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Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus 2023; 15:e38578. [PMID: 37284402 PMCID: PMC10239563 DOI: 10.7759/cureus.38578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/08/2023] Open
Abstract
Vitamin D is a hormone that can be generated in the skin upon ultraviolet light exposure or ingested through supplementation. Vitamin D deficiency may have numerous deleterious effects on health. Sun avoidance strategies should be avoided due to the unwanted health risks associated with hypovitaminosis D. We present an objective investigation of the benefits and risks of using sun exposure to increase vitamin D levels and how it impacts human health. A review of the literature was conducted using Embase and PubMed to examine the relationship between UV exposure, vitamin D levels, health benefits, and risks. UV exposure is the primary method of boosting serum vitamin D levels, which accounts for numerous health benefits. Higher levels of vitamin D are associated with protection against cancer development, including melanoma. Latitude, season, skin color, and sun protection determine UV absorption and vitamin D production. Public health sun protection guidelines decrease the incidence of skin cancer, but sun avoidance can cause hypovitaminosis D. Serum vitamin D levels less than 16 nmol/L increase morbidity through increased non-cutaneous disease. Sun protection strategies should still be implemented to reduce skin cancer, and sunscreen only minimally lowers vitamin D production. Vitamin D deficiency can increase chronic diseases and cancer, while adequate vitamin D levels can help prevent them. UV exposure and vitamin D production are dependent on many factors. Increasing UV exposure without causing sunburn maximizes vitamin D production.
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Affiliation(s)
- Jonathan R Raymond-Lezman
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
| | - Suzanne I Riskin
- Department of Internal Medicine, Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Martin-Gorgojo A, Gilaberte Y, Nagore E. Vitamin D and Skin Cancer: An Epidemiological, Patient-Centered Update and Review. Nutrients 2021; 13:4292. [PMID: 34959844 PMCID: PMC8709188 DOI: 10.3390/nu13124292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The current vitamin D deficiency epidemic is accompanied by an increase in endemic skin cancer. There are still multiple controversies. This review aims to give practical recommendations regarding vitamin D among people at risk or with a personal history of skin cancer. METHODS Narrative review including human research articles published between 2011 and 2021, elaborated bearing in mind an epidemiological, patient-centered approach. RESULTS Ultraviolet (UV) exposure (neither artificial nor natural) is not the ideal source to synthesize vitamin D. There is conflicting epidemiological evidence regarding vitamin D, non-melanoma skin cancer (NMSC), and cutaneous melanoma (CMM), confounded by the effect of sun exposure and other factors. CONCLUSIONS Current evidence is controversial, and there are no widely applicable strategies. We propose three practical recommendations. Firstly, sun protection recommendations should be kept among people at risk or with a personal history of skin cancer. Secondly, vitamin D should preferably be sourced through diet. In patients with melanoma or at risk of cutaneous cancer, serum vitamin D checks are warranted to detect and avoid its insufficiency.
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Affiliation(s)
| | - Yolanda Gilaberte
- Dermatology Department, Hospital Universitario Miguel Servet, IIS Aragon, 50009 Zaragoza, Spain;
| | - Eduardo Nagore
- Dermatology Department, Universidad Catolica de Valencia, 46001 Valencia, Spain;
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3
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Zhao L, Chen R, Nong B, Dou Y, Li Y, Xu Z, Ma C, Du J, Liu H. High prevalence of vitamin D deficiency in Shenzhen pregnant women. J Matern Fetal Neonatal Med 2021; 35:6278-6285. [PMID: 33874834 DOI: 10.1080/14767058.2021.1910667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Vitamin D deficiency is a public health problem worldwide. Vitamin D deficiency in pregnant women often leads to negative clinical consequence and has been distributed differently in certain latitudes. Here, we aimed to determine the prevalence of vitamin D deficiency in pregnant women in Shenzhen City and investigate the influencing factors. METHODS A total of 27,166 healthy pregnant women, undergoing prenatal examinations in our hospital between July 2014 and December 2018, were enrolled in our study. Maternal characteristics, including the duration of pregnancy, age and enrollment time, were recorded. The concentrations of serum 25(OH)D in the blood samples were detected by immunochemistry assays. RESULTS For the total study population, the median serum 25(OH)D concentration was 23.36 [17.98-29.51] ng/mL, and 34.3% and 42.4% of the participants exhibited vitamin D deficiency (serum 25(OH) D < 20 ng/mL) and insufficiency (serum 25(OH)D 21-29 ng/mL), respectively. Vitamin D deficiency decreased with gestation (37.83%, 33.8%, and 29.3% for the first trimester, second trimester and third trimester, respectively, p < .001) and decreased by age (36.03%, 35.20%, 31.86% and 29.83%, for the age groups 18-24, 25-29, 30-34 and 35-46 years, respectively, p < .001). This prevalence had conspicuous seasonality (winter vs. autumn, OR 3.69, 95% CI: 3.42-3.99, p < .001). Temperature was positively associated with women's serum 25(OH)D level (r = 0.48, p < .001). CONCLUSIONS Overall, we demonstrated that vitamin D deficiency in pregnant women in Shenzhen was common and was affected by gestation, age and season/temperature.
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Affiliation(s)
- Lijun Zhao
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Rui Chen
- Department of Clinical Laboratory, The Second People's Hospital of Futian District, Shenzhen, China
| | - Baoting Nong
- Key Laboratory of Gene Engineering of the Ministry of Education and State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-Sen University, Guangzhou, China
| | - Yuhong Dou
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Yuxia Li
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Zhikang Xu
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Caifeng Ma
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Jikun Du
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
| | - Helu Liu
- Central Research Laboratory, Department of Clinical Laboratory, Innovative Research Center of Traditional Chinese Medicine, Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine, The Second People's Hospital of Bao'an Shenzhen (Group), Shajing People's Hospital of Bao'an Shenzhen, Shenzhen, China
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Uptake of Vitamins D 2, D 3, D 4, D 5, D 6, and D 7 Solubilized in Mixed Micelles by Human Intestinal Cells, Caco-2, an Enhancing Effect of Lysophosphatidylcholine on the Cellular Uptake, and Estimation of Vitamins D' Biological Activities. Nutrients 2021; 13:nu13041126. [PMID: 33805560 PMCID: PMC8067314 DOI: 10.3390/nu13041126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamins D have various biological activities, as well as intestinal calcium absorption. There has been recent concern about insufficient vitamin D intake. In addition to vitamins D2 and D3, there are lesser-known vitamins D4–D7. We synthesized vitamins D5–D7, which are not commercially available, and then evaluated and compared the mixed micelles-solubilized vitamins D uptake by Caco-2 cells. Except for vitamin D5, the uptake amounts of vitamins D4–D7 by differentiated Caco-2 cells were similar to those of vitamins D2 and D3. The facilitative diffusion rate in the ezetimibe inhibited pathway was approximately 20% for each vitamin D type, suggesting that they would pass through the pathway at a similar rate. Lysophosphatidylcholine enhanced each vitamin D uptake by approximately 2.5-fold. Lysophosphatidylcholine showed an enhancing effect on vitamin D uptake by reducing the intercellular barrier formation of Caco-2 cells by reducing cellular cholesterol, suggesting that increasing the uptakes of vitamins D and/or co-ingesting them with lysophosphatidylcholine, would improve vitamin D insufficiency. The various biological activities in the activated form of vitamins D4–D7 were estimated by Prediction of Activity Spectra for Substances (PASS) online simulation. These may have some biological activities, supporting the potential as nutritional components.
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Oh ST, Ga DH, Lim JH. Mobile Deep Learning System That Calculates UVI Using Illuminance Value of User's Location. SENSORS 2021; 21:s21041227. [PMID: 33572393 PMCID: PMC7916185 DOI: 10.3390/s21041227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/31/2021] [Accepted: 02/05/2021] [Indexed: 12/23/2022]
Abstract
Ultraviolet rays are closely related with human health and, recently, optimum exposure to the UV rays has been recommended, with growing importance being placed on correct UV information. However, many countries provide UV information services at a local level, which makes it impossible for individuals to acquire user-based, accurate UV information unless individuals operate UV measurement devices with expertise on the relevant field for interpretation of the measurement results. There is a limit in measuring ultraviolet rays’ information by the users at their respective locations. Research about how to utilize mobile devices such as smartphones to overcome such limitation is also lacking. This paper proposes a mobile deep learning system that calculates UVI based on the illuminance values at the user’s location obtained with mobile devices’ help. The proposed method analyzed the correlation between illuminance and UVI based on the natural light DB collected through the actual measurements, and the deep learning model’s data set was extracted. After the selection of the input variables to calculate the correct UVI, the deep learning model based on the TensorFlow set with the optimum number of layers and number of nodes was designed and implemented, and learning was executed via the data set. After the data set was converted to the mobile deep learning model to operate under the mobile environment, the converted data were loaded on the mobile device. The proposed method enabled providing UV information at the user’s location through a mobile device on which the illuminance sensors were loaded even in the environment without UVI measuring equipment. The comparison of the experiment results with the reference device (spectrometer) proved that the proposed method could provide UV information with an accuracy of 90–95% in the summers, as well as in winters.
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Affiliation(s)
- Seung-Taek Oh
- Smart Natural Space Research Center, Kongju National University, Cheonan 31080, Korea;
| | - Deog-Hyeon Ga
- Department of Computer Science & Engineering, Kongju National University, Cheonan 31080, Korea;
| | - Jae-Hyun Lim
- Department of Computer Science & Engineering, Kongju National University, Cheonan 31080, Korea;
- Department of Urban Systems Engineering, Kongju National University, Cheonan 31080, Korea
- Correspondence: ; Tel.: +82-10-8864-6195
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Karamizadeh M, Seif M, Holick MF, Akbarzadeh M. Developing a Model for Prediction of Serum 25-Hydroxyvitamin D Level: The Use of Linear Regression and Machine Learning Methods. J Am Coll Nutr 2021; 41:191-200. [PMID: 33555236 DOI: 10.1080/07315724.2020.1869624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Because vitamin D status affects many organs and tissues of the body, it is important to determine the factors affecting it. The purpose of this study was to develop a model for predicting the serum 25-hydroxyvitamin D [25(OH)D] level in healthy young adults. METHOD This cross-sectional study was conducted on 201 healthy individuals aged 20 to 40 years old in Shiraz, Iran. Data regarding demographic characteristics, vitamin D intake through supplements, and sun exposure habits were gathered. Serum 25(OH)D concentration was also measured. Data were analyzed with R software using linear regression and different machine learning methods such as conditional tree, conditional forest and random forest. RESULTS Based on the linear regression, male sex (p < 0.001), taking 50,000 IU vitamin D3 supplement monthly (p < 0.001), and lower waist circumference (p = 0.018) were identified as effective factors in increasing serum 25(OH)D levels. According to the conditional tree, taking 50,000 IU vitamin D3 supplement monthly (p < 0.001) and sex (p < 0.001) were two main factors in the classification of individuals in terms of serum 25(OH)D levels. Besides, conditional forest and random forest results showed that the most important variable was taking 50,000 IU vitamin D3 supplement monthly. CONCLUSIONS Supplement use is the first and most important predictor of 25(OH)D levels and other factors, including sex and waist circumference, are ranked thereafter, and the importance of these factors is greater in those who do not take vitamin D3 supplements.
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Affiliation(s)
- Malihe Karamizadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Michael F Holick
- Section Endocrinology, Diabetes, Nutrition and Weight Management, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Marzieh Akbarzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Fontanive TO, Dick NRM, Valente MCS, Laranjeira VDS, Antunes MV, Corrêa MDP, Alves RDCM, Linden R, Furlanetto TW. Seasonal variation of vitamin D among healthy adult men in a subtropical region. Rev Assoc Med Bras (1992) 2020; 66:1431-1436. [DOI: 10.1590/1806-9282.66.10.1431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 05/23/2020] [Indexed: 11/21/2022] Open
Abstract
SUMMARY OBJECTIVE: To evaluate seasonal variation of 25(OH)vitamin D [25(OH)D3] levels, and factors associated with it, in healthy adult men, who exercised outdoors for 50 min., at least twice a week, from 10AM to 4PM, in a Brazilian semitropical region. METHODS: Blood samples were collected at the end of each season for 25(OH)D3, measured by liquid chromatography with tandem mass spectrometry. Ultraviolet irradiation was estimated by radiometer, calculating the daily photobiological response to vitamin D synthesis in human skin (D-VitD). The prevalence of 25(OH)D3 <20ng/mL changed with the seasons (p=0.000): 8.7% (n=6/69), 1.5% (n=1/66), 0 (n=0/64), and 21.7% (n=13/60), respectively, at the end of winter, spring, summer, and autumn. The prevalence, adjusted for multiple comparisons, was higher in winter than summer (p=0.026), and in autumn than spring (p=0.001) and summer (p=0.000). There were no associations of 25(OH) D3 levels with BMI (p=0.207), body fat (p=0.064), and phototype (p=0.485), in univariate analysis. It was associated with D-VitD in the 30 days before blood sampling (p=0.000), after adjustment to body fat. The prevalence of 25(OH)D3 <30ng/mL varied seasonally (p=0.000): 69.6% (n=48/69), 68.2% (n=45/66), 43.8% (n=28/64), and 88.4% (n=53/60), respectively, in winter, spring, summer, and autumn. CONCLUSIONS: In a Brazilian subtropical region, a seasonal variation in 25(OH)D3 was observed in healthy adult males, although they spent at least 50 min outdoors twice a week, wearing shorts and T-shirts. 25(OH)D3 <20ng/mL was 21.7% in autumn; D-vitD 30 days prior to blood sampling was the only factor independently associated with 25(OH)D3 levels.
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Jahrami H, Bragazzi NL, Grant WB, AlFarra HSM, AlFara WSM, Mashalla S, Saif Z. Vitamin D Doses from Solar Ultraviolet and Dietary Intakes in Patients with Depression: Results of a Case-Control Study. Nutrients 2020; 12:nu12092587. [PMID: 32858873 PMCID: PMC7551208 DOI: 10.3390/nu12092587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022] Open
Abstract
The purpose of this study to estimate cumulative vitamin D doses from solar ultraviolet and dietary intakes in patients with depression and compare it to healthy controls. Using a case-control research design, a sample of 96 patients with depression were age- and sex-matched with 96 healthy controls. Dietary vitamin D dose was estimated from diet analysis. Vitamin D-weighted ultraviolet solar doses were estimated from action spectrum conversion factors and geometric conversion factors accounting for the skin type, the fraction of body exposed, and age factor. Patients with depression had a lower dose of vitamin D (IU) per day with 234, 153, and 81 per day from all sources, sunlight exposure, and dietary intake, respectively. Controls had a higher intake of vitamin D (IU) per day with 357, 270, and 87 per day from all sources, sunlight exposure, and dietary intake, respectively. Only 19% and 30% met the minimum daily recommended dose of ≥400 IU per day for cases and controls, respectively. The sensitivity, specificity, percentage correctly classified and receiver operating characteristic (ROC) Area for the estimated vitamin D against serum vitamin D as reference were 100%, 79%, 80%, and 89%. Physical activity level was the only predictor of daily vitamin D dose. Vitamin D doses are lower than the recommended dose of ≥400 IU (10 mcg) per day for both cases with depression and healthy controls, being much lower in the former.
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Affiliation(s)
- Haitham Jahrami
- Ministry of Health, Manama, Bahrain, P.O. Box 12 Manama, Bahrain; (H.S.M.A.); (W.S.M.A.); (S.M.); (Z.S.)
- College of Medicine and Medical Sciences, Arabian Gulf University, P.O. Box 26671 Manama, Bahrain
- Correspondence: ; Fax: +97-317-270-637
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, ON M3J 1P3, Canada;
| | - William Burgess Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA;
| | | | | | - Shahla Mashalla
- Ministry of Health, Manama, Bahrain, P.O. Box 12 Manama, Bahrain; (H.S.M.A.); (W.S.M.A.); (S.M.); (Z.S.)
| | - Zahra Saif
- Ministry of Health, Manama, Bahrain, P.O. Box 12 Manama, Bahrain; (H.S.M.A.); (W.S.M.A.); (S.M.); (Z.S.)
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Czerwińska A, Krzyścin J. Numerical estimations of the daily amount of skin-synthesized vitamin D by pre-school children in Poland. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2020; 208:111898. [PMID: 32460118 DOI: 10.1016/j.jphotobiol.2020.111898] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/18/2020] [Accepted: 05/13/2020] [Indexed: 11/27/2022]
Abstract
According to Polish guidelines, children need a daily dose of 600-1000 I·U. vitamin D, which could be skin-synthesized in the period May to September, after at least 15 min solar exposure between 10 am and 3 pm with uncovered forearms and lower legs. In Poland, doctors only prescribe oral supplementation to infants and small children up to 2 years old, rarely for the older children. Numerical estimates of the daily amount of vitamin D (expressed in I.U. vitamin D taken orally) due to the solar exposure for preschoolers have been made on the basis of an observation campaign in Warsaw, Poland. In the period from April to September, the observations of children's clothing of age 4-6 years and the measurements of UV index were carried out in the kindergarten playground and a nearby park (52.31oN, 21.06°E). It appears, that longer exposures (~45 min) are needed to gain the recommended dose. However, the estimation is burden with large uncertainties. The alternative scenario is to allow children to play outside for as long as possible without getting sunburn, i.e. until the personal erythemal threshold is reached. Then, sunscreens should be applied.
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Affiliation(s)
| | - Janusz Krzyścin
- Institute of Geophysics, Polish Academy of Sciences, Warsaw, Poland
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Elsafi SSMS, Nour BM, Abakar AD, Omer IH, Almugadam BS. Vitamin D level and it is association with the severity of pulmonary tuberculosis in patients attended to Kosti Teaching Hospital, Sudan. AIMS Microbiol 2020; 6:65-74. [PMID: 32226915 PMCID: PMC7099198 DOI: 10.3934/microbiol.2020004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/09/2020] [Indexed: 01/08/2023] Open
Abstract
Globally, tuberculosis is one of the major causes of morbidity and mortality in many countries. Previous studies suggest that the incidence and severity of tuberculosis are associated with low levels of vitamin D (Vit D). Therefore, this study aimed to determine the occurrence and associated factors of vitamin D3 deficiency in pulmonary tuberculosis patients at White Nile State, Sudan. 101 individuals of diagnosed pulmonary tuberculosis patients (71 males and 30 females) and 100 non-TB controls (58 males and 42 females) were included in this study. Sputum samples were obtained from TB patients and subjected to examination for acid-fast bacilli (AFB) using Ziehl-Neelsen (ZN) stain and Gene Xpert analysis. Blood samples were collected from both groups and Serum 25(OH)-vitamin D3 was determined by an Enzyme-Linked Immunosorbent Assay. HIV infection in Tuberculosis (TB) group was also investigated using the immunochromatographic test. In our study, the majority of TB patients were suffered from TB relapse (36.6%); non-HIV infected individuals (99.1%) or showed a positive result for AFB (61.4%) in Gene Xpert analysis. Moreover, there is a significant difference in microscopy findings and bacillary levels of AFB, and Rifampicin (RIF) susceptibility pattern of M. tuberculosis strain among sputum samples of TB patients, P-values less 0.0001. Furthermore, we found that TB patients were suffered from vitamin D deficiency. In particular, the mean of vitamin D level was significantly much lower in TB patients (26.7 ± 1.6) compared to non-TB controls (117.3 ± 3.2), P-value equal 0.0001. Likewise, it's much lower in females, individuals of 21-40 years old, and patients with high bacillary levels or those infected by Rifampicin resistance strain. Accordingly, our study was highlighted the TB and Vit D deficiency relationship and showed the need for further studies to a better understanding of the impact of TB on Vit D level and investigate whether vitamin D supplementation can have a role in the prevention and treatment of tuberculosis.
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Affiliation(s)
| | - Bakri Mohammed Nour
- Department of Medical Parasitology, Faculty of Medical Laboratory Sciences, University of Gezira, Wad Medani, Sudan
| | - Adam Dawoud Abakar
- Department of Medical Parasitology, Faculty of Medical Laboratory Sciences, University of Gezira, Wad Medani, Sudan.,Department of Parasitology, Blue Nile National Institute for Communicable Diseases, University of Gezira, Sudan
| | - Izzedeen Haroun Omer
- Department of Medicine, Faculty of Medicine, University of El Imam El Mahdi, Kosti, Sudan
| | - Babiker Saad Almugadam
- Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti, Sudan
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Effect of sun exposure versus oral vitamin D supplementation on serum 25-hydroxyvitamin D concentrations in young adults: A randomized clinical trial. Clin Nutr 2020; 39:727-736. [DOI: 10.1016/j.clnu.2019.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/07/2019] [Accepted: 03/14/2019] [Indexed: 01/09/2023]
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Development and Effect Analysis of UVB-LED General Lighting to Support Vitamin D Synthesis. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10030889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Ultraviolet rays from sunlight are involved in vitamin D synthesis, which is essential in maintaining health. Most in vivo vitamin D synthesis occurs via exposure to sunlight, whereas a small portion is obtained through diet. Therefore, appropriate exposure to sunlight is recommended to satisfy vitamin D requirement. However, vitamin D deficiency still poses a serious issue to numerous people. To resolve this problem, artificial lighting has been studied to provide rays of UV light with characteristics similar to that of sunlight. The present study introduced vitamin D synthesis stimulating UVB-LED light via the general diffusion lighting type to indoor dwellers. However, despite the strides of advancement made in this type of lighting, studies on UVB with relation to vitamin D synthesis are limited. This study aimed to suggest UVB-LED lighting for indoor dwellers and confirm the effectiveness of vitamin D stimulation through animal testing. For this, a UVB-LED providing safe UVB dosage was developed based on the photobiological safety (IEC 62471) of lighting. Next, a comparison study of the suggested lighting and general lighting was executed in an isolated system. The study continued for two weeks and the vitamin D levels within the animal test subject (Rat, Wistar, male) were measured. At this time, the lighting was turned on for 06:00~22:00 considering the sunrise timing and average lighting time for modern people, and blood was collected from the caudal veins of the rats and analyzed for the amount of 25-hydroxyvitamin D [25(OH)D]. Analysis results showed that the amount of 25-hydroxyvitamin D [25(OH)D] in blood was higher, on average, by 6.8% (0.97 ng/mL) and 7.3% (0.9 ng/ml) in rats reared under UVB-LED lighting on the seventh and fourteenth experimental days, respectively, than those under general lighting. It was, therefore, confirmed that vitamin D synthesis in the human body can be supported by the proposed lighting in this study.
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Izadi M, Jonaidi-Jafari N, Pourazizi M, Alemzadeh-Ansari MH, Hoseinpourfard MJ. Photokeratitis induced by ultraviolet radiation in travelers: A major health problem. J Postgrad Med 2019; 64:40-46. [PMID: 29067921 PMCID: PMC5820813 DOI: 10.4103/jpgm.jpgm_52_17] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ultraviolet (UV) irradiation is one of the several environmental hazards that may cause inflammatory reactions in ocular tissues, especially the cornea. One of the important factors that affect how much ultraviolet radiation (UVR) humans are exposed to is travel. Hence, traveling is considered to include a more acute UVR effect, and ophthalmologists frequently evaluate and manage the ocular manifestations of UV irradiation, including UV-induced keratitis. The purpose of this paper is to provide an evidence-based analysis of the clinical effect of UVR in ocular tissues. An extensive review of English literature was performed to gather all available articles from the National Library of Medicine PubMed database of the National Institute of Health, the Ovid MEDLINE database, Scopus, and ScienceDirect that had studied the effect of UVR on the eye and its complications, between January 1970 and June 2014. The results show that UVR at 300 nm causes apoptosis in all three layers of the cornea and induces keratitis. Apoptosis in all layers of the cornea occurs 5 h after exposure. The effect of UVR intensity on the eye can be linked to numerous factors, including solar elevation, time of day, season, hemisphere, clouds and haze, atmospheric scattering, atmospheric ozone, latitude, altitude, longitudinal changes, climate, ground reflection, and geographic directions. The most important factor affecting UVR reaching the earth's surface is solar elevation. Currently, people do not have great concern over eye protection. The methods of protection against UVR include avoiding direct sunlight exposure, using UVR-blocking eyewear (sunglasses or contact lenses), and wearing hats. Hence, by identifying UVR intensity factors, eye protection factors, and public education, especially in travelers, methods for safe traveling can be identified.
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Affiliation(s)
- M Izadi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - N Jonaidi-Jafari
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - M Pourazizi
- Cancer Research Center, Semnan University of Medical Sciences, Semnan; Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M H Alemzadeh-Ansari
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Passeron T, Bouillon R, Callender V, Cestari T, Diepgen TL, Green AC, van der Pols JC, Bernard BA, Ly F, Bernerd F, Marrot L, Nielsen M, Verschoore M, Jablonski NG, Young AR. Sunscreen photoprotection and vitamin D status. Br J Dermatol 2019; 181:916-931. [PMID: 31069788 PMCID: PMC6899926 DOI: 10.1111/bjd.17992] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 12/16/2022]
Abstract
Background Global concern about vitamin D deficiency has fuelled debates on photoprotection and the importance of solar exposure to meet vitamin D requirements. Objectives To review the published evidence to reach a consensus on the influence of photoprotection by sunscreens on vitamin D status, considering other relevant factors. Methods An international panel of 13 experts in endocrinology, dermatology, photobiology, epidemiology and biological anthropology reviewed the literature prior to a 1‐day meeting in June 2017, during which the evidence was discussed. Methods of assessment and determining factors of vitamin D status, and public health perspectives were examined and consequences of sun exposure and the effects of photoprotection were assessed. Results A serum level of ≥ 50 nmol L−1 25(OH)D is a target for all individuals. Broad‐spectrum sunscreens that prevent erythema are unlikely to compromise vitamin D status in healthy populations. Vitamin D screening should be restricted to those at risk of hypovitaminosis, such as patients with photosensitivity disorders, who require rigorous photoprotection. Screening and supplementation are advised for this group. Conclusions Sunscreen use for daily and recreational photoprotection does not compromise vitamin D synthesis, even when applied under optimal conditions. What's already known about this topic? Knowledge of the relationship between solar exposure behaviour, sunscreen use and vitamin D is important for public health but there is confusion about optimal vitamin D status and the safest way to achieve this. Practical recommendations on the potential impact of daily and/or recreational sunscreens on vitamin D status are lacking for healthy people.
What does this study add? Judicious use of daily broad‐spectrum sunscreens with high ultraviolet (UV) A protection will not compromise vitamin D status in healthy people. However, photoprotection strategies for patients with photosensitivity disorders that include high sun‐protection factor sunscreens with high UVA protection, along with protective clothing and shade‐seeking behaviour are likely to compromise vitamin D status. Screening for vitamin D status and supplementation are recommended in patients with photosensitivity disorders.
Linked Comment: https://doi.org/10.1111/bjd.18126. https://doi.org/10.1111/bjd.18494 available online
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Affiliation(s)
- T Passeron
- Department of Dermatology, CHU Nice, Université Côte d'Azur, CHU Nice, 151, route de Ginestière, 06200, Nice, France.,C3M, INSERM U1065 Université Côte d'Azur, 151, route de Ginestière, 06200, Nice, France
| | - R Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Gasthuisberg, 3000, Leuven, Belgium
| | - V Callender
- Callender Dermatology & Cosmetic Center, 12200 Annapolis Road, Suite 315, Glenn Dale, MD, 20769, U.S.A
| | - T Cestari
- Federal University of Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Ramiro Barcellos 2350 zone 13, Porto Alegre, RS, 90035-903, Brazil
| | - T L Diepgen
- Department of Clinical Social Medicine, University of Heidelberg, Voßstr. 2, 69115, Heidelberg, Germany
| | - A C Green
- Cancer and Population Studies Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, 4006, Australia.,CRUK Manchester Institute and Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, M13 9NQ, U.K
| | - J C van der Pols
- School of Exercise and Nutrition Science, Queensland University of Technology, Brisbane, QLD, 4059, Australia
| | - B A Bernard
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - F Ly
- Faculty of Medicine, Pharmacy and Odontology, University Cheikh Anta Diop of Dakar, BP 5825, Dakar, Senegal
| | - F Bernerd
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - L Marrot
- L'Oréal R&I, 1 Avenue Eugène Schueller, 93600, Aulnay-sous-bois, France
| | - M Nielsen
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - M Verschoore
- L'Oréal R&I, Scientific Directorate, 9 rue Pierre Dreyfus, 92110, Clichy, France
| | - N G Jablonski
- Department of Anthropology, The Pennsylvania State University, 409 Carpenter Building, University Park, PA, 16802, U.S.A
| | - A R Young
- St John's Institute of Dermatology, King's College London, London, SE1 9RT, U.K
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Development of UVB LED Lighting System Based on UV Dose Calculation Algorithm to Meet Individual Daily UV Dose. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9122479] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ultraviolet B (UVB) in sunlight is known to promote health when humans are exposed to optimum sunlight. Proper exposure to ultraviolet B is essential to produce vitamin D in the body, which is a particularly important factor for health. However, there has been an increase recently in the number of people who are lacking sunlight exposure due to staying indoors. Avoiding ultraviolet (UV) rays leads to health deterioration. To solve this problem, a portable ultraviolet measuring device that provides users with the UV intensity information of outdoor sunlight has been developed while UVB Light Emitting Diode (LED) lighting technologies capable of providing UVB radiation have been studied. However, existing technologies are mere methods for providing information on ultraviolet rays and artificially exposing to ultraviolet rays, and there is a risk for the UV radiation amount to not meet the daily required UV dose. Therefore, in this paper, a UVB LED general lighting system based on a UV exposure calculation algorithm that supports users’ daily required UV dose is proposed. The proposed system is composed of an IoT (Internet of Things) UV measuring device that measures the UV dose indoors, as well as outdoors, UVB LED general lighting which can safely provide UVB doses at indoors, and a smartphone which provides information on the cumulative UV dose and the estimated amount of vitamin D while it controls UVB LED general lighting. In addition, it is possible to support users’ vitamin D synthesis by providing as much UV light as its shortage through UVB LED general lighting, based on an individual’s UV exposure amount through outdoor sunlight, using a smartphone implementing a UV dose calculation algorithm. In order to confirm the performance of the proposed system, a simulation was conducted assuming that users with skin types 2 and 3 performed outdoor activities within 30 min and entered the room. The result confirmed that the proposed lighting can provide users of all ages with the UV dose required per day.
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Estimated vitamin D synthesis and dietary vitamin D intake among Asians in two distinct geographical locations (Kuala Lumpur, 3°N v. Aberdeen, 57°N) and climates. Public Health Nutr 2018; 21:3118-3124. [PMID: 30176950 DOI: 10.1017/s1368980018002057] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To compare the contributions of UVB exposure and diet to total vitamin D among Asians living in Kuala Lumpur (KL) and Aberdeen (AB). DESIGN Longitudinal study. SETTING UVB exposure (using polysulfone film badges) and skin colour and dietary vitamin D intake (by web-based questionnaire) were measured at each season in AB and during south-west (SWM) and north-east monsoons (NEM) in KL. SUBJECTS One hundred and fifteen Asians in KL and eighty-five Asians in AB aged 20-50 years. RESULTS Median summer UVB exposure of Asians in AB (0·25 SED/d) was higher than UVB exposure for the KL participants (SWM=0·20 SED/d, P=0·02; NEM= 0·14 SED/d, P<0·01). UVB exposure was the major source of vitamin D in KL year-round (60%) but only during summer in AB (59%). Median dietary vitamin D intake was higher in AB (3·50 µg/d (140 IU/d)), year-round, than in KL (SWM=2·05 µg/d (82 IU/d); NEM=1·83 µg/d (73 IU/d), P<0·01). Median total vitamin D (UVB plus diet) was higher in AB only during summer (8·45 µg/d (338 IU/d)) compared with KL (SWM=6·03 µg/d (241 IU/d), P=0·04; NEM=5·35 µg/d (214 IU/d), P<0·01), with a comparable intake across the full year (AB=5·75 µg/d (230 IU/d); KL=6·15 µg/d (246 IU/d), P=0·78). CONCLUSIONS UVB exposure among Asians in their home country is low. For Asians residing at the northerly latitude of Scotland, acquiring vitamin D needs from UVB exposure alone (except in summer) may be challenging due to low ambient UVB in AB (available only from April to October).
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Chlebna-Sokół D, Konstantynowicz J, Abramowicz P, Kulik-Rechberger B, Niedziela M, Obuchowicz A, Ziora K, Karalus-Gach J, Golec J, Michałus I, Karczmarewicz E, Halaba ZP. Evidence of a significant vitamin D deficiency among 9-13-year-old Polish children: results of a multicentre study. Eur J Nutr 2018; 58:2029-2036. [PMID: 29936536 PMCID: PMC6647701 DOI: 10.1007/s00394-018-1756-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/20/2018] [Indexed: 10/29/2022]
Abstract
PURPOSE To evaluate the extent to which the population of Polish preadolescents is vitamin D deficient and to assess seasonal variations in vitamin D status. PARTICIPANTS AND METHODS A total of 720 healthy children aged 9-13 years (409 girls, 311 boys) residing in 6 representative geographical locations in Poland were studied. A parental-assisted questionnaire provided data on nutritional habits, vitamin D supplements and sun exposure. Serum concentration of 25-hydroxyvitamin was determined twice, after the winter in March and after the summer in October. RESULTS In March, vitamin D deficiency (25-50 nmol/L) was found in 64%, and severe deficiency (< 25 nmol/L) in 20.2% of children. In October, the deficiency and severe deficiency were still noticed in 25.9 and 0.1% of children, respectively. The mean serum concentration of 25-OHD was 52% higher in October (55.4 ± 14.0 nmol/L) than in March (36.4 ± 13.5 nmol/L), (p < 0.01). In children with 25-OHD < 50 nmol/L in March, their 25-OHD concentration increased by 64% through March to October (32.5 ± 8.2 vs. 53.2 ± 7.9 nmol/L, p < 0.01). An association was found between 25-OHD concentration and regular consumption of vitamin D supplements, cod-liver oil and fish. CONCLUSIONS The majority of preadolescent Polish boys and girls show vitamin D deficiency after the winter period, although a distinct amelioration over summertime is found in this age group. There is a need to implement effective prevention and intervention strategies in the management of vitamin D deficiency among schoolchildren in Poland, with the supplementation throughout the entire year.
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Affiliation(s)
- Danuta Chlebna-Sokół
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Waszyngtona Street 17, 15-2742, Białystok, Poland
| | - Paweł Abramowicz
- Department of Pediatric Rheumatology, Immunology, and Metabolic Bone Diseases, Medical University of Bialystok, Waszyngtona Street 17, 15-2742, Białystok, Poland
| | - Beata Kulik-Rechberger
- Departament of Paediatric Propaedeutics, Medical University of Lublin, Gębali Street 6, 20-091, Lublin, Poland
| | - Marek Niedziela
- Department of Pediatric Endocrinology and Rheumatology, Poznan University of Medical Sciences, Szpitalna Street 27/33, 60-572, Poznań, Poland
| | - Anna Obuchowicz
- Department of Paediatrics, School of Health Sciences in Katowice, Medical University of Silesia, Batorego Street 15, 41-902, Bytom, Poland
| | - Katarzyna Ziora
- Department of Paediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 3-go Maja Street 13-15, 41-800, Zabrze, Poland
| | - Jolanta Karalus-Gach
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Joanna Golec
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Izabela Michałus
- Department of Pediatric Propaedeutics and Metabolic Bone Diseases, Medical University of Lodz, Sporna Street 36/50, 91-738, Łódź, Poland
| | - Elżbieta Karczmarewicz
- Department of Biochemistry and Experimental Medicine, The Children's Memorial Health Institute in Warsaw, Aleja Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Zenon Piotr Halaba
- Department of Medical Simulation, University of Opole, Oleska Street 48, 45-052, Opole, Poland.
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Alves AS, Ishimura ME, Duarte YADO, Bueno V. Parameters of the Immune System and Vitamin D Levels in Old Individuals. Front Immunol 2018; 9:1122. [PMID: 29910802 PMCID: PMC5992391 DOI: 10.3389/fimmu.2018.01122] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 05/03/2018] [Indexed: 12/23/2022] Open
Abstract
Aim The increased number of individuals older than 80 years, centenarians, and supercentenarians is not a synonym for healthy aging, since severe infections, hospitalization, and disability are frequently observed. In this context, a possible strategy is to preserve the main characteristics/functions of the immune system with the aim to cause less damage to the organism during the aging process. Vitamin D acts on bone marrow, brain, breast, malignant cells, and immune system and has been recommended as a supplement. We aimed to evaluate whether immune parameters and vitamin D serum levels are correlated. Methods We evaluated some features of the immune system using the peripheral blood of individuals older than 80 years (n = 12) compared to young subjects (n = 10). In addition, we correlated these findings with vitamin D serum levels. Results Old individuals presented metabolic parameters of healthy aging and maintained preserved some features of immunity such as CD4/CD8 ratio, and low production of pro-inflammatory cytokines after stimulus. On the other hand, we observed increase in the frequency of myeloid-derived suppressor cells, reduction in circulating leukocytes, in the percentage of total CD8+, and in CD8+ Naïve T cells, in addition to increase in the percentage of CD8+ effector memory re-expressing CD45RA (EMRA) T cells. We found seropositivity for CMV in 97.7%, which was correlated with the decrease of CD8+ Naïve T cells and increase in CD8+ EMRA T cells. Vitamin D levels were insufficient in 50% of old individuals and correlated positively with total CD8+ T cells and negatively with CD8+ EMRA T cells. Conclusion In the studied population, longevity was correlated to maintenance of some immune parameters. Considering the limitations of the study as size of the sample and lack of functional assays, it was found that vitamin D in old individuals was correlated to some features of the immune system, mainly in the CD8 compartment.
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Affiliation(s)
- Amanda Soares Alves
- Division of Immunology, DMIP Microbiology, Immunology, and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Mayari Eika Ishimura
- Division of Immunology, DMIP Microbiology, Immunology, and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | | | - Valquiria Bueno
- Division of Immunology, DMIP Microbiology, Immunology, and Parasitology, Federal University of São Paulo, São Paulo, Brazil
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Adequate vitamin D 3 skin synthesis versus erythema risk in the Northern Hemisphere midlatitudes. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 179:54-65. [PMID: 29334624 DOI: 10.1016/j.jphotobiol.2018.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/29/2017] [Accepted: 01/08/2018] [Indexed: 01/10/2023]
Abstract
Health-optimum-exposure index (HOEI) is proposed to assess if the prescribed amount of vitamin D3 (target value) could be synthesized in the human skin without erythema appearance. It is defined as the ratio between the vitamin D3 quantity received during the maximum allowed outdoor exposure without erythema risk and the target value. Sunbathing is safe for HOEI>1 and 1/HOEI represents a part of minimal erythema dose (MED) necessary to obtain the target value. We examine the following targets: a vitamin D3 quantity equivalent to 1000 IU vitamin D3 taken orally, and an optimal vitamin D3 quantity defined by Krzyścin et al. (2016). The biologically weighted (previtamin D3 and erythemal) doses from the Northern Hemisphere midlatitudinal stations are analyzed to find HOEI dependence on personal and meteorological factors. HOEI depends mostly on the exposed skin area, person's age, and sun elevation at noon but not on the Fitzpatrick skin phototype. We found that only young adults (<21 yr) could safely obtain vitamin D3 quantity, which is equivalent to 1000 IU taken orally, almost throughout the whole year. Duration of such exposures appears <1 h only in the warm subperiods of the year (April-September) for a person with minimal erythema dose of 330 J m-2. Exposing larger part of the body (~30%) enables the oldest persons (>59 yr) to reach 1000 IU target during warm days in spring and summer. The optimal daily vitamin D3 quantity could only be synthesized only by young adults for about 40-60% of days in the May-August period if they expose at least 1/3 part of their body surface area. Vitamin D3 supplementation seems to be necessary over the whole year for the oldest persons with daily dosage of ~2000 IU but reduced to ~1000 IU in summer for sunseekers exposing significant part of the body.
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Wimalawansa SJ. Non-musculoskeletal benefits of vitamin D. J Steroid Biochem Mol Biol 2018; 175:60-81. [PMID: 27662817 DOI: 10.1016/j.jsbmb.2016.09.016] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 09/15/2016] [Accepted: 09/19/2016] [Indexed: 02/06/2023]
Abstract
The aim of this study is to determine and critically evaluate the plausible relationships of vitamin D with extra-skeletal tissues in humans. Severe vitamin D deficiency results in rickets in children and osteomalacia in adults; these beneficial effects in the musculoskeletal system and certain physiological functions are well understood. Nevertheless, mounting reports support additional beneficial effects of vitamin D, outside the musculoskeletal system. This review explores the recent advances in knowledge about the non-skeletal effects of vitamin D. Peer-reviewed papers were extracted from research databases using key words, to assess correlations between vitamin D and extra-skeletal diseases and conditions. As per the guidelines of the Preferred Reporting Items for Systematic Reviews (PRISMA); general interpretations of results are included; taking into consideration the broader evidence and implications. This review summarizes current knowledge of the effects of vitamin D status on extra-skeletal tissues with special attention given to relationships between vitamin D status and various diseases commonly affecting adults; the effects of intervention with vitamin D and exposure to sunlight. Evidence suggests that vitamin D facilitates the regulation of blood pressure; and cardiac; endothelial; and smooth muscle cell functions; playing an important role in cardiovascular protection. In addition; 1,25(OH)2D improves immunity; subdues inflammation; and reduces the incidence and severity of common cancers; autoimmune diseases and infectious diseases. Almost all adequately powered; epidemiological and biological studies that use; adequate doses of vitamin D supplementation in D-deficient populations have reported favorable outcomes. These studies have concluded that optimizing 25(OH)D status improves the functionality of bodily systems; reduces comorbidities; improves the quality of life; and increases survival. Although accumulating evidence supports biological associations of vitamin D sufficiency with improved physical and mental functions; no definitive evidence exists from well-designed; statistically powered; randomized controlled clinical trials. Nevertheless, most studies point to significant protective effects of vitamin D in humans when the minimum 25(OH)D serum level exceeds 30ng/mL and is maintained throughout the year.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Cardio Metabolic Institute, 661 Darmody Avenue, North Brunswick, NJ, USA.
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Shakeri H, Pournaghi SJ, Hashemi J, Mohammad-Zadeh M, Akaberi A. Do sufficient vitamin D levels at the end of summer in children and adolescents provide an assurance of vitamin D sufficiency at the end of winter? A cohort study. J Pediatr Endocrinol Metab 2017; 30:1041-1046. [PMID: 28976910 DOI: 10.1515/jpem-2017-0132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 08/12/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND The changes in serum 25-hydroxyvitamin D (25(OH)D) in adolescents from summer to winter and optimal serum vitamin D levels in the summer to ensure adequate vitamin D levels at the end of winter are currently unknown. This study was conducted to address this knowledge gap. METHODS The study was conducted as a cohort study. Sixty-eight participants aged 7-18 years and who had sufficient vitamin D levels at the end of the summer in 2011 were selected using stratified random sampling. Subsequently, the participants' vitamin D levels were measured at the end of the winter in 2012. A receiver operating characteristic (ROC) curve was used to determine optimal cutoff points for vitamin D at the end of the summer to predict sufficient vitamin D levels at the end of the winter. RESULTS The results indicated that 89.7% of all the participants had a decrease in vitamin D levels from summer to winter: 14.7% of them were vitamin D-deficient, 36.8% had insufficient vitamin D concentrations and only 48.5% where able to maintain sufficient vitamin D. The optimal cutoff point to provide assurance of sufficient serum vitamin D at the end of the winter was 40 ng/mL at the end of the summer. Sex, age and vitamin D levels at the end of the summer were significant predictors of non-sufficient vitamin D at the end of the winter. CONCLUSIONS In this age group, a dramatic reduction in vitamin D was observed over the follow-up period. Sufficient vitamin D at the end of the summer did not guarantee vitamin D sufficiency at the end of the winter. We found 40 ng/mL as an optimal cutoff point.
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Impact of Orientation on the Vitamin D Weighted Exposure of a Human in an Urban Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080920. [PMID: 28813022 PMCID: PMC5577621 DOI: 10.3390/ijerph14080920] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/04/2017] [Accepted: 08/10/2017] [Indexed: 01/17/2023]
Abstract
The vitamin D3-weighted UV exposure of a human with vertical posture was calculated for urban locations to investigate the impact of orientation and obstructions on the exposure. Human exposure was calculated by using the 3D geometry of a human and integrating the radiance, i.e., the radiant energy from the direct solar beam and the diffuse sky radiation from different incident and azimuth angles. Obstructions of the sky are derived from hemispherical images, which are recorded by a digital camera with a fisheye lens. Due to the low reflectivity of most surfaces in the UV range, the radiance from obstructed sky regions was neglected. For spring equinox (21 March), the exposure of a human model with winter clothing in an environment where obstructions cover 40% of the sky varies by up to 25%, depending on the orientation of the human model to the sun. The calculation of the accumulated vitamin D3-weighted exposure of a human with winter clothing walking during lunch break shows that human exposure is reduced by the obstruction of buildings and vegetation by 40%.
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Workineh M, Mathewos B, Moges B, Gize A, Getie S, Stendahl O, Schon T, Abate E. Vitamin D deficiency among newly diagnosed tuberculosis patients and their household contacts: a comparative cross-sectional study. ACTA ACUST UNITED AC 2017. [PMID: 28638616 PMCID: PMC5474861 DOI: 10.1186/s13690-017-0195-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background Recent studies suggest that the incidence and severity of tuberculosis is associated with low levels of vitamin D. Even though individuals living in Ethiopia have a high exposure to sunlight which is a source of vitamin D, tuberculosis is still one of the major causes of morbidity and mortality in the country. Therefore, this study aimed to determine the prevalence and associated factors of vitamin D deficiency in newly diagnosed tuberculosis patients, household contacts and community controls in Gondar, Ethiopia. Methods A comparative cross-sectional study design was conducted. Blood samples were collected from newly diagnosed smear positive pulmonary TB patients, their household contacts and community controls. Serum 25(OH)-vitamin D3 was determined by an Enzyme Linked Immunosorbent Assay. A serum level of 25(OH)-vitamin D3 below < 50 nmol/L was defined as vitamin D deficiency and <25 nmol/L as severe vitamin D deficiency. Results A total of 126 newly diagnosed smear positive TB patients, 57 house hold contacts and 70 apparently community controls were included in the study. The mean ± SD age (years) of TB patients, house hold contacts and community controls was 29.8 ± 11.9, 24.3 ± 14.7 and 27.3 ± 7.6 respectively. Ninety out of 126 (71.4%) TB patients were underweight with a BMI of < 18.5 kg/m2. The mean 25(OH)-vitamin D3 level of TB patients (30.1 ± 19.3 nmol/L) was significantly lower than community controls (38.5 ± 20.9 nmol/L, P = 0.005 and household contacts (37.7 ± 12.8 nmol/L, P =0.031).). The prevalence of vitamin D deficiency was higher in TB patients (83.3%) than in community controls (67.1%, P = 0.009). The prevalence of vitamin D deficiency was also found higher in household contacts (80.7%). Severe vitamin D deficiency was observed in 53%(67/126), 30% (21/70), 19.3%(11/57) of TB patients, community controls and household contacts respectively. Low BMI (AOR = 2.13; 95%CI: 1.02, 3.28) and being positive for tuberculosis (AOR = 1.93; 95%CI: 1.06, 2.86) were significant predictors of severe vitamin D deficiency. Conclusion High prevalence of vitamin D deficiency was found among newly diagnosed TB patients and in their household contacts. The present study warrants further studies to determine the role of vitamin D supplementation in the prevention and treatment of tuberculosis in Ethiopia.
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Affiliation(s)
- Meseret Workineh
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Biniam Mathewos
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Beyene Moges
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Adissu Gize
- St. Paul's Millennium Medical College, Addis Ababa, Ethiopia
| | - Sisay Getie
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
| | - Olle Stendahl
- Department of Medical Microbiology, Linkoping University, Linköping, Sweden
| | - Thomas Schon
- Department of Medical Microbiology, Linkoping University, Linköping, Sweden.,Department of Clinical Microbiology and Infectious Diseases, Kalmar county Hospital, Kalmar, Sweden
| | - Ebba Abate
- Department of Immunology & Molecular Biology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia
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Køster B, Søndergaard J, Nielsen JB, Christensen KB, Allen M, Olsen A, Bentzen J. Knowledge deficit, attitude and behavior scales association to objective measures of sun exposure and sunburn in a Danish population based sample. PLoS One 2017; 12:e0178190. [PMID: 28542543 PMCID: PMC5444774 DOI: 10.1371/journal.pone.0178190] [Citation(s) in RCA: 12] [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: 02/22/2017] [Accepted: 05/08/2017] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to develop new scales measuring knowledge and attitude about UVR and sun related behavior, and to examine their association to sun related behavior objectively measured by personal dosimetry. During May-August 2013, 664 Danes wore a personal electronic UV-dosimeter for one week that measured their UVR exposure. Afterwards, they answered a questionnaire on sun-related items. We applied descriptive analysis, linear and logistic regression analysis to evaluate the associations between the questionnaire scales and objective UVR measures. Perceiving protection as routine and important were positively correlated with protective behavior. Knowledge deficit of UV and risk of melanoma, perceived benefits and importance of protection behavior was also correlated with use of protection. ‘Knowledge deficit of UV and risk of melanoma and Perceived barrier towards sun avoidance between 12 and 15’ were both associated with increased risk of sunburn. Attitude towards tan was associated to both outdoor time and exposure as well as use of protection, but not to sunburn. The results regarding Knowledge deficit of UV and risk of melanoma associated to UVR exposure and Perceived barrier towards sun avoidance between 12 and 15 emphasize the importance of awareness of melanoma risk and the priority of the skin cancer prevention advice. Shifting activities to outside the suns peak-hours could be an approach for structural and campaign preventive measures. Knowledge of items predicting exposure to UVR, use of protection and sunburn are important for planning of preventive interventions and melanoma research.
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Affiliation(s)
- Brian Køster
- Department of Prevention and Information, Danish Cancer Society, Strandboulevarden 49, Copenhagen Ø, Denmark
- Research Unit of General Practice, University of Southern Denmark,Odense, Denmark
- * E-mail:
| | - Jens Søndergaard
- Research Unit of General Practice, University of Southern Denmark,Odense, Denmark
| | - Jesper Bo Nielsen
- Research Unit of General Practice, University of Southern Denmark,Odense, Denmark
| | - Karl Bang Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Martin Allen
- Electrical and Computer Engineering, University of Canterbury, Christchurch, New Zealand
| | - Anja Olsen
- Research Centre, Danish Cancer Society, Copenhagen, Denmark
| | - Joan Bentzen
- Department of Prevention and Information, Danish Cancer Society, Strandboulevarden 49, Copenhagen Ø, Denmark
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Yang J, Wang H, Ji A, Ma L, Wang J, Lian C, Wei Z, Wang L. Vitamin D Signaling Pathways Confer the Susceptibility of Esophageal Squamous Cell Carcinoma in a Northern Chinese Population. Nutr Cancer 2017; 69:593-600. [PMID: 28362172 DOI: 10.1080/01635581.2017.1299873] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Experimental studies have determined the chemopreventive effects of vitamin D against the esophageal squamous cell carcinoma (ESCC); however, results from the epidemiological studies are not yet well established. The current study aimed to evaluate the associations between plasma vitamin D levels and variants on vitamin D metabolic-related genes with the risks for ESCC. A hospital-based case-control study was performed. Five hundred eighty-two ESCC patients and 569 controls were recruited in a Northern Chinese population. Common variants on vitamin D metabolism-related genes CYP24A1, DHCR7, GC, CYP27B1, and vitamin D receptor (VDR) and the plasma 25(OH)D level were determined. The unconditional logistic regression method was applied to determine the associations between the variants and vitamin D level and ESCC. Higher plasma 25(OH)D was associated with a reduced risk for ESCC, especially for rs2296241, rs11568820, and rs4646536. The variants rs2296241 on CYP24A1 and rs11568820 on VDR are significantly associated with ESCC cancer. Vitamin D signaling pathways may participate in the ESCC development. Further studies with larger sample size are warranted to confirm the results. Intervention studies are needed to determine whether vitamin D supplementation may reduce the ESCC risk in the Chinese population.
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Affiliation(s)
- Jianzhou Yang
- a School of Public Health, Central South University , Changsha , Hunan , China.,b Department of Preventive Medicine , Changzhi Medical College , Changzhi , China
| | - Haili Wang
- c Central Laboratory , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Aifang Ji
- c Central Laboratory , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Liang Ma
- c Central Laboratory , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Jinsheng Wang
- c Central Laboratory , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Changhong Lian
- d Department of Oncology , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Zibai Wei
- d Department of Oncology , Heping Hospital Affiliated to Changzhi Medical College , Changzhi , China
| | - Lidong Wang
- e Henan Key Laboratory for Esophageal Cancer Research, Zhengzhou University , Zhengzhou , China
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Zhao Y, Yu Y, Li H, Chang Z, Li Y, Duan Y, Wang J, Jiang S, Yang Z, Yin SA. Vitamin D status and the prevalence of deficiency in lactating women from eight provinces and municipalities in China. PLoS One 2017; 12:e0174378. [PMID: 28334009 PMCID: PMC5363952 DOI: 10.1371/journal.pone.0174378] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 03/08/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has become prevalent worldwide in recent years. However, less evidence was available for lactating women. OBJECTIVE The purpose of the study was to understand vitamin D status and prevalence of deficiency in lactating women and associated risk factors for vitamin D deficiency from eight provinces and municipalities in China. METHODS Lactating women within 1-10 months postpartum were recruited in 2011-2013 from eight provinces and municipalities in China. Radioimmunoassay was used to measure serum 25-hydroxyvitamin D [25(OH)D] concentration. Standardized questionnaire was used to collect information on season, living site, ethnicity and socio-demographic characteristics. RESULTS Totally 2004 lactating women were recruited. The median (p25, p75) of 25(OH)D was 15.8 (10.5, 24.0) nmol/L. The prevalence of vitamin D deficiency was 85.3% as 25(OH)D <30nmol/L. Serum 25(OH)D levels of lactating women were significantly lower during October-January (14.0nmol/L) than during February-May (18.0nmol/L) (P<0.001), and were significantly higher in Dai ethnicity (22.5nmol/L) than in Hui ethnicity (Chinese Muslims) (9.0nmol/L) (P<0.001). For every 10,000 CNY annual income per capita increasing, serum 25(OH)D levels significantly increased 1.04 times (P<0.001). The odds of vitamin D deficiency in winter were 2.56 times higher than that in spring (OR 2.56, 95%CI: 1.91-3.43). CONCLUSIONS Vitamin D deficiency of lactating women was highly prevalent in the eight provinces and municipalities in China. It is urgent to study the strategy and intervention ways for improving vitamin D status of lactating women, especially for certain population groups during low sunlight exposure season.
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Affiliation(s)
- Yao Zhao
- Beijing Center for Disease Control and Prevention, Beijing, China PR
- Beijing Research Center for Preventive Medicine, Beijing, China PR
| | - Yingjie Yu
- Beijing Center for Disease Control and Prevention, Beijing, China PR
- Beijing Research Center for Preventive Medicine, Beijing, China PR
| | - Hong Li
- Beijing Center for Disease Control and Prevention, Beijing, China PR
- Beijing Research Center for Preventive Medicine, Beijing, China PR
| | - Zhirong Chang
- Beijing Dongcheng Center for Disease Control and Prevention, Beijing, China PR
| | - Yongjin Li
- Beijing Shunyi Center for Disease Control and Prevention, Beijing, China PR
| | - Yifan Duan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China PR
| | - Jie Wang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China PR
| | - Shan Jiang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China PR
| | - Zhenyu Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China PR
| | - Shi-an Yin
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, China PR
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Sun exposure, UV irradiance and serum 25-hydroxycholecalciferol in pregnant women in rural north India. Public Health Nutr 2016; 20:1755-1759. [PMID: 27989262 DOI: 10.1017/s136898001600313x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To document the effect of season and environmental pollution on UVB irradiance; and to estimate cutaneous vitamin D synthesis in village women in different seasons. DESIGN Radiant UVB energy was measured by a spectroradiometer in different seasons and, in April and May, on successive days in open areas at the city outskirts, at a crowded inner-city area and the villages of our participants. Clothing, outdoor activity pattern and serum 25-hydroxycholecalciferol (25(OH)D) levels were documented. SETTING Rural north India, latitude 26·8°N. SUBJECTS Pregnant women (n 139, aged 20-40 years). RESULTS UVB irradiance ranged from 56 µW/cm2 in January to 470 µW/cm2 in June. Proportion of skin exposed was 18·5 % in summer and 9·5 % in winter. Mean (sd) daily duration of sun exposure was 3·2 (0·2) h during winter and 2·1 (0·4) h during summer. Cutaneous vitamin D synthesis was estimated to be 19·25 µg (770 IU) during winter and 37·25 µg (1490 IU) during summer. Mean (sd) serum 25(OH)D was 28 (15) nmol/l during winter (92 % of participants with 50 nmol/l). Mean (sd) UVB irradiance at peak summer was significantly higher at the open areas and in the villages than at the inner-city location (340 (45) and 310 (60) v. 250 (50) µW/cm2, P=0·03). CONCLUSIONS In our population, at latitude 26·8°N, poor skin exposure is a limiting factor in all seasons. During winter, low UVB radiation energy also contributes. Particulate pollution limits UVB irradiance. Vitamin D supplementation during winter may be necessary.
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Ultraviolet radiation and effects on humans: the paradigm of maternal vitamin D production during pregnancy. Eur J Clin Nutr 2016; 71:1268-1272. [PMID: 27677369 DOI: 10.1038/ejcn.2016.188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 08/23/2016] [Indexed: 12/30/2022]
Abstract
Current evidence indicates that neonates born of mothers with vitamin D deficiency during pregnancy have greater risk for developing hypocalcemia, rickets and extra-skeletal disorders. Despite the classic knowledge that ultraviolet-B (UVB) exposure is the most efficient way for a future mother to obtain optimal vitamin D concentrations, no current consensus or clinical recommendations exist regarding the duration and timing of UVB exposure for pregnant women. This article offers a narrative review of available data regarding how UVB exposure affects maternal vitamin D production during pregnancy, along with a discourse on clinical implications of this public health issue. Future studies would benefit from adopting UVB exposure estimates to recommend appropriate UVB exposure to pregnant women. Doing so could provide a more holistic and practical approach in managing maternal hypovitaminosis D during pregnancy.
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Fajuyigbe D, Young AR. The impact of skin colour on human photobiological responses. Pigment Cell Melanoma Res 2016; 29:607-618. [PMID: 27454804 PMCID: PMC5132026 DOI: 10.1111/pcmr.12511] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/11/2016] [Indexed: 01/30/2023]
Abstract
Terrestrial solar ultraviolet radiation (UVR) exerts both beneficial and adverse effects on human skin. Epidemiological studies show a lower incidence of skin cancer in people with pigmented skins compared to fair skins. This is attributed to photoprotection by epidermal melanin, as is the poorer vitamin D status of those with darker skins. We summarize a wide range of photobiological responses across different skin colours including DNA damage and immunosuppression. Some studies show the generally modest photoprotective properties of melanin, but others show little or no effect. DNA photodamage initiates non‐melanoma skin cancer and is reduced by a factor of about 3 in pigmented skin compared with white skin. This suggests that if such a modest reduction in DNA damage can result in the significantly lower skin cancer incidence in black skin, the use of sunscreen protection might be extremely beneficial for susceptible population. Many contradictory results may be explained by protocol differences, including differences in UVR spectra and exposure protocols. We recommend that skin type comparisons be done with solar‐simulated radiation and standard erythema doses or physical doses (J/m2) rather than those based solely on clinical endpoints such as minimal erythema dose (MED).
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Affiliation(s)
- Damilola Fajuyigbe
- Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, St John's Institute of Dermatology, King's College London, London, UK
| | - Antony R Young
- Division of Genetics and Molecular Medicine, Faculty of Life Sciences and Medicine, St John's Institute of Dermatology, King's College London, London, UK
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Kelly D, Theodoratou E, Farrington SM, Fraser R, Campbell H, Dunlop MG, Zgaga L. The contributions of adjusted ambient ultraviolet B radiation at place of residence and other determinants to serum 25-hydroxyvitamin D concentrations. Br J Dermatol 2016; 174:1068-78. [PMID: 26581342 DOI: 10.1111/bjd.14296] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Solar ultraviolet B (UVB) radiation is the major source of vitamin D (vitD) for humans. OBJECTIVES To describe ambient UVB radiation at wavelengths that induce vitD synthesis (vitD-UVB) in Scotland, and to examine the relationship to serum 25-hydroxyvitamin D (25OHD). METHODS We estimated the average vitD-UVB dose for each day of the year and for each postcode area in Scotland, using the Tropospheric Emission Monitoring Internet Service database. Cumulative and weighted vitD-UVB (CW-vitD-UVB) exposure at place of residence was calculated for each participant. Plasma 25OHD was assayed in 1964 healthy participants. RESULTS Significant seasonal and geographical variation in vitD-UVB was observed. Ambient vitD-UVB exposure at place of residence was significantly associated with plasma 25OHD (P < 0·01). An average increase in 25OHD of 1 ng mL(-1) was observed for every 1000 mJ cm(-2) higher CW-vitD-UVB dose or for every 2·5 μg of daily supplement taken. Adequate 25OHD concentration (> 16 ng mL(-1)) was observed in the majority when CW-vitD-UVB dose was > 6000 mJ cm(-2), a level of ambient radiation achieved only in summer months in Scotland. When predicting vitD deficiency, dramatic improvement in the area under the curve was observed (from 0·55 to 0·70) after CW-vitD-UVB dose was added to the model, in addition to a range of other covariates. CONCLUSIONS Ambient vitD-UVB can be a useful predictor of vitD status. Geotemporally mapped measurements of vitD-UVB can be used as a proxy for vitD status or as a covariate in epidemiological research, particularly if 25OHD is unavailable.
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Affiliation(s)
- D Kelly
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - E Theodoratou
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, U.K
| | - S M Farrington
- Colon Cancer Genetics Group, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, U.K
- MRC Human Genetics Unit, Western General Hospital Edinburgh, Edinburgh, EH4 2XU, U.K
| | - R Fraser
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, U.K
| | - H Campbell
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, U.K
- Colon Cancer Genetics Group, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, U.K
- MRC Human Genetics Unit, Western General Hospital Edinburgh, Edinburgh, EH4 2XU, U.K
| | - M G Dunlop
- Colon Cancer Genetics Group, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, U.K
- MRC Human Genetics Unit, Western General Hospital Edinburgh, Edinburgh, EH4 2XU, U.K
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, EH8 9AG, U.K
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Shinkov A, Borissova AM, Dakovska L, Vlahov J, Kassabova L, Svinarov D, Krivoshiev S. Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 60:217-22. [PMID: 26910625 PMCID: PMC10522306 DOI: 10.1590/2359-3997000000109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. MATERIALS AND METHODS Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. RESULTS In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). CONCLUSION The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.
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Affiliation(s)
- Alexander Shinkov
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Anna-Maria Borissova
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Lilia Dakovska
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jordan Vlahov
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Lidia Kassabova
- Central Laboratory of Therapeutic Drug Management and Clinical PharmacologyAlexander University HospitalMedical University of SofiaSofiaBulgariaCentral Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Dobrin Svinarov
- Central Laboratory of Therapeutic Drug Management and Clinical PharmacologyAlexander University HospitalMedical University of SofiaSofiaBulgariaCentral Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Stefan Krivoshiev
- Department of HemodialysisQueen Jovanna HospitalMedical University of SofiaSofiaBulgariaDepartment of Hemodialysis, Queen Jovanna Hospital, Medical University of Sofia, Sofia, Bulgaria
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Sudhanshu S, Upadhyaya P, Sahu M, Agarwal V, Bhatia V. Sun exposure, ultraviolet (UV) irradiance and serum 25 hydroxycholecalciferol (25OHD) in pregnant women in rural North India. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2015. [PMCID: PMC4428308 DOI: 10.1186/1687-9856-2015-s1-p63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Vitamin D and ultraviolet phototherapy in Caucasians. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 147:69-74. [DOI: 10.1016/j.jphotobiol.2015.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Revised: 03/05/2015] [Accepted: 03/06/2015] [Indexed: 02/02/2023]
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The influence of the environment and clothing on human exposure to ultraviolet light. PLoS One 2015; 10:e0124758. [PMID: 25923778 PMCID: PMC4414538 DOI: 10.1371/journal.pone.0124758] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 03/05/2015] [Indexed: 12/01/2022] Open
Abstract
Objection The aim of this study is to determine the effect of clothing and the environment on human exposure to ultraviolet light. Methods The ultraviolet (ultraviolet A and ultraviolet B) light intensity was measured, and air quality parameters were recorded in 2014 in Beijing, China. Three types of clothing (white polyester cloth, pure cotton white T-shirt, and pure cotton black T-shirt) were individually placed on a mannequin. The ultraviolet (ultraviolet A and ultraviolet B) light intensities were measured above and beneath each article of clothing, and the percentage of ultraviolet light transmission through the clothing was calculated. Results (1) The ultraviolet light transmission was significantly higher through white cloth than through black cloth; the transmission was significantly higher through polyester cloth than through cotton. (2) The weather significantly influenced ultraviolet light transmission through white polyester cloth; transmission was highest on clear days and lowest on overcast days (ultraviolet A: P=0.000; ultraviolet B: P=0.008). (3) Air quality parameters (air quality index and particulate matter 2.5 and 10) were inversely related to the ultraviolet light intensity that reached the earth’s surface. Ultraviolet B transmission through white polyester cloth was greater under conditions of low air pollution compared with high air pollution. Conclusion Clothing color and material and different types of weather affected ultraviolet light transmission; for one particular cloth, the transmission decreased with increasing air pollution.
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Lee YA, Kim HY, Hong H, Kim JY, Kwon HJ, Shin CH, Yang SW. Risk factors for low vitamin D status in Korean adolescents: the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009. Public Health Nutr 2014; 17:764-71. [PMID: 23462341 PMCID: PMC10282207 DOI: 10.1017/s1368980013000438] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Revised: 01/17/2013] [Accepted: 01/22/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the prevalence of vitamin D deficiency and predictors for low vitamin D status in Korean adolescents living between latitudes 33° and 39° N. DESIGN A descriptive cross-sectional study. SETTING Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2009. SUBJECTS A total of 1510 healthy adolescents aged 12-18 years (806 male, mean age 14.7 years) participated. Possible predictors for low vitamin D status (log-transformed 25-hydroxyvitamin D (25(OH)D) concentrations) were evaluated. RESULTS The prevalence of vitamin D deficiency (25(OH)D<20 ng/ml) was 89.1% in spring, 53.7% in summer, 63.9% in autumn and 90.5% in winter. Winter season, older age, higher education level reached, being female, being obese, a lack of vitamin D supplementation, lower milk consumption (0-<200 ml/d) and a lack of physical activity were unadjusted predictors (all P < 0.05). Multiple linear regression analysis showed that winter season (P < 0.001), higher education level (P < 0.001) and a lack of vitamin D supplementation (P = 0.012) were independent predictors for low vitamin D status. The modifying effect of season on the association between vitamin D supplement use and vitamin D status was significant (P < 0.001). CONCLUSIONS Vitamin D deficiency was highly prevalent in Korean adolescents, especially those in higher school grades. Vitamin D supplementation may contribute to maintain a better vitamin D status with lower seasonal variation. Further studies are required to determine optimal vitamin D intakes to maintain sufficient vitamin D status for Korean adolescents.
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Affiliation(s)
- Young Ah Lee
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-769, Republic of Korea
| | - Hwa Young Kim
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-769, Republic of Korea
| | - Hyunsook Hong
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji Young Kim
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-769, Republic of Korea
| | - Hyun Jin Kwon
- Health and Exercise Science, Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
| | - Choong Ho Shin
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-769, Republic of Korea
| | - Sei Won Yang
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-769, Republic of Korea
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Han SW, Kim SJ, Lee DJ, Kim KM, Joo NS. The Relationship between Serum 25-Hydroxyvitamin D, Parathyroid Hormone and the Glomerular Filtration Rate in Korean Adults: The Korea National Health and Nutrition Examination Survey between 2009 and 2011. Korean J Fam Med 2014; 35:98-106. [PMID: 24724005 PMCID: PMC3978191 DOI: 10.4082/kjfm.2014.35.2.98] [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] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 02/27/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The glomerular filtration rate (GFR) decreases with age, while parathyroid hormone (PTH) increases. There are a few reports only on the relationship between GFR and PTH under the category of serum 25-hydroxyvitamin D (25[OH]D) concentration. METHODS Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, a cross-sectional study was conducted on the association between serum 25(OH)D concentration, GFR and PTH in Korean adults aged 50 years or older. Serum PTH concentration was compared to the tertiles of GFR after adjustment for relevant variables. In addition, the serum PTH concentration was compared with the GFR under the category of serum 25(OH) D concentration (<20, 20-30, >30 ng/mL). RESULTS The mean estimated GFR (eGFR) was 74.8 mL/min in men and 73.1 mL/min in women. The mean PTH and 25(OH) D was 66.8 pg/mL, 20.5 ng/mL in men and 69.0 pg/mL, 18.2 ng/mL in women. The serum PTH concentration showed a significant negative correlation with the serum 25(OH) D and eGFR in both genders. The serum PTH concentration significantly increased at the lower tertile of eGFR in male adults In addition, a decrease of serum PTH concentration was marked in the vitamin D sufficient male adults (>30 ng/mL). CONCLUSION This present study demonstrated that serum PTH concentration showed negative correlation with eGFR, however, serum PTH increase may be minimized by maintaining proper serum 25(OH)D concentrations under similar eGFR status in Korean adults aged 50 and above.
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Affiliation(s)
- Sung-Woo Han
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Sung-Jin Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Duck-Joo Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kwang-Min Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
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Behar-Cohen F, Baillet G, de Ayguavives T, Garcia PO, Krutmann J, Peña-García P, Reme C, Wolffsohn JS. Ultraviolet damage to the eye revisited: eye-sun protection factor (E-SPF®), a new ultraviolet protection label for eyewear. Clin Ophthalmol 2013; 8:87-104. [PMID: 24379652 PMCID: PMC3872277 DOI: 10.2147/opth.s46189] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Ultraviolet (UV) radiation potentially damages the skin, the immune system, and structures of the eye. A useful UV sun protection for the skin has been established. Since a remarkable body of evidence shows an association between UV radiation and damage to structures of the eye, eye protection is important, but a reliable and practical tool to assess and compare the UV-protective properties of lenses has been lacking. Among the general lay public, misconceptions on eye-sun protection have been identified. For example, sun protection is mainly ascribed to sunglasses, but less so to clear lenses. Skin malignancies in the periorbital region are frequent, but usual topical skin protection does not include the lids. Recent research utilized exact dosimetry and demonstrated relevant differences in UV burden to the eye and skin at a given ambient irradiation. Chronic UV effects on the cornea and lens are cumulative, so effective UV protection of the eyes is important for all age groups and should be used systematically. Protection of children's eyes is especially important, because UV transmittance is higher at a very young age, allowing higher levels of UV radiation to reach the crystalline lens and even the retina. Sunglasses as well as clear lenses (plano and prescription) effectively reduce transmittance of UV radiation. However, an important share of the UV burden to the eye is explained by back reflection of radiation from lenses to the eye. UV radiation incident from an angle of 135°-150° behind a lens wearer is reflected from the back side of lenses. The usual antireflective coatings considerably increase reflection of UV radiation. To provide reliable labeling of the protective potential of lenses, an eye-sun protection factor (E-SPF®) has been developed. It integrates UV transmission as well as UV reflectance of lenses. The E-SPF® compares well with established skin-sun protection factors and provides clear messages to eye health care providers and to lay consumers.
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Affiliation(s)
- Francine Behar-Cohen
- French Institute of Health and Medical Research, Team 17, Centre de Recherche des Cordeliers, France
| | - Gilles Baillet
- Research and Development Center, Essilor International, Saint Maur des Fossés, France
| | - Tito de Ayguavives
- Research and Development Center, Essilor International, Saint Maur des Fossés, France
| | | | - Jean Krutmann
- IUF Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Pablo Peña-García
- Department of Research, Fundacion Jorge Alio, Alicante, Spain
- Division of Ophthalmology, University Miguel Hernández, Alicante, Spain
| | - Charlotte Reme
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, University of Zurich, Switzerland
| | - James S Wolffsohn
- Life and Health Sciences, Aston University, Aston Triangle, Birmingham, UK
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Krutmann J, Béhar-Cohen F, Baillet G, de Ayguavives T, Ortega Garcia P, Peña-García P, Remé C, Wolffsohn J. Towards standardization of UV eye protection: what can be learned from photodermatology? PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2013; 30:128-36. [DOI: 10.1111/phpp.12089] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Jean Krutmann
- Leibniz Research Institute for Environmental Medicine (IUF); Düsseldorf Germany
| | - Francine Béhar-Cohen
- Team 17; Unit 872; French Institute of Medical and Health Research (INSERM); Centre de Recherche des Cordeliers; Paris France
- Université Paris Descartes, Sorbonne Paris Cité; Hôtel-Dieu de Paris (Assistance Publique Hôpitaux de Paris); Paris France
| | - Gilles Baillet
- Research and Development Center; Essilor International; Saint Maur des Fossés France
| | - Tito de Ayguavives
- Research and Development Center; Essilor International; Saint Maur des Fossés France
| | | | - Pablo Peña-García
- Department of Research; Fundacion Jorge Alio; Alicante Spain
- Division of Ophthalmology; Miguel Hernández University; Alicante Spain
| | - Charlotte Remé
- Laboratory of Retinal Cell Biology; Department of Ophthalmology; University of Zurich; Zurich Switzerland
| | - James Wolffsohn
- Ophthalmic Research Group; School of Life and Health Sciences; Aston University; Birmingham UK
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Vierucci F, Del Pistoia M, Fanos M, Gori M, Carlone G, Erba P, Massimetti G, Federico G, Saggese G. Vitamin D status and predictors of hypovitaminosis D in Italian children and adolescents: a cross-sectional study. Eur J Pediatr 2013; 172:1607-17. [PMID: 23959324 DOI: 10.1007/s00431-013-2119-z] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 07/23/2013] [Indexed: 11/25/2022]
Abstract
UNLABELLED Hypovitaminosis D affects children and adolescents all around the world. Italian data on vitamin D status and risk factors for hypovitaminosis D during pediatric age are lacking. Six hundred fifty-two children and adolescents (range 2.0-21.0 years) living in the northwestern area of Tuscany were recruited at the Department of Pediatrics, University Hospital Pisa. None of them had received vitamin D supplementation in the previous 12 months. 25-hydroxyvitamin D (25-OH-D) and parathyroid hormone (PTH) levels were analyzed in all subjects. Severe vitamin D deficiency was defined as serum levels of 25-OH-D<25.0 nmol/L (10.0 ng/mL) and vitamin D deficiency a<50.0 nmol/L (20.0 ng/mL). Serum 25-OH-D levels of 50.0-74.9 nmol/L (20.0-29.9 ng/mL) indicated vitamin D insufficiency, whereas 25-OH-D levels ≥ 75.0 nmol/L (30.0 ng/mL) were considered sufficient. Hypovitaminosis D was defined as 25-OH-D levels<75.0 nmol/L (30.0 ng/mL). The median serum 25-OH-D level was 51.8 nmol/L, range 6.7-174.7 (20.7 ng/mL, range 2.7-70.0), with a prevalence of vitamin D deficiency, insufficiency, and sufficiency of 45.9, 33.6, and 20.5 %, respectively. The prevalence of severe vitamin D deficiency was 9.5 %. Adolescents had lower median 25-OH-D levels (49.8 nmol/L, range 8.1-174.7; 20.0 ng/mL, range 3.2-70.0) than children (55.6 nmol/L, range 6.8-154.6; 22.3 ng/mL, range 2.7-61.9, p=0.006). Non-white individuals (n=37) had median serum 25-OH-D levels in the range of deficiency (28.2 nmol/L, range 8.1-86.2; 11.3 ng/mL, range 3.2-34.5), with 36/37 having hypovitaminosis D. Logistic regression showed significant increased risk of hypovitaminosis D in the following: blood samples taken in winter (odds ratio (OR) 27.20), spring (OR 26.44), and fall (OR 8.27) compared to summer; overweight (OR 5.02) and obese (OR 5.36) subjects compared to individuals with normal BMI; low sun exposure (OR 8.64) compared to good exposure, and regular use of sunscreens (OR 7.06) compared to non-regular use. Gender and place of residence were not associated with vitamin D status. The 25-OH-D levels were inversely related to the PTH levels (r=-0.395, p<0.0001). Sixty-three out of the 652 (9.7 %) subjects showed secondary hyperparathyroidism. CONCLUSION Italian children and adolescents who were not receiving vitamin D supplementation had high prevalence of hypovitaminosis D. Careful identification of factors affecting vitamin D status is advisable to promptly start vitamin D supplementation in children and adolescents.
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Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc 2013; 88:720-55. [PMID: 23790560 PMCID: PMC3761874 DOI: 10.1016/j.mayocp.2013.05.011] [Citation(s) in RCA: 731] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 05/21/2013] [Accepted: 05/23/2013] [Indexed: 02/09/2023]
Abstract
It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskeletal health benefits of vitamin D. This review was obtained by searching English-language studies published up to April 1, 2013, in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials (search terms: vitamin D and supplementation) and focuses on recent challenges regarding the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D concentrations from dietary sources, supplements, and sun exposure. The effect of vitamin D on fetal programming epigenetics and gene regulation could potentially explain why vitamin D has been reported to have such wide-ranging health benefits throughout life. There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality.
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Affiliation(s)
- Arash Hossein-nezhad
- Department of Medicine, Section of Endocrinology, Nutrition, and Diabetes, Vitamin D, Skin, and Bone Research Laboratory, Boston University Medical Center, Boston, MA
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Seckmeyer G, Schrempf M, Wieczorek A, Riechelmann S, Graw K, Seckmeyer S, Zankl M. A novel method to calculate solar UV exposure relevant to vitamin D production in humans. Photochem Photobiol 2013; 89:974-83. [PMID: 23517086 DOI: 10.1111/php.12074] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 03/12/2013] [Indexed: 11/28/2022]
Abstract
We present a novel method to calculate vitamin D3 -weighted exposure by integrating the incident solar spectral radiance over all relevant parts of the human body. Earlier investigations are based on the irradiance on surfaces, whereas our calculated exposure of a voxel model of a human takes into account the complex geometry of the radiation field. Assuming that sufficient vitamin D3 (1000 international units) can be produced within the human body in one minute for a completely uncovered body in vertical posture in summer at midlatitudes (e.g. Rome, June 21, noon, UV index of 10), we calculate the exposure times needed in other situations or seasons to gain enough vitamin D3 . Our calculations show that the UV index is not a good indicator for the exposure which depends on the orientation of the body (e.g. vertical (standing) or horizontal (lying down) posture). Without clothing the exposure is dominated by diffuse sky radiation and it is nearly irrelevant how the body in vertical posture is oriented toward the sun. At the winter solstice (December 21, noon, cloudy) at least in central Europe sufficient vitamin D3 cannot be obtained with realistic clothing, even if the exposure were extended to all daylight hours.
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Affiliation(s)
- Gunther Seckmeyer
- Institute of Meteorology and Climatology, Leibniz University of Hannover, Hannover, Germany.
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Lee YA, Kim JY, Kang MJ, Chung SJ, Shin CH, Yang SW. Adequate vitamin D status and adiposity contribute to bone health in peripubertal nonobese children. J Bone Miner Metab 2013; 31:337-45. [PMID: 23371560 DOI: 10.1007/s00774-012-0419-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 12/18/2012] [Indexed: 11/30/2022]
Abstract
The dietary reference intake (DRI) of vitamin D for Korean children was reduced from 400 IU/day in 2005 to 200 IU/day in 2010. We evaluated the risk factors for low 25-hydroxyvitamin D [25(OH)D] status and its relationships with bone health in peripubertal nonobese children living in Seoul or Gyeonggi-do. One hundred children (9.3 ± 1.9 years, 71 prepubertal, 45 boys) participated in the winter (n = 38, December through March) and summer (June through September). Bone mineral content (Z_BMC), fat mass (Z_FM), lean mass (Z_LM), and bone mineral density for the total body (Z_TB) and lumbar spine (Z_L1-4) were measured using dual-energy X-ray absorptiometry. Twenty-nine percent of children (47.4 % in winter, 17.7 % in summer) were vitamin D deficient (25(OH)D level of <20 ng/mL). The winter season (P = 0.008) and low vitamin D intake (P = 0.044) were associated with low 25(OH)D level. The 25(OH)D level correlated positively with Z_BMC (P = 0.040), Z_TB (P = 0.027), and Z_L1-4 (P = 0.045) independently of sex, puberty, Z_FM, Z_LM, physical activity level, and calcium intake. Z_FM correlated independently with Z_BMC (P < 0.001), Z_TB (P = 0.037), and Z_L1-4 (P < 0.001). In conclusion, almost half of peripubertal nonobese children were vitamin D deficient in winter. Adequate vitamin D status and adiposity contributed to good bone health in nonobese children. Considering the beneficial effects of adequate vitamin D status on bone health, the current DRI may be insufficient for preventing vitamin D deficiency in winter among Korean children.
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Affiliation(s)
- Young Ah Lee
- Division of Endocrinology and Metabolism, Department of Pediatrics, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-769, Korea
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Seasonal changes in vitamin D status among Danish adolescent girls and elderly women: the influence of sun exposure and vitamin D intake. Eur J Clin Nutr 2013; 67:270-4. [PMID: 23388663 DOI: 10.1038/ejcn.2013.3] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES To determine seasonal variation in vitamin D status in healthy Caucasian adolescent girls and elderly community-dwelling women living in Denmark, and to quantify the impact of sun exposure and intake on the seasonal changes in vitamin D status. SUBJECTS/METHODS A 1-year longitudinal observational study of 54 girls (11-13 years) and 52 women (70-75 years). The participants were examined three times (winter-summer-winter). Serum 25-hydroxyvitamin D (S-25OHD) concentration and vitamin D intake were measured at each visit. Sun exposure was measured during summer. RESULTS S-25OHD concentrations (winter, summer, winter) were median (25, 75 percentiles) 23.4 (16.5, 36.4), 60.3 (42.7, 67.7), 29.5 (22.2, 40.4) and 47.2 (27.3, 61.1), 67.3 (35.1, 79.2), 50.5 (32.7, 65.5)nmol/l for girls and women, respectively. The usual sun habits were determinant (P=0.002) for change in vitamin D status from winter to summer. Vitamin D intake from supplements (P<0.0001) and diet (P=0.002) were determinants for change in vitamin D status from summer to winter. Winter vitamin D status of 50 nmol/l is achievable when vitamin D status the previous summer was ≈ 100 nmol/l. If summer vitamin D status is only ≈ 60 nmol/l, vitamin D status the following winter would be ≈ 28 nmol/l. CONCLUSIONS Low vitamin D status among adolescent girls and elderly women during two consecutive winter seasons, improved vitamin D status during the summer and better vitamin D status in women than in girls was found. The estimations show that a summer S-25OHD concentration ≈ 100 nmol/l is needed to achieve a concentration of ≈ 50 nmol/l the following winter.
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Vitamin D and respiratory infections in infants and toddlers: a nutri-shine perspective. HANDBOOK OF VITAMIN D IN HUMAN HEALTH 2013; 4. [PMCID: PMC7123025 DOI: 10.3920/978-90-8686-765-3_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
There is compelling evidence of a global problem of poor vitamin D status in expecting mothers and postnatal life; and even more critical, is the evidence showing the association of vitamin D deficiency with increased morbidity and mortality risks from respiratory infections. Viral and bacterial pneumonia kills more children than any other illness, accounting for 19 % of all deaths in children less than five years of age worldwide; and under-nutrition, which includes vitamin D insufficiency/deficiency, has been implicated in 53 % of all these deaths. Poor vitamin D status is a result of insufficient sunlight exposure and/or poor dietary intake. Greater understanding of the role of vitamin D deficiency in precipitating lung infections grew from the use of rodent models and observational and intervention studies in infants and toddlers. Vitamin D adequacy is important to maintaining the key protective mechanism of developing lungs since it mediates the synthesis of antimicrobial peptides, the lungs strongest defense against viral and bacterial pathogens. If vitamin D intervention currently under study in several clinical trials is proven successful, then implementation of new fortification practices, revised guidelines for healthy sun exposure and public health programs for vitamin D supplementation of pregnant/lactating women and their infants may be effective strategies to aide in preventing neonates and children under five from developing pneumonia. Globally, there is potential to save more than a million young lives with preventive treatment, a compelling reason why the efficacy of optimizing vitamin D mediated defense against respiratory pathogens in infants and children merits further study.
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Evaluation of drug and sunscreen permeation via skin irradiated with UVA and UVB: Comparisons of normal skin and chronologically aged skin. J Dermatol Sci 2012; 68:135-48. [DOI: 10.1016/j.jdermsci.2012.09.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 09/05/2012] [Accepted: 09/08/2012] [Indexed: 11/18/2022]
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Nair-Shalliker V, Clements M, Fenech M, Armstrong BK. Personal Sun Exposure and Serum 25-hydroxy Vitamin D Concentrations. Photochem Photobiol 2012; 89:208-14. [DOI: 10.1111/j.1751-1097.2012.01201.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Abstract
The incidence of vitamin D deficiency is rising worldwide, yet in the vast majority of patients, the condition remains undiagnosed and untreated. Current evidence overwhelmingly indicates that supplemental doses greater than 800 IU/day have beneficial effects on the musculoskeletal system, improving skeletal homeostasis, thus leading to fewer falls and fractures. Evidence is also accumulating on the beneficial effects of vitamin D on extraskeletal systems, such as improving immune health, autoimmune disorders, cancer, neuromodulation, diabetes, and metabolic syndrome. The cause-effect relationship of vitamin D deficiency with increasing incidences of nonskeletal disorders is being investigated. Published reports support the definition of sufficiency, serum levels of 25-hydroxyvitamin D [25(OH)D] greater than 30 ng/mL (75 nmol/L). To achieve this, most people need vitamin D supplementation ranging from 600 to 2000 IU/day; consumption up to of 5000 international units (IU) per day of vitamin D is reported as safe. Although light-skinned individuals need 1000 IU/day of vitamin D, elderly and dark-skinned individuals are likely to need approximately 2000 IU/day to maintain serum 25(OH)D levels greater than 30 ng/mL. Other vulnerable patients, such as the obese, those who have undergone bariatric surgery, and those with gastrointestinal malabsorption syndromes, may require higher doses of vitamin D to maintain normal serum levels and be healthy.
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Affiliation(s)
- Sunil J Wimalawansa
- Physiology & Integrative Biology, Endocrinology, Metabolism & Nutrition, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
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Godar DE, Pope SJ, Grant WB, Holick MF. Solar UV doses of adult Americans and vitamin D(3) production. DERMATO-ENDOCRINOLOGY 2011; 3:243-50. [PMID: 22259652 DOI: 10.4161/derm.3.4.15292] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 12/01/2010] [Accepted: 12/22/2010] [Indexed: 01/10/2023]
Abstract
BACKGROUND Sunlight contains UV radiation that affects human health in both detrimental (skin cancers) and beneficial (vitamin D(3)) ways. An evaluation of the vitamin D status of adult Americans (22-40, 41-59, 60+ yr) show many have deficient or insufficient serum levels of 25-hydroxyvitamin D, indicating they are not getting enough from dietary sources or sunlight. Those findings are in conflict with calculated values from the American Academy of Dermatology who insist people make "ample" vitamin D(3) (≥1,000 IU/day) from their "casual," or everyday, outdoor UV exposures even if they use sunscreens with sun protection factor 15. OBJECTIVE We investigated this situation using the everyday outdoor UV doses of indoor-working adult Americans (∼7,000) in the north (45°N) and south (35°N) to calculate how much vitamin D(3) they produce each season with and without vacationing. RESULTS Only during the summer can skin type II Caucasian adults (21-59 yr) meet their minimum (600 IU/day) vitamin D(3) needs from everyday exposures, but only if they do not wear professional clothes or sunscreens (except beach vacations). METHOD To do vitamin D(3) calculations properly, we used action spectrum and geometric conversion factors, not previously incorporated into other calculations. CONCLUSIONS Most adult Americans do not go outside enough to meet their minimum or optimum (≥1,200 IU/day) vitamin D(3) needs all year. The darker skin types (III-VI) and the oldest people (>59 yr) are at the highest risk for not making enough vitamin D(3) during the year from everyday outdoor exposures even with a 2-3 week summer vacation.
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Affiliation(s)
- Dianne E Godar
- US Food and Drug Administration; Center for Devices and Radiological Health; Rockville, MD USA
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