[The vitamin D endocrine system]

Are sun exposure time, dietary patterns, and vitamin D intake related to the socioeconomic status of Portuguese children?

OBJECTIVES

To investigate the association among sun exposure time, vitamin D intake, dietary patterns, and socioeconomic status in Portuguese children.

METHODS

Participants aged 3-11 years (50.1% females) were recruited from public and private schools (n = 118) in the districts of Coimbra (n = 2980), Lisbon (n = 3066), and Porto (n = 2426). Parents reported their children's daily sun exposure time during the summer season and reported children's food consumption, including vitamin D food sources, using standardized questionnaires. Parents' education level was used as a proxy measure to the socioeconomic status (SES). The principal component factor analysis (PCA) method was used to identify dietary patterns. The eight dietary patterns identified were labeled in: "fast food", "rich in vitamin D", "sugary drinks", "vitamin D", "candies", "supplements", "rich in calcium" and "vegetables/healthy". Linear regression analyses were performed to investigate the association between sun exposure time and dietary patterns according to SES.

RESULTS

A total of 4755 children were included. Children from high SES had significantly longer sun exposure time (p < .001) and more frequently consumed vitamin D supplements (p < .001). "Fast food" pattern showed a negative association with sun exposure time in medium and high SES (p = .014 and p < .001, respectively).

CONCLUSION

Children with lower SES spend less time exposed to the sun, consume fewer dietary sources of vitamin D, and consume more foods rich in fat and sugar.

The role of interaction between vitamin D and VDR FokI gene polymorphism (rs2228570) in sleep quality of adults

To evaluate association of vitamin D with sleep quality in adults and the influence of VDR-gene polymorphism FokI (rs2228570;A > G). Cross-sectional population-based study in adults, conducted in Brazil. The outcome was sleep-quality, evaluated by the Pittsburgh Sleep Quality Index. Vitamin D was determined by indirect electrochemiluminescence and classified as deficiency (VDD), 25(OH)D < 20 ng/mL in a healthy population or 25(OH)D < 30 ng/mL for groups at risk for VDD. FokI polymorphism in the VDR-gene was genotyped by qPCR and classified as homozygous wild (FF or AA), heterozygous (Ff or AG), or homozygous mutant (ff or GG). Multivariate logistic analysis was used to estimate the association between vitamin D and FokI polymorphism with sleep-quality. In a total of 1674 individuals evaluated, 53.6% had poor-sleep-quality, 31.5% had VDD, and the genotype frequency of the FokI polymorphism was 9.9% FF, 44.6% Ff, and 45.5% ff. In multivariate analysis, individuals with VDD had 1.51 times the chance of poor-sleep-quality, and individuals with the ff genotype had 1.49 times the chance of poor-sleep-quality (OR:1.49;95%CI:1.05-2.12) when compared to individuals with the FF or Ff genotype. In the combined analysis, individuals with VDD and ff genotype had more chance of poor-sleep-quality than individuals with sufficient vitamin D and genotype Ff or FF (OR:2.19;95%CI:1.27-3.76). Our data suggest that VDD and VDR FokI gene polymorphism are associated with poor-sleep-quality, and combining the two factors increases the chance of poor-sleep-quality compared to separate groups.

Immunomodulatory Effects of Vitamin D and Zinc on Viral Infection

Several nutrients are crucial in enhancing the immune system and preserving the structural integrity of bodily tissue barriers. Vitamin D (VD) and zinc (Zn) have received considerable interest due to their immunomodulatory properties and ability to enhance the body's immune defenses. Due to their antiviral, anti-inflammatory, antioxidative, and immunomodulatory properties, the two nutritional powerhouses VD and Zn are crucial for innate and adaptive immunity. As observed with COVID-19, deficiencies in these micronutrients impair immune responses, increasing susceptibility to viral infections and severe disease. Ensuring an adequate intake of VD and Zn emerges as a promising strategy for fortifying the immune system. Ongoing clinical trials are actively investigating their potential therapeutic advantages. Beyond the immediate context of the pandemic, these micronutrients offer valuable tools for enhancing immunity and overall well-being, especially in the face of future viral threats. This analysis emphasizes the enduring significance of VD and Zn as both treatment and preventive measures against potential viral challenges beyond the current health crisis. The overview delves into the immunomodulatory potential of VD and Zn in combating viral infections, with particular attention to their effects on animals. It provides a comprehensive summary of current research findings regarding their individual and synergistic impacts on immune function, underlining their potential in treating and preventing viral infections. Overall, this overview underscores the need for further research to understand how VD and Zn can modulate the immune response in combatting viral diseases in animals.

Efficacy of B-vitamins and vitamin D therapy in improving depressive and anxiety disorders: a systematic review of randomized controlled trials

OBJECTIVES

This systematic review aimed to evaluate the efficacy of B vitamins and vitamin D therapy in improving the standard treatment of depression and anxiety disorders. We also aimed to gather the evidence supporting the recommendations for supplementation in clinical practice.

METHODS

Performed between March 2020 and September 2021, the main inclusion criteria were randomized controlled trials (RCTs), with patients ≥ 18 years old, both sexes, fulfilling target diagnoses of major depressive disorder (MDD), generalized anxiety disorder (GAD), or mild to severe depressive and anxiety symptoms. In addition, the RCTs were included if the scales to assess the severity of the symptoms were standardized rating scales in psychiatric. Trials that reported diagnoses of schizophrenia, perinatal depression, bipolar depression, sleep disorders, eating disorders, cancer, and multiple sclerosis in association with any of the mentioned diagnoses were excluded.

RESULTS

We identified 20 RCTs that matched all eligibility criteria, totaling 2,256 subjects, diagnosed with MDD, GAD, and depressive or anxiety symptoms. Supplementation with folic acid or L-methylfolate, B1, B12 or methylcobalamin, and vitamin D (in different doses and study duration) significantly decreased depression score scales by increasing response to standard pharmacological treatment or as monotherapy, including partial or complete remission. As for anxiety symptoms, the availability of results is limited to adjuvant vitamin D therapy.

DISCUSSION

B vitamins and vitamin D associated with other compounds also showed significant results, so the improvement in symptoms cannot be attributed strictly to those. Our results suggest that intervention with B vitamins and/or vitamin D may be an effective and well-tolerated adjuvant strategy for improving the symptoms of depression and anxiety, according to the patient's clinical status and nutritional biomarkers.

Impact of Vitamin D Supplementation on the Clinical Outcomes and Epigenetic Markers in Patients with Acute Coronary Syndrome

Vitamin D has recently been found to influence the renin-angiotensin system (RAS); it can reduce the effects of renin-angiotensin system inhibitors (RASI) by decreasing plasma renin. This study examines the effect of vitamin D supplements on cardiac fibrosis markers, echocardiographic parameters, and epigenetic markers in patients with established acute coronary syndrome (ACS). It also looks at the incidence of vitamin D receptor (VDR) gene polymorphisms Apa I (rs7975232), Bsm I (rs1544410), Taq I (rs731236), and Fok I (rs2228570) and its association with the development of secondary major acute cardiovascular events (MACE) and heart failure (HF). A randomized controlled trial in which patients were divided into two groups was performed. Group 1 comprised of 125 ACS patients who received ACS standard therapy alone, while Group 2 consisted of 125 ACS patients who received ACS standard therapy plus vitamin D according to their vitamin D levels. Patients were monitored for 24 months to find subsequent MACE and HF. Vitamin D therapy for ACS patients resulted in a substantial decline in end systolic and end diastolic volumes (p = 0.0075 and 0.002, respectively), procollagen type III N-terminal peptide (PIIINP) and soluble ST2 levels (p = 0.007 and 0.001, respectively), as well as in ejection fraction and vitamin D level (p = 0.0001 and 0.008, respectively). In addition, vitamin D treatment was linked to a significant decline in the levels of noncoding RNA, such as mir361, lncRNA MEG3, and lncRNA Chaer (p = 2.9 × 10-4, 2.2 × 10-6, and 1.2 × 10-5, respectively). Furthermore, patients who suffered MACE had significantly higher levels of the Bsm I CC and Fok I GG genotypes (p = 4.8 × 10-4 and 0.003, respectively), while patients with HF had significantly higher levels of the Taq I AA genotype (p = 4.2 × 10-7). Supplementing ACS patients with vitamin D has been demonstrated to limit cardiac fibrosis and echocardiographic parameters, as well as epigenetic markers. Additionally, MACE and HF among ACS patients may be related to genetic variations among VDR gene polymorphisms.

Association of sun exposure and seasonality with vitamin D levels in Brazilian children and adolescents

OBJECTIVE

This study aimed to verify vitamin D concentration in children and adolescents during the seasons of the year and to compare vitamin D concentration between children engaged in outdoor activities and those engaged in indoor activities.

METHODS

This is a cross-sectional study with a sample of 708 children and adolescents (aged 6-18 years), excluding 109 (16 were over 19 years old; 39 had a disease that required continuous treatment; 20 were on continuous medication; and 34 had no vitamin D data), ending with 599. The plasma concentration of 25-hydroxyvitamin D2 was measured with commercial kits following manufacturer instructions.

RESULTS

Participants who engaged in outdoor activities, as well as those who had data collected during summer and spring, had higher levels of vitamin D. According to the Poisson regression, the proportion of participants with inadequate levels of vitamin D was greater in the participants whose vitamin D was measured during spring (PR 1.15, 95%CI 1.03-1.29) and winter (PR 1.18, 95%CI 1.05-1.32). Also, a greater proportion of inadequate vitamin D was observed for those engaged in indoor activities (PR 1.08, 95%CI 1.01-1.15).

CONCLUSIONS

Participants who measured the vitamin during the summer and autumn had a lower prevalence of hypovitaminosis D. Even in regions with high solar incidence throughout the year, vitamin D levels can vary significantly during the period's seasons.

Moodithaya S, K. A, Kumar Chatterjee P. Micronutrients- The crucial dietary elements in Covid-19 pandemic: A review

The mutation of the SARS-CoV-2 virus, which cause person-to-person transmission, is the pivotal reason for the pandemic outbreak in the year 2020. Infection symptoms include fever, dry cough, lethargy, severe pneumonia, respiratory distress syndrome, and death. COVID-19 induces a systemic inflammatory reaction that impairs the immune system, commonly known as cytokine release syndrome. Pro-inflammatory cytokines and chemokines are abundant in COVID-19 sufferers' bodies. COVID-19 has a disproportionate impact on the elderly, both directly and through several comorbidities associated with age. Nutrition is without hesitation, a crucial factor in maintaining good health. Some nutrients are essential for the immune system's health and function, exhibiting synergistic actions in critical immune response steps. Vitamin D, C, and Zinc stand out among these nutrients because they have immunomodulatory properties and help to maintain physical tissue barriers. Considering the viability of the virus, nutrients that boost the immunity henceforth the severity of viral infections declines with improved prognosis become important. As a result, the purpose of this review is to provide a complete outline of vitamins D, C, and zinc's involvement during the immune response towards infection, and to enlighten their commensal action of maintaining physical barriers including integument and mucous membrane. Appropriate vitamin D, C, and zinc consumption may represent a feasible pharmacological intervention during the COVID-19 pandemic due to the high surge in population interaction and the commencement of inflammation.  

The Combined Relationship of Vitamin D and Weight-Bearing Sports Participation on Areal Bone Density and Geometry Among Adolescents: ABCD - Growth Study

Osteoporosis is a public health problem, which negatively impacts society and national health services worldwide. Altered mineralization of the skeleton can be caused by persistent vitamin D deficiency. However, the combined impact of both on bone health is still under investigation. In fact, although there is compelling evidence in the literature about the positive effect of weight-bearing sports participation on bone mineral density, its impact on bone geometry gains more attention in pediatric population. The sports modalities that we evaluated were artistic gymnastics and track and field. Nonsports group was composed of 43 adolescents. Bone density was assessed using dual-energy X-ray absorptiometry. Vitamin D concentration was assessed by blood analysis. In the crude comparison of bone outcomes, the sport group presented higher aBMD only in the trochanter (p-value = 0.040). Considering the combination of the engagement in sports and vitamin D, adolescents in the sports group presented significantly higher values of aBMD in lower limbs, whole body, trochanter, shaft, and femur whole body (p-value = 0.024, 0.035, 0.001, 0.019 and 0.003 respectly). In contrast, only the sport group with high vitamin D presented a higher CSA (p-value = 0.015) and femur neck aBMD compared to the non-sport/low vitamin D group. Only adolescents with a combination of sports participation and higher serum concentrations of vitamin D presented better bone geometry, denoting the relevance of the combination of both factors to bone health.

Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review

OBJECTIVES

To evaluate the effect of vitamin D supplementation on glycemic control in children and adolescents with T1DM.

CONTENT

A systematic search was conducted of the Medline/PubMed, Web of Science, Embase, BVS/Lilacs, Cochrane Library, Scopus, Cinahl, Food Science, and FSTA databases. Two reviewers independently extracted article data and assessed quality.

SUMMARY

A total of 1,613 eligible articles were retrieved, ten of which met the selection criteria: eight clinical trials, one retrospective cohort study, and one cross-sectional study. Regarding the cutoff points used to classify vitamin D status, most of the studies set deficiency at 25-hydroxyvitamin D <20 ng/mL, sufficiency at ≥30 ng/mL, and insufficiency as the interval between these values. Regarding intervention strategies, most used cholecalciferol for supplementation, but there was great variation in the dose and supplementation time. When evaluating the effect of vitamin D supplementation on HbA1c, a significant improvement in glycemic control was observed in 50% of the studies. However, only one of these studies was classified as being of positive methodological quality, with three having their quality classified as neutral and one as negative.

OUTLOOK

There is yet no consistent evidence on the effect of vitamin D supplementation on glycemic control as an adjuvant in the treatment of children and adolescents with T1DM.

Effects of Vitamin D Levels on Cardiovascular Diseases: A Systematic Review

Background:

Cardiovascular diseases (CVDs) are a group of pathologies that involve heart and blood vessel disorders and are considered the main cause of death in the world. Epidemiological studies have shown the association between low vitamin D (VD) levels and CVD. This vitamin, in addition to acting on bone metabolism, plays a role in modulating the cardiovascular system.

Objective:

The present study assesses the effects of VD levels on CVD through a systematic literature review.

Method:

For this purpose, the PICO strategy was used to prepare the guiding question, and articles were searched in the PubMed, Scopus, Science Direct, and Web of Science databases by two authors independently. To guarantee the quality of the evidence of the articles included in the review, the Newcastle-Ottawa scale was used. The literature review followed the PRISMA recommendations.

Results:

In this review, 22,757 articles were identified, but only 10 were considered eligible, of which 70% are prospective cohorts and 30% are retrospective cohorts. The study showed that low 25(OH)D levels correlate with an increased risk of cardiovascular events and death from CVD, including in patients who had preexisting CVD. However, one article did not demonstrate this association.

Conclusion:

As a result, VD correlates with cardiovascular events and the risk of death.

Asthma and vitamin D in Brazilian adolescents: Study of Cardiovascular Risks in Adolescents (ERICA)

Objective:

To evaluate the association between asthma prevalence and serum levels of vitamin D in Brazilian adolescents.

Methods:

This was a cross-sectional, school-based study involving adolescents between 12-17 years of age from four large Brazilian cities located at different latitudes (Fortaleza, Rio de Janeiro, Brasília, and Porto Alegre). Information on asthma diagnosis, lifestyle, and sociodemographic characteristics was collected by means of self-administered questionnaires. Serum concentrations of calcifediol were dichotomized as sufficient (≥ 20 ng/mL) or insufficient/deficient (< 20 ng/mL) levels. Bivariate analyses were carried out between vitamin D levels and prevalence of active asthma (AA), as well as other variables in study, using the chi-square test. Generalized linear models were configured to analyze potential confounding factors (p < 0.20).

Results:

Between 2013 and 2014, 1,053 adolescents were evaluated. The prevalences of AA and insufficient/deficient levels of calcifediol were 15.4% and 21%, respectively. There were no statistically significant associations between AA and hypovitaminosis D. The prevalences of AA and vitamin D insufficiency were, respectively, 2.34 (95% CI, 1,28-4.30) and 3.22 (95% CI, 1.75-5.95) times higher in Porto Alegre than in Rio de Janeiro, regardless of possible confounding factors. However, no significant associations were found between the prevalence of AA and vitamin-D-related variables in any of the cities.

Conclusions:

No association was found between AA and low levels of vitamin D in adolescents living at different latitudes in Brazil.

Safety and effectiveness of vitamin D mega-dose: A systematic review

INTRODUCTION

Supplementation with high doses of vitamin D, known as mega-dose or "stoss therapy," refers to administering high doses of vitamin D by oral or intramuscular route in short periods of time. In this sense, conducting a review to organize this knowledge in a single article will generate a helpful instrument for researchers working in this area and for health professionals who use this therapeutic tool.

OBJECTIVE

To carry out a literature review on safety and efficacy (normalization of serum vitamin D level, and changes in the clinical picture) of vitamin D mega-dose use.

METHODOLOGY

This is a systematic review of the literature searching data through the electronic banks of PubMed, Scielo, and LILACS, using the following keywords: "vitamin D," "mega-dose," "stoss therapy," "cholecalciferol," in different combinations. CONSORT questionnaire was used to assess the quality of the included studies.

RESULTS

Of the 59 articles screened for this review, 10 were included in the review, studying patients with rickets, osteoporosis, and critically ill patients. Two studies compared the exact dosage of vitamin D by different routes of administration, and three studies compared different doses by the same route. All others studied vitamin D mega-dose versus placebo. Adverse effects were observed through the presence of hypercalcemia/hypercalciuria. Serum vitamin D levels were normalized between 70 and 100% of patients, and adverse effects ranged between 1.9 and 18.5%.

CONCLUSION

The study demonstrated that vitamin D mega-dose therapy is effective in normalizing serum vitamin levels, and the toxicity assessed through adverse effects was low, with no expressive clinical significance. Despite this, there is still a need for further studies in the area to confirm the results found.

Nutritional supplementation of the pharmacotherapy of prostate diseases

Introduction: Nutritional supplementation is an integral part of modern pharmacotherapeutic strategies for prostate diseases with different levels of evidence for specific nutrients.

Provitamin A (beta-carotene), vitamin A (retinol) and prostate diseases. Their effects have not been sufficiently studied, and the available data are conflicting to recommend them as a nutritional supplement.

Vitamin E (tocopherol) and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicting to recommend it as a nutritional supplement.

Vitamin C (ascorbic acid) and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicted to recommend it as a nutritional supplement.

Vitamin K and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicted to recommend it as a nutritional supplement.

Vitamin D and prostate diseases. The evidence base of the vitamin D prostatotropic effects has been accumulated, which allows us to consider its deficiency replacement as an effective nutritional supplement in prostate diseases.

Omega-3 PUFAs and prostate diseases. They have universal physiological effects; however, the evidence base for their recommendation as a nutritional supplement for prostate diseases is still insufficient.

Zinc and prostate diseases. Positive effects of zinc on the prostate gland are known for a fact and allow us to recommend it as a nutritional supplement for prostate diseases.

Selenium and prostate diseases. The reliably proven positive effects of selenium on the prostate gland allow us to recommend it as a nutritional supplement for prostate diseases.

Magnesium and prostate diseases. Its effects have not been sufficiently studied, and the available data are conflicting to recommend it as a nutritional supplement.

The possible benefits of vitamin D in COVID-19

Molecular studies have demonstrated the importance of the exacerbated immune response to SARS-CoV-2 infection, called the cytokine storm, in more severe COVID-19. The pathophysiology is complex and involves several homeostatic factors; among them, a deficit of vitamin D draws attention because of its high frequency in the population. Some evidence suggests that people with low serum vitamin D levels have worse outcomes, often requiring intensive care. This review analyzed the studies available in the global literature addressing the benefits of vitamin D in COVID-19, relating serum levels to the severity of the disease, and indicating vitamin D as a possible prophylactic and therapy in infection.

Deficiency of vitamin D and its relation with clinical and laboratory activity of inflammatory bowel diseases

Objective To evaluate the serum concentrations of vitamin D and their relation with inflammatory bowel diseases.

Methods This is a quantitative and descriptive study, with individuals assisted by the interdisciplinary ambulatory of Inflammatory Bowel Disease of the Family and Community Health Unit of Itajaí/SC from September 2015 to October 2016. Socioeconomic data, life habits, and biochemical tests were collected, with the use of clinical indexes of classification of the disease activity: Harvey-Bradshaw Index (Crohn's Disease) and Partial Mayo Score (Chronic Nonspecific Ulcerative Colitis).

Results Of the 60 patients evaluated, 57% (n = 34) had Crohn's Disease and 43% (n = 26) had Chronic Nonspecific Ulcerative Colitis. According to disease activity, 75% (n = 45) were in the remission phase, 13% (n = 8) had mild activity, and 9% (n = 5) had moderate activity. Regarding vitamin D, 63% (n = 38) had deficiency of this vitamin and 37% (n = 22) presented sufficiency. With the association of serum vitamin D concentrations and disease activity, we observed statistical significance among the variables (p = 0.005). Regarding biochemical exams, the majority of patients with fecal calprotectin elevation presented vitamin D deficiency (p = 0.025). Statistically significant correlation between HSV and vitamin D (p = 0.0001) was found.

Conclusion According to the findings of this study, vitamin D deficiency is related to the clinical and laboratory activity of inflammatory bowel diseases.

Vitamin D and Its Role in the Lipid Metabolism and the Development of Atherosclerosis

Vitamin D, a crucial hormone in the homeostasis and metabolism of calcium bone, has lately been found to produce effects on other physiological and pathological processes genomically and non-genomically, including the cardiovascular system. While lower baseline vitamin D levels have been correlated with atherogenic blood lipid profiles, 25(OH)D supplementation influences the levels of serum lipids in that it lowers the levels of total cholesterol, triglycerides, and LDL-cholesterol and increases the levels of HDL-cholesterol, all of which are known risk factors for cardiovascular disease. Vitamin D is also involved in the development of atherosclerosis at the site of the blood vessels. Deficiency of this vitamin has been found to increase adhesion molecules or endothelial activation and, at the same time, supplementation is linked to the lowering presence of adhesion surrogates. Vitamin D can also influence the vascular tone by increasing endothelial nitric oxide production, as seen in supplementation studies. Deficiency can lead, at the same time, to oxidative stress and an increase in inflammation as well as the expression of particular immune cells that play a pivotal role in the development of atherosclerosis in the intima of the blood vessels, i.e., monocytes and macrophages. Vitamin D is also involved in atherogenesis through inhibition of vascular smooth muscle cell proliferation. Furthermore, vitamin D deficiency is consistently associated with cardiovascular events, such as myocardial infarction, STEMI, NSTEMI, unstable angina, ischemic stroke, cardiovascular death, and increased mortality after acute stroke. Conversely, vitamin D supplementation does not seem to produce beneficial effects in cohorts with intermediate baseline vitamin D levels.

Zinc, Vitamin D and Vitamin C: Perspectives for COVID-19 With a Focus on Physical Tissue Barrier Integrity

Some nutrients play key roles in maintaining the integrity and function of the immune system, presenting synergistic actions in steps determinant for the immune response. Among these elements, zinc and vitamins C and D stand out for having immunomodulatory functions and for playing roles in preserving physical tissue barriers. Considering the COVID-19 pandemic, nutrients that can optimize the immune system to prevent or lower the risk of severe progression and prognosis of this viral infection become relevant. Thus, the present review aims to provide a comprehensive overview of the roles of zinc and vitamins C and D in the immune response to viral infections, focusing on the synergistic action of these nutrients in the maintenance of physical tissue barriers, such as the skin and mucous membranes. The evidence found in the literature shows that deficiency of one or more of these three elements compromises the immune response, making an individual more vulnerable to viral infections and to a worse disease prognosis. Thus, during the COVID-19 pandemic, the adequate intake of zinc and vitamins C and D may represent a promising pharmacological tool due to the high demand for these nutrients in the case of contact with the virus and onset of the inflammatory process. Ongoing clinical trials will help to clarify the role of these nutrients for COVID-19 management.

Is hypovitaminosis D associated with fibromyalgia? A systematic review

CONTEXT

Recent findings have suggested a high prevalence of vitamin D deficiency or insufficiency in fibromyalgia (FM) patients despite the lack of clinical and pathophysiological evidence.

OBJECTIVE

A systematic review was conducted to examine the association between vitamin D status and FM, including the effect of vitamin D supplementation.

DATA SOURCE

PubMed, LILACS, Scopus, SciELO, Cochrane, and EMBASE were searched, from January 2000 to July 2018, using the descriptors "Fibromyalgia" and "Vitamin D."

STUDY SELECTION

Trials including FM patients in whom vitamin D levels were assessed were eligible for inclusion.

DATA EXTRACTION

Data comprised age, gender, country, aims, bias, diagnosis criteria, cutoff point, and status of vitamin D, together with FM symptoms and vitamin D supplementation protocol.

RESULTS

A total of 26 articles were selected. Most of the studies were found to present unreliable control groups and small samples. Experimental data on vitamin D supplementation indicated improvement in certain FM symptoms.

CONCLUSION

Prevalence of hypovitaminosis D in the FM population and the cause-effect relationship were inconclusive. Nevertheless, vitamin D supplementation may be considered as a co-adjuvant in FM therapy.

The impact of vitamin D supplementation on VDR gene expression and body composition in monozygotic twins: randomized controlled trial

Vitamin D supplementation is widely used. However, there is no consensus on the use and dosage of this supplement and the existing recommendations arise from studies based on the benefits that this nutrient can facilitate in bones. In addition, individual genetics can influence the response to supplementation, therefore, research involving monozygotic twins aims to reduce these differences in phenotypic responses. The objective of this randomised controlled study is to examine the effect of vitamin D supplementation on body composition and the expression of the vitamin D receptor (VDR) mRNA. An intervention was performed through supplementation with cholecalciferol at the concentration of 2000 IU in 90 healthy adult monozygotic twins (male or female pairs) for 2 months. The findings showed that serum vitamin D concentration increased by 65% and VDR gene expression sixty times (p = 0.001). Changes in body composition parameters were observed regarding body fat and lean mass. Our results indicate that an increase in serum vitamin D concentration may have potential therapeutic implications.

The Role of Vitamin D and Sunlight Incidence in Cancer

BACKGROUND

Vitamin D (VD) deficiency affects individuals of different ages in many countries. VD deficiency may be related to several diseases, including cancer.

OBJECTIVE

This study aimed to review the relationship between VD deficiency and cancer.

METHODS

We describe the proteins involved in cancer pathogenesis and how those proteins can be influenced by VD deficiency. We also investigated a relationship between cancer death rate and solar radiation.

RESULTS

We found an increased bladder cancer, breast cancer, colon-rectum cancer, lung cancer, oesophagus cancer, oral cancer, ovary cancer, pancreas cancer, skin cancer and stomach cancer death rate in countries with low sunlight. It was also observed that amyloid precursor protein, ryanodine receptor, mammalian target of rapamycin complex 1, and receptor for advanced glycation end products are associated with a worse prognosis in cancer. While the Klotho protein and VD receptor are associated with a better prognosis in the disease. Nfr2 is associated with both worse and better prognosis in cancer.

CONCLUSION

The literature suggests that VD deficiency might be involved in cancer progression. According to sunlight data, we can conclude that countries with low average sunlight have high cancers death rate. New studies involving transcriptional and genomic data in combination with VD measurement in long-term experiments are required to establish new relationships between VD and cancer.

A complete physical mapping of the vitamin D receptor gene for dental implant loss: A pilot study

OBJECTIVES

The aim of this pilot case-control study was to investigate the association of clinical variables and genetic polymorphisms in the vitamin D receptor gene (VDR) with dental implant loss.

MATERIAL AND METHODS

This study was carried out with 244 individuals with mean age 51.90 ± 11.28 (81 cases and 163 controls matched by age, sex, and smoking habit). Also, the clusterization phenomenon was investigated stratifying the sample into two groups: (a) 34 patients with multiple losses (presenting two or more lost implants) and (b) 210 without multiple losses (up to one implant loss). Sociodemographic, clinical, and periodontal parameters were analyzed. The tagSNPs in the VDR gene were analyzed by real-time PCR. Univariate and multivariate analyses were performed (p < .05).

RESULTS

Edentulism, number of implants installed, and Gingival, Plaque, and Calculus Indexes were associated with implant loss in the univariate analysis. After the multivariate analysis, the allele G of rs3782905 in the recessive model, together with number of installed implants and Gingival Index, was associated with implant failure.

CONCLUSION

It is suggested that the allele G of rs3782905 in the recessive model may be a new genetic risk marker for dental implant loss in patients who lost two or more dental implants. In addition, number of implants installed and Gingival Index were also associated. Replication is mandatory to confirm these findings, due to the modest sample size of this work.

Sun exposure, skin lesions and vitamin D production: evaluation in a population of fishermen

BACKGROUND

Exposure to UVR provides benefits related to vitamin D synthesis, but also causes harms, since UVB is considered a complete carcinogen. There is no definition of the level of sun exposure and the proportion of exposed body required for proper synthesis of vitamin D in the skin without causing it damage.

OBJECTIVES

This study aims to analyze the sun exposure index, vitamin D levels and clinical changes in the skin caused by constant sun exposure in the fishermen population.

METHODS

It is a cross-sectional, observational and analytical study. The sample consisted of fishermen and was calculated in 174 individuals. The questionnaire was applied, the dermatological examination was carried out and the examinations of calcidiol, parathyroid hormone, calcium and phosphorus were requested. Data were expressed as percentages. The comparative analysis was done through the Chi-square test, and the correlations were established through the Pearson's linear coefficient. Results: We observed that there was vitamin D deficiency in a small part of the cases (11.46%), and the frequency of diagnosis of skin cancer was 2.7% of the cases surveyed.

STUDY LIMITATIONS

The difficulty in categorizing the sun exposure index.

CONCLUSION

The fact that fishermen expose themselves to the sun chronically and have been exposed to the sun for more than 15 years, between 21 and 28 hours a week, and without photoprotection, were indicative factors for protection against vitamin D deficiency. Chronic exposure to sun and high vitamin levels D may be indicative of protection of this population against skin cancer.

Avaliação da frequência de deficiência de vitamina D em pacientes com obesidade

Introdução: A obesidade é um problema de saúde pública mundial. Além das diversas alterações metabólicas encontradas em indivíduos obesos, há evidências de alterações no sistema endócrino, como observado no metabolismo da vitamina D.Objetivos:Avaliar a frequência de deficiência de vitamina D em uma amostra de pacientes adultos com obesidade.Materiais e métodos: Foi realizado um estudo transversal retrospectivo analisando 183 prontuários dos pacientes atendidos pela primeira vez buscando tratamento para obesidade. Após os fatores de exclusão, restaram 113 prontuários válidos.Resultados: O IMC variou de 30.1 a 77.1, com uma mediana de 44.5 kg/m2. Trinta pacientes (26,55 %) tinham a Vitamina D abaixo de 20 ng/ml, sendo considerados com diagnóstico de Deficiência de Vitamina D. Nenhum correlação foi encontrada entre os níveis de Vitamina D e os parâmetros antropométricos. Houve associação significativa estatística dos níveis de Vitamina D com colesterol total (r=-0.26; p=0.0053), LDL-colesterol (r=-0.25; p=0.0071), além de uma tendência à significância com os níveis de TGP (r=0.16; p=0.088).Conclusão: Houve uma elevada frequência de deficiência de vitamina D em pacientes obesos. Não houve correlação entre os níveis de vitamina D e os marcadores antropométricos, porém foi encontrada uma correlação inversa de vitamina D com níveis de colesterol total e LDL-colesterol, mostrando a relação com a dislipidemia. Também, houve uma tendência à significância com os níveis de TGP, o que provavelmente remete à esteatose hepática, comum em obesos.

Vitamin D supplementation alters the expression of genes associated with hypertension and did not induce DNA damage in rats

Vitamin D3 deficiency has been correlated with altered expression of genes associated with increased blood pressure (BP); however, the role of vitamin D3 supplementation in the genetic mechanisms underlying hypertension remains unclear. Thus, the aim of this study was investigate the consequences of vitamin D3 supplemented (10,000 IU/kg) or deficient (0 IU/kg) diets on regulation of expression of genes related to hypertension pathways in heart cells of spontaneously hypertensive rats (SHR) and normotensive Wistar Kyoto (WKY) controls. An additional aim was to assess the impact of vitamin D3 on DNA damage and oxidative stress markers. The gene expression profiles were determined by PCR array, DNA damage was assessed by an alkaline comet assay, and oxidative stress markers by measurement of thiobarbituric acid reactive substances (TBARS) and glutathione (GSH) levels. In SHR rats data showed that the groups of genes most differentially affected by supplemented and deficient diets were involved in BP regulation and renin-angiotensin system. In normotensive WKY controls, the profile of gene expression was similar between the two diets. SHR rats were more sensitive to changes in gene expression induced by dietary vitamin D3 than normotensive WKY animals. In addition to gene expression profile, vitamin D3 supplemented diet did not markedly affect DNA or levels of TBARS and GSH levels in both experimental groups. Vitamin D3 deficient diet produced lipid peroxidation in SHR rats. The results of this study contribute to a better understanding of the role of vitamin D3 in the genetic mechanisms underlying hypertension. Abbreviations: AIN, American Institute of Nutrition; EDTA, disodium ethylenediaminetetraacetic acid; GSH, glutathione; PBS, phosphate buffer solution; SHR, spontaneously hypertensive rats; TBARS, thiobarbituric acid reactive substances; WKY, Wistar Kyoto.

Association between physical activity and vitamin D: A narrative literature review

Summary This narrative review of the medical literature assessed whether outdoor and indoor physical activity would increase the plasma levels of vitamin D. Synthesis of this liposoluble vitamin is mainly mediated by sunlight on the skin, where it is activated to perform its main action, which is to control the serum levels of calcium as soon as the element is absorbed in the intestines, assisting in the regulation of bone metabolism. Physical activity is any body movement that results in energy expenditure, while outdoor physical activity refers to physical activity carried out at public parks or other open spaces, as is the case of the popular practice of taking walks. Exercising outdoors would have both the benefits of physical activity and of sun exposure, namely the synthesis of vitamin D. However, according to the studies analyzed, increased plasma concentration of vitamin D occurs with physical activity both indoors and outdoors.

Cichorium intybus root extract: A "vitamin D-like" active ingredient to improve skin barrier function

During the aging process, the human skin suffers many alterations including dryness, skin barrier function damage. The skin barrier function is important to the prevention of skin alterations and maintenance of homeostasis. So, the objective of this study was to assess the clinical efficacy on skin barrier function of Cichorium intybus root extract in cosmetic formulations with or without UV filters. Fifty women, aged between 45 and 60 years, were divided into two groups. One group received vehicle formulations containing UV filters, and the other group received formulations without UV filters. Both groups received a formulation containing the extract and the vehicle. The formulations were applied twice daily to the upper arms after washing with sodium lauryl sulphate. Transepidermal water loss (TEWL) and skin microrelief were evaluated before and after a 14- and 28-day period of treatment. The control regions and regions where the vehicles were applied showed an increase in the TEWL. For the formulations containing the extract, decreased TEWL and improved microrelief were observed when compared to the vehicle and control areas after a 28-day period. In conclusion, Cichorium intybus root extract showed protective and restructuring effects on the skin and stands out as an innovative ingredient to improve skin barrier function.

Ultraviolet index: a light in atopic dermatitis and vitamin D research?

BACKGROUND

The role played by vitamin D in atopic dermatitis is controversial and has been the focus of many studies. The ultraviolet index has not been considered in this type of research.

OBJECTIVES

The objectives of the study were to assess 25-hydroxy vitamin D [25(OH)D] serum level in atopic dermatitis patients and control group, to investigate the association between atopic dermatitis clinical severity (using the SCORing Atopic Dermatitis index - SCORAD) and 25(OH)D serum levels, and to evaluate the independent predictors, including Ultraviolet index, SCORAD and 25(OH)D.

METHODS

We conducted a cross-sectional study of 106 atopic dermatitis patients. A control group was matched with a subsample of 54 participants with atopic dermatitis. SCORAD index, laboratory tests, and local Ultraviolet index were assessed.

RESULTS

The atopic dermatitis patients had serum 25(OH)D levels and mean UVI significantly higher than the control group. Immunoglobulin E and Ultraviolet index were associated with the SCORAD index. Skin type, age and Ultraviolet index were independent predictors of 25(OH)D.

CONCLUSIONS

Although statistically significant, the different levels of 25(OH)D between the paired groups may be attributed to the higher mean Ultraviolet index in atopic dermatitis patients. Since Ultraviolet index is an independent predictor of SCORAD index and of 25(OH)D level, it may work as a confounding factor in studies involving atopic dermatitis and 25(OH)D and must be considered in this kind of research.

Elderly with proximal hip fracture present significantly lower levels of 25-hydroxyvitamin D

OBJECTIVE

To compare serum 25-hydroxyvitamin D (25[OH]D) levels, a serum marker of vitamin D3, between patients with and without proximal hip fracture.

METHODS

This was a case-control study in which serum samples of 25(OH)D were obtained from 110 proximal hip fracture inpatients and 231 control patients without fractures, all over 60 years of age. Levels of 25(OH)D lower than or equal to 20 ng/mL were considered deficient; from 21 ng/mL to 29 ng/mL, insufficient; and above 30 ng/mL, sufficient. Sex, age, and ethnicity were considered for association with the study groups and 25(OH)D levels.

RESULTS

Patients with proximal hip fracture had significantly lower serum 25(OH)D levels (21.07 ng/mL) than controls (28.59 ng/mL; p = 0.000). Among patients with proximal hip fracture, 54.5% had deficient 25(OH)D levels, 27.2% had insufficient levels, and only 18.2% had sufficient levels. In the control group, 30.3% of patients had deficient 25(OH)D levels, 30.7% had insufficient levels, and 38.9% had sufficient levels. Female patients had decreased serum 25(OH)D levels both in the fracture group and in the control group (19.50 ng/mL vs. 26.94 ng/mL; p = 0.000) when compared with male patients with and without fracture (25.67 ng/mL vs. 33.74 ng/mL; p = 0.017). Regarding age, there was a significant association between 25(OH)D levels and risk of fracture only for the age groups 71-75 years and above 80 years.

CONCLUSION

Patients with proximal hip fracture had significantly decreased serum 25(OH)D levels when compared with the control group. Female patients had significantly lower serum 25(OH)D levels in both groups.

The base medium affects ultrastructure and survival of bovine preantral follicles cultured in vitro

The aim of this study was to determine the effectiveness of minimum essential medium alpha modification (α-MEM), tissue culture medium 199 (TCM-199), and McCoy's medium (McCoy's) on IVC of preantral follicles included in the bovine ovarian cortex (in situ). Bovine ovarian fragments were cultured in α-MEM, TCM-199, or McCoy supplemented ((+)) with glutamine, insulin, transferrin, selenium, ascorbic acid, BSA, penicillin, streptomycin, and HEPES buffer in 24-well plates, at 37 °C and 5% CO2 for 1 or 7 days. The morphology of follicles, normal, primordial and development (primary and secondary), as well as viability and morphometric variables of follicles and oocytes were assessed. The morphology and morphometry of preantral follicles were analyzed by ANOVA followed by the Tukey and Dunnett tests, and viability variables were determined by the chi-square test. The results showed that TCM-199(+) reduced significantly (P < 0.05) the percentage of morphologically normal and viable follicles after 7 days of culture compared to the control. Similar results were observed in McCoy(+), in which the percentage of viable follicles after 7 days of culture was significantly lower (P < 0.05) than in the control. However, it was similar (P > 0.05) between α-MEM(+) and TCM-199(+). Moreover, follicular diameters in McCoy(+) and TCM-199(+) were significantly smaller (P < 0.05) than in control and α-MEM(+) after 7 days of culture. In addition, the ultrastructure of preantral follicles was similar between the control and α-MEM(+) after 7 days of culture. In conclusion, α-MEM(+) showed to be the most effective medium to preserve morphology, morphometry and ultrastructure of bovine preantral follicles, ensuring their viability and growth after in situ culture.

Balanço de minerais e desempenho em frangos de corte aos 21 dias de idade alimentados com rações contendo Solanum malacoxylon

ResumoEstudou-se o desempenho produtivo e as quantidades de cálcio (Ca), fósforo (P), magnésio (Mg), potássio (K) e sódio (Na) nas excretas e carcaças de frangos de corte aos 21 dias de idade alimentados com adição de Solanum malacoxylon (SM) nas rações. Adotou-se delineamento inteiramente casualizado, com três tratamentos: 0,0, 2,5 e 5,0g de SM/kg de ração, sendo cinco repetições e quatro aves por unidade experimental. O uso de 5,0 g de SM/kg de ração reduziu o ganho de peso e piorou a conversão alimentar, embora o consumo não tenha sido influenciado. A inclusão da planta não afetou (p>0,05) os teores de cálcio, magnésio, potássio e sódio nas excretas e, consequentemente, na absorção desses minerais. A composição mineral das carcaças foi alterada, sendo as concentrações de Na, Mg e K, influenciadas. Recomenda-se a adição de até 2,5g de SM/kg de ração para frangos de corte até 21 dias de idade.

Use of vitamin d3 and its metabolites in broiler chicken feed on performance, bone parameters and meat quality

The objective of this experiment was to assess the use of different vitamin D metabolites in the feed of broiler chickens and the effects of the metabolites on performance, bone parameters and meat quality. A total of 952 one-day-old male broiler chicks were distributed in a completely randomised design, with four treatments, seven replicates and 34 birds per experimental unit. The treatments consisted of four different sources of vitamin D included in the diet, D₃, 25(OH)D₃, 1,25(OH)₂D₃, and 1α(OH)D₃, providing 2000 and 1600 IU of vitamin D in the starter (1 to 21 d) and growth phases (22 to 42 d), respectively. Mean weight, feed:gain and weight gain throughout the rearing period were less in animals fed 1α(OH)D₃ when compared with the other treatments (p<0.05). No significant differences were noted among the treatments (p>0.05) for various bone parameters. Meat colour differed among the treatments (p>0.05). All of the metabolites used in the diets, with the exception of 1α(OH)D₃, can be used for broiler chickens without problems for performance and bone quality, however, some aspects of meat quality were affected.