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Fang A, Zhao Y, Yang P, Zhang X, Giovannucci EL. Vitamin D and human health: evidence from Mendelian randomization studies. Eur J Epidemiol 2024; 39:467-490. [PMID: 38214845 DOI: 10.1007/s10654-023-01075-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 10/30/2023] [Indexed: 01/13/2024]
Abstract
We summarized the current evidence on vitamin D and major health outcomes from Mendelian randomization (MR) studies. PubMed and Embase were searched for original MR studies on vitamin D in relation to any health outcome from inception to September 1, 2022. Nonlinear MR findings were excluded due to concerns about the validity of the statistical methods used. A meta-analysis was preformed to synthesize study-specific estimates after excluding overlapping samples, where applicable. The methodological quality of the included studies was evaluated according to the STROBE-MR checklist. A total of 133 MR publications were eligible for inclusion in the analyses. The causal association between vitamin D status and 275 individual outcomes was examined. Linear MR analyses showed genetically high 25-hydroxyvitamin D (25(OH)D) concentrations were associated with reduced risk of multiple sclerosis incidence and relapse, non-infectious uveitis and scleritis, psoriasis, femur fracture, leg fracture, amyotrophic lateral sclerosis, anorexia nervosa, delirium, heart failure, ovarian cancer, non-alcoholic fatty liver disease, dyslipidemia, and bacterial pneumonia, but increased risk of Behçet's disease, Graves' disease, kidney stone disease, fracture of radium/ulna, basal cell carcinoma, and overall cataracts. Stratified analyses showed that the inverse association between genetically predisposed 25(OH)D concentrations and multiple sclerosis risk was significant and consistent regardless of the genetic instruments GIs selected. However, the associations with most of the other outcomes were only pronounced when using genetic variants not limited to those in the vitamin D pathway as GIs. The methodological quality of the included MR studies was substantially heterogeneous. Current evidence from linear MR studies strongly supports a causal role of vitamin D in the development of multiple sclerosis. Suggestive support for a number of other health conditions could help prioritize conditions where vitamin D may be beneficial or harmful.
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Affiliation(s)
- Aiping Fang
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Yue Zhao
- Department of Nutrition, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Ping Yang
- School of Nursing, Peking University, Beijing, China
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA
| | - Xuehong Zhang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Edward L Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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2
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Alonso N, Zelzer S, Eibinger G, Herrmann M. Vitamin D Metabolites: Analytical Challenges and Clinical Relevance. Calcif Tissue Int 2023; 112:158-177. [PMID: 35238975 PMCID: PMC8892115 DOI: 10.1007/s00223-022-00961-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/16/2022] [Indexed: 01/25/2023]
Abstract
Recent research activities have provided new insights in vitamin D metabolism in various conditions. Furthermore, substantial progress has been made in the analysis of vitamin D metabolites and related biomarkers, such as vitamin D binding protein. Liquid chromatography tandem mass spectrometric (LC-MS/MS) methods are capable of accurately measuring multiple vitamin D metabolites in parallel. Nevertheless, only 25(OH)D and the biologically active form 1,25(OH)2D are routinely measured in clinical practice. While 25(OH)D remains the analyte of choice for the diagnosis of vitamin D deficiency, 1,25(OH)2D is only recommended in a few conditions with a dysregulated D metabolism. 24,25(OH)2D, free and bioavailable 25(OH)D, and the vitamin D metabolite ratio (VMR) have shown promising results, but technical pitfalls in their quantification, limited clinical data and the lack of reference values, impede their use in clinical practice. LC-MS/MS is the preferred method for the measurement of all vitamin D related analytes as it offers high sensitivity and specificity. In particular, 25(OH)D and 24,25(OH)2D can accurately be measured with this technology. When interpreted together, they seem to provide a functional measure of vitamin D metabolism beyond the analysis of 25(OH)D alone. The determination of VDBP, free and bioavailable 25(OH)D is compromised by unresolved analytical issues, lacking reference intervals and insufficient clinical data. Therefore, future research activities should focus on analytical standardization and exploration of their clinical value. This review provides an overview on established and new vitamin D related biomarkers including their pathophysiological role, preanalytical and analytical aspects, expected values, indications and influencing conditions.
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Affiliation(s)
- N Alonso
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - S Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - G Eibinger
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - M Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
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3
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Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases. Nutrients 2023; 15:nu15020334. [PMID: 36678205 PMCID: PMC9864832 DOI: 10.3390/nu15020334] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023] Open
Abstract
Deficiency in vitamin D (VitD), a lipid-soluble vitamin and steroid hormone, affects approximately 24% to 40% of the population of the Western world. In addition to its well-documented effects on the musculoskeletal system, VitD also contributes importantly to the promotion and preservation of cardiovascular health via modulating the immune and inflammatory functions and regulating cell proliferation and migration, endothelial function, renin expression, and extracellular matrix homeostasis. This brief overview focuses on the cardiovascular and cerebrovascular effects of VitD and the cellular, molecular, and functional changes that occur in the circulatory system in VitD deficiency (VDD). It explores the links among VDD and adverse vascular remodeling, endothelial dysfunction, vascular inflammation, and increased risk for cardiovascular and cerebrovascular diseases. Improved understanding of the complex role of VDD in the pathogenesis of atherosclerotic cardiovascular diseases, stroke, and vascular cognitive impairment is crucial for all cardiologists, dietitians, and geriatricians, as VDD presents an easy target for intervention.
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Susarla G, Chan W, Li A, Davoudi S, Ahmadi T, Sathe S, Tom L, Papaliodis GN, Mercader JM, Leong A, Sobrin L. Mendelian Randomization Shows a Causal Effect of Low Vitamin D on Non-infectious Uveitis and Scleritis Risk. Am J Ophthalmol 2022; 244:11-18. [PMID: 35948088 DOI: 10.1016/j.ajo.2022.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/03/2022] [Indexed: 01/30/2023]
Abstract
PURPOSE To investigate a causal relationship between Vitamin D levels and non-infectious uveitis and scleritis using Mendelian randomization (MR) techniques. DESIGN Two-sample Mendelian randomization case-control study. METHODS The study setting was a biobank of an academic, integrated health care system. The patient population comprised 375 case patients with a non-infectious uveitis and/or scleritis diagnosis and no diagnosis of infectious, trauma-related, or drug-induced uveitis/scleritis. In addition, there were 4167 controls with no uveitis or scleritis diagnosis. Causal effect estimates of low 25-hydroxy Vitamin D (25OHD) on uveitis/scleritis risk were calculated. RESULTS We found an association of genetically decreased 25OHD with uveitis/scleritis risk (odds ratio [OR] = 2.16, 95% CI = 1.01-4.64, P = .049, per SD decrease in log25OHD). In a first sensitivity MR analysis excluding the genetic variants that are unlikely to have a role in biologically active 25OHD, effect estimates were consistent with those from the primary analysis (OR = 2.38, 95% CI =1.06-5.36, P = 0.035, per SD of log25OHD). Furthermore, in a second sensitivity analysis using only the 6 variants within the CYP2R1 locus (which encodes 25OHD hydroxylase, the liver enzyme responsible for converting Vitamin D to 25OHD), genetically decreased 25OHD was strongly associated with increased uveitis/scleritis risk (OR = 6.42, 95% CI = 3.19-12.89, P = 1.7 × 10-7, per SD of log25OHD). CONCLUSIONS Our findings suggest a causal relationship between low Vitamin D levels and higher risk of non-infectious uveitis and scleritis. Vitamin D supplementation may be a low-cost, low-risk intervention to mitigate non-infectious uveitis and scleritis risk, and should be explored in a prospective trial.
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Affiliation(s)
- Gayatri Susarla
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Weilin Chan
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Ashley Li
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Samaneh Davoudi
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Tina Ahmadi
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Shaleen Sathe
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Lisa Tom
- Department of Ophthalmology (L.T.), University of Miami Health System, Bascom Palmer Eye Institute, Miami, Florida, USA
| | - George N Papaliodis
- Uveitis Department (G.N.P.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Josep M Mercader
- Diabetes Unit and Center for Genomic Medicine (J.M.M.), Massachusetts General Hospital, Boston, Massachusetts, USA; Department of Medicine (J.M.M., A.L.), Harvard Medical School, Boston, Massachusetts, USA; Programs in Metabolism and Medical and Population Genetics (J.M.M., A.L.), Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Aaron Leong
- Department of Medicine (J.M.M., A.L.), Harvard Medical School, Boston, Massachusetts, USA; Programs in Metabolism and Medical and Population Genetics (J.M.M., A.L.), Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA; Diabetes Unit (A.L.), Endocrine Division, Massachusetts General Hospital, Boston, Massachusetts, USA; Division of General Internal Medicine (A.L.), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lucia Sobrin
- From the Retina Department (G.S., W.C., A.L., S.D., T.A., S.S., L.S.), Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
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Zhu A, Kuznia S, Niedermaier T, Holleczek B, Schöttker B, Brenner H. Consistent Inverse Associations of Total, “Bioavailable”, Free, and “Non-Bioavailable” Vitamin D with Incidence of Diabetes among Older Adults with Lower Baseline HbA1c (≤6%) Levels. Nutrients 2022; 14:nu14163282. [PMID: 36014788 PMCID: PMC9413175 DOI: 10.3390/nu14163282] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Serum 25-hydroxyvitamin (25(OH)D) levels are inversely associated with risk of diabetes. The “free hormone hypothesis” suggests potential effects to be mainly related to concentrations of “bioavailable” and free rather than total 25(OH)D. We assessed associations of serum concentrations of vitamin D-binding protein (VDBP), as well as total “bioavailable”, complementary “non-bioavailable”, and free 25(OH)D, with the risk of developing diabetes among non-diabetic older adults in a large population-based cohort study in Germany. Methods: We included 4841 non-diabetic older adults aged 50–75 years at the baseline exam from the ESTHER cohort conducted in Saarland, Germany, in 2001–2002. Concentrations of “bioavailable” and free 25(OH)D were derived from serum concentrations of VDBP, total 25(OH)D, and albumin. Incidence of diabetes was ascertained during up to 14 years of follow-up. Associations were quantified by multivariable Cox proportional hazards regression models with comprehensive confounder adjustment. Results: During a median follow-up of 10.6 years, 837 non-diabetic participants developed diabetes. We observed similar inverse associations with developing diabetes for VDBP (hazard ratio (HR) for lowest versus highest quintile: 1.37, 95% confidence interval (CI): 1.09, 1.72), total 25(OH)D (HR: 1.31, 95% CI: 1.03, 1.66), and “non-bioavailable” 25(OH)D (HR: 1.30, 95% CI: 1.02, 1.65). Associations were smaller and statistically insignificant for “bioavailable” and free 25(OH)D. However, associations of total “non-bioavailable”, “bioavailable”, and free 25(OH)D with incidence of diabetes were much stronger among, and essentially restricted to, participants with lower baseline HbA1c (≤6%) levels. Conclusions: This large prospective cohort study of older Caucasian adults, in agreement with results from randomized trials and Mendelian randomization studies, supports a protective effect of vitamin D against development of diabetes. The “free hormone theory” may not be relevant in this context. However, our results underline the importance of adequate vitamin D status among those who have not yet shown any sign of impaired glucose tolerance.
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Affiliation(s)
- Anna Zhu
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Sabine Kuznia
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Medical Faculty Heidelberg, Heidelberg University, 69120 Heidelberg, Germany
| | - Tobias Niedermaier
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | | | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Network Aging Research, Heidelberg University, 69115 Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Network Aging Research, Heidelberg University, 69115 Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221421300
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6
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Moon RJ, Cooke LDF, D’Angelo S, Curtis EM, Titcombe P, Davies JH, Godfrey KM, Cleal JK, Lewis RM, Cooper C, Harvey NC. Maternal and Fetal Genetic Variation in Vitamin D Metabolism and Umbilical Cord Blood 25-Hydroxyvitamin D. J Clin Endocrinol Metab 2022; 107:e3403-e3410. [PMID: 35474389 PMCID: PMC9282354 DOI: 10.1210/clinem/dgac263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Single nucleotide polymorphisms (SNPs) in vitamin D metabolism pathway genes are associated with circulating 25-hydroxyvitamin D (25(OH)D) in adults. Less is known about the relationships between mother and offspring SNPs and umbilical cord blood 25(OH)D. OBJECTIVE (1) To undertake a meta-analysis of the relationships of maternal and offspring SNPs in the vitamin D metabolism pathway and cord blood 25(OH)D in pregnant women including novel data; and (2) to examine these relationships in women who received antenatal cholecalciferol supplementation in a clinical trial. METHODS Novel data analysis from an observational mother-offspring cohort study (Southampton Women's Survey) and the MAVIDOS double-blind, randomized, placebo-controlled trial of 1000 IU/day cholecalciferol supplementation in pregnancy, and an electronic literature search of published studies in PubMed up to 31 July 2021. Studies reporting associations between rs12785878 (DHCR7), rs10741657 (CYP2R1), rs6013897 (CYP24A1), or rs2282679 (GC) and cord blood 25(OH)D. One published study was included in addition to the novel data analysis. Associations between both maternal and offspring SNPs at rs2282679 (GC) and rs12785878 (DHCR7), and cord blood 25(OH)D were identified. When maternal genotype was adjusted for offspring genotype, and vice versa, there was persisting evidence for associations with maternal rs12785878 (β [95% CI] 1.6 nmol/L [0.3, 2.8] per common allele), and offspring rs2282679 (β 3.1 nmol/L ]2.0, 4.4] per common allele). Maternal and offspring SNPs at rs1074657 and rs613897 were not associated with cord blood 25(OH)D. RESULT Associations between both maternal and offspring SNPs at rs2282679 (GC) and rs12785878 (DHCR7), and cord blood 25(OH)D were identified. When maternal genotype was adjusted for offspring genotype, and vice versa, there was persisting evidence for associations with maternal rs12785878 (β [95% CI] 1.6 nmol/L [0.3, 2.8] per common allele), and offspring rs2282679 (β 3.1 nmol/L ]2.0, 4.4] per common allele). Maternal and offspring SNPs at rs1074657 and rs613897 were not associated with cord blood 25(OH)D. CONCLUSION Common genetic variation in the vitamin D metabolism pathway is associated with umbilical cord blood 25(OH)D.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
- Paediatric Endocrinology, Southampton Children’s Hospital, Southampton University Hospitals NHS Foundation Trust, Southampton,UK
| | - Laura D F Cooke
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton,UK
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
| | - Philip Titcombe
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
| | - Justin H Davies
- Paediatric Endocrinology, Southampton Children’s Hospital, Southampton University Hospitals NHS Foundation Trust, Southampton,UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton,UK
| | - Jane K Cleal
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton,UK
| | - Rohan M Lewis
- The Institute of Developmental Sciences, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton,UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton,UK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton,UK
- NIHR Southampton Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton,UK
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7
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Speeckaert MM, Delanghe JR. Commentary: Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19? Front Immunol 2022; 13:875973. [PMID: 35392098 PMCID: PMC8980473 DOI: 10.3389/fimmu.2022.875973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Marijn M Speeckaert
- Department of Nephrology, Ghent University Hospital, Ghent, Belgium.,Research Foundation-Flanders (FWO), Brussels, Belgium
| | - Joris R Delanghe
- Department of Diagnostic Sciences, Ghent University, Ghent, Belgium
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8
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Niu P, Li H, Liu D, Zhang YF, Liu Y, Liang C. Association Between HDL-C and Bone Mineral Density: An Cross-Sectional Analysis. Int J Gen Med 2021; 14:8863-8872. [PMID: 34866931 PMCID: PMC8637772 DOI: 10.2147/ijgm.s334972] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/20/2021] [Indexed: 01/18/2023] Open
Abstract
Background Dyslipidemia has been found to contribute to increased risk of osteoporosis and its association with bone mineral density (BMD) remains controversial. We determined whether blood lipid levels are linked with change of BMD. Methods In a large sample from the MIDUS II study, we sought to evaluate the relationship between blood lipid levels and BMD. Multivariate linear regression models and smooth curve analysis were constructed by controlling a great range of confounding factors. Results The median age of them was 52.5 years, and the number of males was 176 (40%). Univariate analysis showed that blood high-density lipoprotein-cholesterol (HDL-C) level was negatively related to lunar total femur (r = −0.266, P < 0.001), lunar radius ultradistal (UD) (r = −0.297, P < 0.001), lunar radius 1/3 (r = −0.307, P = 0.001) and femoral neck (r = −0.172, P = 0.001). In multivariate linear analysis, except for blood triglyceride, total cholesterol and low-density lipoprotein cholesterol (LDL-C), we found that blood HDL-C level was still negatively related to lunar total femur [B = −0.002, B 95% CI (−0.002, −0.001), P < 0.001], lunar radius UD [B = −0.001, 95% CI (−0.001, 0), P = 0.002], lunar radius 1/3 [B = −0.001, 95% CI (−0.001, 0), P = 0.003] and femoral neck [B = −0.001, 95% CI (−0.002, 0), P = 0.039] after adjustments of demographic characteristics, lifestyle, disease history were made. Furthermore, we found that age, sex, and body mass index (BMI) had modifying effects on this negative association. Conclusion This study confirmed the negative association between HDL-C and BMD in the observational analysis from (MIDUS) study and provides high-quality evidence that age, sex and BMI had modifying effects on this negative association.
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Affiliation(s)
- Peng Niu
- Department of Spine and Joint Surgery, Second General Hospital of Nanyang, Nanyang City, 473009, Henan Province, People's Republic of China
| | - Haibo Li
- China Department of Orthopaedics, People's Hospital of Xuecheng, Zaozhuang City, 277000, Shandong Province, People's Republic of China
| | - Dejun Liu
- China Department of Orthopaedics, People's Hospital of Xuecheng, Zaozhuang City, 277000, Shandong Province, People's Republic of China
| | - Yan Feng Zhang
- Department of Spine and Joint Surgery, Second General Hospital of Nanyang, Nanyang City, 473009, Henan Province, People's Republic of China
| | - YongXi Liu
- Department of Spine and Joint Surgery, Second General Hospital of Nanyang, Nanyang City, 473009, Henan Province, People's Republic of China
| | - Cheng Liang
- The Orthopaedic Center of Joint and Trauma Surgery, The Affiliated Hiser Hospital of Qingdao University, Qingdao City, Shandong Province, 266000, People's Republic of China
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9
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Setayesh L, Amini A, Bagheri R, Moradi N, Yarizadeh H, Asbaghi O, Casazza K, Yekaninejad MS, Wong A, Suzuki K, Mirzaei K. Elevated Plasma Concentrations of Vitamin D-Binding Protein Are Associated with Lower High-Density Lipoprotein and Higher Fat Mass Index in Overweight and Obese Women. Nutrients 2021; 13:nu13093223. [PMID: 34579103 PMCID: PMC8472481 DOI: 10.3390/nu13093223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/08/2021] [Accepted: 09/15/2021] [Indexed: 12/17/2022] Open
Abstract
(1) Background: Observational studies have established that vitamin D-binding protein (DBP) and 25-hydroxyvitamin D3 (25(OH)D) concentrations are the major factors affecting the bioavailability of 25(OH)D. It has also been shown that poor 25(OH)D bioavailability elevates the risk of obesity and its related cardio-metabolic disorders. However, the relationship between 25(OH)D and DBP concentrations with cardio-metabolic risk factors in overweight and obese cohorts has not been established. Consequently, we evaluated the association between DBP and 25(OH)D concentrations with lipid profile, blood pressure (BP), and body composition in overweight and obese women. (2) Methods: In this cross-sectional study of 236 overweight and obese women, DBP and 25(OH)D concentrations were measured using an enzyme-linked immunosorbent assay. Body composition was assessed via bioelectrical impedance analysis. Lipid profile and BP were assessed by an auto-analyzer and digital BP monitor, respectively. The associations were examined by multivariate logistic regression. (3) Results: The indicated showed an inverse relationship between DBP and high-density lipoprotein (HDL) (p = 0.010) concentrations (where individuals with higher DBP had lower HDL) which, after adjusting for possible cofounders, remained significant (p = 0.006). Moreover, DBP concentration was positively associated with fat mass index (FMI) after adjustment (p = 0.022). No significant relationships were observed among 25(OH)D and target variables. (4) Conclusions: In conclusion, lower concentrations of HDL and higher values of FMI are associated with higher concentrations of DBP in overweight and obese women. These findings present novel awareness regarding the association of DBP with some metabolic and body composition variables in overweight and obese women. However, a two-way causal relationship between DBP and target variables should be considered.
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Affiliation(s)
- Leila Setayesh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (L.S.); (H.Y.)
| | - Abbas Amini
- Department of Mechanical Engineering, Australian College of Kuwait, Safat 13015, Kuwait;
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan 8174673441, Iran;
| | - Nariman Moradi
- Cellular and Molecular Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj 6617713446, Iran;
| | - Habib Yarizadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (L.S.); (H.Y.)
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran 1416753955, Iran;
| | - Krista Casazza
- Marieb College of Health and Human Services, Florida Gulf Coast University, Fort Myers, FL 33965, USA;
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA 22207, USA;
| | - Katsuhiko Suzuki
- Faculty of Sport Sciences, Waseda University, Tokyo 2-579-15, Japan
- Correspondence: (K.S.); (K.M.)
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran 1417613151, Iran; (L.S.); (H.Y.)
- Correspondence: (K.S.); (K.M.)
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10
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Georgakis MK, Gill D. Mendelian Randomization Studies in Stroke: Exploration of Risk Factors and Drug Targets With Human Genetic Data. Stroke 2021; 52:2992-3003. [PMID: 34399585 DOI: 10.1161/strokeaha.120.032617] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Elucidating the causes of stroke is key to developing effective preventive strategies. The Mendelian randomization approach leverages genetic variants related to an exposure of interest to investigate the effects of varying that exposure on disease risk. The random allocation of genetic variants at conception reduces confounding from environmental factors and thus strengthens causal inference, analogous to treatment allocation in a randomized controlled trial. With the recent explosion in the availability of human genetic data, Mendelian randomization has proven a valuable tool for studying risk factors for stroke. In this review, we provide an overview of recent developments in the application of Mendelian randomization to unravel the pathophysiology of stroke subtypes and identify therapeutic targets for clinical translation. The approach has offered novel insight into the differential effects of risk factors and antihypertensive, lipid-lowering, and anticoagulant drug classes on risk of stroke subtypes. Analyses have further facilitated the prioritization of novel drug targets, such as for inflammatory pathways underlying large artery atherosclerotic stroke and for the coagulation cascade that contributes to cardioembolic stroke. With continued methodological advances coupled with the rapidly increasing availability of genetic data related to a broad range of stroke phenotypes, the potential for Mendelian randomization in this context is expanding exponentially.
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Affiliation(s)
- Marios K Georgakis
- Institute for Stroke and Dementia Research (ISD) (M.K.G.), University Hospital of Ludwig Maximilians-University (LMU), Munich, Germany.,Department of Neurology (M.K.G.), University Hospital of Ludwig Maximilians-University (LMU), Munich, Germany
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom (D.G.).,Clinical Pharmacology and Therapeutics Section, Institute of Medical and Biomedical Education and Institute for Infection and Immunity, St George's, University of London, United Kingdom (D.G.).,Clinical Pharmacology Group, Pharmacy and Medicines Directorate, St George's University Hospitals NHS Foundation Trust, London, United Kingdom (D.G.).,Novo Nordisk Research Centre Oxford, Old Road Campus, United Kingdom (D.G.)
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11
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Speeckaert MM, Delanghe JR. Contribution of Vitamin D-Binding Protein Polymorphism to Susceptibility and Outcome of COVID-19 Patients. J Nutr 2021; 151:2498-2499. [PMID: 34363485 PMCID: PMC8385920 DOI: 10.1093/jn/nxab234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Key Words
- 1,25(oh)2d, 1,25-dihydroxyvitamin d
- 25(oh)d, 25-hydroxyvitamin d
- apache ii, acute physiology and chronic health evaluation ii
- covid-19, coronavirus disease 2019
- dbp, vitamin d–binding protein
- f-actin, filamentous actin
- g-actin, globular actin
- gc, group-specific component
- icu, intensive care unit
- sars-cov-2, severe acute respiratory syndrome coronavirus-2
- triss, trauma and injury severity score.
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12
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Xiao J, Lv J, Wang S, Zhou Y, Chen L, Lu J, Zhang X, Wang X, Gu Y, Lu Q. Association of serum 25-hydroxyvitamin D with metabolic syndrome and type 2 diabetes: a one sample Mendelian randomization study. BMC Geriatr 2021; 21:391. [PMID: 34187381 PMCID: PMC8244233 DOI: 10.1186/s12877-021-02307-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/25/2021] [Indexed: 01/08/2023] Open
Abstract
Background Vitamin D deficiency has been associated with type 2 diabetes (T2D) and metabolic syndrome (MS) and its components. However, it is unclear whether a low concentration of vitamin D is the cause or consequence of these health conditions. Thus, this study aimed to evaluate the association of vitamin D concentrations and its genetic risk scores (GRSs) with MS and its component diseases, such as T2D, in middle-aged and elderly participants from rural eastern China. Methods A subset of 2393 middle-aged and elderly individuals were selected from 70,458 participants of the Nantong Chronic Diseases Study of 2017–2018 in China. We used two 25-hydroxyvitamin D (25[OH]D) synthesis single-nucleotide polymorphisms (SNPs) (DHCR7-rs12785878 and CYP2R1-rs10741657) and two 25(OH) D metabolism SNPs (GC-rs2282679 and CYP24A1-rs6013897) for creating GRSs, which were used as instrumental variables to assess the effect of genetically lowered 25(OH) D concentrations on MS and T2D based on the Wald ratio. F statistics were used to validate that the four SNPs genetically determined 25(OH) D concentrations. Results Compared to vitamin D sufficient individuals, individuals with vitamin D insufficiency had an odds ratio (OR [95% confidence interval {CI}]) of MS of 1.30 (1.06–1.61) and of T2D of 1.32 (1.08–1.64), individuals with vitamin D deficiency had an ORs (95% CI) of MS of 1.50 (1.24–1.79) and of T2D of 1.47 (1.12–1.80), and those with vitamin D severe deficiency had an ORs (95% CI) of MS of 1.52 (1.29–1.85) and of T2D of 1.54 (1.27–1.85). Mendelian randomization analysis showed a 25-nmol/L decrease in genetically instrumented serum 25(OH) D concentrations using the two synthesis SNPs (DHCR7 and CYP2R1 genes) associated with the risk of T2D and abnormal diastolic blood pressure (DBP) with ORs of 1.10 (95%CI: 1.02–1.45) for T2D and 1.14 (95%CI: 1.03–1.43) for DBP. Conclusions This one sample Mendelian randomization analysis shows genetic evidence for a causal role of lower 25(OH) D concentrations in promoting of T2D and abnormal DBP in middle-aged and elderly participants from rural China. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02307-6.
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Affiliation(s)
- Jing Xiao
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019
| | - Jingyi Lv
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019
| | - Shiyu Wang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019
| | - Yang Zhou
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019
| | - Lunwen Chen
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019
| | - Juying Lu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226001
| | - Xiaoyi Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226001
| | - Xiaojian Wang
- Department of Chronic Disease and Prevention, Center for Disease Control and Prevention of Haian, Nantong, Jiangsu, P.R. China, 226600
| | - Yunjuan Gu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226001.
| | - Qingyun Lu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, P.R. China, 226019.
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13
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Twelve years of GWAS discoveries for osteoporosis and related traits: advances, challenges and applications. Bone Res 2021; 9:23. [PMID: 33927194 PMCID: PMC8085014 DOI: 10.1038/s41413-021-00143-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 12/21/2020] [Indexed: 02/03/2023] Open
Abstract
Osteoporosis is a common skeletal disease, affecting ~200 million people around the world. As a complex disease, osteoporosis is influenced by many factors, including diet (e.g. calcium and protein intake), physical activity, endocrine status, coexisting diseases and genetic factors. In this review, we first summarize the discovery from genome-wide association studies (GWASs) in the bone field in the last 12 years. To date, GWASs and meta-analyses have discovered hundreds of loci that are associated with bone mineral density (BMD), osteoporosis, and osteoporotic fractures. However, the GWAS approach has sometimes been criticized because of the small effect size of the discovered variants and the mystery of missing heritability, these two questions could be partially explained by the newly raised conceptual models, such as omnigenic model and natural selection. Finally, we introduce the clinical use of GWAS findings in the bone field, such as the identification of causal clinical risk factors, the development of drug targets and disease prediction. Despite the fruitful GWAS discoveries in the bone field, most of these GWAS participants were of European descent, and more genetic studies should be carried out in other ethnic populations to benefit disease prediction in the corresponding population.
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14
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Mull B, Davis R, Munir I, Perez MC, Simental AA, Khan S. Differential expression of Vitamin D binding protein in thyroid cancer health disparities. Oncotarget 2021; 12:596-607. [PMID: 33868582 PMCID: PMC8021030 DOI: 10.18632/oncotarget.27920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 03/05/2021] [Indexed: 12/20/2022] Open
Abstract
Thyroid cancer incidence, recurrence, and death rates are higher among Filipino Americans than European Americans. We propose that vitamin D binding protein (DBP) with multifunctionality with ethnic variability plays a key role within different ethnicities. In this study, we determined the correlation between differential DBP expression in tumor tissues and cancer staging in Filipino Americans versus European Americans. We assayed DBP expression by immunohistochemistry and analyzed the data with confocal microscopy on 200 thyroid cancer archival tissue samples obtained from both ethnicities. DBP-stable knockdown/gain-in-function assays were done by using DBP-shRNA/DBP-cDNA-expression in vitro. The majority of Filipino Americans presented with advanced tumor staging. In contrast, European Americans showed early staging and very few advanced tumors. A significantly low to no DBP staining was detected and correlated to the advanced staging in Filipino Americans. On the contrary, in the tumor tissues derived from European Americans, moderate to strong DBP staining was detected and correlated to early staging. When downregulation of the DBP gene in papillary thyroid cancer (PTC) cell lines was observed, tumor proliferation and migration were enhanced. On the other hand, the upregulation of the DBP gene decreased cell proliferation and migration in PTC cells. In conclusion, we determined a differential expression of an essential biological molecule (DBP) is linked to cancer staging in thyroid cancer health disparities in two ethnicities. Loss-of-DBP/gain-in-DBP-function influenced tumor progression. A future study is underway to determine the DBP regulation and its downstream pathways to elucidate strategies to eliminate the observed thyroid cancer health disparities.
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Affiliation(s)
| | - Ryan Davis
- Division of Biochemistry, Loma Linda, CA 92350, USA.,Center for Health Disparities & Molecular Medicine, Loma Linda, CA 92350, USA
| | - Iqbal Munir
- Riverside University Health System, Moreno Valley, CA 92555, USA
| | - Mia C Perez
- Department of Pathology & Human Anatomy, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
| | - Alfred A Simental
- Department of Otolaryngology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
| | - Salma Khan
- Division of Biochemistry, Loma Linda, CA 92350, USA.,Center for Health Disparities & Molecular Medicine, Loma Linda, CA 92350, USA.,Department of Otolaryngology, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.,Department of Internal Medicine, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA
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15
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Vitamin D and Cardiovascular Disease: An Updated Narrative Review. Int J Mol Sci 2021; 22:ijms22062896. [PMID: 33809311 PMCID: PMC7998446 DOI: 10.3390/ijms22062896] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 03/10/2021] [Accepted: 03/10/2021] [Indexed: 12/16/2022] Open
Abstract
During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.
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16
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Pál É, Hricisák L, Lékai Á, Nagy D, Fülöp Á, Erben RG, Várbíró S, Sándor P, Benyó Z. Ablation of Vitamin D Signaling Compromises Cerebrovascular Adaptation to Carotid Artery Occlusion in Mice. Cells 2020; 9:cells9061457. [PMID: 32545499 PMCID: PMC7349396 DOI: 10.3390/cells9061457] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 12/14/2022] Open
Abstract
Vitamin D insufficiency has been associated with increased incidence and severity of cerebrovascular disorders. We analyzed the impact of impaired vitamin D signaling on the anatomical and functional aspects of cerebrovascular adaptation to unilateral carotid artery occlusion (CAO), a common consequence of atherosclerosis and cause of ischemic stroke. Cerebrocortical blood flow (CoBF) showed a significantly increased drop and delayed recovery after CAO in mice carrying a functionally inactive vitamin D receptor (VDR) with the most sustained perfusion deficit in the temporal cortex. To identify the cause(s) for this altered adaptation, the extent of compensatory blood flow increase in the contralateral carotid artery and the morphology of pial collaterals between the anterior and middle cerebral arteries were determined. Whereas VDR deficiency had no significant influence on the contralateral carotid arterial blood flow increase, it was associated with decreased number and increased tortuosity of pial anastomoses resulting in unfavorable changes of the intracranial collateral circulation. These results indicate that VDR deficiency compromises the cerebrovascular adaptation to CAO with the most sustained consequences in the temporal cortex. The dysregulation can be attributed to the altered development and function of pial collateral circulation whereas extracranial vessels may not be impaired.
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Affiliation(s)
- Éva Pál
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
- Correspondence: (É.P.); (Z.B.); Tel.: +36-1-210-0306 (É.P.); +36-1-210-0306 (Z.B.)
| | - László Hricisák
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
| | - Ágnes Lékai
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
| | - Dorina Nagy
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
| | - Ágnes Fülöp
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
| | - Reinhold G. Erben
- Department of Biomedical Sciences, University of Veterinary Medicine Vienna, 1210 Vienna, Austria;
| | - Szabolcs Várbíró
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary;
| | - Péter Sándor
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
| | - Zoltán Benyó
- Institute of Translational Medicine, Semmelweis University, 1094 Budapest, Hungary; (L.H.); (Á.L.); (D.N.); (Á.F.); (P.S.)
- Correspondence: (É.P.); (Z.B.); Tel.: +36-1-210-0306 (É.P.); +36-1-210-0306 (Z.B.)
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17
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Bikle D, Christakos S. New aspects of vitamin D metabolism and action - addressing the skin as source and target. Nat Rev Endocrinol 2020; 16:234-252. [PMID: 32029884 DOI: 10.1038/s41574-019-0312-5] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2019] [Indexed: 12/19/2022]
Abstract
Vitamin D has a key role in stimulating calcium absorption from the gut and promoting skeletal health, as well as many other important physiological functions. Vitamin D is produced in the skin. It is subsequently metabolized to its hormonally active form, 1,25-dihydroxyvitamin D (1,25(OH)2D), by the 1-hydroxylase and catabolized by the 24-hydroxylase. In this Review, we pay special attention to the effect of mutations in these enzymes and their clinical manifestations. We then discuss the role of vitamin D binding protein in transporting vitamin D and its metabolites from their source to their targets, the free hormone hypothesis for cell entry and HSP70 for intracellular transport. This is followed by discussion of the vitamin D receptor (VDR) that mediates the cellular actions of 1,25(OH)2D. Cell-specific recruitment of co-regulatory complexes by liganded VDR leads to changes in gene expression that result in distinct physiological actions by 1,25(OH)2D, which are disrupted by mutations in the VDR. We then discuss the epidermis and hair follicle, to provide a non-skeletal example of a tissue that expresses VDR that not only makes vitamin D but also can metabolize it to its hormonally active form. This enables vitamin D to regulate epidermal differentiation and hair follicle cycling and, in so doing, to promote barrier function, wound healing and hair growth, while limiting cancer development.
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Affiliation(s)
- Daniel Bikle
- Departments of Medicine and Dermatology, University of California San Francisco, San Francisco, CA, USA.
- VA Medical Center, San Francisco, CA, USA.
| | - Sylvia Christakos
- Departments of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, the State University of New Jersey, Newark, NJ, USA
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18
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Vitamin D binding protein is related to cardiac autonomic function and metabolic status in prediabetes. Nutr Res 2020; 75:56-66. [PMID: 31982803 DOI: 10.1016/j.nutres.2019.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/12/2019] [Accepted: 12/19/2019] [Indexed: 11/21/2022]
Abstract
A putative causal relationship between vitamin D status and glucose metabolism and a direct effect of vitamin D on cardiac autonomic function (CAF) have been suggested. We hypothesized that vitamin D binding protein (DBP), as a transporter of vitamin D, might also influence CAF and the overall metabolic risk. The present study aims to assess the relationship between DBP and CAF and metabolic status in a high-risk population with prediabetes. A total of 174 subjects (mean age 49.1±12.9 years, mean body mass index 30.2±6.2 kg/m2) were divided into 2 groups according to glucose tolerance: 48 with normal glucose tolerance and 126 with prediabetes. Glucose tolerance was assessed during oral glucose tolerance test, applying 2006 World Health Organization criteria. Fasting and postload glucose and immunoreactive insulin were measured (homeostatic model assessment of insulin resistance and homeostatic model assessment of β-cell function were calculated). Anthropometric indexes, blood pressure, hemoglobin A1c, creatinine, lipids, high-sensitivity C-reactive protein, total 25-hydroxyvitamin D, DBP (free 25-hydroxyvitamin D was calculated), and intact parathormone were measured. Body composition was estimated by impedance analysis (InBody 720), whereas tissue advanced glycation end products were assessed by skin autofluorescence (AGE Reader, DiagnOptics, the Netherlands). CAF was evaluated by АNX-3.0 system, applying standard autonomic tests. DBP was found to be elevated in women, as well as in the presence of cardiac autonomic dysfunction and metabolic syndrome. DBP was related to parasympathetic activity in both sexes and in prediabetes; to body fat in women and in prediabetes; and to age and high-density lipoprotein cholesterol in men. Vitamin D deficiency was established in 40.8% of the studied cohort. These results support the hypothesis that DBP is associated with CAF and some metabolic parameters in prediabetes.
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19
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Zhang H, Wang T, Han Z, Wang L, Zhang Y, Wang L, Liu G. Impact of Vitamin D Binding Protein Levels on Alzheimer's Disease: A Mendelian Randomization Study. J Alzheimers Dis 2020; 74:991-998. [PMID: 32116251 DOI: 10.3233/jad-191051] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Until now, observational studies, randomized controlled trials (RCTs), and Mendelian randomization (MR) studies have explored the impact of vitamin D on Alzheimer's disease (AD), and reported inconsistent findings. In MR studies, the sensitivity analysis by removing GC rs2282679 variant highlighted no association of 25OHD levels with AD risk, which indicates that vitamin D-binding protein (DBP) encoded by GC may have distinct effects on AD risk. Here, we aim to clarify this assumption. We selected the GC rs2282679 variant associated with DBP levels (p = 3.30E-76) as the instrumental variable, and extracted the summary statistics of rs2282679 variant in multiple AD GWAS datasets from IGAP, Complex Trait Genetics (CTG) lab, and UK Biobank. We then performed a MR study to investigate the causal association between DBP levels and AD. In IGAP, MR analysis showed that the genetically DBP levels (per 1 standard deviation (SD) increase 50 mg/L) were significantly associated with reduced AD risk (OR = 0.63, 95% CI: 0.45-0.89, p = 0.009). Importantly, the estimates from two sensitivity analyses were consistent with the main estimate in terms of direction and magnitude. Meanwhile, we found no causal association between DBP levels and other four AD phenotypes in CTG lab and UK Biobank. In summary, we highlight the role of DBP levels in AD risk, and provide strong support evidence that DBP may be the therapeutic agent for the treatment of AD. Meanwhile, our findings clarify the assumption that DBP may drive the observed relationship between 25OHD levels and AD.
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Affiliation(s)
- Haihua Zhang
- National Engineering Laboratory of Internet Medical Diagnosis and Treatment Technology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tao Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
| | - Zhifa Han
- School of Medicine, School of Pharmaceutical Sciences, THU-PKU Center for Life Sciences, Tsinghua University, Beijing, China
- State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing, China
- Department of Pathophysiology, Peking Union Medical College, Beijing, China
| | - Longcai Wang
- Department of Anesthesiology, The Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Yan Zhang
- Department of Pathology, The Affiliated Hospital of Weifang Medical University, Weifang, China
| | - Lijun Wang
- Department of Encephalopathy, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, China
| | - Guiyou Liu
- National Engineering Laboratory of Internet Medical Diagnosis and Treatment Technology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
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20
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Abstract
Vitamin D is necessary for bone health but may also have many extra-skeletal effects. The vitamin D endocrine system has major effects on gene and protein expression in many cells and tissues related to the cardiovascular system. In addition, many preclinical studies in animals with vitamin D deficiency or genetically silenced expression of the vitamin D receptor or vitamin D metabolizing enzymes suggest that the absence of vitamin D action may result in cardiovascular events. This includes dysfunctions of endothelial cells, thereby accelerating the process of atherosclerosis, hypertension or abnormal coagulation, ultimately resulting in higher risks for all major cardiovascular or cerebrovascular events. A wealth of observational studies in different parts of the world have fairly consistently found a strong association between a poor vitamin D status and surrogate markers or hard cardiovascular events. A few Mendelian randomization studies did, however, not find a link between genetically lower serum 25OHD concentrations and cardiovascular events. Finally, many RCTs could not demonstrate a consistent effect on surrogate markers, and a limited number of RCTs did so far not find whatever effect on hard cardiovascular endpoints such as myocardial ischemia or infarction, stroke, or cardiovascular death. In conclusion, preclinical data generated a plausible hypothesis of a link between vitamin D status and extra-skeletal events, including cardiovascular endpoints. Whether the vitamin D endocrine system is redundant for the human vascular system or whether the RCTs have not been optimally designed to answer the research question is thus not yet settled.
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Affiliation(s)
- R Bouillon
- Clinical & Experimental Endocrinology, Department Chronic Diseases, Metabolism and Ageing, KU Leuven, Herestraat 49 ON1 box 902, 3000, Leuven, Belgium.
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21
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Chen C, Chen Y, Weng P, Xia F, Li Q, Zhai H, Wang N, Lu Y. Association of 25-hydroxyvitamin D with cardiometabolic risk factors and metabolic syndrome: a mendelian randomization study. Nutr J 2019; 18:61. [PMID: 31660975 PMCID: PMC6819483 DOI: 10.1186/s12937-019-0494-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 10/14/2019] [Indexed: 12/17/2022] Open
Abstract
Background Low circulating vitamin D levels have been associated with increased risk of metabolic syndrome (MS) and cardiometabolic risk factors in multiple epidemiology studies. However, whether this association is causal is still unclear. We aimed to test whether genetically lowered vitamin D levels were associated with MS and its metabolic traits, using mendelian randomization (MR) methodology. Methods Ten thousand six hundred fifty-five participants were enrolled from the SPECT-China study, which was performed in 23 sites in East China during 2014 to 2016. Using four single-nucleotide polymorphisms (SNPs) in the DHCR7, CYP2R1, GC and CYP24A1 genes with known effects on 25(OH) D concentrations, we created a genetic risk score (GRS) as instrumental variable (IV) to estimate the effect of genetically lowered 25(OH) D on MS and cardiometabolic risk factors. MS was defined according to the International Diabetes Federation criteria. Results Lower measured 25(OH)D levels were associated with MS (OR 0.921, 95% CI 0.888, 0.954) after multivariable adjustment. However, the MR-derived odds ratio of genetically determined 25(OH) D for risk of MS was 0.977 (95% CI 0.966, 1.030). The MR-derived estimates for raised fasting plasma glucose was 0.578 (95% CI 0.321, 0.980) per 10 nmol/L GRSsynthesis determined increase of 25(OH) D levels. Conclusions We found no evidence that genetically determined reduction in 25(OH)D conferred an increased risk of MS and its metabolic traits. However, we created our GRS only on the basis of common variants, which represent limited amount of variance in 25(OH)D. MR studies using rare variants, and large-scale well-designed RCTs about the effect of vitamin D supplementation on MS are warranted to further validate the findings.
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Affiliation(s)
- Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Pan Weng
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, 200011, China.
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22
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Meng X, Li X, Timofeeva MN, He Y, Spiliopoulou A, Wei WQ, Gifford A, Wu H, Varley T, Joshi P, Denny JC, Farrington SM, Zgaga L, Dunlop MG, McKeigue P, Campbell H, Theodoratou E. Phenome-wide Mendelian-randomization study of genetically determined vitamin D on multiple health outcomes using the UK Biobank study. Int J Epidemiol 2019; 48:1425-1434. [PMID: 31518429 PMCID: PMC6857754 DOI: 10.1093/ije/dyz182] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is highly prevalent across the globe. Existing studies suggest that a low vitamin D level is associated with more than 130 outcomes. Exploring the causal role of vitamin D in health outcomes could support or question vitamin D supplementation. METHODS We carried out a systematic literature review of previous Mendelian-randomization studies on vitamin D. We then implemented a Mendelian Randomization-Phenome Wide Association Study (MR-PheWAS) analysis on data from 339 256 individuals of White British origin from UK Biobank. We first ran a PheWAS analysis to test the associations between a 25(OH)D polygenic risk score and 920 disease outcomes, and then nine phenotypes (i.e. systolic blood pressure, diastolic blood pressure, risk of hypertension, T2D, ischaemic heart disease, body mass index, depression, non-vertebral fracture and all-cause mortality) that met the pre-defined inclusion criteria for further analysis were examined by multiple MR analytical approaches to explore causality. RESULTS The PheWAS analysis did not identify any health outcome associated with the 25(OH)D polygenic risk score. Although a selection of nine outcomes were reported in previous Mendelian-randomization studies or umbrella reviews to be associated with vitamin D, our MR analysis, with substantial study power (>80% power to detect an association with an odds ratio >1.2 for per standard deviation increase of log-transformed 25[OH]D), was unable to support an interpretation of causal association. CONCLUSIONS We investigated the putative causal effects of vitamin D on multiple health outcomes in a White population. We did not support a causal effect on any of the disease outcomes tested. However, we cannot exclude small causal effects or effects on outcomes that we did not have enough power to explore due to the small number of cases.
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Affiliation(s)
- Xiangrui Meng
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Xue Li
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Maria N Timofeeva
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Yazhou He
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Athina Spiliopoulou
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Wei-Qi Wei
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Aliya Gifford
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Hongjiang Wu
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Timothy Varley
- Public Health and Intelligence, NHS National Services Scotland, Edinburgh, UK
| | - Peter Joshi
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Joshua C Denny
- Department of Biomedical Informatics, Vanderbilt University Medical Centre, Nashville, TN, USA
| | - Susan M Farrington
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Lina Zgaga
- Discipline of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Malcolm G Dunlop
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, and MRC Human Genetics Unit Western General Hospital Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Paul McKeigue
- Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK
| | - Harry Campbell
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Evropi Theodoratou
- Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
- Edinburgh Cancer Research Centre, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
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23
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Bouillon R, Marcocci C, Carmeliet G, Bikle D, White JH, Dawson-Hughes B, Lips P, Munns CF, Lazaretti-Castro M, Giustina A, Bilezikian J. Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions. Endocr Rev 2019; 40:1109-1151. [PMID: 30321335 PMCID: PMC6626501 DOI: 10.1210/er.2018-00126] [Citation(s) in RCA: 544] [Impact Index Per Article: 108.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/17/2018] [Indexed: 02/06/2023]
Abstract
The etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D-deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.
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Affiliation(s)
- Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Geert Carmeliet
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Belgium
| | - Daniel Bikle
- Veterans Affairs Medical Center and University of California San Francisco, San Francisco, California
| | - John H White
- Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section, VU University Medical Center, HV Amsterdam, Netherlands
| | - Craig F Munns
- Children’s Hospital at Westmead, Sydney, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Marise Lazaretti-Castro
- Division of Endocrinology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Andrea Giustina
- Chair of Endocrinology, Vita-Salute San Raffaele University, Milan, Italy
| | - John Bilezikian
- Department of Endocrinology, Columbia University College of Physicians and Surgeons, New York, New York
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24
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Dichgans M, Pulit SL, Rosand J. Stroke genetics: discovery, biology, and clinical applications. Lancet Neurol 2019; 18:587-599. [PMID: 30975520 DOI: 10.1016/s1474-4422(19)30043-2] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 02/07/2023]
Abstract
Stroke, a leading cause of long-term disability and death worldwide, has a heritable component. Recent gene discovery efforts have expanded the number of known single-gene disorders associated with stroke and have linked common variants at approximately 35 genetic loci to stroke risk. These discoveries have highlighted novel mechanisms and pathways implicated in stroke related to large artery atherosclerosis, cardioembolism, and small vessel disease, and defined shared genetic influences with related vascular traits. Genetics has also successfully established causal relationships with risk factors and holds promise for prioritising targets for exploration in clinical trials. Genome-wide polygenic scores enable the identification of high-risk individuals before the emergence of vascular risk factors. Challenges ahead include a better understanding of rare variants and ancestral differences for integration of genetics into precision medicine, integration with other omics data, uncovering the genetic factors that govern stroke recurrence and stroke outcome, and the conversion of genetic discoveries to novel therapies.
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Affiliation(s)
- Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
| | - Sara L Pulit
- Department of Genetics, Centre for Molecular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford University, Oxford, UK; Program in Medical Population and Genetics, Broad Institute, Cambridge, MA, USA
| | - Jonathan Rosand
- Program in Medical Population and Genetics, Broad Institute, Cambridge, MA, USA; Henry and Allison McCance Center for Brain Health, and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
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25
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Zendehdel A, Arefi M. Molecular evidence of role of vitamin D deficiency in various extraskeletal diseases. J Cell Biochem 2019; 120:8829-8840. [PMID: 30609168 DOI: 10.1002/jcb.28185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND Role of vitamin D is not only limited to skeletal system but various other systems of the body, such as immune system, endocrine system, and cardiopulmonary system. MATERIALS AND METHODS It is supported by the confirmations of systems-wide expression of vitamin D receptor (VDR), endocrinal effect of calcitriol, and its role in immune responses. RESULTS Expression of VDR in various systems, immunoregulatory and hormonal response of vitamin D and deficiency of vitamin D may establish various pathologies in the body. CONCLUSION This review provides molecular evidence of relation of vitamin D with extra skeletal.
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Affiliation(s)
- Abolfazl Zendehdel
- Department of Geriatric Medicine, Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arefi
- Department of Clinical Toxicology, School of Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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26
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Parveen R, Kapur P, Venkatesh S, Agarwal NB. Attenuated serum 25-hydroxyvitamin D and vitamin D binding protein associated with cognitive impairment in patients with type 2 diabetes. Diabetes Metab Syndr Obes 2019; 12:1763-1772. [PMID: 31571953 PMCID: PMC6748038 DOI: 10.2147/dmso.s207728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/10/2019] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Clinical studies suggest that 25-hydroxyvitamin D (25[OH]D) deficiency plays a pivotal role in both type 2 diabetes mellitus (T2DM) and cognitive impairment. However, it is unclear if 25(OH)D deficiency could be a possible cause of cognitive impairment in T2DM. Vitamin-D binding protein (VDBP) acts as a major 25(OH)D transporter. Preclinical study has demonstrated improvement in cognitive function by VDBP via inhibiting synaptic degeneration. The aim of the study was to assess the association between serum 25(OH)D, VDBP and cognitive impairment in T2DM patients. PATIENTS AND METHODS In this case-control study, cognitive function was assessed using the Mini-Mental State Examination (MMSE) and serum 25(OH)D and VDBP levels were estimated using ELISA kits. RESULTS A total of 88 subjects were included in the study. T2DM patients had lower serum 25(OH)D (p=0.02), VDBP levels (p=0.04) and MMSE scores (p<0.0001) than controls. T2DM patients had higher prevalence of 25(OH)D deficiency and insufficiency, aOR 0.322 (0.128-0.809), p=0.016 and cognitive impairment, aOR 4.405 (1.617-12.002); p=0.004. Cognitive impairment was associated with serum 25(OH)D, aOR 0.131 (0.027-0.638); p=0.014 and VDBP, aOR 1.008 (1.001-1.015), p=0.029. A general linear model showed a significant association of MMSE with serum 25(OH)D (p=0.022). CONCLUSION Serum 25(OH)D deficiency and cognitive impairment was higher in T2DM patients. Routine assessment of cognitive function is suggested to prevent further behavioral complications. The association of VDBP and cognitive impairment in T2DM needs further exploration.
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Affiliation(s)
- Rizwana Parveen
- Department of Pharmaceutical Medicine, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi110062, India
| | - Prem Kapur
- Hamdard Institute of Medical Sciences and Research, HAH Centenary Hospital, Jamia Hamdard, New Delhi110062, India
| | - Shubhashree Venkatesh
- Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi110062, India
| | - Nidhi Bharal Agarwal
- Centre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi110062, India
- Correspondence: Nidhi Bharal AgarwalCentre for Translational and Clinical Research, School of Chemical & Life Sciences, Jamia Hamdard, New Delhi110062, IndiaTel +91 981 833 4770Email
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27
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Bikle DD, Schwartz J. Vitamin D Binding Protein, Total and Free Vitamin D Levels in Different Physiological and Pathophysiological Conditions. Front Endocrinol (Lausanne) 2019; 10:317. [PMID: 31191450 PMCID: PMC6546814 DOI: 10.3389/fendo.2019.00317] [Citation(s) in RCA: 213] [Impact Index Per Article: 42.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/01/2019] [Indexed: 12/19/2022] Open
Abstract
This review focuses on the biologic importance of the vitamin D binding protein (DBP) with emphasis on its regulation of total and free vitamin D metabolite levels in various clinical conditions. Nearly all DBP is produced in the liver, where its regulation is influenced by estrogen, glucocorticoids and inflammatory cytokines but not by vitamin D itself. DBP is the most polymorphic protein known, and different DBP alleles can have substantial impact on its biologic functions. The three most common alleles-Gc1f, Gc1s, Gc2-differ in their affinity with the vitamin D metabolites and have been variably associated with a number of clinical conditions. Although DBP has a number of biologic functions independent of vitamin D, its major biologic function is that of regulating circulating free and total levels of vitamin D metabolites. 25 hydroxyvitamin D (25(OH)D) is the best studied form of vitamin D as it provides the best measure of vitamin D status. In a normal non-pregnant individual, approximately 0.03% of 25(OH)D is free; 85% is bound to DBP, 15% is bound to albumin. The free hormone hypothesis postulates that only free 25(OH)D can enter cells. This hypothesis is supported by the observation that mice lacking DBP, and therefore with essentially undetectable 25(OH)D levels, do not show signs of vitamin D deficiency unless put on a vitamin D deficient diet. Similar observations have recently been described in a family with a DBP mutation. This hypothesis also applies to other protein bound lipophilic hormones including glucocorticoids, sex steroids, and thyroid hormone. However, tissues expressing the megalin/cubilin complex, such as the kidney, have the capability of taking up 25(OH)D still bound to DBP, but most tissues rely on the free level. Attempts to calculate the free level using affinity constants generated in a normal individual along with measurement of DBP and total 25(OH)D have not accurately reflected directly measured free levels in a number of clinical conditions. In this review, we examine the impact of different clinical conditions as well as different DBP alleles on the relationship between total and free 25(OH)D, using only data in which the free 25(OH)D level was directly measured. The major conclusion is that a number of clinical conditions alter this relationship, raising the question whether measuring just total 25(OH)D might be misleading regarding the assessment of vitamin D status, and such assessment might be improved by measuring free 25(OH)D instead of or in addition to total 25(OH)D.
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Affiliation(s)
- Daniel David Bikle
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Endocrine Research Unit, San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States
- *Correspondence: Daniel David Bikle
| | - Janice Schwartz
- Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
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28
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Jorde R. The Role of Vitamin D Binding Protein, Total and Free 25-Hydroxyvitamin D in Diabetes. Front Endocrinol (Lausanne) 2019; 10:79. [PMID: 30837950 PMCID: PMC6389604 DOI: 10.3389/fendo.2019.00079] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 01/30/2019] [Indexed: 12/16/2022] Open
Abstract
Vitamin D is important for bone health, but may also have extra-skeletal effects. Vitamin D and its binding protein DBP have immunological effects and may therefore be important in the development of type 1 diabetes (T1DM), and low serum levels of 25-hydroxyvitamin D (25(OH)D) are associated with later development of type 2 diabetes (T2DM). However, it has so far been difficult to convincingly show an effect of vitamin D supplementation on prevention or treatment of diabetes. The serum level of 25(OH)D has traditionally been used as a marker of a subject's vitamin D status. This measurement includes both 25(OH)D bound to DBP and albumin as well as the free from of 25(OH)D. However, according to the free hormone hypothesis, the free form is the biologically active. Previously the free form of 25(OH)D had to be calculated based on measurements of 25(OH)D, DBP, and albumin, but recently a method for direct measurement of free 25(OH)D has become commercially available. This is important in clinical conditions where the amount of DBP is affected, and has caused a renewed interest in which vitamin D metabolite to measure in clinical situations. In the present review the relations between DBP, total and free 25(OH)D in T1DM and T2DM are described.
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Affiliation(s)
- Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway
- *Correspondence: Rolf Jorde
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29
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Bellan M, Marzullo P. New Insights on Low Vitamin D Plasma Concentration as a Potential Cardiovascular Risk Factor. Open Rheumatol J 2018. [DOI: 10.2174/1874312901812010261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The role of Vitamin D hormone in human health and disease is still debated. Recently, growing attention has been paid to its putative role in cardiovascular system homeostasis with several studies that suggested a correlation between low vitamin D levels and increased cardiovascular risk. Several mechanisms are involved in the development of cardiovascular diseases: systemic inflammation, endothelial dysfunction, arterial hypertension and insulin resistance. In the present paper, we have revised the current literature supporting a role for vitamin D in the development of these pathogenetic processes. Finally, we have evaluated the current evidence linking vitamin D to atherosclerosis and its natural consequence, cardiovascular diseases.
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30
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Abstract
PURPOSE OF REVIEW This review summarizes the basic principles of Mendelian randomization (MR) and provides evidence for the causal effect of multiple modifiable factors on bone outcomes. RECENT FINDINGS Several studies using MR approach have provided support for the causal effect of obesity on bone mineral density (BMD). Strikingly, studies have failed to prove a causal association between elevated 25(OH) D concentrations and higher BMD in community-dwelling individuals. The MR approach has been successfully used to evaluate multiple factors related to bone mineral density variation and/or fracture risk. The MR approach avoids some of the classical observational study limitations and provides more robust causal evidence, ensuring bigger success of the clinical trials. The selection of interventions based on genetic evidence could have a substantial impact on clinical practice.
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Affiliation(s)
- Katerina Trajanoska
- Departments of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Fernando Rivadeneira
- Departments of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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31
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Larsson SC, Traylor M, Mishra A, Howson JM, Michaëlsson K, Markus HS. Serum 25-Hydroxyvitamin D Concentrations and Ischemic Stroke and Its Subtypes. Stroke 2018; 49:2508-2511. [DOI: 10.1161/strokeaha.118.022242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Observational studies have reported increased risk of ischemic stroke among individuals with low serum 25-hydroxyvitamin D (S-25OHD) concentrations but uncertainty remains about the causality of this association. We sought to determine whether S-25OHD concentrations are causally associated with ischemic stroke and its subtypes using Mendelian randomization.
Methods—
We used summary-level data for ischemic stroke (34 217 cases and 404 630 noncases) from the MEGASTROKE consortium. As instruments, we used 6 single nucleotide polymorphisms, explaining 7.5% of the variance in S-25OHD, previously identified to be associated with S-25OHD concentrations in the Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits consortium (n=79 366). The analyses were conducted using the inverse-variance–weighted method and complemented with the weighted median, heterogeneity-penalized, and Mendelian randomization-Egger approaches.
Results—
Genetically higher S-25OHD concentration was not associated with ischemic stroke. The odds ratios (95% CI) per genetically predicted 1-SD (≈18 nmol/L) increase in S-25OHD concentrations, based on all 6 single nucleotide polymorphisms, were 1.01 (0.94–1.08;
P
=0.84) for all ischemic stroke, 0.94 (0.80–1.11;
P
=0.49) for large artery stroke, 0.95 (0.82–1.11;
P
=0.55) for small vessel stroke, and 1.02 (0.90–1.16;
P
=0.74) for cardioembolic stroke. The results were similar in sensitivity analyses.
Conclusions—
These findings provide no support that higher S-25OHD concentrations are causally associated with any ischemic stroke subtype. Thus, vitamin D supplementation will unlikely reduce the risk of ischemic stroke in the general population.
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Affiliation(s)
- Susanna C. Larsson
- From the Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (S.C.L.)
| | - Matthew Traylor
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (M.T., H.S.M.)
| | - Aniket Mishra
- Bordeaux Population Health Research Center, University of Bordeaux, INSERM UMR 1219, France (A.M.)
| | - Joanna M.M. Howson
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, United Kingdom (J.M.M.H.)
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Sweden (K.M.)
| | - Hugh S. Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, United Kingdom (M.T., H.S.M.)
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32
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Trajanoska K, Morris JA, Oei L, Zheng HF, Evans DM, Kiel DP, Ohlsson C, Richards JB, Rivadeneira F. Assessment of the genetic and clinical determinants of fracture risk: genome wide association and mendelian randomisation study. BMJ 2018; 362:k3225. [PMID: 30158200 PMCID: PMC6113773 DOI: 10.1136/bmj.k3225] [Citation(s) in RCA: 163] [Impact Index Per Article: 27.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/02/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To identify the genetic determinants of fracture risk and assess the role of 15 clinical risk factors on osteoporotic fracture risk. DESIGN Meta-analysis of genome wide association studies (GWAS) and a two-sample mendelian randomisation approach. SETTING 25 cohorts from Europe, United States, east Asia, and Australia with genome wide genotyping and fracture data. PARTICIPANTS A discovery set of 37 857 fracture cases and 227 116 controls; with replication in up to 147 200 fracture cases and 150 085 controls. Fracture cases were defined as individuals (>18 years old) who had fractures at any skeletal site confirmed by medical, radiological, or questionnaire reports. Instrumental variable analyses were performed to estimate effects of 15 selected clinical risk factors for fracture in a two-sample mendelian randomisation framework, using the largest previously published GWAS meta-analysis of each risk factor. RESULTS Of 15 fracture associated loci identified, all were also associated with bone mineral density and mapped to genes clustering in pathways known to be critical to bone biology (eg, SOST, WNT16, and ESR1) or novel pathways (FAM210A, GRB10, and ETS2). Mendelian randomisation analyses showed a clear effect of bone mineral density on fracture risk. One standard deviation decrease in genetically determined bone mineral density of the femoral neck was associated with a 55% increase in fracture risk (odds ratio 1.55 (95% confidence interval 1.48 to 1.63; P=1.5×10-68). Hand grip strength was inversely associated with fracture risk, but this result was not significant after multiple testing correction. The remaining clinical risk factors (including vitamin D levels) showed no evidence for an effect on fracture. CONCLUSIONS This large scale GWAS meta-analysis for fracture identified 15 genetic determinants of fracture, all of which also influenced bone mineral density. Among the clinical risk factors for fracture assessed, only bone mineral density showed a major causal effect on fracture. Genetic predisposition to lower levels of vitamin D and estimated calcium intake from dairy sources were not associated with fracture risk.
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Affiliation(s)
- Katerina Trajanoska
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - John A Morris
- Lady Davis Institute, Jewish General Hospital, McGill University, Montréal, Québec, Canada
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Ling Oei
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Hou-Feng Zheng
- DaP Lab, School of Life Sciences, Westlake University and Westlake Institute for Advanced Study, Hangzhou, Zhejiang, China
- Institute of Aging Research and the Affiliated Hospital, School of Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - David M Evans
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- University of Queensland Diamantina Institute, University of Queensland, Translational Research Institute, Brisbane, Australia
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Claes Ohlsson
- Centre for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, Sahlgrenska, Gothenburg, Sweden
| | - J Brent Richards
- Lady Davis Institute, Jewish General Hospital, McGill University, Montréal, Québec, Canada
- Department of Human Genetics, McGill University, Montréal, Québec, Canada
| | - Fernando Rivadeneira
- Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Tsuprykov O, Chen X, Hocher CF, Skoblo R, Hocher B. Why should we measure free 25(OH) vitamin D? J Steroid Biochem Mol Biol 2018; 180:87-104. [PMID: 29217467 DOI: 10.1016/j.jsbmb.2017.11.014] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 11/21/2022]
Abstract
Vitamin D, either in its D2 or D3 form, is essential for normal human development during intrauterine life, kidney function and bone health. Vitamin D deficiency has also been linked to cancer development and some autoimmune diseases. Given this huge impact of vitamin D on human health, it is important for daily clinical practice and clinical research to have reliable tools to judge on the vitamin D status. The major circulating form of vitamin D is 25-hydroxyvitamin D (25(OH)D), although it is not the most active metabolite, the concentrations of total 25-hydroxyvitamin D in the serum are currently routinely used in clinical practice to assess vitamin D status. In the circulation, vitamin D - like other steroid hormones - is bound tightly to a special carrier - vitamin D-binding protein (DBP). Smaller amounts are bound to blood proteins - albumin and lipoproteins. Only very tiny amounts of the total vitamin D are free and potentially biologically active. Currently used vitamin D assays do not distinguish between the three forms of vitamin D - DBP-bound vitamin D, albumin-bound vitamin D and free, biologically active vitamin D. Diseases or conditions that affect the synthesis of DBP or albumin thus have a huge impact on the amount of circulating total vitamin D. DBP and albumin are synthesized in the liver, hence all patients with an impairment of liver function have alterations in their total vitamin D blood concentrations, while free vitamin D levels remain mostly constant. Sex steroids, in particular estrogens, stimulate the synthesis of DBP. This explains why total vitamin D concentrations are higher during pregnancy as compared to non-pregnant women, while the concentrations of free vitamin D remain similar in both groups of women. The vitamin D-DBP as well as vitamin D-albumin complexes are filtered through the glomeruli and re-uptaken by megalin in the proximal tubule. Therefore, all acute and chronic kidney diseases that are characterized by a tubular damage, are associated with a loss of vitamin D-DBP complexes in the urine. Finally, the gene encoding DBP protein is highly polymorphic in different human racial groups. In the current review, we will discuss how liver function, estrogens, kidney function and the genetic background might influence total circulating vitamin D levels and will discuss what vitamin D metabolite is more appropriate to measure under these conditions: free vitamin D or total vitamin D.
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Affiliation(s)
- Oleg Tsuprykov
- IFLB, Institute for Laboratory Medicine, Berlin, Berlin, Germany; Institute of Nutritional Sciences, University of Potsdam, Potsdam, Germany
| | - Xin Chen
- Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Carl-Friedrich Hocher
- Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China; First Medical Faculty, Charles University of Prague, Prague, Czech Republic
| | - Roman Skoblo
- IFLB, Institute for Laboratory Medicine, Berlin, Berlin, Germany
| | - Berthold Hocher
- Institute of Nutritional Sciences, University of Potsdam, Potsdam, Germany; Departments of Embryology and Nephrology, The First Affiliated Hospital, Jinan University, Guangzhou, China.
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Bellou V, Belbasis L, Tzoulaki I, Evangelou E. Risk factors for type 2 diabetes mellitus: An exposure-wide umbrella review of meta-analyses. PLoS One 2018; 13:e0194127. [PMID: 29558518 PMCID: PMC5860745 DOI: 10.1371/journal.pone.0194127] [Citation(s) in RCA: 359] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 02/26/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a global epidemic associated with increased health expenditure, and low quality of life. Many non-genetic risk factors have been suggested, but their overall epidemiological credibility has not been assessed. METHODS We searched PubMed to capture all meta-analyses and Mendelian randomization studies for risk factors of T2DM. For each association, we estimated the summary effect size, its 95% confidence and prediction interval, and the I2 metric. We examined the presence of small-study effects and excess significance bias. We assessed the epidemiological credibility through a set of predefined criteria. RESULTS We captured 86 eligible papers (142 associations) covering a wide range of biomarkers, medical conditions, and dietary, lifestyle, environmental and psychosocial factors. Adiposity, low hip circumference, serum biomarkers (increased level of alanine aminotransferase, gamma-glutamyl transferase, uric acid and C-reactive protein, and decreased level of adiponectin and vitamin D), an unhealthy dietary pattern (increased consumption of processed meat and sugar-sweetened beverages, decreased intake of whole grains, coffee and heme iron, and low adherence to a healthy dietary pattern), low level of education and conscientiousness, decreased physical activity, high sedentary time and duration of television watching, low alcohol drinking, smoking, air pollution, and some medical conditions (high systolic blood pressure, late menarche age, gestational diabetes, metabolic syndrome, preterm birth) presented robust evidence for increased risk of T2DM. CONCLUSIONS A healthy lifestyle pattern could lead to decreased risk for T2DM. Future randomized clinical trials should focus on identifying efficient strategies to modify harmful daily habits and predisposing dietary patterns.
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Affiliation(s)
- Vanesa Bellou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Lazaros Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
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Karuwanarint P, Phonrat B, Tungtrongchitr A, Suriyaprom K, Chuengsamarn S, Schweigert FJ, Tungtrongchitr R. Vitamin D-binding protein and its polymorphisms as a predictor for metabolic syndrome. Biomark Med 2018; 12:465-473. [PMID: 29504805 DOI: 10.2217/bmm-2018-0029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AIM To investigate the relationship of vitamin D-binding protein (GC) and genetic variation of GC (rs4588, rs7041 and rs2282679) with metabolic syndrome (MetS) in the Thai population. MATERIALS & METHODS GC-globulin concentrations were measured by quantitative western blot analysis in 401 adults. All participants were genotyped using TaqMan allelic discrimination assays. RESULTS GC-globulin levels were significatly lower in MetS subjects than in control subjects, in which significant negative correlations of GC-globulin levels with systolic blood pressure, glucose and age were found. Male participants who carried the GT genotype for rs4588 showed an increased risk of MetS compared with the GG wild-type (odds ratio: 3.25; p = 0.004). CONCLUSION GC-globulin concentrations and variation in GC rs4588 were supported as a risk factor for MetS in Thais.
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Affiliation(s)
- Piyaporn Karuwanarint
- Department of Tropical Nutrition & Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Benjaluck Phonrat
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Anchalee Tungtrongchitr
- Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kanjana Suriyaprom
- Faculty of Medical Technology, Rangsit University, Pathumthani, Thailand
| | - Somlak Chuengsamarn
- Division of Endocrinology & Metabolism, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center Srinakharinwirot University, Nakornnayok, Thailand
| | - Florian J Schweigert
- Institute of Nutrition Science, Department of Physiology & Pathophysiology of Nutrition, University of Potsdam, Germany
| | - Rungsunn Tungtrongchitr
- Department of Tropical Nutrition & Food Science, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
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The Pros and Cons of Mendelian Randomization Studies to Evaluate Emerging Cardiovascular Risk Factors. CURRENT CARDIOVASCULAR RISK REPORTS 2018. [DOI: 10.1007/s12170-018-0566-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Fawzy MS, Abu AlSel BT. Assessment of Vitamin D-Binding Protein and Early Prediction of Nephropathy in Type 2 Saudi Diabetic Patients. J Diabetes Res 2018; 2018:8517929. [PMID: 29850609 PMCID: PMC5903345 DOI: 10.1155/2018/8517929] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 02/04/2018] [Indexed: 12/20/2022] Open
Abstract
Early detection of diabetic nephropathy (DN) represents a great challenge in an attempt to reduce the burden of chronic kidney diseases in diabetic patients. This study aimed to investigate the potential early prediction role of urinary vitamin D-binding protein (uVDBP) for the diagnosis of DN and to examine the possible correlation to serum VDBP, high-sensitivity C-reactive protein (hs-CRP), and insulin resistance in these patients. Serum and urine samples were obtained from 40 healthy volunteers and 120 patients with type 2 diabetes divided into 3 groups: normoalbuminuria, microalbuminuria, and macroalbuminuria (urinary albumin excretion rate < 30, 30-300, and >300 μg/mg, resp.); n = 40/group. Serum and urinary VDBP levels were quantified by ELISA. Insulin resistance has been assessed by homeostasis model assessment index (HOMAI). Correction for urine creatinine concentration was applied for urinary quantitative measurements. uVDBP levels were significantly elevated in micro- and macroalbuminuria patient groups compared with those of the normoalbuminuria patient group and controls (820.4 ± 402.8 and 1458.1 ± 210.0 compared with 193.1 ± 141.0 and 127.7 ± 21.9 ng/mg, resp.) (P < 0.001). There was significant correlation between serum and urinary levels of VDBP in total patient group. Receiver operating characteristic analysis of uVDBP levels showed optimum cut-off value of 216.0 ng/mg corresponding to 98.8% sensitivity and 80.0% specificity and an area under the curve of 0.973 to discriminate the normoalbuminuria from the microalbuminuria groups. In multivariate analysis, ordination plot showed obvious demarcation between the study groups caused by the higher levels of uVDBP and albumin/creatinine ratio among other variables. The study findings suggested a possible clinical application of uVDPB as an early and a good marker for the detection of early renal disease in type 2 DM Saudi patients. Large-scale validation studies are warranted to confirm the results before including uVDBP with the available list of other conventional biomarkers.
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Affiliation(s)
- Manal S. Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
- Department of Medical Biochemistry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Baraah T. Abu AlSel
- Department of Microbiology, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia
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Afzal S, Nordestgaard BG. Vitamin D and Risk of Cardiovascular Disease. Arterioscler Thromb Vasc Biol 2017; 37:1981-1982. [DOI: 10.1161/atvbaha.117.310204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shoaib Afzal
- From the Department of Clinical Biochemistry and The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark (S.A., B.G.N.); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.); and The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Denmark (B.G.N.)
| | - Børge G. Nordestgaard
- From the Department of Clinical Biochemistry and The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark (S.A., B.G.N.); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (B.G.N.); and The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital, Denmark (B.G.N.)
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Qi L, Ma W, Heianza Y, Zheng Y, Wang T, Sun D, Rimm EB, Hu FB, Giovannucci E, Albert CM, Rexrode KM, Manson JE. Independent and Synergistic Associations of Biomarkers of Vitamin D Status With Risk of Coronary Heart Disease. Arterioscler Thromb Vasc Biol 2017; 37:2204-2212. [PMID: 28882871 PMCID: PMC5658253 DOI: 10.1161/atvbaha.117.309548] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/22/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To comprehensively evaluate the independent associations and potential interactions of vitamin D-related biomarkers including total and bioavailable 25-hydroxyvitamin D (25OHD), VDBP (vitamin D binding protein), and parathyroid hormone (PTH) with risk of coronary heart disease (CHD). APPROACH AND RESULTS We prospectively identified incident cases of nonfatal myocardial infarction and fatal CHD among women in the Nurses' Health Study during 20 years of follow-up (1990-2010). Using risk-set sampling, 1 to 2 matched controls were selected for each case. The analysis of 25OHD and PTH included 382 cases and 575 controls; the analysis of VDBP included 396 cases and 398 controls. After multivariate adjustment, plasma levels of total 25OHD, bioavailable 25OHD, and PTH were not significantly associated with CHD risk. VDBP was associated with a lower CHD risk with an extreme-quartile odds ratio of 0.60 (95% confidence interval, 0.39-0.92; P trend=0.02). When examining the biomarkers jointly, a significant, inverse association between 25OHD and CHD was observed among participants with higher PTH levels (P for interaction=0.02). The odds ratio (95% confidence interval) comparing the highest quartile of 25OHD to lowest was 0.43 (0.23-0.82; P trend=0.003) when PTH levels were above population median (35.3 pg/mL), whereas among the rest of participants the corresponding odds ratio (95% confidence interval) was 1.28 (0.70-2.36; P trend=0.43). CONCLUSIONS Our data suggest that higher 25OHD levels were associated with a lower CHD risk when PTH levels were high, whereas no association was observed for participants with low PTH levels. VDBP but not bioavailable 25OHD was independently associated with lower CHD risk.
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Affiliation(s)
- Lu Qi
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
| | - Wenjie Ma
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Yoriko Heianza
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Yan Zheng
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Tiange Wang
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Dianjianyi Sun
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Eric B Rimm
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Frank B Hu
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Edward Giovannucci
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Christine M Albert
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kathryn M Rexrode
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - JoAnn E Manson
- From the Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA (L.Q., Y.H., T.W., D.S.); Department of Epidemiology (L.Q., W.M., E.B.R., F.B.H., E.G., J.E.M.) and Department of Nutrition (L.Q., Y.Z., E.B.R., F.B.H., E.G.), Harvard T.H. Chan School of Public Health, Boston, MA; and Channing Division of Network Medicine (L.Q., E.B.R., F.B.H., E.G., J.E.M.) and Division of Preventive Medicine (C.M.A., K.M.R., J.E.M.), Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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Grübler MR, März W, Pilz S, Grammer TB, Trummer C, Müllner C, Schwetz V, Pandis M, Verheyen N, Tomaschitz A, Fiordelisi A, Laudisio D, Cipolletta E, Iaccarino G. Vitamin-D concentrations, cardiovascular risk and events - a review of epidemiological evidence. Rev Endocr Metab Disord 2017; 18:259-272. [PMID: 28451877 DOI: 10.1007/s11154-017-9417-0] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Vitamin D has long been established as an elemental factor of bone physiology. Beyond mineral metabolism, the expression of the vitamin D receptor has been identified throughout the cardiovascular (CV) system. Experimental studies showed beneficial effects of vitamin D on heart and vessels, but vitamin D intoxication in animals also led to hypercalcemia and vascular calcification. Our knowledge has been extended by epidemiological studies that showed that 25-hydroxyvitamin D (25(OH)D) levels are inversely associated with an increased CV risk itself, but also with established CV risk factors, such as arterial hypertension, endothelial dysfunction and atherosclerosis. Conversely, randomized controlled trials could not document significant and consistent effects of vitamin D supplementation on CV risk or events. Potential explanations may lie in differences in reference ranges or the possibility that low vitamin D in CV disease is only an epiphenomenon. In the latter case, the key question is why low 25(OH)D levels are such a strong predictor of health. While we wait for new data, the current conclusion is that vitamin D is a strong risk marker for CV risk factors and for CV diseases itself.
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Affiliation(s)
- Martin Robert Grübler
- Swiss Cardiovascular Centre Bern, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 8, 3010, Bern, Switzerland.
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
| | - Winfried März
- Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, and Rheumatology), Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, and Augsburg, Mannheim, Germany
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, Netherlands
| | - Tanja B Grammer
- Mannheim Institute of Public Health, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Christian Trummer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Christian Müllner
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Verena Schwetz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Marlene Pandis
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Nicolas Verheyen
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Andreas Tomaschitz
- Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
- Bad Gleichenberg Clinic, Schweizereiweg 4, 8344, Bad Gleichenberg, Austria
| | | | | | - Ersilia Cipolletta
- Department of Medicine, Surgery Odontoiatrics-Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Guido Iaccarino
- Department of Medicine, Surgery Odontoiatrics-Scuola Medica Salernitana, University of Salerno, Salerno, Italy
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41
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Mallard SR, Howe AS, Houghton LA. Vitamin D status and weight loss: a systematic review and meta-analysis of randomized and nonrandomized controlled weight-loss trials. Am J Clin Nutr 2016; 104:1151-1159. [PMID: 27604772 DOI: 10.3945/ajcn.116.136879] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/02/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Obesity is associated with lower concentrations of serum 25-hydroxyvitamin D; however, uncertainty exists as to the direction of causation. To date, meta-analyses of randomized controlled vitamin D-supplementation trials have shown no effect of raising circulating vitamin D on body weight, although several weight-loss-intervention trials have reported an increase in circulating vitamin D after weight reduction. OBJECTIVE We undertook a systematic review and meta-analysis of randomized and nonrandomized controlled trials to determine whether weight loss compared with weight maintenance leads to an increase in serum 25-hydroxyvitamin D. DESIGN A systematic search for controlled weight-loss-intervention studies published up to 31 March 2016 was performed. Studies that included participants of any age with changes in adiposity and serum 25-hydroxyvitamin D as primary or secondary outcomes were considered eligible. RESULTS We identified 4 randomized controlled trials (n = 2554) and 11 nonrandomized controlled trials (n = 917) for inclusion in the meta-analysis. Random assignment to weight loss compared with weight maintenance resulted in a greater increase in serum 25-hydroxyvitamin D with a mean difference of 3.11 nmol/L (95% CI: 1.38, 4.84 nmol/L) between groups, whereas a mean difference of 4.85 nmol/L (95% CI: 2.59, 7.12 nmol/L) was observed in nonrandomized trials. No evidence for a dose-response effect of weight loss on the change in serum 25-hydroxyvitamin D was shown overall. CONCLUSIONS Our results indicate that vitamin D status may be marginally improved with weight loss in comparison with weight maintenance under similar conditions of supplemental vitamin D intake. Although additional studies in unsupplemented individuals are needed to confirm these findings, our results support the view that the association between obesity and lower serum 25-hydroxyvitamin D may be due to reversed causation with increased adiposity leading to suboptimal concentrations of circulating vitamin D. This trial was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42015023836.
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Affiliation(s)
| | - Anna S Howe
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - Lisa A Houghton
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
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Li SS, Gao LH, Zhang XY, He JW, Fu WZ, Liu YJ, Hu YQ, Zhang ZL. Genetically Low Vitamin D Levels, Bone Mineral Density, and Bone Metabolism Markers: a Mendelian Randomisation Study. Sci Rep 2016; 6:33202. [PMID: 27625044 PMCID: PMC5021966 DOI: 10.1038/srep33202] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 08/22/2016] [Indexed: 01/08/2023] Open
Abstract
Low serum 25-hydroxyvitamin D (25OHD) is associated with osteoporosis and osteoporotic fracture, but it remains uncertain whether these associations are causal. We conducted a Mendelian randomization (MR) study of 1,824 postmenopausal Chinese women to examine whether the detected associations between serum 25OHD and bone mineral density (BMD) and bone metabolism markers were causal. In observational analyses, total serum 25OHD was positively associated with BMD at lumbar spine (P = 0.003), femoral neck (P = 0.006) and total hip (P = 0.005), and was inversely associated with intact parathyroid hormone (PTH) (P = 8.18E-09) and procollagen type 1 N-terminal propeptide (P1NP) (P = 0.020). By contract, the associations of bioavailable and free 25OHD with all tested outcomes were negligible (all
P > 0.05). The use of four single nucleotide polymorphisms, GC-rs2282679, NADSYN1-rs12785878, CYP2R1-rs10741657 and CYP24A1-rs6013897, as candidate instrumental variables in MR analyses showed that none of the two stage least squares models provided evidence for associations between serum 25OHD and either BMD or bone metabolism markers (all P > 0.05). We suggest that after controlling for unidentified confounding factors in MR analyses, the associations between genetically low serum 25OHD and BMD and bone metabolism markers are unlikely to be causal.
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Affiliation(s)
- Shan-Shan Li
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Li-Hong Gao
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Xiao-Ya Zhang
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Jin-We He
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Wen-Zhen Fu
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Yu-Juan Liu
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Yun-Qiu Hu
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
| | - Zhen-Lin Zhang
- Metabolic Bone Disease and Genetics Research Unit, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.,Shanghai Key Clinical Center for Metabolic Disease, Shanghai 200233, China
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43
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Manousaki D, Mokry LE, Ross S, Goltzman D, Richards JB. Mendelian Randomization Studies Do Not Support a Role for Vitamin D in Coronary Artery Disease. ACTA ACUST UNITED AC 2016; 9:349-56. [PMID: 27418593 DOI: 10.1161/circgenetics.116.001396] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/17/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND Observational studies support a possible association between decreased vitamin D levels and risk of coronary artery disease (CAD); however, it remains unclear whether this relationship is causal. We aimed to evaluate whether genetically lowered vitamin D levels influence the risk of CAD using a Mendelian randomization approach. METHODS AND RESULTS In this 2-stage Mendelian randomization study, we first identified single-nucleotide polymorphisms associated with 25-hydroxyvitamin D (25OHD) levels in the SUNLIGHT consortium (n=33 996), then tested them for possible violation of Mendelian randomization assumptions. A count of risk alleles was tested for association with 25OHD levels in a separate cohort (n=2347). Alleles were weighted by their relative effect on 25OHD and tested for their combined effect on CAD in the Coronary Artery Disease Genome-Wide Replication and Meta-Analysis (CARDIoGRAM) study (22 233 cases/64 762 controls). Four single-nucleotide polymorphisms were identified to be associated with 25OHD levels, all in or near genes implicated in 25OHD synthesis, transport or metabolism. A count of these risk alleles was strongly associated with 25OHD (n=2347, F-test statistic=49.7, P=2×10(-12)). None of the single-nucleotide polymorphisms associated with 25OHD levels were associated with CAD (all P values >0.6). The Mendelian randomization odds ratio (OR) for CAD was 0.99 (95% confidence interval, 0.84-1.17; P=0.93; I(2)=0) per SD decrease in log-transformed 25OHD levels. These results persisted after sensitivity analyses for population stratification and pleiotropy. CONCLUSIONS Genetically lowered 25OHD levels were not associated with increased risk of CAD in a large, well-powered study, suggesting that previous associations between circulating 25OHD levels and CAD are possibly confounded or due to reverse causation.
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Affiliation(s)
- Despoina Manousaki
- From the Department of Epidemiology, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (D.M., L.E.M., S.R., J.B.R.); Departments of Medicine (D.G., J.B.R.) and Human Genetics (J.B.R.), McGill University, Montreal, Quebec, Canada; and Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom (J.B.R.)
| | - Lauren E Mokry
- From the Department of Epidemiology, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (D.M., L.E.M., S.R., J.B.R.); Departments of Medicine (D.G., J.B.R.) and Human Genetics (J.B.R.), McGill University, Montreal, Quebec, Canada; and Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom (J.B.R.)
| | - Stephanie Ross
- From the Department of Epidemiology, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (D.M., L.E.M., S.R., J.B.R.); Departments of Medicine (D.G., J.B.R.) and Human Genetics (J.B.R.), McGill University, Montreal, Quebec, Canada; and Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom (J.B.R.)
| | - David Goltzman
- From the Department of Epidemiology, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (D.M., L.E.M., S.R., J.B.R.); Departments of Medicine (D.G., J.B.R.) and Human Genetics (J.B.R.), McGill University, Montreal, Quebec, Canada; and Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom (J.B.R.)
| | - J Brent Richards
- From the Department of Epidemiology, Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada (D.M., L.E.M., S.R., J.B.R.); Departments of Medicine (D.G., J.B.R.) and Human Genetics (J.B.R.), McGill University, Montreal, Quebec, Canada; and Department of Twin Research and Genetic Epidemiology, King's College London, United Kingdom (J.B.R.).
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44
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Robinson PC, Choi HK, Do R, Merriman TR. Insight into rheumatological cause and effect through the use of Mendelian randomization. Nat Rev Rheumatol 2016; 12:486-96. [PMID: 27411906 DOI: 10.1038/nrrheum.2016.102] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Establishing causality of risk factors is important to determine the pathogenetic mechanisms underlying rheumatic diseases, and can facilitate the design of interventions to improve care for affected patients. The presence of unmeasured confounders, as well as reverse causation, is a challenge to the assignment of causality in observational studies. Alleles for genetic variants are randomly inherited at meiosis. Mendelian randomization analysis uses these genetic variants to test whether a particular risk factor is causal for a disease outcome. In this Review of the Mendelian randomization technique, we discuss published results and potential applications in rheumatology, as well as the general clinical utility and limitations of the approach.
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Affiliation(s)
- Philip C Robinson
- School of Medicine, Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston Road, Brisbane, Queensland 4006, Australia.,Department of Rheumatology, Royal Brisbane and Women's Hospital, Butterfield St and Bowen Bridge Rd, Brisbane, Queensland 4029, Australia
| | - Hyon K Choi
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Ron Do
- Genetics and Genome Sciences, Mount Sinai School of Medicine, 1 Gustav L. Levy Place, New York 10029-5674, USA
| | - Tony R Merriman
- Department of Biochemistry, 710 Cumberland Street, University of Otago, Dunedin 9054, New Zealand
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45
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Hopewell JC, Clarke R. Emerging Risk Factors for Stroke. Stroke 2016; 47:1673-8. [DOI: 10.1161/strokeaha.115.010646] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/14/2016] [Indexed: 12/18/2022]
Affiliation(s)
- Jemma C. Hopewell
- From the Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Robert Clarke
- From the Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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46
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Investigating causality in the association between 25(OH)D and schizophrenia. Sci Rep 2016; 6:26496. [PMID: 27215954 PMCID: PMC4877705 DOI: 10.1038/srep26496] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 05/03/2016] [Indexed: 01/08/2023] Open
Abstract
Vitamin D deficiency is associated with increased risk of schizophrenia. However, it is not known whether this association is causal or what the direction of causality is. We performed two sample bidirectional Mendelian randomization analysis using single nucleotide polymorphisms (SNPs) robustly associated with serum 25(OH)D to investigate the causal effect of 25(OH)D on risk of schizophrenia, and SNPs robustly associated with schizophrenia to investigate the causal effect of schizophrenia on 25(OH)D. We used summary data from genome-wide association studies and meta-analyses of schizophrenia and 25(OH)D to obtain betas and standard errors for the SNP-exposure and SNP-outcome associations. These were combined using inverse variance weighted fixed effects meta-analyses. In 34,241 schizophrenia cases and 45,604 controls, there was no clear evidence for a causal effect of 25(OH)D on schizophrenia risk. The odds ratio for schizophrenia per 10% increase in 25(OH)D conferred by the four 25(OH)D increasing SNPs was 0.992 (95% CI: 0.969 to 1.015). In up to 16,125 individuals with measured serum 25(OH)D, there was no clear evidence that genetic risk for schizophrenia causally lowers serum 25(OH)D. These findings suggest that associations between schizophrenia and serum 25(OH)D may not be causal. Therefore, vitamin D supplementation may not prevent schizophrenia.
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47
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Abstract
Vitamin D is a precursor of the steroid hormone calcitriol that is crucial for bone and mineral metabolism. Both the high prevalence of vitamin D deficiency in the general population and the identification of the vitamin D receptor in the heart and blood vessels raised interest in the potential cardiovascular effects of vitamin D. Experimental studies have demonstrated various cardiovascular protective actions of vitamin D, but vitamin D intoxication in animals is known to induce vascular calcification. In meta-analyses of epidemiological studies, vitamin D deficiency is associated with an increased cardiovascular risk. Findings from Mendelian randomization studies and randomized, controlled trials (RCTs) do not indicate significant effects of a general vitamin D supplementation on cardiovascular outcomes. Previous RCTs, however, were not adequately designed to address extraskeletal events, and did not focus on vitamin D-deficient individuals. Therefore, currently available evidence does not support cardiovascular benefits or harms of vitamin D supplementation with the commonly used doses, and whether vitamin D has cardiovascular effects in individuals with overt vitamin D deficiency remains to be evaluated. Here, we provide an update on clinical studies on vitamin D and cardiovascular risk, discuss ongoing vitamin D research, and consider the management of vitamin D deficiency from a cardiovascular health perspective.
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48
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Abbasi A. Mendelian randomization studies of biomarkers and type 2 diabetes. Endocr Connect 2015; 4:249-60. [PMID: 26446360 PMCID: PMC4654400 DOI: 10.1530/ec-15-0087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/07/2015] [Indexed: 12/16/2022]
Abstract
Many biomarkers are associated with type 2 diabetes (T2D) risk in epidemiological observations. The aim of this study was to identify and summarize current evidence for causal effects of biomarkers on T2D. A systematic literature search in PubMed and EMBASE (until April 2015) was done to identify Mendelian randomization studies that examined potential causal effects of biomarkers on T2D. To replicate the findings of identified studies, data from two large-scale, genome-wide association studies (GWAS) were used: DIAbetes Genetics Replication And Meta-analysis (DIAGRAMv3) for T2D and the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) for glycaemic traits. GWAS summary statistics were extracted for the same genetic variants (or proxy variants), which were used in the original Mendelian randomization studies. Of the 21 biomarkers (from 28 studies), ten have been reported to be causally associated with T2D in Mendelian randomization. Most biomarkers were investigated in a single cohort study or population. Of the ten biomarkers that were identified, nominally significant associations with T2D or glycaemic traits were reached for those genetic variants related to bilirubin, pro-B-type natriuretic peptide, delta-6 desaturase and dimethylglycine based on the summary data from DIAGRAMv3 or MAGIC. Several Mendelian randomization studies investigated the nature of associations of biomarkers with T2D. However, there were only a few biomarkers that may have causal effects on T2D. Further research is needed to broadly evaluate the causal effects of multiple biomarkers on T2D and glycaemic traits using data from large-scale cohorts or GWAS including many different genetic variants.
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Affiliation(s)
- Ali Abbasi
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Addenbrooke's Hospital, Post Box 285, Cambridge CB2 0QQ, UKDepartment of Epidemiology and Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands MRC Epidemiology UnitUniversity of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Addenbrooke's Hospital, Post Box 285, Cambridge CB2 0QQ, UKDepartment of Epidemiology and Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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49
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Kueider AM, Tanaka T, An Y, Kitner-Triolo MH, Palchamy E, Ferrucci L, Thambisetty M. State- and trait-dependent associations of vitamin-D with brain function during aging. Neurobiol Aging 2015; 39:38-45. [PMID: 26923400 DOI: 10.1016/j.neurobiolaging.2015.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/04/2015] [Accepted: 11/04/2015] [Indexed: 01/08/2023]
Abstract
We investigated whether (1) serum levels of 25-hydroxyvitamin D [25(OH)D] and single nucleotide polymorphisms (SNPs) in the group-specific component (GC) gene-regulating serum 25(OH)D levels are associated with cognition in older individuals; and (2) whether causal relationships exist between 25(OH)D and cognition during aging. Data from 1207 participants in the Baltimore Longitudinal Study of Aging were analyzed (mean follow-up, 10.4 years) to test associations between serum 25(OH)D and cognition. Two GC SNPs were used to derive a composite genetic risk score associated with lower 25(OH)D concentrations. Lower serum 25(OH)D and higher GC composite scores were associated with lower executive function at baseline. Mendelian randomization analyses suggested a causal relationship between lower serum 25(OH)D and poorer executive function and psychomotor speed. The SNP score was also associated with lower performance on measures of visuospatial abilities at baseline but with attenuated declines over time in visuospatial abilities and executive function. Widespread associations between vitamin-D regulatory SNPs and cognition suggest a mechanistic basis for the relationship between serum 25(OH)D levels and cognition during aging.
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Affiliation(s)
- Alexandra M Kueider
- Unit of Clinical and Translational Neuroscience, Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | | | - Elango Palchamy
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, National Institute on Aging, Baltimore, MD, USA
| | - Madhav Thambisetty
- Unit of Clinical and Translational Neuroscience, Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA.
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50
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Delanghe JR, Speeckaert R, Speeckaert MM. Behind the scenes of vitamin D binding protein: more than vitamin D binding. Best Pract Res Clin Endocrinol Metab 2015; 29:773-86. [PMID: 26522461 DOI: 10.1016/j.beem.2015.06.006] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although being discovered in 1959, the number of published papers in recent years reveals that vitamin D binding protein (DBP), a member of the albuminoid superfamily, is a hot research topic. Besides the three major phenotypes (DBP1F, DBP1S and DBP2), more than 120 unique variants have been described of this polymorphic protein. The presence of DBP has been demonstrated in different body fluids (serum, urine, breast milk, ascitic fluid, cerebrospinal fluid, saliva and seminal fluid) and organs (brain, heart, lungs, kidneys, placenta, spleen, testes and uterus). Although the major function is binding, solubilization and transport of vitamin D and its metabolites, the name of this glycoprotein hides numerous other important biological functions. In this review, we will focus on the analytical aspects of the determination of DBP and discuss in detail the multifunctional capacity [actin scavenging, binding of fatty acids, chemotaxis, binding of endotoxins, influence on T cell response and influence of vitamin D binding protein-macrophage activating factor (DBP-MAF) on bone metabolism and cancer] of this abundant plasma protein.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium
| | | | - Marijn M Speeckaert
- Department of Clinical Chemistry, Ghent University Hospital, Ghent, Belgium; Department of Nephrology, Ghent University Hospital, Ghent, Belgium
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