2000, or 4000 IU/d, respectively (P = 0.63). The median plasma 25(OH)D concentration at 3 mo differed significantly between supplementation arms at 13.7, 29.7, 34.8, and 45.9 ng/mL, respectively (P < 0.001). An estimated 1640 IU vitamin D₃/d was needed to raise the plasma 25(OH)D concentration to ≥ 20 ng/mL in ≥ 97.5% of participants, whereas a dose of 4000 IU/d was needed to achieve concentrations ≥ 33 ng/mL in ≥ 80% of subjects. No significant hypercalcemia was seen in a subset of participants. CONCLUSIONS Within African Americans, an estimated 1640 IU vitamin D₃/d was required to achieve concentrations of plasma 25(OH)D recommended by the Institute of Medicine, whereas 4000 IU/d was needed to reach concentrations predicted to reduce cancer and cardiovascular disease risk in prospective observational studies. These results may be helpful for informing future trials of disease prevention.
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Affiliation(s)
- Kimmie Ng
- Department of Medical Oncology (KN, JAM, and CSF) and Center for Community-Based Research (JBS, EG-S, and KME), Dana-Farber Cancer Institute, Boston, MA; the Division of Public Health Sciences, Washington University School of Medicine, St Louis, MO (BFD); the Division of Gastroenterology, Massachusetts General Hospital, Boston, MA (ATC); the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (ATC, ELG, and CSF); the Division of Pediatrics, Medical University of South Carolina, Charleston, SC (BWH); the Division of General Medicine, Brigham and Women's Hospital, Boston, MA (PDC); the Department of Psychology and Neuroscience, Duke University, Durham, NC (GGB); and the Departments of Nutrition (JBS and ELG) and Social and Behavioral Sciences (KME), Harvard School of Public Health, Boston, MA
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Jacobs ET, Thomson CA, Flatt SW, Newman VA, Rock CL, Pierce JP. Correlates of 25-hydroxyvitamin D and breast cancer stage in the Women's Healthy Eating and Living Study. Nutr Cancer 2013; 65:188-94. [PMID: 23441606 DOI: 10.1080/01635581.2013.756531] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Inverse associations between circulating 25-hydroxyvitamin D [25(OH)D] and breast cancer stage have been reported, thus it is critical to understand the variables that contribute to 25(OH)D levels among women with breast cancer. Among 904 women in the Women's Healthy Eating and Living Study, plasma 25(OH)D concentrations were measured and data on demographic characteristics, diet, physical activity, and tumor characteristics were collected at study entry. Statistically significant associations with 25(OH)D concentrations were observed for body mass index (BMI), body surface area (BSA), height, smoking, total vitamin D intake, physical activity, and race or ethnicity. Of the correlates of 25(OH)D, BMI, BSA, height, physical activity, and study site were associated with stage of breast cancer; however, concentrations of 25(OH)D were not significantly related to stage. In fully adjusted logistic regression models, the ORs (95% CIs) for the association between vitamin D deficiency and Stage II and III cancers were 0.85 (0.59-1.22) and 1.23 (0.71-2.15), respectively (P trend = 0.59), compared to Stage I. This study confirms previous work regarding the correlates of 25(OH)D concentrations but does not provide support for an association between vitamin D status and breast cancer stage.
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Affiliation(s)
- Elizabeth T Jacobs
- Arizona Cancer Center and Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724-5024, USA.
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Hormonal relationships to bone mass in elderly Spanish men as influenced by dietary calcium and vitamin D. Nutrients 2013; 5:4924-37. [PMID: 24304609 PMCID: PMC3875934 DOI: 10.3390/nu5124924] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 11/19/2013] [Accepted: 11/21/2013] [Indexed: 12/31/2022] Open
Abstract
We aim to evaluate whether calcium and vitamin D intake is associated with 25-hydroxyvitamin D (25-OH-Vitamin D3) and parathyroid hormone (PTH) serum concentrations or is associated with either the phalangeal dual energy X-ray absorptiometry (pDXA) or the quantitative bone ultrasound (QUS) in independent elderly men. Serum PTH and 25-OH-Vitamin D3 were measured in 195 healthy elderly men (mean age: 73.31 ± 5.10 year). Food intake was quantified using a dietetic scale. Participants with 25-OH-Vitamin D3 levels ≥ 30 ng/mL (75 nmol/L) and a calcium intake of 800–1200 mg/day exhibited the lowest PTH levels (41.49 ± 16.72 ng/mL). The highest PTH levels (75.60 ± 14.16 ng/mL) were observed in the <30 ng/mL group 25-OH-Vitamin D3 with a calcium intake >1200 mg/day. No significant differences in the serum PTH levels based on the serum 25-OH-Vitamin D3 levels were observed among participants with a calcium intake of 800–1200 mg/day. Serum PTH was inversely correlated with serum 25-OH-Vitamin D3 in the entire patient sample (r = −0.288, p = 0.019). No differences in any of the three densitometry techniques were observed between any of the age groups in the 800–1200 mg/day and >1200 mg/day calcium intake groups. PTH levels correlate negatively with serum 25-OH-Vitamin D3 levels, and neither calcium nor vitamin D intake exert a strong influence on either of the two parameters.
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Mocanu V, Vieth R. Three-year follow-up of serum 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density in nursing home residents who had received 12 months of daily bread fortification with 125 μg of vitamin D₃. Nutr J 2013; 12:137. [PMID: 24120120 PMCID: PMC3874673 DOI: 10.1186/1475-2891-12-137] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 10/07/2013] [Indexed: 11/16/2022] Open
Abstract
Background We conducted a single-arm clinical trial in institutionalized seniors, on the effects of high-dose vitamin D3-fortified bread daily intake (clinicaltrials.gov registration NCT00789503). Methods At 1 and 3 years after the dietary fortification was stopped, serum 25-hydroxyvitamin D (25(OH)D), parathyroid hormone (PTH) and bone mineral density were measured in 23 of the original study subjects, aged 60-82 years who had consumed bread buns (100 g) fortified with 320 mg elemental calcium and 125 μg (5,000 IU) vitamin D3 daily for one year. Results At the end of the 1-year supplementation phase (receiving vitamin D3 fortified bread daily), mean (SD) serum 25(OH)D was 127.3 ± 37.8 nmol/L (baseline for this follow-up). At 1-year follow-up, the serum 25(OH)D was 64.9 ± 24.8 nmol/L (p = 0.001, vs. baseline); and at 3-year follow-up it was 28.0 ± 15.0 nmol/L (p = 0.001 vs. baseline). Serum PTH was 18.8 ± 15.6 pg/ml at baseline while at Year 3 it was 48.4 ± 18.4 pg/ml (p = 0.001 vs. baseline). Lumbar spine BMD did not change from baseline to Year 3. However, by Year 3, hip BMD had decreased (0.927 ± 0.130 g/cm2 vs. 0.907 ± 0.121 g/cm2, p = 0.024). Conclusion Vitamin D nutritional status exhibits a long half-life in the body, and a true steady-state plateau may not even be reached 1 year after a discontinuation in dose. Furthermore, once the need for vitamin D has been established, based on a low baseline serum 25(OH)D concentrations, the appropriate action is to maintain corrective vitamin D supplementation over the long term. Trial registration Clinical trial registration number: NCT00789503
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Affiliation(s)
- Veronica Mocanu
- Department of Pathophysiology, Grigore T, Popa University of Medicine and Pharmacy, 16 Universitatii str, Iasi 700115, Romania.
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Cabral MA, Borges CN, Maia JMC, Aires CAM, Bandeira F. Prevalence of vitamin D deficiency during the summer and its relationship with sun exposure and skin phototype in elderly men living in the tropics. Clin Interv Aging 2013; 8:1347-51. [PMID: 24124357 PMCID: PMC3794891 DOI: 10.2147/cia.s47058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The aim of the study reported here was to determine the prevalence of vitamin D deficiency among elderly men and its association with sun exposure and skin phototypes. SUBJECTS AND METHODS This was an analytical cross-sectional study, which involved 284 men aged 60 years or over, randomly recruited from a basic care unit in the city of Recife (Brazil). MEASUREMENTS Serum levels of 25 hydroxyvitamin D (25(OH)D), sun index, and skin phototypes were evaluated. RESULTS The prevalence of vitamin D deficiency was 31.5% and 66.7% when cut points of less than 20 and 30 ng/mL, respectively, were used. Mean serum 25(OH)D was 27.86 ± 13.52 standard deviation (SD) ng/mL. There was no difference (P = 0.113) in 25(OH) D (23.98 ± 14.66 SD vs 29.88 ± 13.78 SD) between individuals in the lowest quartile (Q) of the sun index (Q1: 1.96) compared with those in the highest (Q4: 7.86). When considering a cutoff of 20 ng/mL, the sun index was different in the two groups (P = 0.006), but there was no difference when cutoffs of 25 and 30 ng/mL were used. After adjustment, sun index and body mass index were associated positively and negatively, respectively with serum 25(OH)D independently. Most subjects (66.7%) had Fitzpatrick's skin phototypes IV, V, and VI. Low calcium intake was observed in 72%. There was no difference in serum 25(OH)D levels between patients with low intake and those with intermediate and high intakes. Only 2.5% were taking a vitamin supplement. CONCLUSION We found a high prevalence of vitamin D deficiency among elderly men despite their high sun exposure during the summer months.
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Affiliation(s)
- Marcelo Azevedo Cabral
- Department of Clinical Medicine, University of Pernambuco Medical School, Recife, Brazil
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Abstract
AIM : To examine the prevalence and risk factors of low vitamin D status (vitamin D deficiency or insufficiency) among patients in a methadone maintenance treatment (MMT) program. DESIGN : Cross-sectional study of subjects recruited from an MMT program in a higher latitude (Boston, MA). MEASUREMENTS : Standardized survey and medical record review were used to assess patient characteristics. Serum was tested to determine vitamin D deficiency (25-hydroxyvitamin D <20 ng/mL) and insufficiency (25-hydroxyvitamin D between 20 and 30 ng/mL). Multivariable analyses were used to assess risk factors associated with vitamin D deficiency. FINDINGS : Low vitamin D status was found in 52% of the subjects (48 of 93), deficiency in 36%, and insufficiency in an additional 16%. Older age (OR = 3.47; 95% CI 1.31-9.22) and black or Hispanic race/ethnicity (OR 3.34; 95% CI 1.30-8.58) were significantly associated with higher risk of vitamin D deficiency. CONCLUSION : Low vitamin D status was present in a majority of patients recruited from an MMT program. This raises the question as to whether this is a generalizable phenomenon and whether these patients are at higher risk of complications of low vitamin D status including bone pain, periodontal disease, osteomalacia, and cardiovascular disease.
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Mitchell DM, Henao MP, Finkelstein JS, Burnett-Bowie SAM. Prevalence and predictors of vitamin D deficiency in healthy adults. Endocr Pract 2013; 18:914-23. [PMID: 22982792 DOI: 10.4158/ep12072.or] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Vitamin D deficiency is highly prevalent in high-risk patient populations, but the prevalence among otherwise healthy adults is less well-defined. The goal of this study was to determine the prevalence and predictors of low 25-hydroxyvitamin D [25(OH)D] levels in healthy younger adults. METHODS This was a cross-sectional study of 634 healthy volunteers aged 18-50 years performed between January, 2006 and May, 2008. We measured serum 25(OH)D and parathyroid hormone and recorded demographic variables including age, sex, race, and use of multivitamin supplements. RESULTS Thirty-nine percent of subjects had 25(OH)D ≤ 20 ng/mL and 64% had 25(OH)D ≤ 30 ng/mL. Predictors of lower 25(OH)D levels included male sex, black or Asian race, and lack of multivitamin use (P<0.001 for each predictor). Seasonal variation in 25(OH)D levels was present in the overall cohort but was not observed in multivitamin users. Lower 25(OH)D levels were associated with increased risk of elevated parathyroid hormone. Regression models predicted 25(OH)D levels ≤ 20 or ≤ 30 ng/mL with areas under the receiver operating characteristic curves of 0.76 and 0.80, respectively. CONCLUSION Low 25(OH)D levels are prevalent in healthy adults and may confer risk of skeletal disease. Black and Asian adults are at increased risk of deficiency and multivitamin use appears partially protective. Our models predicting low 25(OH)D levels may guide decision-making regarding whom to screen for vitamin D deficiency.
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Affiliation(s)
- Deborah M Mitchell
- Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
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Freedman DM, Cahoon EK, Rajaraman P, Major JM, Doody MM, Alexander BH, Hoffbeck RW, Kimlin MG, Graubard BI, Linet MS. Sunlight and other determinants of circulating 25-hydroxyvitamin D levels in black and white participants in a nationwide U.S. study. Am J Epidemiol 2013; 177:180-92. [PMID: 23292956 DOI: 10.1093/aje/kws223] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Circulating 25-hydroxyvitamin D (25(OH)D), a marker for vitamin D status, is associated with bone health and possibly cancers and other diseases; yet, the determinants of 25(OH)D status, particularly ultraviolet radiation (UVR) exposure, are poorly understood. Determinants of 25(OH)D were analyzed in a subcohort of 1,500 participants of the US Radiologic Technologists (USRT) Study that included whites (n = 842), blacks (n = 646), and people of other races/ethnicities (n = 12). Participants were recruited monthly (2008-2009) across age, sex, race, and ambient UVR level groups. Questionnaires addressing UVR and other exposures were generally completed within 9 days of blood collection. The relation between potential determinants and 25(OH)D levels was examined through regression analysis in a random two-thirds sample and validated in the remaining one third. In the regression model for the full study population, age, race, body mass index, some seasons, hours outdoors being physically active, and vitamin D supplement use were associated with 25(OH)D levels. In whites, generally, the same factors were explanatory. In blacks, only age and vitamin D supplement use predicted 25(OH)D concentrations. In the full population, determinants accounted for 25% of circulating 25(OH)D variability, with similar correlations for subgroups. Despite detailed data on UVR and other factors near the time of blood collection, the ability to explain 25(OH)D was modest.
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Affiliation(s)
- D Michal Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland 20892-7238, USA.
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Okereke OI, Lyness JM, Lotrich FE, Reynolds CF. Depression in Late-Life: a Focus on Prevention. FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2013; 11:22-31. [PMID: 24729758 PMCID: PMC3982610 DOI: 10.1176/appi.focus.11.1.22] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Depression is a leading cause of disease burden, disability and distress for millions of older adults. Thus, prevention of late-life depression is a priority research area. This article addresses the science of late-life depression prevention with the following: 1) an introduction to the Institute of Medicine framework of universal, selective and indicated prevention as it pertains to late-life depression, with particular attention to successes of indicated and selective prevention in primary care; 2) a discussion of how biomarkers can be integrated into prevention research, using interferon-alpha-induced depression as a model; 3) an outline for expansion of prevention to non-specialist care delivery systems in Low and Middle Income Countries - thus, extending the reach of current successful approaches; 4) a description of a novel approach to simultaneous testing of universal, selective and indicated prevention in late-life depression, with emphasis on study design features required to achieve practical, scalable tests of health impact.
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Affiliation(s)
- Olivia I Okereke
- Channing Division of Network Medicine (OIO), Department of Medicine, and Department of Psychiatry (OIO), Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Psychiatry (JML), University of Rochester School of Medicine & Dentistry, Rochester, NY, United States; University of Pittsburgh Medical Center (FEL), Pittsburgh, PA, United States; Department of Psychiatry (CFR), University of Pittsburgh School of Medicine, and Department of Behavioral and Community Health Sciences (CFR), Graduate School of Public Health, Pittsburgh, PA, United States
| | - Jeffrey M Lyness
- Channing Division of Network Medicine (OIO), Department of Medicine, and Department of Psychiatry (OIO), Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Psychiatry (JML), University of Rochester School of Medicine & Dentistry, Rochester, NY, United States; University of Pittsburgh Medical Center (FEL), Pittsburgh, PA, United States; Department of Psychiatry (CFR), University of Pittsburgh School of Medicine, and Department of Behavioral and Community Health Sciences (CFR), Graduate School of Public Health, Pittsburgh, PA, United States
| | - Francis E Lotrich
- Channing Division of Network Medicine (OIO), Department of Medicine, and Department of Psychiatry (OIO), Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Psychiatry (JML), University of Rochester School of Medicine & Dentistry, Rochester, NY, United States; University of Pittsburgh Medical Center (FEL), Pittsburgh, PA, United States; Department of Psychiatry (CFR), University of Pittsburgh School of Medicine, and Department of Behavioral and Community Health Sciences (CFR), Graduate School of Public Health, Pittsburgh, PA, United States
| | - Charles F Reynolds
- Channing Division of Network Medicine (OIO), Department of Medicine, and Department of Psychiatry (OIO), Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Psychiatry (JML), University of Rochester School of Medicine & Dentistry, Rochester, NY, United States; University of Pittsburgh Medical Center (FEL), Pittsburgh, PA, United States; Department of Psychiatry (CFR), University of Pittsburgh School of Medicine, and Department of Behavioral and Community Health Sciences (CFR), Graduate School of Public Health, Pittsburgh, PA, United States
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Kincse G, Varga J, Somogyi P, Szodoray P, Surányi P, Gaál J. The impact of secondary hyperparathyroidism on the efficacy of antiresorptive therapy. BMC Musculoskelet Disord 2012; 13:244. [PMID: 23227959 PMCID: PMC3529113 DOI: 10.1186/1471-2474-13-244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 12/06/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the present study was to assess whether the efficacy of bisphosphonate treatment is influenced by PTH levels measured in newly diagnosed osteoporotic patients and to identify the threshold value, beyond which PTH level negatively influences therapeutic efficacy. METHODS One hundred and thirty-eight osteoporotic patients were enrolled into the study. All subjects underwent laboratory screening, bone densitometry with DEXA, and x-ray imaging. The changes in bone density were evaluated after a mean follow-up period of 13.37 ± 1.29 months. Correlation analysis was performed on the clinical data of patients, the percentage changes of BMD values, and the PTH levels measured at the beginning of study, using SPSS software. RESULTS The mean age of the subjects was 64.82 ± 10.51 years, and the female-to-male ratio was 116/22. Baseline BMD value measured with AP DEXA scanning was 0.854 ± 0.108 g/cm(2) in the L(1-4) vertebrae and 0.768 ± 0.115 g/cm(2) in the left femoral neck. By the end of the follow-up period, these values changed to 0.890 ± 0.111 g/cm(2) and 0.773 ± 0.111 g/cm(2), respectively. We found a statistically significant, negative correlation between PTH levels and the percentage changes of lumbar BMD values measured at the end of the follow-up (correlation coefficient R(2) = 0.121, p < 0.0001). The analysis of frequency histograms suggested that negative effects on bone might be expected above a PTH level of 60 pg/mL (7.3 pmol/L). CONCLUSION Our findings imply that a baseline PTH level over 60 ng/mL can reduce the efficacy of bisphosphonate treatment.
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Affiliation(s)
- Gyöngyvér Kincse
- Department of Rheumatology, Kenézy Gyula Hospital, Debrecen, Hungary
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Glover TL, Goodin BR, Horgas AL, Kindler LL, King CD, Sibille KT, Peloquin CA, Riley JL, Staud R, Bradley LA, Fillingim RB. Vitamin D, race, and experimental pain sensitivity in older adults with knee osteoarthritis. ARTHRITIS AND RHEUMATISM 2012; 64:3926-35. [PMID: 23135697 PMCID: PMC3510313 DOI: 10.1002/art.37687] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 08/23/2012] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Low circulating serum levels of 25-hydroxyvitamin D (referred to hereafter as vitamin D) have been correlated with many health conditions, including chronic pain. Recent clinical practice guidelines define vitamin D levels <20 ng/ml as deficient and levels of 21-29 ng/ml as insufficient. Vitamin D insufficiency, including the most severe levels of deficiency, is more prevalent in black Americans. Ethnic and race group differences have been reported in both clinical and experimental pain, with black Americans reporting increased pain. The purpose of this study was to examine whether variations in vitamin D levels contribute to race differences in knee osteoarthritis pain. METHODS The sample consisted of 94 participants (74% women), including 45 blacks and 49 whites with symptomatic knee osteoarthritis. Their average age was 55.8 years (range 45-71 years). Participants completed a questionnaire on knee osteoarthritis symptoms and underwent quantitative sensory testing, including measures of sensitivity to heat-induced and mechanically induced pain. RESULTS Blacks had significantly lower levels of vitamin D compared to whites, demonstrated greater clinical pain, and showed greater sensitivity to heat-induced and mechanically induced pain. Low levels of vitamin D predicted increased experimental pain sensitivity, but did not predict self-reported clinical pain. Group differences in vitamin D levels significantly predicted group differences in heat pain and pressure pain thresholds at the index knee and ipsilateral forearm. CONCLUSION These data demonstrate that race differences in experimental pain are mediated by differences in the vitamin D level. Vitamin D deficiency may be a risk factor for increased knee osteoarthritis pain in black Americans.
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Affiliation(s)
- T L Glover
- University of Florida, Gainesville, FL 32610, USA.
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Decreased serum vitamin D in idiopathic benign paroxysmal positional vertigo. J Neurol 2012; 260:832-8. [PMID: 23096068 DOI: 10.1007/s00415-012-6712-2] [Citation(s) in RCA: 88] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 10/03/2012] [Accepted: 10/05/2012] [Indexed: 10/27/2022]
Abstract
Previous studies have demonstrated an association of osteopenia/osteoporosis with idiopathic benign paroxysmal positional vertigo (BPPV). Since vitamin D takes part in the regulation of calcium and phosphorus found in the body and plays an important role in maintaining proper bone structure, decreased bone mineral density in patients with BPPV may be related to decreased serum vitamin D. We measured the serum levels of 25-hydroxyvitamin D in 100 patients (63 women and 37 men, mean age ± SD = 61.8 ± 11.6) with idiopathic BPPV and compared the data with those of 192 controls (101 women and 91 men, mean age ± SD = 60.3 ± 11.3) who had lived in the same community without dizziness or imbalance during the preceding year. The selection of the controls and acquisition of clinical information were done using the data from the Fourth Korean National Health and Nutrition Examination Survey, 2008. The serum level of 25-hydroxyvitamin D was lower in the patients with BPPV than in the controls (mean ± SD = 14.4 ± 8.4 versus 19.1 ± 6.8 ng/ml, p = 0.001). Furthermore, patients with BPPV showed a higher prevalence of decreased serum vitamin D (<20 ng/ml, 80.0 vs. 60.1 %, p < 0.001) than the controls. Multiple logistic regression analyses adjusted for age, sex, body mass index, hypertension, diabetes, proteinuria, regular exercise and the existence of decreased bone mineral density demonstrated that vitamin D insufficiency (10-20 ng/ml) and deficiency (<10 ng/ml) were associated with BPPV with the odds ratios of 3.8 (95 % confidence interval = 1.51-9.38, p = 0.004) and 23.0 (95 % confidence interval = 6.88-77.05, p < 0.001). Our study demonstrated an association between idiopathic BPPV and decreased serum vitamin D. Decreased serum vitamin D may be a risk factor of BPPV.
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Crandall CJ, Miller-Martinez D, Greendale GA, Binkley N, Seeman TE, Karlamangla AS. Socioeconomic status, race, and bone turnover in the Midlife in the US Study. Osteoporos Int 2012; 23:1503-12. [PMID: 21811862 PMCID: PMC3257365 DOI: 10.1007/s00198-011-1736-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 06/07/2011] [Indexed: 10/17/2022]
Abstract
UNLABELLED Among a group of 940 US adults, economic adversity and minority race status were associated with higher serum levels of markers of bone turnover. These results suggest that higher levels of social stress may increase bone turnover. INTRODUCTION To determine socioeconomic status (SES) and race differences in levels of bone turnover. METHODS Using data from the Biomarker Substudy of the Midlife in the US (MIDUS) study (491 men, 449 women), we examined cross-sectional associations of SES and race with serum levels of bone turnover markers (bone-specific alkaline phosphatase [BSAP], procollagen type I N-terminal propeptide [PINP], and N-telopeptide [Ntx]) separately in men and women. Linear multivariable regression was used to control for body weight, menopausal transition stage, and age. RESULTS Among men, low family poverty-to-income ratio (FPIR) was associated with higher turnover, but neither education nor race was associated with turnover. Men with FPIR <3 had 1.808 nM BCE higher Ntx (P = 0.05), 3.366 U/L higher BSAP (P = 0.02), and 7.066 higher PINP (P = 0.02). Among women, neither education nor FPIR was associated with bone turnover, but Black women had 3.688 nM BCE higher Ntx (P = 0.001), 5.267 U/L higher BSAP (P = 0.005), and 11.906 μg/L higher PINP (P = 0.008) compared with non-Black women. CONCLUSIONS Economic adversity was associated with higher bone turnover in men, and minority race status was associated with higher bone turnover in women, consistent with the hypothesis that higher levels of social stresses cause increased bone turnover. The magnitude of these associations was comparable to the effects of some osteoporosis medications on levels of turnover.
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Affiliation(s)
- Carolyn J. Crandall
- Division of General Internal Medicine, David Geffen School of Medicine at University of California, Los Angeles
| | - Dana Miller-Martinez
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles
| | - Gail A. Greendale
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles
| | - Neil Binkley
- University of Wisconsin-Madison Osteoporosis Clinical Center and Research Program, Madison, WI
| | - Teresa E. Seeman
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles
| | - Arun S. Karlamangla
- Division of Geriatrics, David Geffen School of Medicine at University of California, Los Angeles
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Shoben AB, Levin G, de Boer IH, Yeung C, Watnick S, Ayers E, Kestenbaum B. Variation in oral calcitriol response in patients with stages 3-4 CKD. Am J Kidney Dis 2012; 59:645-52. [PMID: 22285224 PMCID: PMC3328668 DOI: 10.1053/j.ajkd.2011.11.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 11/29/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Oral calcitriol decreases parathyroid hormone (PTH) concentrations in patients who have chronic kidney disease (CKD); however, treatment response is highly variable. We evaluated whether patient characteristics affect the PTH response to oral calcitriol in nondialysis patients with CKD in a clinic-based setting. STUDY DESIGN Cohort study. SETTING & PARTICIPANTS This study included 379 new oral calcitriol users in the Veterans' Affairs Northwest Health Network. All had stages 3-4 CKD, hyperparathyroidism, and a serum PTH measurement before and 1-6 months after initiating oral calcitriol therapy. PREDICTORS Patient-level characteristics hypothesized to affect calcitriol response: race, body size, concurrent medications, and kidney function. OUTCOMES Relative decrease in serum PTH concentration after starting oral calcitriol therapy. MEASUREMENTS Data were abstracted from the Veterans' Affairs Northwest Health Network (VISN 20) Data Warehouse, which includes electronic pharmacy and laboratory records. RESULTS Mean estimated glomerular filtration rate was 30 mL/min/1.73 m(2) and mean initial PTH concentration was 199 pg/mL. Regular- (0.25 μg/d) and low-dose (<0.25 μg/d) oral calcitriol were associated with on average 23% and 13% relative decreases in serum PTH concentrations, respectively. After adjustment for calcitriol dosage, initial PTH concentration, and time to follow-up measurement, African American race was associated with a blunted calcitriol response (geometric mean final PTH value, 26% higher; 95% CI, 8%-47%). Serum albumin concentration <3.5 g/dL also was associated with a diminished calcitriol response (geometric mean final PTH, 19% higher; 95% CI, 6%-35%). Although numbers were small, concurrent use of benzodiazepines and nonactivated vitamin D supplements was associated with a significantly greater PTH response. LIMITATIONS Clinic-based study is limited by the availability of PTH measurements after starting calcitriol therapy. Study of a predominantly older male population. CONCLUSIONS In patients with stages 3-4 CKD, African American race and low serum albumin level are associated with a diminished PTH response to oral calcitriol.
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Affiliation(s)
- Abigail B Shoben
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH 43210-1240, USA.
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Parker-Autry CY, Burgio KL, Richter HE. Vitamin D status: a review with implications for the pelvic floor. Int Urogynecol J 2012; 23:1517-26. [PMID: 22415704 DOI: 10.1007/s00192-012-1710-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 02/09/2012] [Indexed: 12/31/2022]
Abstract
Vitamin D is a micronutrient vital in calcium homeostasis and musculoskeletal function. Vitamin D insufficiency is a common variant of vitamin D deficiency that shows clinical signs of rickets and osteomalacia. The clinical significance of vitamin D insufficiency is being explored in several medical conditions. However, the most robust work suggests a role in musculoskeletal disease. The pelvic floor is a unique part of the body and the function of which is dependent on interrelationships between muscle, nerve, connective tissue, and bone. Pelvic floor disorders result when these relationships are disrupted. This paper reviews current knowledge regarding vitamin D nutritional status, the importance of vitamin D in muscle function, and how insufficient or deficient vitamin D levels may play a role in the function of the female pelvic floor.
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Affiliation(s)
- Candace Y Parker-Autry
- Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, 619 19th Street South, 176F, Suite 10382, Birmingham, AL 35249, USA.
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Murphy AB, Kelley B, Nyame YA, Martin IK, Smith DJ, Castaneda L, Zagaja GJ, Hollowell CMP, Kittles RA. Predictors of serum vitamin D levels in African American and European American men in Chicago. Am J Mens Health 2012; 6:420-6. [PMID: 22398989 DOI: 10.1177/1557988312437240] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vitamin D deficiency is epidemiologically linked to prostate, breast, and colon cancer. When compared with European American (EA) men, African American (AA) men have increased risk of prostate cancer, but few studies evaluate vitamin D status in AA men. The authors evaluate the biological and environmental predictors of vitamin D deficiency in AA and EA men in Chicago, Illinois, a low ultraviolet radiation environment. Blood samples were collected from 492 men, aged between 40 and 79 years, from urology clinics at three hospitals in Chicago, along with demographic and medical information, body mass index, and skin melanin content using a portable narrow-band reflectometer. Vitamin D intake and ultraviolet radiation exposure were assessed using validated questionnaires. The results demonstrated that Black race, cold season of blood draw, elevated body mass index, and lack of vitamin D supplementation increase the risk of vitamin D deficiency. Supplementation is a high-impact, modifiable risk factor. Race and sunlight exposure should be taken into account for recommended daily allowances for vitamin D intake.
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Affiliation(s)
- Adam B Murphy
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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Ginde AA, Wolfe P, Camargo CA, Schwartz RS. Defining vitamin D status by secondary hyperparathyroidism in the U.S. population. J Endocrinol Invest 2012; 35:42-8. [PMID: 21606669 DOI: 10.3275/7742] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vitamin D is associated with a variety of health outcomes, but the exact definition of vitamin D sufficiency remains controversial. AIM We sought to define skeletal-related vitamin D sufficiency by estimating maximum PTH suppression in the U.S. population. METHODS We performed a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES), 2003-2006. We examined the association between serum 25-hydroxyvitamin D (25OHD) level and serum PTH level in 14,681 participants aged ≥6 yr. We also evaluated the 25OHD-PTH association using 2 thresholds of hyperparathyroidism: PTH≥45 pg/ml and ≥75 pg/ml. RESULTS The mean 25OHD level was 24 ng/ml and mean PTH was 42 pg/ml. PTH≥45 pg/ml was present in 35% of the population, while PTH≥75 pg/ml was present in 7%. The prevalence of 25OHD levels <40 ng/ml and <30 ng/ml was 95% and 77%, respectively. In both unadjusted and adjusted models, there was a strong inverse relationship between 25OHD and PTH. Compared to 25OHD≥40 ng/ml, the 25OHD-PTH association was 2.36 [95% confidence interval (CI), 2.08-2.67] times greater for 25OHD<5 ng/ml and 1.12 (95%CI, 1.07-1.17) times greater for 25OHD 30-39.9 ng/ml. Compared to 25OHD≥40 ng/ml, 25OHD levels of 20- 29.9 ng/ml [odds ratio (OR) 2.0 (95%CI, 1.4-2.8)] but not 30- 39.9 ng/ml [OR 1.1 (95%CI, 0.8-1.6)] were independently associated with PTH≥45 pg/ml. CONCLUSIONS Optimal vitamin D status, defined by estimated maximum PTH suppression, does not occur until at least 25OHD levels ≥40 ng/ml. Using these thresholds, most of the U.S. population needs more vitamin D. Large, prospective studies are needed to determine optimal vitamin D supplementation.
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Affiliation(s)
- A A Ginde
- Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, CO 80045, USA.
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Shea MK, Houston DK, Tooze JA, Davis CC, Johnson MA, Hausman DB, Cauley JA, Bauer DC, Tylavsky F, Harris TB, Kritchevsky SB. Correlates and prevalence of insufficient 25-hydroxyvitamin D status in black and white older adults: the health, aging and body composition study. J Am Geriatr Soc 2011; 59:1165-74. [PMID: 21668915 PMCID: PMC3282467 DOI: 10.1111/j.1532-5415.2011.03476.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To determine the prevalence and correlates of vitamin D insufficiency in black and white older adults. DESIGN Cross-sectional. SETTING Health, Aging and Body Composition Study. PARTICIPANTS Nine hundred seventy-seven black and 1,604 white adults aged 70 to 81. MEASUREMENTS Logistic regression and classification and regression tree analysis were used to identify correlates of vitamin D insufficiency (25-hydroxyvitamin D (25(OH)D) <30 ng/mL) separately in blacks and whites. RESULTS The prevalence of 25(OH)D insufficiency was 84% in blacks and 57% in whites. Seventy-six percent of blacks and 56% of whites did not take a multivitamin; those who did not take a multivitamin were more likely to be vitamin D insufficient (odds ratio (OR)=5.17 (95% confidence interval (CI)=3.47-7.70) for blacks; OR=2.56, 95% CI=2.05-3.19 for white). Additional risk factors for vitamin D insufficiency were vitamin D-containing supplement use, female sex, and obesity in blacks; and winter season, low dietary vitamin D intake, obesity, type 2 diabetes mellitus, and female sex in whites. CONCLUSION Vitamin D insufficiency was more prevalent in blacks than whites. Not consuming a multivitamin increased the odds of vitamin D insufficiency in blacks and whites. Knowledge of additional risk factors such as dietary intake and comorbid conditions may help identify older adults who are likely to be vitamin D insufficient.
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Affiliation(s)
- M Kyla Shea
- Department of Internal Medicine, School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA.
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Gutiérrez OM, Farwell WR, Kermah D, Taylor EN. Racial differences in the relationship between vitamin D, bone mineral density, and parathyroid hormone in the National Health and Nutrition Examination Survey. Osteoporos Int 2011; 22:1745-53. [PMID: 20848081 PMCID: PMC3093445 DOI: 10.1007/s00198-010-1383-2] [Citation(s) in RCA: 235] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Accepted: 08/18/2010] [Indexed: 02/07/2023]
Abstract
UNLABELLED It is unclear whether optimal levels of 25-hydroxyvitamin D (25(OH)D) in whites are the same as in minorities. In adult participants of NHANES, the relationships between 25(OH)D, bone mineral density (BMD), and parathyroid hormone (PTH) differed in blacks as compared to whites and Mexican-Americans, suggesting that optimal 25(OH)D levels for bone and mineral metabolism may differ by race. INTRODUCTION Blacks and Hispanics have lower 25-hydroxyvitamin D concentrations than whites. However, it is unclear whether 25(OH)D levels considered "optimal" for bone and mineral metabolism in whites are the same as those in minority populations. METHODS We examined the relationships between 25(OH)D and parathyroid hormone in 8,415 adult participants (25% black and 24% Mexican-American) in the National Health and Nutrition Examination Surveys 2003-2004 and 2005-2006; and between 25(OH)D and bone mineral density in 4,206 adult participants (24% black and 24% Mexican-American) in the 2003-2004 sample. RESULTS Blacks and Mexican-Americans had significantly lower 25(OH)D and higher PTH concentrations than whites (P < 0.01 for both). BMD significantly decreased (P < 0.01) as serum 25(OH)D and calcium intake declined among whites and Mexican-Americans, but not among blacks (P = 0.2). The impact of vitamin D deficiency (25(OH)D ≤ 20 ng/ml) on PTH levels was modified by race/ethnicity (P for interaction, 0.001). Whereas inverse relationships between 25(OH)D and PTH were observed above and below a 25(OH)D level of 20 ng/ml in whites and Mexican-Americans, an inverse association between 25(OH)D and PTH was only observed below this threshold in blacks, with the slope of the relationship being essentially flat (P = 0.7) above this cut-point, suggesting that PTH may be maximally suppressed at lower 25(OH)D levels in blacks than in whites or Mexican-Americans. CONCLUSIONS The relationships between 25(OH)D, BMD, and PTH may differ by race among US adults. Whether race-specific ranges of optimal vitamin D are needed to appropriately evaluate the adequacy of vitamin D stores in minorities requires further study.
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Affiliation(s)
- O M Gutiérrez
- Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th street, CRB, C-221, Room 815, Miami, FL 33136, USA.
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Sai AJ, Walters RW, Fang X, Gallagher JC. Relationship between vitamin D, parathyroid hormone, and bone health. J Clin Endocrinol Metab 2011; 96:E436-46. [PMID: 21159838 PMCID: PMC3047227 DOI: 10.1210/jc.2010-1886] [Citation(s) in RCA: 187] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
CONTEXT There is a controversy regarding the definition of vitamin D insufficiency as it relates to bone health. OBJECTIVE The objective of the study was to examine the evidence for a threshold value of serum 25-hydroxyvitamin D (25OHD) that defines vitamin D insufficiency as it relates to bone health. DESIGN AND PARTICIPANTS This was a cross-sectional analysis of baseline data in 488 elderly Caucasian women, mean age 71 yr, combined with a literature review of 70 studies on the relationship of serum PTH to serum 25OHD. SETTING The study was conducted in independent-living women in the midwest United States. MAIN OUTCOME MEASURE The relationship between serum 25OHD, serum PTH, and serum osteocalcin and 24-h urine N-telopeptides was evaluated. RESULTS Serum PTH was inversely correlated with serum 25OHD (r = -0.256, P < 0.0005), but no threshold as defined by suppression of serum PTH was found within the serum 25OHD range 6-60 ng/ml (15-150 nmol/liter). However, in contrast, there was a threshold for bone markers, serum osteocalcin and urine N-telopeptides, that increased only below a serum 25OHD of approximately 18 ng/ml (45 nmol/liter). Calcium absorption was not correlated with serum PTH and serum 25OHD, and no threshold was found. A literature review of 70 studies generally showed a threshold for serum PTH with increasing serum 25OHD, but there was no consistency in the threshold level of serum 25OHD that varied from 10 to 50 ng/ml (25-125 nmol/liter). CONCLUSIONS Vitamin D insufficiency should be defined as serum 25OHD less than 20 ng/ml (50 nmol/liter) as it relates to bone.
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Affiliation(s)
- A J Sai
- Bone Metabolism Unit, Department of Medicine, Creighton University Medical Center, 601 North 30 Street, Suite 6718, Omaha, Nebraska 68131, USA.
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Stein EM, Yin MT, McMahon DJ, Shu A, Zhang CA, Ferris DC, Colon I, Dobkin JF, Hammer SM, Shane E. Vitamin D deficiency in HIV-infected postmenopausal Hispanic and African-American women. Osteoporos Int 2011; 22:477-87. [PMID: 20585939 PMCID: PMC3105902 DOI: 10.1007/s00198-010-1299-x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 05/06/2010] [Indexed: 11/25/2022]
Abstract
UNLABELLED We evaluated vitamin D status in HIV+ and HIV- postmenopausal African-American (AA) and Hispanic women. Most women (74-78%) had insufficient 25-hydroxyvitamin D (25OHD) levels, regardless of HIV status. 25OHD was lower in AA women and women lacking supplement use, providing support for screening and supplementation. Among HIV+ women, 25OHD was associated with current CD4 but not type of antiretroviral therapy. INTRODUCTION To evaluate vitamin D status and factors associated with vitamin D deficiency and insufficiency in HIV-infected (HIV+) postmenopausal minority women. METHODS In this cross-sectional study, 89 HIV+ and 95 HIV- postmenopausal women (33% AA and 67% Hispanic) underwent assessment of 25OHD, 1,25-dihydroxyvitamin D, parathyroid hormone, markers of bone turnover and bone mineral density by dual energy X-ray absorptiometry. RESULTS The prevalence of low 25OHD did not differ by HIV status; the majority of both HIV+ and HIV- women (74-78%) had insufficient levels (<30 ng/ml). Regardless of HIV status, 25OHD was significantly lower in AA subjects, and higher in subjects who used both calcium and multivitamins. In HIV+ women on antiretroviral therapy (ART), 25OHD was directly associated with current CD4 count (r=0.32; p<0.01) independent of age, ethnicity, BMI, or history of AIDS-defining illness. No association was observed between 1,25(OH)(2)D and CD4 count or between serum 25OHD, 1,25(OH)(2)D or PTH and type of ART. CONCLUSIONS In postmenopausal minority women, vitamin D deficiency was highly prevalent and associated with AA race and lack of supplement use, as well as lower current CD4 cell count. These results provide support for screening and repletion of vitamin D in HIV+ patients.
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Affiliation(s)
- E. M. Stein
- Columbia University Medical Center, New York, NY, USA
| | - M. T. Yin
- Columbia University Medical Center, New York, NY, USA. Division of Infectious Diseases, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, New York, NY 10032, USA
| | - D. J. McMahon
- Columbia University Medical Center, New York, NY, USA
| | - A. Shu
- Columbia University Medical Center, New York, NY, USA
| | - C. A. Zhang
- Columbia University Medical Center, New York, NY, USA
| | | | - I. Colon
- Columbia University Medical Center, New York, NY, USA
| | - J. F. Dobkin
- Columbia University Medical Center, New York, NY, USA
| | - S. M. Hammer
- Columbia University Medical Center, New York, NY, USA
| | - E. Shane
- Columbia University Medical Center, New York, NY, USA
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McCullough ML, Weinstein SJ, Freedman DM, Helzlsouer K, Flanders WD, Koenig K, Kolonel L, Laden F, Le Marchand L, Purdue M, Snyder K, Stevens VL, Stolzenberg-Solomon R, Virtamo J, Yang G, Yu K, Zheng W, Albanes D, Ashby J, Bertrand K, Cai H, Chen Y, Gallicchio L, Giovannucci E, Jacobs EJ, Hankinson SE, Hartge P, Hartmuller V, Harvey C, Hayes RB, Horst RL, Shu XO. Correlates of circulating 25-hydroxyvitamin D: Cohort Consortium Vitamin D Pooling Project of Rarer Cancers. Am J Epidemiol 2010; 172:21-35. [PMID: 20562191 PMCID: PMC2892536 DOI: 10.1093/aje/kwq113] [Citation(s) in RCA: 104] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Accepted: 04/12/2010] [Indexed: 12/19/2022] Open
Abstract
Low vitamin D status is common globally and is associated with multiple disease outcomes. Understanding the correlates of vitamin D status will help guide clinical practice, research, and interpretation of studies. Correlates of circulating 25-hydroxyvitamin D (25(OH)D) concentrations measured in a single laboratory were examined in 4,723 cancer-free men and women from 10 cohorts participating in the Cohort Consortium Vitamin D Pooling Project of Rarer Cancers, which covers a worldwide geographic area. Demographic and lifestyle characteristics were examined in relation to 25(OH)D using stepwise linear regression and polytomous logistic regression. The prevalence of 25(OH)D concentrations less than 25 nmol/L ranged from 3% to 36% across cohorts, and the prevalence of 25(OH)D concentrations less than 50 nmol/L ranged from 29% to 82%. Seasonal differences in circulating 25(OH)D were most marked among whites from northern latitudes. Statistically significant positive correlates of 25(OH)D included male sex, summer blood draw, vigorous physical activity, vitamin D intake, fish intake, multivitamin use, and calcium supplement use. Significant inverse correlates were body mass index, winter and spring blood draw, history of diabetes, sedentary behavior, smoking, and black race/ethnicity. Correlates varied somewhat within season, race/ethnicity, and sex. These findings help identify persons at risk for low vitamin D status for both clinical and research purposes.
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Gutiérrez OM, Isakova T, Smith K, Epstein M, Patel N, Wolf M. Racial differences in postprandial mineral ion handling in health and in chronic kidney disease. Nephrol Dial Transplant 2010; 25:3970-7. [PMID: 20530498 DOI: 10.1093/ndt/gfq316] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Increased serum phosphate is associated with cardiovascular disease. Compared with whites, blacks have significantly higher serum phosphate and increased risk of hyperphosphataemia in health and chronic kidney disease (CKD). While population-based studies suggest that diminished urinary phosphorus excretion in blacks may explain these differences, few physiological studies explored the potential mechanisms. The aim of this study was to examine racial differences in postprandial urinary mineral ion excretion in health and in CKD. METHODS Twenty-eight healthy (18 white and 10 black) and 19 CKD (9 white and 10 black) subjects consumed a standardized meal; after which, blood and urine samples were collected for 4 h for measurement of phosphate, calcium, parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23). RESULTS Although serum phosphate did not differ by race, blacks had ∼30% lower postprandial fractional excretion of phosphate than whites in health (P < 0.001) and CKD (P = 0.02). Similarly, blacks had ∼35% lower fractional excretion of calcium in health (P = 0.02) and CKD (P = 0.3). Moreover, the postprandial response in serum calcium among CKD subjects differed by race (P = 0.03), with serum calcium significantly decreasing in whites but not blacks. CONCLUSIONS Blacks had lower fractional excretion of phosphate than whites despite similar levels of PTH and FGF23 in health and in CKD, suggesting racial variability in renal sensitivity to phosphaturic hormones. Furthermore, blacks defend postprandial serum calcium more effectively than whites in CKD. Further studies are needed to define the mechanisms underlying these observations and evaluate whether racial differences in mineral ion handling may contribute to disparities in CKD outcomes.
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Affiliation(s)
- Orlando M Gutiérrez
- Division of Nephrology and Hypertension, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA.
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Freedman BI, Wagenknecht LE, Hairston KG, Bowden DW, Carr JJ, Hightower RC, Gordon EJ, Xu J, Langefeld CD, Divers J. Vitamin d, adiposity, and calcified atherosclerotic plaque in african-americans. J Clin Endocrinol Metab 2010; 95:1076-83. [PMID: 20061416 PMCID: PMC2841532 DOI: 10.1210/jc.2009-1797] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Inverse associations are reported between circulating 25-hydroxyvitamin D and visceral adiposity. The effects of vitamin D levels on atherosclerosis are unknown. OBJECTIVE The objective of this study was to test for relationships between vitamin D, adiposity, bone density, and atherosclerosis in African-Americans. DESIGN Circulating 25-hydroxyvitamin D, 1,25 dihydroxyvitamin D, intact PTH, C-reactive protein and computed tomography-derived calcified atherosclerotic plaque (CP), bone density, and fat volumes were measured. SETTING Examinations were performed at a single outpatient general clinical research center visit. SUBJECTS Three hundred forty African-Americans with type 2 diabetes were evaluated. Mean +/- SD age was 55.6 +/- 9.6 yr, diabetes duration 10.6 +/- 8.3 yr, glomerular filtration rate 1.6 +/- 0.5 ml/sec, body mass index 35.6 +/- 8.7 kg/m(2), and 25-hydroxyvitamin D concentration 50.4 +/- 30.5 nmol/liter. MAIN OUTCOME MEASURE Biomarkers were tested for association with pericardial, visceral, im, and sc adipose tissues; thoracic and lumbar vertebral bone density; and aorta, coronary, and carotid artery CP. RESULTS Adjusting for age, gender, body mass index, glycosylated hemoglobin, and glomerular filtration rate, 25-hydroxyvitamin D was negatively associated with visceral adiposity (P = 0.009) and positively associated with carotid artery CP and aorta CP (P = 0.013 and 0.014, respectively) but not with coronary artery CP or bone density. CONCLUSIONS We confirmed an inverse association between vitamin D and visceral adiposity in African-Americans with diabetes. In addition, positive associations exist between 25-hydroxyvitamin D and aorta and carotid artery CP in African-Americans. The effects of supplementing vitamin D to raise the serum 25-hydroxyvitamin D level on atherosclerosis in African-Americans are unknown. Prospective trials are needed to determine the cardiovascular effects of supplemental vitamin D in this ethnic group.
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Affiliation(s)
- Barry I Freedman
- Section on Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, North Carolina 27157-1053, USA.
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Buell JS, Dawson-Hughes B, Scott TM, Weiner DE, Dallal GE, Qui WQ, Bergethon P, Rosenberg IH, Folstein MF, Patz S, Bhadelia RA, Tucker KL. 25-Hydroxyvitamin D, dementia, and cerebrovascular pathology in elders receiving home services. Neurology 2009; 74:18-26. [PMID: 19940273 DOI: 10.1212/wnl.0b013e3181beecb7] [Citation(s) in RCA: 202] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Vitamin D deficiency has potential adverse effects on neurocognitive health and subcortical function. However, no studies have examined the association between vitamin D status, dementia, and cranial MRI indicators of cerebrovascular disease (CVD). METHODS Cross-sectional investigation of 25-hydroxyvitamin D [25(OH)D], dementia, and MRI measures of CVD in elders receiving home care (aged 65-99 years) from 2003 to 2007. RESULTS Among 318 participants, the mean age was 73.5 +/- 8.1 years, 231 (72.6%) were women, and 109 (34.3%) were black. 25(OH)D concentrations were deficient (<10 ng/mL) in 14.5% and insufficient (10-20 ng/mL) in 44.3% of participants. There were 76 participants (23.9%) with dementia, 41 of which were classified as probable AD. Mean 25(OH)D concentrations were lower in subjects with dementia (16.8 vs 20.0 ng/mL, p < 0.01). There was a higher prevalence of dementia among participants with 25(OH)D insufficiency (< or =20 ng/mL) (30.5% vs 14.5%, p < 0.01). 25(OH)D deficiency was associated with increased white matter hyperintensity volume (4.9 vs 2.9 mL, p < 0.01), grade (3.0 vs 2.2, p = 0.04), and prevalence of large vessel infarcts (10.1% vs 6.9%, p < 0.01). After adjustment for age, race, sex, body mass index, and education, 25(OH)D insufficiency (< or =20 ng/mL) was associated with more than twice the odds of all-cause dementia (odds ratio [OR] = 2.3, 95% confidence interval [CI] 1.2-4.2), Alzheimer disease (OR = 2.5, 95% CI 1.1-6.1), and stroke (with and without dementia symptoms) (OR = 2.0, 95% CI 1.0-4.0). CONCLUSIONS Vitamin D insufficiency and deficiency was associated with all-cause dementia, Alzheimer disease, stroke (with and without dementia symptoms), and MRI indicators of cerebrovascular disease. These findings suggest a potential vasculoprotective role of vitamin D.
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Affiliation(s)
- J S Buell
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, 711 Washington St., Boston, MA 02111, USA
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Wilkins CH, Birge SJ, Sheline YI, Morris JC. Vitamin D deficiency is associated with worse cognitive performance and lower bone density in older African Americans. J Natl Med Assoc 2009; 101:349-54. [PMID: 19397226 DOI: 10.1016/s0027-9684(15)30883-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Vitamin D deficiency is common in older adults and is more prevalent among persons with darker pigmented skin. The detrimental effects of vitamin D deficiency on the bone are widely known; however, recent data suggest that vitamin D deficiency may contribute to other disorders, including low mood, cognitive impairment, and impaired mobility. OBJECTIVE The purpose of this study was to determine whether nonskeletal diseases such as depression, cognitive impairment, and physical disability, which have been associated with vitamin D deficiency, are more commonly seen in older African Americans. DESIGN In a cross-sectional study of 60 older adults (30 African Americans and 30 European Americans), vitamin D status, cognitive performance, physical performance, and bone mineral density (BMD) were assessed. Differences between groups and differences between those with vitamin D deficiency and those with normal vitamin D levels were tested. RESULTS African Americans had a lower mean 25-hydroxyvitamin D level (17.98 ng/ml; SD, 6.9) compared to European Americans (25.20 ng/ml; SD, 7.0; p < .0001). Participants with vitamin D deficiency performed worse on a measure of cognitive performance, the Short Blessed Test (10.87 vs 6.31; p = .016); the Physical Performance Test (PPT) (27.00 vs 28.96; p = .039); and had lower BMD (0.823 vs 0.914; p = .005) and t scores (-1.29 vs -0.72; p = .008) of the hip. Among African Americans, vitamin D deficiency was associated with worse cognitive performance and lower BMD of the hip. CONCLUSIONS Vitamin D deficiency in older African Americans was associated with worse cognitive performance and lower BMD of the hip.
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Affiliation(s)
- Consuelo H Wilkins
- Department of Medicine, Division of Geriatrics and Nutritional Science, Alzheimer's Disease Research Center, Washington University School of Medicine, St Louis, Missouri 63108, USA.
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Buell JS, Scott TM, Dawson-Hughes B, Dallal GE, Rosenberg IH, Folstein MF, Tucker KL. Vitamin D is associated with cognitive function in elders receiving home health services. J Gerontol A Biol Sci Med Sci 2009; 64:888-95. [PMID: 19377013 PMCID: PMC2981461 DOI: 10.1093/gerona/glp032] [Citation(s) in RCA: 135] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2008] [Accepted: 01/20/2009] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The objective of this study was to examine the association between 25-hydroxyvitamin D, 25(OH)D, and cognitive function. METHODS A cross-sectional investigation of 25(OH)D and cognition was completed in 377 black and 703 non-black (mainly Caucasian) elders (65-99 years) participating in the nutrition and memory in elders study. Participants underwent a comprehensive neuropsychological battery, and 25(OH)D concentrations were obtained. RESULTS More than 65% of elders had suboptimal 25(OH)D concentrations (< or =20 ng/mL or < or =50 nmol/L). Approximately 18% were deficient in 25(OH)D (<10 ng/mL or <25 nmol/L). After adjusting for age, sex, race, body mass index, education, center, kidney function, seasonality, physical activity, and alcohol use, 25(OH)D was associated with better performance on trails A (beta = -0.49, p < .03), trails B (beta = -0.73, p < .02), digit symbol (beta = 0.19, p < .001), matrix reasoning (beta = 0.04, p < .02), and block design (beta = 0.07, p < .04) tests. Associations remained after adjustment for homocysteine, apoE4 allele, plasma B vitamins, and multivitamin use (y/n). 25(OH)D concentrations >20 ng/mL were associated with better performance on tests of executive function, including trails A (80.5 vs 95, p < .05), trails B (205s vs 226s, p < .05), matrix reasoning (7.8 vs 7.0, p = .03), and digit symbol (31.5 vs 37, p < .01). There were no associations between 25(OH)D and memory tests. Factor analysis yielded factors for memory, executive function, and attention/processing speed. After adjustment, 25(OH)D was associated with the executive function (beta = 0.01, p < 0.01) and attention/processing speed factors (beta = 0.01, p = .03), but not the memory factor (beta = -0.001, p = 0.65). CONCLUSIONS 25(OH)D was positively associated with cognitive performance, particularly with measures of executive function in this elderly population.
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Affiliation(s)
- Jennifer S. Buell
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
| | - Tammy M. Scott
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, Massachusetts
| | - Gerard E. Dallal
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, Massachusetts
| | - Irwin H. Rosenberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, Massachusetts
| | - Marshal F. Folstein
- Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts
| | - Katherine L. Tucker
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts
- Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA), Tufts University, Boston, Massachusetts
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Tseng M, Giri V, Bruner DW, Giovannucci E. Prevalence and correlates of vitamin D status in African American men. BMC Public Health 2009; 9:191. [PMID: 19534831 PMCID: PMC2708155 DOI: 10.1186/1471-2458-9-191] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2009] [Accepted: 06/18/2009] [Indexed: 02/03/2023] Open
Abstract
Background Few studies have examined vitamin D insufficiency in African American men although they are at very high risk. We examined the prevalence and correlates of vitamin D insufficiency among African American men in Philadelphia. Methods Participants in this cross-sectional analysis were 194 African American men in the Philadelphia region who were enrolled in a risk assessment program for prostate cancer from 10/96–10/07. All participants completed diet and health history questionnaires and provided plasma samples, which were assessed for 25-hydroxyvitamin D (25(OH)D) concentrations. We used linear regression models to examine associations with 25(OH)D concentrations and logistic regression to estimate odds ratios (OR) for having 25(OH)D ≥ 15 ng/mL. Results Mean 25(OH)D was 13.7 ng/mL, and 61% of men were classified as having vitamin D insufficiency (25(OH)D <15 ng/mL). Even among men with vitamin D intake ≥ 400 IU/day, 55% had 25(OH)D concentrations <15 ng/mL. In multivariate models, 25(OH)D concentrations were significantly associated with supplemental vitamin D intake (OR 4.3, 95% confidence interval (CI) 1.5, 12.4) for >400 vs. 0 IU/day), milk consumption (OR 5.9, 95% CI 2.2, 16.0 for ≥ 3.5 vs. <1 time per week), and blood collection in the summer. Additionally, 25(OH)D concentrations increased with more recreational physical activity (OR 1.3, 95% CI 1.1, 1.6 per hour). A significant inverse association of body mass index with 25(OH)D concentrations in bivariate analyses was attenuated with adjustment for season of blood collection. Conclusion The problem of low vitamin D status in African American men may be more severe than previously reported. Future efforts to increase vitamin D recommendations and intake, such as through supplementation, are warranted to improve vitamin D status in this particularly vulnerable population.
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Affiliation(s)
- Marilyn Tseng
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
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Araujo AB, Travison TG, Esche GR, Holick MF, Chen TC, McKinlay JB. Serum 25-hydroxyvitamin D and bone mineral density among Hispanic men. Osteoporos Int 2009; 20:245-55. [PMID: 18548306 PMCID: PMC2756973 DOI: 10.1007/s00198-008-0652-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2007] [Accepted: 05/05/2008] [Indexed: 11/30/2022]
Abstract
UNLABELLED There are few data on the skeletal health of Hispanic men. We observed differences in vitamin D deficiency and low BMD between Hispanic ethnic subgroups that persisted with adjustment for risk factors. Our data indicate a substantial burden of low BMD and vitamin D deficiency among Hispanic men. INTRODUCTION Disparities within ethnic groups are generally ignored, but in evolving populations they may have implications for public health. We examined ethnic variation in serum 25-hydroxyvitamin D [25(OH)D] and bone mineral density (BMD) among Hispanic American men. METHODS Three hundred and fifty-eight Hispanic males 30 to 79 years of age were studied. Logistic regression models assessed variation in odds of vitamin D deficiency (<20 ng/mL) and low BMD (T-score<-1) by ethnicity, with and without adjustment for risk factors (age, smoking, occupation, physical activity, body mass index, and sunlight exposure). RESULTS Vitamin D deficiency was most common among Puerto Rican (26%), compared with Dominican (21%), Central American (11%), and South American (9%) men. Percentages with low BMD were: South American (44%), Puerto Rican (34%), Dominican (29%), and Central American (23%). Adjustment for age and risk factors failed to account for Hispanic subgroup differences in vitamin D deficiency and low BMD. Population estimates indicate a substantial burden of low BMD and vitamin D deficiency among Hispanic men. CONCLUSIONS Our findings underscore the importance of examining the skeletal health of Hispanic subgroups, and suggest that a considerable number of Hispanic men may be at elevated risk of fracture and vitamin D deficiency.
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Affiliation(s)
| | | | | | - Michael F. Holick
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston MA, USA 02118
| | - Tai C. Chen
- Section of Endocrinology, Diabetes, and Nutrition, Department of Medicine, Boston University School of Medicine, Boston MA, USA 02118
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Grant WB. Solar ultraviolet-B irradiance and vitamin D may reduce the risk of septicemia. DERMATO-ENDOCRINOLOGY 2009; 1:37-42. [PMID: 20046587 PMCID: PMC2715199 DOI: 10.4161/derm.1.1.7250] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 10/13/2008] [Indexed: 01/08/2023]
Abstract
The primary features of the epidemiology of septicemia in the United States include highest rates in winter and the Northeast, lowest in fall and in the West; higher rates among African Americans than white Americans; a rapid increase in incidence with age; comorbidity with several chronic and infectious diseases; and a rapid increase in incidence rate starting in the early 1980s. This article reviews the literature on the epidemiology of septicemia in the United States, along with the roles of solar ultraviolet-B (UVB) and vitamin D3 related to the more important features. Solar UVB doses in summer are highest in the Southwest and lowest in the Northeast. Serum 25-hydroxyvitamin D [25(OH)D] levels are highest in summer, lowest in winter. African Americans have much lower 25(OH)D levels than those of white Americans. Serum 25(OH)D levels decline rapidly with advancing age. The risk of diseases comorbid with septicemia are generally inversely correlated with serum 25(OH)D levels. Sun-avoidance messages may have led to lower population levels of 25(OH)D, although prevalence of antibiotic-resistant bacteria may have increased. Previous reports have shown that 1,25-dihydroxyvitamin D upregulates human cathelicidin, LL-37, which has antimicrobial as well as antiendotoxin activity. The general agreement between the epidemiology of septicemia in the United States and the variations of solar UVB and the effects of vitamin D supports the hypothesis that both play important roles in reducing the risk of septicemia. Further study is warranted to evaluate this hypothesis.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition and Health Research Center (SUNARC); San Francisco, California USA
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Johnson MA, Davey A, Park S, Hausman DB, Poon LW. Age, race and season predict vitamin D status in African American and white octogenarians and centenarians. J Nutr Health Aging 2008; 12:690-5. [PMID: 19043643 PMCID: PMC2978665 DOI: 10.1007/bf03028616] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Poor vitamin D status has been associated with osteoporosis, falls, cardiovascular diseases, cancer, autoimmune diseases, pain, nursing home placement, and other age-related conditions, but little is known about the prevalence and predictors of vitamin D status in those aged 80 and older. Thus, this study tested the hypothesis that vitamin D status would be 1) poorer in a population-based multi-ethnic sample of centenarians as compared with octogenarians and 2) predicted by specific dietary, demographic or environmental factors. DESIGN Cross-sectional population-based analyses. SETTING Northern Georgia in the United States. PARTICIPANTS Men and women aged 80 to 89 (octogenarians, n=80) and 98 and older (centenarians, n=237). MEASUREMENTS Regression analyses were used to examine the associations of serum 25-hydroxyvitamin D [25(OH)D] with age, gender, race, living arrangements, dairy food intake, supplement intake, and season. RESULTS The prevalence of vitamin D insufficiency [25(OH)D<50 nmol/L] was higher in centenarians than in octogenarians (p<0.02). In logistic regression analyses, the risk of being vitamin D insufficient was significantly increased by being a centenarian vs. octogenarian (p<0.005) and by being African American vs. white (p<0.001) and decreased by taking a supplement with vitamin D (p<0.001) or by having vitamin D status measured in the summer or fall (each p<0.05), compared with spring. CONCLUSIONS Centenarians and octogenarians are at high risk for vitamin D insufficiency for many of the same reasons identified in younger populations. Given the numerous potential adverse consequences of poor vitamin D status, efforts are needed to ensure vitamin D adequacy in these older adults.
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Affiliation(s)
- M A Johnson
- The University of Georgia, Department of Foods and Nutrition, 280 Dawson Hall, Athens, GA 30602, USA.
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Holick MF. The vitamin D deficiency pandemic and consequences for nonskeletal health: mechanisms of action. Mol Aspects Med 2008; 29:361-8. [PMID: 18801384 PMCID: PMC2629072 DOI: 10.1016/j.mam.2008.08.008] [Citation(s) in RCA: 233] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2008] [Accepted: 08/12/2008] [Indexed: 10/21/2022]
Abstract
Vitamin D, the sunshine vitamin, is important for childhood bone health. Over the past two decades, it is now recognized that vitamin D not only is important for calcium metabolism and maintenance of bone health throughout life, but also plays an important role in reducing risk of many chronic diseases including type I diabetes, multiple sclerosis, rheumatoid arthritis, deadly cancers, heart disease and infectious diseases. How vitamin D is able to play such an important role in health is based on observation that all tissues and cells in the body have a vitamin D receptor, and, thus, respond to its active form 1,25-dihydroxyvitamin D. However, this did not explain how living at higher latitudes and being at risk of vitamin D deficiency increased risk of these deadly diseases since it was also known that the 1,25-dihydroxyvitamin D levels are normal or even elevated when a person is vitamin D insufficient. Moreover, increased intake of vitamin D or exposure to more sunlight will not induce the kidneys to produce more 1,25-dihydroxyvitamin D. The revelation that the colon, breast, prostate, macrophages and skin among other organs have the enzymatic machinery to produce 1,25-dihydroxyvitamin D provides further insight as to how vitamin D plays such an essential role for overall health and well being. This review will put into perspective many of the new biologic actions of vitamin D and on how 1,25-dihydroxyvitamin D is able to regulate directly or indirectly more than 200 different genes that are responsible for a wide variety of biologic processes.
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Affiliation(s)
- Michael F Holick
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin and Bone Research Laboratory, Boston University Medical Center, Boston, MA, USA.
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