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Hariri Z, Kord-Varkaneh H, Alyahya N, Prabahar K, Găman MA, Abu-Zaid A. Higher Dietary Vitamin D Intake Influences the Lipid Profile and hs-CRP Concentrations: Cross-Sectional Assessment Based on The National Health and Nutrition Examination Survey. Life (Basel) 2023; 13:life13020581. [PMID: 36836938 PMCID: PMC9965151 DOI: 10.3390/life13020581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Background. An unanswered question in the field of nutrition is whether there is an association between vitamin D intake and the lipid profile in adults. We conducted this cross-sectional study in order to investigate the impact of vitamin D intake on the lipid profile of adults in the context of the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Methods. Serum lipids and high-sensitivity C-reactive protein (hs-CRP) concentrations and the Vitamin D intake in 2588 people aged 19 to 70 years was collected using laboratory analysis and 24-h recall, respectively. The one-way ANOVA test was used to compare quantitative variables and the chi-squared test was used to compare qualitative ones. Multivariate logistic regression for three models was performed to assess the odds ratio (OR) of high total cholesterol (TC) (>200 mg/dL), triglycerides (TG) (>150 mg/dL), low-density lipoprotein cholesterol (LDL-C) (>115 mg/dL), high-density lipoprotein cholesterol (HDL-C) (<40 mg/dL) and hs-CRP (>1 mg/l) based on the tertiles of dietary vitamin D (D2 + D3) intake. Results. After adjusting for age, sex, race, body mass index, serum 25-hydroxyvitamin D2, alcohol intake, energy intake, protein intake, carbohydrate intake, fiber intake and fat intake, individuals in the tertile with the highest versus lowest vitamin D intake (>1 mcg/day vs. <0.10 mcg/day) had lower odds of displaying elevated TC, LDL-C and hs-CRP concentrations (OR 0.57; CI: 0.37 to 0.88; P-trend: 0.045, OR 0.59; CI: 0.34 to 1.01; P-trend: 0.025 and OR 0.67; CI: 0.45 to 0.99; P-trend: 0.048, respectively). Based on the results of the logistic regression, no correlation between vitamin D intake and changes in TG or HDL-C values was noted. Conclusions. Our cross-sectional study indicates that higher dietary vitamin D (D2 + D3) intake is associated with lower TC, LDL-C and hs-CRP levels. No relationship between dietary vitamin D intake and TG or HDL-C values was detected. Further large-scale randomized trials are needed to evaluate the actual association between dietary vitamin D intake and the lipid profile.
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Affiliation(s)
- Zahra Hariri
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Noura Alyahya
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Correspondence: (M.-A.G.); (A.A.-Z.)
| | - Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Correspondence: (M.-A.G.); (A.A.-Z.)
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Can Bioactive Food Substances Contribute to Cystic Fibrosis-Related Cardiovascular Disease Prevention? Nutrients 2023; 15:nu15020314. [PMID: 36678185 PMCID: PMC9860597 DOI: 10.3390/nu15020314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Advances in cystic fibrosis (CF) care have significantly improved the quality of life and life expectancy of patients. Nutritional therapy based on a high-calorie, high-fat diet, antibiotics, as well as new therapies focused on CFTR modulators change the natural course of the disease. They do so by improving pulmonary function and growing BMI. However, the increased weight of such patients can lead to unwanted long-term cardiovascular effects. People with CF (pwCF) experience several cardiovascular risk factors. Such factors include a high-fat diet and increased dietary intake, altered lipid metabolism, a decrease in the level of fat-soluble antioxidants, heightened systemic inflammation, therapeutic interventions, and diabetes mellitus. PwCF must pay special attention to food and eating habits in order to maintain a nutritional status that is as close as possible to the proper physiological one. They also have to benefit from appropriate nutritional counseling, which is essential in the evolution and prognosis of the disease. Growing evidence collected in the last years shows that many bioactive food components, such as phytochemicals, polyunsaturated fatty acids, and antioxidants have favorable effects in the management of CF. An important positive effect is cardiovascular prevention. The possibility of preventing/reducing cardiovascular risk in CF patients enhances both quality of life and life expectancy in the long run.
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Chen YC, Li WC, Ke PH, Chen IC, Yu W, Huang HY, Xiong XJ, Chen JY. Association between metabolic body composition status and vitamin D deficiency: A cross-sectional study. Front Nutr 2022; 9:940183. [PMID: 35967768 PMCID: PMC9365955 DOI: 10.3389/fnut.2022.940183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the risk of vitamin D deficiency in a relatively healthy Asian population, with (i) metabolically healthy normal weight (MHNW) (homeostasis model assessment-insulin resistance [HOMA-IR] < 2. 5 without metabolic syndrome [MS], body mass index [BMI] < 25), (ii) metabolically healthy obesity (MHO) (HOMA-IR < 2.5, without MS, BMI ≥ 25), (iii) metabolically unhealthy normal weight (MUNW) (HOMA-IR ≥ 2.5, or with MS, BMI < 25), and (iv) metabolically unhealthy obesity (MUO) (HOMA-IR ≥ 2.5, or with MS, BMI ≥ 25) stratified by age and sex. This cross-sectional study involved 6,655 participants aged ≥ 18 years who underwent health checkups between 2013 and 2016 at the Chang Gung Memorial Hospital. Cardiometabolic and inflammatory markers including anthropometric variables, glycemic indices, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and serum 25-hydroxy vitamin D levels, were retrospectively investigated. Compared to the MHNW group, the MHO group showed a higher odds ratio (OR) [1.35, 95% confidence interval (CI) 1.05-1.73] for vitamin D deficiency in men aged < 50 years. By contrast, in men aged > 50 years, the risk of vitamin D deficiency was higher in the MUO group (OR 1.44, 95% CI 1.05-1.97). Among women aged < and ≥ 50 years, the MUO group demonstrated the highest risk for vitamin D deficiency, OR 2.33 vs. 1.54, respectively. Our study revealed that in women of all ages and men aged > 50 years, MUO is associated with vitamin D deficiency and elevated levels of metabolic biomarkers. Among men aged < 50 years, MHO had the highest OR for vitamin D deficiency.
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Affiliation(s)
- Yi-Chuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan.,Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Pin-Hsuan Ke
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - I-Chun Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Hsiung-Ying Huang
- Department of Pulmonary and Critical Care Medicine, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Xue-Jie Xiong
- Department of Oncology, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
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4
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Shah AK, Dhalla NS. Effectiveness of Some Vitamins in the Prevention of Cardiovascular Disease: A Narrative Review. Front Physiol 2021; 12:729255. [PMID: 34690803 PMCID: PMC8531219 DOI: 10.3389/fphys.2021.729255] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/17/2021] [Indexed: 01/01/2023] Open
Abstract
By virtue of their regulatory role in various metabolic and biosynthetic pathways for energy status and cellular integrity, both hydro-soluble and lipo-soluble vitamins are considered to be involved in maintaining cardiovascular function in health and disease. Deficiency of some vitamins such as vitamin A, B6, folic acid, C, D, and E has been shown to be associated with cardiovascular abnormalities whereas supplementation with these vitamins has been claimed to reduce cardiovascular risk for hypertension, atherosclerosis, myocardial ischemia, arrhythmias, and heart failure. However, the data from several experimental and clinical studies for the pathogenesis of cardiovascular disease due to vitamin deficiency as well as therapy due to different vitamins are conflicting. In this article, we have attempted to review the existing literature on the role of different vitamins in cardiovascular disease with respect to their deficiency and supplementation in addition to examining some issues regarding their involvement in heart disease. Although both epidemiological and observational studies have shown some merit in the use of different antioxidant vitamins for the treatment of cardiovascular disorders, the results are not conclusive. Furthermore, in view of the complexities in the mechanisms of different cardiovascular disorders, no apparent involvement of any particular vitamin was seen in any specific cardiovascular disease. On the other hand, we have reviewed the evidence that deficiency of vitamin B6 promoted KCl-induced Ca2+ entry and reduced ATP-induced Ca2+-entry in cardiomyocytes in addition to decreasing sarcolemmal (SL) ATP binding. The active metabolite of vitamin B6, pyridoxal 5′-phosphate, attenuated arrhythmias due to myocardial infarction (MI) as well as cardiac dysfunction and defects in the sarcoplasmic reticulum (SR) Ca2+-transport in the ischemic-reperfused hearts. These observations indicate that both deficiency of some vitamins as well as pretreatments with different vitamins showing antioxidant activity affect cardiac function, metabolism and cation transport, and support the view that antioxidant vitamins or their metabolites may be involved in the prevention rather than the therapy of cardiovascular disease.
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Affiliation(s)
- Anureet K Shah
- School of Kinesiology, Nutrition and Food Science, California State University, Los Angeles, Los Angeles, CA, United States
| | - Naranjan S Dhalla
- Department of Physiology and Pathophysiology, St. Boniface Hospital Albrechtsen Research Centre, Max Rady College of Medicine, Institute of Cardiovascular Sciences, University of Manitoba, Winnipeg, MB, Canada
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5
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Prasad M, Rajarajeswari D, Aruna P, Ramalingam K, Viswakumar R, Fathima N, Vishwakarma SK, Khan AA. Status of Vitamin D Receptor Gene Polymorphism and 25-Hydroxy Vitamin D Deficiency with Essential Hypertension. Indian J Clin Biochem 2021; 37:335-341. [PMID: 34149207 PMCID: PMC8203720 DOI: 10.1007/s12291-021-00984-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/03/2021] [Indexed: 11/28/2022]
Abstract
Essential hypertension (EH) is a multifactorial and complex disease with high rate of incidence and associated co-morbidities. Previous studies do not provide unanimous results for the risk of hypertension and association with Fok I genotype frequency and serum vitamin D levels. Hence, this study was undertaken to determine the status of Fok I vitamin D receptor (VDR) gene polymorphism along with vitamin D levels and blood pressure in patients with EH. Four hundred (200 controls and 200 cases of essential hypertension) participants from general Indian population were enrolled in this study. Peripheral blood samples were collected for genotyping Fok I-VDR gene polymorphism using PCR–RFLP method whereas 25-OH vitamin D levels in serum were quantified using high performance liquid chromatography (HPLC). Significantly reduced 25-OH vitamin D levels were observed in patients with EH (24.04 ± 8.62 vs 50.46 ± 15.46) compared to control subjects (p = 0.0001). Homozygous recessive genotype ‘ff’ frequency was increased by 8.06 fold (CI: 3.71–17.47, p = 0.0001) in patients with EH compared to dominant ‘FF’ genotype frequency. In conclusion, recessive ‘ff’ genotype frequency correlates with reduced serum vitamin D levels and results in significantly increased systolic and diastolic blood pressures leading to predisposition of EH.
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Affiliation(s)
- M Prasad
- Department of Biochemistry, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - D Rajarajeswari
- Department of Biochemistry, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - P Aruna
- Department of Biochemistry, ACSR Government Medical College, Dargamitta, Nellore, Andhra Pradesh 524004 India
| | - K Ramalingam
- Department of Biochemistry, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - R Viswakumar
- Department of Biochemistry, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - Nusrath Fathima
- Department of Genetics, Osmania University, Hyderabad, Telangana 500007 India
| | - Sandeep Kumar Vishwakarma
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, Telangana 500058 India
| | - Aleem Ahmed Khan
- Central Laboratory for Stem Cell Research and Translational Medicine, Centre for Liver Research and Diagnostics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, Telangana 500058 India
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6
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Andreeva GF, Gorbunov VM. Basic Aspects of Seasonal Cardiovascular Mortality. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2021. [DOI: 10.20996/1819-6446-2021-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The review demonstrates the main aspects of seasonal cardiovascular mortality. Climatic factors, including seasonal weather changes, have a significant impact on the biosphere. People are also characterized by the seasonal dynamics of the activity of many organs and systems, biochemical parameters, and mortality. Cardiovascular mortality is also characterized by seasonal fluctuations: in winter it is maximum, in summer it is minimal. The same patterns are characteristic of mortality from cardiovascular diseases (myocardial infarction, stroke, cardiac arrhythmias, etc.). The article presents the basic patterns of seasonal cardiovascular mortality in various climatic zones, the cardiovascular mortality of countries located in the equatorial and subequatorial climatic region. In addition, the mortality displacement phenomenon, the paradox of winter mortality. The main trends in changes in cardiovascular mortality over a long period of time are demonstrated. The paper discusses some of the mechanisms that underlie the dynamics of cardiovascular mortality during the year: seasonal fluctuations in the level of vitamin D, lipids in the blood plasma, changes in hemodynamic parameters, the effects of microbial and viral infections in the cold season, etc. In addition, data on seasonal the dynamics of risk factors for cardiovascular diseases is considered: an increase in body weight, a physical activity decrease, a change in the nutrition structure in the winter, the seasonal dynamics of depression, anxiety, hostility, the relationship of seasonal cardiovascular mortality with socio-economic, demographic and other factors. In conclusion, the main ways of development and prevention of seasonal CV cardiovascular mortality M, taking into account modern technologies at the international level, for state health departments, for specific patients, are demonstrated.
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Affiliation(s)
- G. F. Andreeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Gorbunov
- National Medical Research Center for Therapy and Preventive Medicine
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7
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Wee CL, Mokhtar SS, Singh KKB, Yahaya S, Leung SWS, Rasool AHG. Calcitriol Supplementation Ameliorates Microvascular Endothelial Dysfunction in Vitamin D-Deficient Diabetic Rats by Upregulating the Vascular eNOS Protein Expression and Reducing Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:3109294. [PMID: 33623633 PMCID: PMC7875614 DOI: 10.1155/2021/3109294] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/14/2020] [Accepted: 01/20/2021] [Indexed: 12/28/2022]
Abstract
Diabetes mellitus contributes to macro- and microvascular complications, leading to adverse cardiovascular events. This study examined the effects of vitamin D deficiency on the vascular function and tissue oxidative status in the microcirculation of diabetic rats and to determine whether these effects can be reversed with calcitriol (active vitamin D metabolite) supplementation. Streptozotocin-induced diabetic rats were fed for 10 weeks with control diet (DC) or vitamin D-deficient diet without (DD) or with oral calcitriol supplementation (0.15 μg/kg) in the last four weeks (DDS) (10 rats each group). A nondiabetic rat group that received control diet was also included (NR). After 10 weeks, rats were sacrificed; mesenteric arterial rings with and without endothelium were studied using wire myograph. Western blotting of the mesenteric arterial tissue was performed to determine the protein expression of endothelial nitric oxide synthase (eNOS) enzyme. Antioxidant enzyme superoxide dismutase (SOD) activity and oxidative stress marker malondialdehyde (MDA) levels in the mesenteric arterial tissue were also measured. The DC group had significantly lower acetylcholine-induced relaxation and augmented endothelium-dependent contraction, with reduced eNOS expression, compared to NR rats. In mesenteric arteries of DD, acetylcholine-induced endothelium-dependent and sodium nitroprusside-induced endothelium-independent relaxations were lower than those in DC. Calcitriol supplementation in DDS restored endothelium-dependent relaxation. Mesenteric artery endothelium-dependent contraction of DD was greater than DC; it was not affected by calcitriol supplementation. The eNOS protein expression and SOD activity were significantly lower while MDA levels were greater in DD compared to DC; these effects were not observed in DDS that received calcitriol supplementation. In conclusion, vitamin D deficiency causes eNOS downregulation and oxidative stress, thereby impairing the vascular function and posing an additional risk for microvascular complications in diabetes. Calcitriol supplementation to diabetics with vitamin D deficiency could potentially be useful in the management of or as an adjunct to diabetes-related cardiovascular complications.
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Affiliation(s)
- Chee Lee Wee
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - Siti Safiah Mokhtar
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - Kirnpal Kaur Banga Singh
- Department of Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - Sahran Yahaya
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
| | - Susan Wai Sum Leung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Aida Hanum Ghulam Rasool
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu, Kelantan, Malaysia
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Wei YX, Dong SM, Wang YY, Zhang P, Sun MY, Wei YX, Meng XC, Wang Y. Autophagy participates in the protection role of 1,25-dihydroxyvitamin D3 in acute myocardial infarction via PI3K/AKT/mTOR pathway. Cell Biol Int 2020; 45:394-403. [PMID: 33146448 DOI: 10.1002/cbin.11495] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 09/09/2020] [Accepted: 10/31/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is associated with acute myocardial infarction (AMI); thus we aimed to explore improvement effects of 1,25-dihydroxyvitamin D3 (VD3) on the AMI and its potential mechanism. AMI models were constructed using male C57/BL6J mice and randomly treated with normal saline or VD3, using sham rats as control. Heart functions, myocardial damage, apoptosis, and inflammation were evaluated. Cardiomyocytes isolated from 3-day-old suckling mice were used for in vitro verification. After VD3 treatment, AMI-induced cardiac dysfunction was reversed with better cardiac function parameters. VD3 treatment reduced inflammatory cell infiltration and myocardial infarction area accompanied by the reduction of inflammatory factors and myocardial infarction markers compared with the AMI group. VD3 treatment obviously alleviated AMI-induced myocardial apoptosis, along with Bcl-2 upregulation and downregulation of caspase-3, caspase-9, and Bax. Both in vivo and in vitro experiments revealed that VD3 enhanced the expression of LC3II and Beclin-1 and decreased soluble p62. Furthermore, VD3 enhanced the AMI-caused inhibition of PI3K, p-AKT, and p-mTOR expression, which was conversely reversed by the addition of 3-methyladenine in vitro. The study highlights the improvement effects of VD3 on cardiac functions. We proposed a potential mechanism that VD3 protects against myocardial damage, inflammation, and apoptosis by promoting autophagy through PI3K/AKT/mTOR pathway.
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Affiliation(s)
- Yun-Xia Wei
- Department of Emergency, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.,Department of Cardiovascular, Shijiazhuang HuaYao Hospital, Shijiazhuang, Hebei, China
| | - Shi-Min Dong
- Department of Emergency, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuan-Yuan Wang
- Department of Respiratory, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Pu Zhang
- Department of Emergency, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ming-Yu Sun
- Department of Cardiovascular, Shijiazhuang HuaYao Hospital, Shijiazhuang, Hebei, China
| | - Yun-Xiao Wei
- Department of Neurology, Shijiazhuang HuaYao Hospital, Shijiazhuang, Hebei, China
| | - Xian-Ce Meng
- Department of Neurology, Shijiazhuang HuaYao Hospital, Shijiazhuang, Hebei, China
| | - Yue Wang
- Department of Respiratory, Shijiazhuang HuaYao Hospital, Shijiazhuang, Hebei, China
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9
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Abstract
The relationship between coronary artery disease (CAD) and low serum 25-hydroxyvitamin D (25(OH)D) levels has emerged. Postmenopausal (PM) women are at increased risk of CAD and vitamin D (VitD) deficiency.To investigate the relationship between CAD and VitD levels in PM women.This case-control study included 93 consecutive female patients aged 50 to 79 years old undergoing coronary angiography for evaluation of CAD and 119 age-matched controls. Serum 25(OH)D concentrations were classed as adequate (serum 25(OH)D: ≥20 ng/mL); insufficient (serum 25(OH)D: 10 to <20 ng/mL); and deficient (serum 25(OH)D: <10 ng/mL). Major cardiovascular risk factors were also explored.CAD occurred in 67/127 (52.8%) patients with VitD deficiency; 21/66 (31.8%) patients that were VitD insufficient; and in 5/19 (26.3%) patients with adequate VitD levels. Multivariate regression analysis suggested that a deficiency of VitD increased CAD (odds ratio = 2.891; 95% confidence interval = 1.459-7.139, P < .001).VitD deficiency should be evaluated in PM women as a possible cause of CAD.
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Affiliation(s)
| | - Yan-Yan Li
- Department of cardiac surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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10
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Therapeutic targets of vitamin D receptor ligands and their pharmacokinetic effects by modulation of transporters and metabolic enzymes. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2019. [DOI: 10.1007/s40005-019-00429-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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11
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Gül SS, Aygün H. Cardioprotective effect of vitamin D and melatonin on doxorubicin-induced cardiotoxicity in rat model: an electrocardiographic, scintigraphic and biochemical study. ACTA ACUST UNITED AC 2018. [DOI: 10.18621/eurj.410029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Identification of Novel Non-secosteroidal Vitamin D Receptor Agonists with Potent Cardioprotective Effects and devoid of Hypercalcemia. Sci Rep 2017; 7:8427. [PMID: 28814738 PMCID: PMC5559458 DOI: 10.1038/s41598-017-08670-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 07/12/2017] [Indexed: 12/22/2022] Open
Abstract
Vitamin D regulates many biological processes, but its clinical utility is limited by its hypercalcemic effect. Using a virtual screening platform to search novel chemical probes that activate the vitamin D signaling, we report discovery of novel non-steroidal small-molecule compounds that activate the vitamin D receptor (VDR), but are devoid of hypercalcemia. A lead compound (known as VDR 4-1) demonstrated potent transcriptional activities in a VDR reporter gene assay, and significantly ameliorated cardiac hypertrophy in cell culture studies and in animal models. VDR 4-1 also effectively suppressed secondary hyperparathyroidism in 1α-hydroxylase knockout mice. In contrast to 1α,25-dihydroxyvitamin D3 (1,25-D3 or calcitriol), a naturally occurring VDR agonist, VDR 4-1 therapy even at high doses did not induce hypercalcemia. These findings were accompanied by a lack of upregulation of calcium transport genes in kidney and in the gut providing a mechanism for the lack of hypercalcemia. Furthermore, VDR 4-1 therapy significantly suppressed cardiac hypertrophy and progression to heart failure in both vitamin D deficient and normal mice without inducing significant hypercalcemia. In conclusion, we have identified a unique VDR agonist compound with beneficial effects in mouse models of hyperparathyroidism and heart failure without inducing significant hypercalcemia.
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13
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Yang J, Zhou M, Ou CQ, Yin P, Li M, Tong S, Gasparrini A, Liu X, Li J, Cao L, Wu H, Liu Q. Seasonal variations of temperature-related mortality burden from cardiovascular disease and myocardial infarction in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 224:400-406. [PMID: 28222981 DOI: 10.1016/j.envpol.2017.02.020] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/10/2017] [Accepted: 02/10/2017] [Indexed: 06/06/2023]
Abstract
Incidence rate of cardiovascular disease (CVD) has significant seasonal trend, being higher in winter. However, the extent to which the seasonal variation of CVD deaths was caused by temperature remains unclear. We obtained daily data on temperature and CVD and myocardial infarction (MI) mortality from nine Chinese mega-cities during 2007-2013. Distributed lag non-linear models were applied to assess the city-specific temperature-related daily excess deaths across lag 0-21 days, using the minimum-mortality temperature as reference. Then, estimates of excess deaths in four seasons were separately aggregated from the daily series, and its ratio to the corresponding total deaths produced seasonal attributable fraction (AF). In total, 1,079,622 CVD and 201,897 MI deaths were recorded in the nine Chinese cities. Significant and non-linear associations between temperature and mortality were observed, with a total of 195,516 CVD and 50,658 MI deaths attributable to non-optimum temperatures. 103,439 (95% empirical CI: 54,475-141,537) CVD and 24,613 (5891-36,279) MI deaths related to non-optimum temperature occurred in winter, compared with 15,923 (1436-28,853) and 4946 (-325-9016) in summer. Temperature-related AFs were higher among MI than CVD, with AFs of 42% (9-62%) and 35% (19-48%) in winter, and 13% (-1-23%) and 8% (1-14%) in summer, respectively. This study may have important implications for developing effective targeted intervention measures on CVD events.
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Affiliation(s)
- Jun Yang
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Maigeng Zhou
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Peng Yin
- The National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing 100050, China
| | - Mengmeng Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences School of Basic Medicine, Peking Union Medical College, Beijing 100005, China
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, Keppel Street WC1E 7HT, London, United Kingdom
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Jing Li
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Lina Cao
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, China
| | - Haixia Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
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14
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Zhao X, Fang R, Yu R, Chen D, Zhao J, Xiao J. Maternal Vitamin D Status in the Late Second Trimester and the Risk of Severe Preeclampsia in Southeastern China. Nutrients 2017; 9:E138. [PMID: 28216561 PMCID: PMC5331569 DOI: 10.3390/nu9020138] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/11/2017] [Accepted: 02/10/2017] [Indexed: 12/13/2022] Open
Abstract
The association between maternal vitamin D deficiency and the risk of severe preeclampsia is still debated. In the present study, we aimed to evaluate vitamin D status in Chinese pregnant women and investigate its correlation with the odds of developing severe preeclampsia. A cohort study was performed on 13,806 pregnant women who routinely visited the antenatal care clinics and subsequently delivered at the Wuxi Maternity and Child Health Hospital. All the subjects in the cohort had their serum 25-hydroxyvitamin D (25(OH)D) concentrations measured during pregnancy. A high prevalence of maternal vitamin D deficiency (25(OH)D < 50 nmol/L) was found. Pregnant women who had different BMIs before pregnancy had significantly different serum concentrations of 25(OH)D. There was also a significant difference in the serum 25(OH)D concentration among pregnant women of different ages. The serum 25(OH)D concentration was significantly lower in pregnant women who subsequently developed severe preeclampsia compared with those who did not. Maternal vitamin D deficiency at 23-28 weeks of gestation was strongly associated with increased odds for severe preeclampsia after adjusting for relevant confounders (adjusted OR, 3.16; 95% CI, 1.77-5.65). Further studies are required to investigate whether vitamin D supplementation would reduce the risk of severe preeclampsia and improve pregnancy outcomes.
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Affiliation(s)
- Xin Zhao
- Department of Obstetrics, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
- Centre for Reproductive Medicine, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Rui Fang
- Centre for Reproductive Medicine, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Renqiang Yu
- Department of Newborn, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Daozhen Chen
- Central Laboratory, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Jun Zhao
- Central Laboratory, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
| | - Jianping Xiao
- Department of Obstetrics, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi 214002, China.
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15
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Aljefree NM, Lee P, Alsaqqaf JM, Ahmed F. Association between Vitamin D Status and Coronary Heart Disease among Adults in Saudi Arabia: A Case-Control Study. Healthcare (Basel) 2016; 4:healthcare4040077. [PMID: 27763496 PMCID: PMC5198119 DOI: 10.3390/healthcare4040077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/27/2016] [Accepted: 10/11/2016] [Indexed: 12/20/2022] Open
Abstract
Recent evidence has pointed out an association between vitamin D deficiency and coronary heart disease (CHD). Due to the growing epidemic of CHD and vitamin D deficiency in Saudi Arabia, exploring the role of vitamin D in the prevention of CHD is crucial. The aim of this study was to examine the association between vitamin D status and CHD in Saudi Arabian adults. This case-control study included 130 CHD cases and 195 age-sex matched controls. Study subjects were recruited from three hospitals in the western region of Saudi Arabia. Study participants were interviewed face-to-face to collect data on their socio-demographic characteristics and family history of CHD. Fasting blood samples were collected, and serum levels of vitamin D, glucose, and total cholesterol were measured. Body weight, height, and blood pressure measurements were also recorded. Severe vitamin D deficiency (25(OH)D < 10 ng/mL) was much more prevalent in CHD cases than in controls (46% and 3%, respectively). The results of multivariate logistic regression showed that vitamin D deficiency (25(OH)D < 20 ng/mL) was associated with CHD, with an odds ratio of 6.5 (95% CI: 2.7-15, p < 0.001). The current study revealed that vitamin D deficiency is independently associated with CHD, suggesting an important predictor of CHD among Saudi adults.
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Affiliation(s)
- Najlaa M Aljefree
- Public Health, School of Medicine and Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia.
| | - Patricia Lee
- Public Health, School of Medicine and Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia.
| | - Jamal M Alsaqqaf
- Department of Cardiology, King Abdulla Medical City (KAMC), Makkah 21955, Saudi Arabia.
| | - Faruk Ahmed
- Public Health, School of Medicine and Menzies Health Institute Queensland, Gold Coast Campus, Griffith University, Southport, QLD 4222, Australia.
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16
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Lee S, Ahuja V, Masaki K, Evans RW, Barinas-Mitchell EJM, Ueshima H, Shin C, Choo J, Hassen L, Edmundowicz D, Kuller LH, Willcox B, Sekikawa A. A Significant Positive Association of Vitamin D Deficiency with Coronary Artery Calcification among Middle-aged Men: For the ERA JUMP Study. J Am Coll Nutr 2016; 35:614-620. [PMID: 27315115 DOI: 10.1080/07315724.2015.1118651] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Although a significant positive association of vitamin D deficiency with coronary heart disease has been demonstrated in cross-sectional as well as prospective studies, only a few studies have examined the association of vitamin D deficiency with subclinical atherosclerosis. We examined whether vitamin D deficiency is associated with subclinical atherosclerosis, as measured by coronary artery calcification (CAC) in asymptomatic adults. METHODS In a population-based cross-sectional study, 195 men aged 40 to 49 years without cardiovascular disease were randomly selected (98 Caucasian and 97 Japanese American men). Liquid chromatography-tandem mass spectrometry was utilized to measure serum vitamin D. CAC was examined by electron beam computed tomography using standardized protocols and read centrally at the University of Pittsburgh using Agatston's methods. To investigate an association between vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] < 20 ng/mL) and CAC (defined as Agatston score ≥ 10), we utilized multivariable logistic regression models. RESULTS Prevalence of CAC and vitamin D deficiency was 27.2% and 10.3%, respectively. Participants with CAC were significantly older, had significantly higher body mass index (BMI), and had higher rates of smoking. Those with CAC were 3.31 times likely to be vitamin D deficient, after adjusting for traditional cardiovascular risk factors (odds ratio [OR] = 3.31, 95% confidence interval [CI], 1.12-9.77). CONCLUSIONS In this population-based study of healthy middle-aged men, vitamin D deficiency had a significant positive association with the presence of CAC.
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Affiliation(s)
- Sunghee Lee
- a Institute of Human Genomic Study, Korea University Ansan Hospital , Ansan , SOUTH KOREA
| | - Vasudha Ahuja
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Kamal Masaki
- d Department of Geriatric Medicine , the John A. Burns School of Medicine, University of Hawaii , Honolulu , Hawaii
| | - Rhobert W Evans
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Emma J M Barinas-Mitchell
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Hirotsugu Ueshima
- e Department of Health Science , Shiga University of Medical Science , Otsu , Shiga , JAPAN
| | - Chol Shin
- b Department of Internal Medicine , Korea University Ansan Hospital , Ansan , SOUTH KOREA
| | - Jina Choo
- g Korea University College of Nursing , Seoul , SOUTH KOREA
| | - Lauren Hassen
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Daniel Edmundowicz
- f Cardiovascular Institute, University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania
| | - Lewis H Kuller
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania
| | - Bradley Willcox
- d Department of Geriatric Medicine , the John A. Burns School of Medicine, University of Hawaii , Honolulu , Hawaii
| | - Akira Sekikawa
- c Department of Epidemiology , Graduate School of Public Health, University of Pittsburgh , Pittsburgh , Pennsylvania.,e Department of Health Science , Shiga University of Medical Science , Otsu , Shiga , JAPAN
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17
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Association of kidney stones with atherosclerotic cardiovascular disease among adults in the United States: Considerations by race-ethnicity. Physiol Behav 2016; 157:63-6. [DOI: 10.1016/j.physbeh.2016.01.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/26/2015] [Accepted: 01/22/2016] [Indexed: 11/17/2022]
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18
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Huang CJ, McAllister MJ, Slusher AL, Webb HE, Mock JT, Acevedo EO. Obesity-Related Oxidative Stress: the Impact of Physical Activity and Diet Manipulation. SPORTS MEDICINE-OPEN 2015; 1:32. [PMID: 26435910 PMCID: PMC4580715 DOI: 10.1186/s40798-015-0031-y] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/11/2015] [Indexed: 01/03/2023]
Abstract
Obesity-related oxidative stress, the imbalance between pro-oxidants and antioxidants (e.g., nitric oxide), has been linked to metabolic and cardiovascular disease, including endothelial dysfunction and atherosclerosis. Reactive oxygen species (ROS) are essential for physiological functions including gene expression, cellular growth, infection defense, and modulating endothelial function. However, elevated ROS and/or diminished antioxidant capacity leading to oxidative stress can lead to dysfunction. Physical activity also results in an acute state of oxidative stress. However, it is likely that chronic physical activity provides a stimulus for favorable oxidative adaptations and enhanced physiological performance and physical health, although distinct responses between aerobic and anaerobic activities warrant further investigation. Studies support the benefits of dietary modification as well as exercise interventions in alleviating oxidative stress susceptibility. Since obese individuals tend to demonstrate elevated markers of oxidative stress, the implications for this population are significant. Therefore, in this review our aim is to discuss (i) the role of oxidative stress and inflammation as associated with obesity-related diseases, (ii) the potential concerns and benefits of exercise-mediated oxidative stress, and (iii) the advantageous role of dietary modification, including acute or chronic caloric restriction and vitamin D supplementation.
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Affiliation(s)
- Chun-Jung Huang
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, 777 Glades Road, FH11A-126B, Boca Raton, FL 33431 USA
| | | | - Aaron L Slusher
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, 777 Glades Road, FH11A-126B, Boca Raton, FL 33431 USA ; Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA USA
| | - Heather E Webb
- Department of Kinesiology, Texas A&M University-Corpus Christi, Corpus Christi, TX USA
| | - J Thomas Mock
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, 777 Glades Road, FH11A-126B, Boca Raton, FL 33431 USA
| | - Edmund O Acevedo
- Department of Kinesiology and Health Sciences, Virginia Commonwealth University, Richmond, VA USA
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19
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Fan Y, Zhang SX, Ren M, Hong LF, Yan XN. Impact of 1, 25-(OH)2D3 on Left Ventricular Hypertrophy in Type 2 Diabetic Rats. ACTA ACUST UNITED AC 2015; 30:114-20. [PMID: 26149003 DOI: 10.1016/s1001-9294(15)30022-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the impact of 1, 25-(OH)2D3 on left ventricular hypertrophy (LVH) in type 2 diabetic rats. METHODS Type 2 diabetic mellitus (DM) model rats were established by intraperitoneally injecting with 30 mg/kg streptozotocin. After 8 weeks, 19 male rats were identified as diabetic with left ventricular hypertrophy (LVH) by ultrasound examination, and randomly assigned into three groups: untreated (DM-LVH, n=7), treated with insulin (DM-LVH+INS, n=6), and treated with 1, 25-(OH)2D3 (DM-LVH+VD, n=6). Healthy male rats were used as the controls group (n=6). The fasting blood glucose and the insulin level were determined weekly. The left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor level were determined by 4 weeks later. RESULTS In the DM-LVH model group, the insulin level was significantly decreased compared with the non-diabetic control group (P<0.05), whereas the blood glucose, left ventricular mass index, myocardial collagen content, collagen volume fraction, and 1, 25-(OH)2D3-receptor expression were significantly increased (all P<0.05). In the DM-LVH+INS and DM-LVH+VD groups, the insulin levels were significantly increased compared with the DM-LVH model group (P<0.05), whereas the other parameters were significantly decreased (all P<0.05). CONCLUSION 1, 25-(OH)2D3 could reverse LVH in diabetic rats and that the mechanism may involve stimulating insulin secretion and reducing blood glucose via direct up-regulation of 1, 25-(OH)2D3-receptor expression.
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Abstract
PURPOSE OF REVIEW To provide an overview of the association between vitamin D deficiency and atherosclerosis. RECENT FINDINGS Vitamin D exerts protective effects on atherosclerosis through multiple mechanisms. It has been shown to protect against endothelial dysfunction, vascular smooth muscle cell proliferation and migration, and modulation of the immune system, as well as the inflammatory response. In addition, vitamin D has been shown to have systemic effects on insulin resistance, dyslipidemia, and hypertension. SUMMARY Vitamin D deficiency is widely prevalent in the United States and worldwide. Although deficiency of this fat-soluble vitamin is usually associated with musculoskeletal disorder, it is associated with a wide range of disease processes that include multiple organ systems. Recently, there has been mounting evidence linking vitamin D deficiency to cardiovascular disease and atherosclerosis.
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21
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Vitamin D for the prevention of cardiovascular disease: Are we ready for that? Atherosclerosis 2015; 241:729-40. [PMID: 26135478 DOI: 10.1016/j.atherosclerosis.2015.06.034] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 06/16/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022]
Abstract
A general concept of clinical benefit of vitamin D supplementation has emerged from the evidence in prevention of osteoporosis. From the cardiovascular point of view, clinical benefit of such supplementation remains less clear. Studies in vitro and in animal models demonstrated the expression of vitamin D receptors in endothelial cells, vascular smooth muscle and cardiomyocytes. Vitamin D has been directly implicated in endothelium-mediated vasodilation, anti-coagulant activity and inhibition of the inflammatory response. Indirectly, it may favor the reduction of blood pressure, myocardial hypertrophy and ventricular arrhythmias. In contrast to these mechanistic findings, cross-sectional, longitudinal and small clinical trials have not been consistent in demonstrating association between cardiovascular events and vitamin D. Besides, methodological issues in the tests for serum levels of vitamin D may also contribute to this puzzle. Hence, in the current state of knowledge, it may be too early to consider or to rule out vitamin D as a tool to either estimate or mitigate residual cardiovascular risk. In this review, we discuss recent advances and potential limitations in mechanistic and clinical evidences that are outlining the framework of interaction between vitamin D and cardiovascular risk.
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22
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Donneyong MM, Hornung CA, Taylor KC, Baumgartner RN, Myers JA, Eaton CB, Gorodeski EZ, Klein L, Martin LW, Shikany JM, Song Y, Li W, Manson JE. Risk of heart failure among postmenopausal women: a secondary analysis of the randomized trial of vitamin D plus calcium of the women's health initiative. Circ Heart Fail 2015; 8:49-56. [PMID: 25398967 PMCID: PMC4303506 DOI: 10.1161/circheartfailure.114.001738] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/30/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND Vitamin D supplementation may be an inexpensive intervention to reduce heart failure (HF) incidence. However, there are insufficient data to support this hypothesis. This study evaluates whether vitamin D plus calcium (CaD) supplementation is associated with lower rates of HF in postmenopausal women and whether the effects differ between those at high versus low risk for HF. METHODS AND RESULTS Analyses were restricted to 35 983 (of original 36 282) women aged 50 to 79 years old in the Women's Health Initiative randomized trial of CaD supplementation who were randomized 1:1 in a double-blinded fashion to receive 1000 mg/d of calcium plus 400 IU/d of vitamin D3 or placebo. Overall, 744 adjudicated incident HF cases (intervention, 363; control, 381) occurred during a median follow-up of 7.1 (interquartile range, 1.6) years. CaD supplementation, compared with placebo, was not associated with reduced HF risk in the overall population, hazard ratio, 0.95; P=0.46. However, CaD supplementation had differential effects (P interaction=0.005) in subgroups stratified by baseline risk status of HF defined by the presence (high risk=17 449) or absence (low risk=18 534) of pre-existing HF precursors including coronary heart diseases, diabetes mellitus, or hypertension: 37% (hazard ratio, 0.63 [95% confidence interval, 0.46-0.87]) lower risk of HF in the low-risk versus hazard ratio, 1.06; P=0.51, in the high-risk subgroups. CONCLUSIONS CaD supplementation did not significantly reduce HF incidence in the overall cohort, however, it was beneficial among postmenopausal women without major HF precursors while of little value in high-risk subgroups. Additional studies are warranted to confirm these findings and investigate the underlying mechanism. CLINICAL TRIAL REGISTRATION URL http://www.clinicaltrials.gov. Unique identifier: NCT00000611.
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Affiliation(s)
- Macarius M Donneyong
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.).
| | - Carlton A Hornung
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Kira C Taylor
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Richard N Baumgartner
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - John A Myers
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Charles B Eaton
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Eiran Z Gorodeski
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Liviu Klein
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Lisa W Martin
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - James M Shikany
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Yiqing Song
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - Wenjun Li
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
| | - JoAnn E Manson
- From the Division of Pharmacoepidemiology and Pharmacoeconomics (M.M.D.) and Department of Medicine (J.E.M.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, School of Public Health and Information Sciences, University of Louisville, KY (M.M.D., C.A.H., K.C.T., R.N.B.); Department of Family Medicine, Brown University School of Medicine, Providence, RI (C.B.E.); Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (E.Z.G.); Division of Cardiology, University of California, San Francisco (L.K.); Heart and Vascular Institute, George Washington University, Washington DC (L.W.M.); Division of Preventive Medicine, University of Alabama, Birmingham (J.M.S.); Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis (Y.S.); and Department of Medicine, University of Massachusetts Medical School, Worcester (W.L.)
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Sedighi M, Haghnegahdar A. Role of vitamin D3 in treatment of lumbar disc herniation--pain and sensory aspects: study protocol for a randomized controlled trial. Trials 2014; 15:373. [PMID: 25257359 PMCID: PMC4190421 DOI: 10.1186/1745-6215-15-373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 09/04/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Vitamin D receptors have been identified in the spinal cord, nerve roots, dorsal root ganglia and glial cells, and its genetic polymorphism association with the development of lumbar disc degeneration and herniation has been documented. Metabolic effects of active vitamin D metabolites in the nucleus pulposus and annulus fibrosus cells have been studied. Lumbar disc herniation is a process that involves immune and inflammatory cells and processes that are targets for immune regulatory actions of vitamin D as a neurosteroid hormone. In addition to vitamin D's immune modulatory properties, its receptors have been identified in skeletal muscles. It also affects sensory neurons to modulate pain. In this study, we aim to study the role of vitamin D3 in discogenic pain and related sensory deficits. Additionally, we will address how post-treatment 25-hydroxy vitamin D3 level influences pain and sensory deficits severity. The cut-off value for serum 25-hydroxy vitamin D3 that would be efficacious in improving pain and sensory deficits in lumbar disc herniation will also be studied. METHODS/DESIGN We will conduct a randomized, placebo-controlled, double-blind clinical trial. Our study population will include 380 cases with one-level and unilateral lumbar disc herniation with duration of discogenic pain less than 8 weeks. Individuals who do not have any contraindications, will be divided into three groups based on serum 25-hydroxy vitamin D3 level, and each group will be randomized to receive either a single-dose 300,000-IU intramuscular injection of vitamin D3 or placebo. All patients will be under conservative treatment. Pre-treatment and post-treatment assessments will be performed with the McGill Pain Questionnaire and a visual analogue scale. For the 15-day duration of this study, questionnaires will be filled out during telephone interviews every 3 days (a total of five times). The initial and final interviews will be scheduled at our clinic. After 15 days, serum 25-hydroxy vitamin D3 levels will be measured for those who have received vitamin D3 (190 individuals). TRIAL REGISTRATION Iranian Registry for Clinical Trials ID: IRCT2014050317534N1 (trial registration: 5 June 2014).
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Affiliation(s)
- Mahsa Sedighi
- Department of Neurosurgery, Shiraz Medical School, Shiraz University of Medical Sciences, PO Box 71345-1536, Shiraz, Iran.
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24
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Abstract
Vitamin D is a hormone with pleiotropic effects. It mainly regulates calcium and phosphate metabolism through interactions with FGF23 and its receptor klotho. In addition, it has been shown that Vitamin D also regulates the immune response and has protective effects from cardiovascular disease, cancer and infections. Most renal transplant recipients have overt Vitamin D deficiency, a condition that may be associated with a decline in graft function and other complications. After kidney transplantation, elevated levels of FGF23 may predict increased risks of death and allograft loss. Theoretically, an optimal Vitamin D supplementation might favor operational tolerance and protect transplant recipients from the triad cardiovascular disease-cancer-infection. However, more solid data are needed to confirm this and to set the optimal level of serum Vitamin D supplementation in order to attain the best clinical outcome.
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Affiliation(s)
- Claudio Ponticelli
- Nephrology and Dialysis Unit, Humanitas Clinical and Research Centre, via Manzoni 56, Rozzano (Mi), Italy
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25
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Dorsch MP, Nemerovski CW, Ellingrod VL, Cowger JA, Dyke DB, Koelling TM, Wu AH, Aaronson KD, Simpson RU, Bleske BE. Vitamin D receptor genetics on extracellular matrix biomarkers and hemodynamics in systolic heart failure. J Cardiovasc Pharmacol Ther 2014; 19:439-45. [PMID: 24500905 DOI: 10.1177/1074248413517747] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Vitamin D deficiency has been associated with the development of myocardial hypertrophy and inflammation. These findings suggest that vitamin D status and vitamin D receptor (VDR) genomics may play a role in myocardial fibrosis. The aim of this pilot study was to determine the association between vitamin D levels, VDR polymorphisms, and biomarkers of left ventricular remodeling and hemodynamics. METHODS In a cross-sectional pilot study, patients with ejection fraction (EF) <40% (and New York Heart Association ≥ II) undergoing right heart catheterization were included in the study. Blood was collected for determination of 25-hydroxyvitamin D level (antibody competitive immunoassay), VDR genotypes (BsmI, ApaI, TaqI, and FokI), and biomarkers (N-terminal propeptide of collagen type III [PIIINP], matrix metalloproteinase 2, and galectin 3). The vitamin D genotypes were determined through the use of pyrosequencing. RESULTS A total of 30 patients with a mean EF of 17% ± 8% were enrolled. There was a significant association between the BsmI C allele, ApaI G allele, and TaqI A allele, which formed a haplotype block (CGA) for analysis. There were no differences in baseline parameters between patients with the VDR haplotype block (n = 20) and those without (n = 10). Individual genotypes were not associated with any biomarker or hemodynamics. Patients with the CGA haplotype demonstrated significantly higher log PIIINP values (1.74 ± 0.32 mcg/mL vs 1.36 ± 0.31 mcg/mL, P = .0041). When evaluating vitamin D levels below and above the median level (19 ng/mL), there was no significant difference between these 2 groups in regard to biomarker levels for left ventricular remodeling. CONCLUSION This study has shown that a biomarker for collagen type III synthesis, PIIINP, was associated with the CGA haplotype of BsmI, ApaI, and TaqI single nucleotide polymorphisms on the VDR. These findings suggest that VDR genetics may play a role in myocardial fibrosis in patients with systolic heart failure.
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Affiliation(s)
- Michael P Dorsch
- Department of Pharmacy Services, University of Michigan Health System, Ann Arbor, Michigan, USA
| | | | - Vicki L Ellingrod
- Department of Clinical and Social Administrative Sciences, University of Michigan, College of Pharmacy, Ann Arbor, MI, USA
| | | | - D Bradley Dyke
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Todd M Koelling
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Audrey H Wu
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Keith D Aaronson
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Health Systems, Ann Arbor, MI, USA
| | - Robert U Simpson
- Department of Pharmacology, University of Michigan, Medical School, Ann Arbor, MI, USA
| | - Barry E Bleske
- Department of Clinical and Social Administrative Sciences, University of Michigan, College of Pharmacy, Ann Arbor, MI, USA
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Association between serum level of vitamin D and lipid profiles in type 2 diabetic patients in Iran. J Diabetes Metab Disord 2014; 13:7. [PMID: 24398023 PMCID: PMC3937161 DOI: 10.1186/2251-6581-13-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 11/26/2013] [Indexed: 01/08/2023]
Abstract
Background It is suggested that vitamin D deficiency is associated with cardiovascular disease (CVD) via its effect on lipid profiles. The objective of this study was to determine the association between fasting serum levels of 25(OH) D and lipid profiles in patients with type 2 diabetes. Methods This cross-sectional study was conducted on 108 type 2 diabetics. Patients were selected randomly among members of the Iranian Diabetes Association according to study criteria. Fasting concentration of 25(OH) D, calcium, phosphorus, parathyroid hormone (PTH) and lipid profiles (including triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and total cholesterol) were measured. Results The mean serum levels of 25-hydroxyvitamin D (25(OH) D) and PTH were 53.41 ± 33.25 nmol/l and 40.24 ± 18.24 pmol/l, respectively, in type 2 diabetic patients. Prevalence of vitamin D deficiency was 58.34% and vitamin D sufficiency and insufficiency combined was 41.66%. Although in diabetic patients with vitamin D deficiency, serum levels of total cholesterol, TG, and LDL were higher and HDL was lower compared to patients with vitamin D sufficiency, this association was statistically significant only for serum level of TG (145.91 ± 79.00 vs. 122.95 ± 55.82 mg/dl). Conclusions The results of present study show that serum concentrations of 25(OH) D were inversely associated with TG. More interventional studies are needed to confirm the relationship between serum concentration of vitamin D and lipid profile in patients with type 2 diabetes.
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Chaudhuri JR, Mridula KR, Alladi S, Anamika A, Umamahesh M, Balaraju B, Swath A, Bandaru VCSS. Serum 25-hydroxyvitamin d deficiency in ischemic stroke and subtypes in Indian patients. J Stroke 2014; 16:44-50. [PMID: 24741564 PMCID: PMC3961818 DOI: 10.5853/jos.2014.16.1.44] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/25/2013] [Accepted: 11/28/2013] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND PURPOSE Vitamin D deficiency is common across all age groups and may contribute to cardiovascular diseases. Serum 25-hydroxyvitamin D deficiency causing ischemic stroke has been documented in recent reports. AIM To investigate the association of serum 25-hydroxyvitamin D deficiency with ischemic stroke and subtypes. METHODS We recruited 250 consecutive ischemic stroke patients and 250 age and sex matched controls attending the Department of Neurology, at Yashoda hospital, Hyderabad, India, from January 2011 to December 2012. All ischemic stroke patients underwent stroke subtyping. We measured 25-hydroxyvitamin D by chemiluminescence test, serum calcium, phosphorus, alkaline phosphatase, and C-reactive protein (CRP) in cases and controls. RESULTS Out of 250 stroke patients, 190 (76%) were men and mean age was 58.4±11.1 years (age range-26-89 years). 25-hydroxyvitamin D deficiency was observed in 122 (48.8%) stroke patients and 79 (31.6%) controls (P=0.001). Among stroke patients, serum 25-hydroxyvitamin D deficiency was found in 54.9% (50/91) of patients with large artery atherosclerosis, 54% (20/37) in cardioembolic stroke, 44.4% (20/45) in small artery diseases, 42.8% (15/35) in stroke of other determined etiology and 40.4% (17/42) in stroke of un-determined etiology. Multiple logistic regression analysis showed an independent association of 25-hydroxyvitamin D deficiency with ischemic stroke (odds ratio: 1.6; 95% CI 1.2-2.8). The association was strongest with large artery atherosclerosis (odds ratio: 2.4; 95% CI 1.6-3.5) and cardioembolic stroke (odds ratio: 2.0; 95% CI 1.0-3.2). CONCLUSIONS We found that 25-hydroxyvitamin D deficiency had an independent association with ischemic stroke. The association was established in large artery arthrosclerosis and cardioembolic stroke.
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Affiliation(s)
| | - K. Rukmini Mridula
- Department of Neurology, Nizam's Institution of Medical Sciences, Hyderabad, India
| | - Suvarna Alladi
- Department of Neurology, Nizam's Institution of Medical Sciences, Hyderabad, India
| | - A. Anamika
- Department of Biochemistry, Yashoda Hospital, Hyderabad, India
| | - M. Umamahesh
- Department of Radiology, Yashoda Hospital Hyderabad, India
| | - Banda Balaraju
- Department of Medicine, Yashoda Hospital, Hyderabad, India
| | - A. Swath
- Department of Neurology, Yashoda Hospital, Hyderabad, India
| | - VCS Srinivasarao Bandaru
- Department of Neurology, Yashoda Hospital, Hyderabad, India
- Department of Clinical Research, Yashoda Hospital, Hyderabad, India
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Brøndum-Jacobsen P, Nordestgaard BG, Nielsen SF, Benn M. Skin cancer as a marker of sun exposure associates with myocardial infarction, hip fracture and death from any cause. Int J Epidemiol 2013; 42:1486-96. [PMID: 24038635 DOI: 10.1093/ije/dyt168] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Sun exposure is the single most important risk factor for skin cancer, but sun exposure may also have beneficial effects on health. We tested the hypothesis that individuals with skin cancer (non-melanoma skin cancer and cutaneous malignant melanoma) have less myocardial infarction, hip fracture and death from any cause, compared with general population controls. METHODS We examined the entire Danish population above age 40 years from 1980 through 2006, comprising 4.4 million individuals. Diagnoses of non-melanoma skin cancer (n=129,206), cutaneous malignant melanoma (n=22,107), myocardial infarction (n=327,856), hip fracture (n=129,419), and deaths from any cause (n=1,629,519) were drawn from national registries. RESULTS In individuals with vs without non-melanoma skin cancer, multifactorially adjusted odds ratios were 0.96 (95% confidence interval: 0.94-0.98) for myocardial infarction and 1.15 (1.12-1.18) for hip fracture, and the multifactorially adjusted hazard ratio was 0.52 (0.52-0.53) for death from any cause. Risk of hip fracture was reduced (odds ratios were below 1.0) in individuals below age 90 years. In individuals with vs without cutaneous malignant melanoma, corresponding odds ratios were 0.79 (0.74-0.84) for myocardial infarction and 0.84 (0.76-0.93) for hip fracture, and the corresponding hazard ratio for death from any cause was 0.89 (0.87-0.91); however, cutaneous malignant melanoma was associated positively with death from any cause in some individuals. CONCLUSIONS In this nationwide study, having a diagnosis of skin cancer was associated with less myocardial infarction, less hip fracture in those below age 90 years and less death from any cause. Causal conclusions cannot be made from our data. A beneficial effect of sun exposure per se needs to be examined in other studies.
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Affiliation(s)
- Peter Brøndum-Jacobsen
- Department of Clinical Biochemistry, Herlev Hospital, Herlev, Denmark, Department of Clinical Biochemistry, Gentofte Hospital, Copenhagen, Denmark and Copenhagen University Hospital and Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Maki KC, Rains TM, Schild AL, Dicklin MR, Park KM, Lawless AL, Kelley KM. Effects of low-fat dairy intake on blood pressure, endothelial function, and lipoprotein lipids in subjects with prehypertension or stage 1 hypertension. Vasc Health Risk Manag 2013; 9:369-79. [PMID: 23901280 PMCID: PMC3726585 DOI: 10.2147/vhrm.s45684] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE This randomized crossover trial assessed the effects of 5 weeks of consuming low-fat dairy (one serving/day each of 1% fluid milk, low-fat cheese, and low-fat yogurt) versus nondairy products (one serving/day each of apple juice, pretzels, and cereal bar) on systolic and diastolic blood pressures (SBP and DBP), vascular function (reactive hyperemia index [RHI] and augmentation index), and plasma lipids. METHODS Patients were 62 men and women (mean age 54.5 years, body mass index 29.2 kg/m(2)) with prehypertension or stage 1 hypertension (mean resting SBP/DBP 129.8 mmHg/80.8 mmHg) while not receiving antihypertensive medications. A standard breakfast meal challenge including two servings of study products was administered at the end of each treatment period. RESULTS Dairy and nondairy treatments did not produce significantly different mean SBP or DBP in the resting postprandial state or from premeal to 3.5 hours postmeal (SBP, 126.3 mmHg versus 124.9 mmHg; DBP, 76.5 mmHg versus 75.7 mmHg), premeal (2.35 versus 2.20) or 2 hours postmeal (2.33 versus 2.30) RHI, and premeal (22.5 versus 23.8) or 2 hours postmeal (12.4 versus 13.2) augmentation index. Among subjects with endothelial dysfunction (RHI ≤ 1.67; n = 14) during the control treatment, premeal RHI was significantly higher in the dairy versus nondairy condition (2.32 versus 1.50, P = 0.002). Fasting lipoprotein lipid values were not significantly different between treatments overall, or in subgroup analyses. CONCLUSION No significant effects of consuming low-fat dairy products, compared with low-fat nondairy products, were observed for blood pressures, measures of vascular function, or lipid variables in the overall sample, but results from subgroup analyses were consistent with the hypothesis that dairy foods might improve RHI in those with endothelial dysfunction.
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Affiliation(s)
- Kevin C Maki
- Biofortis Clinical Research, Addison, IL 60101, USA.
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Abstract
This paper review seasonal patterns across twelve cardiovascular diseases: Deep venous thrombosis, pulmonary embolism, aortic dissection and rupture, stroke, intracerebral hemorrhage, hypertension, heart failure, angina pectoris, myocardial infarction, sudden cardiac death, venricular arrythmia and atrial fibrillation, and discuss a possible cause of the occurrence of these diseases. There is a clear seasonal trend of cardiovascular diseases, with the highest incidence occurring during the colder winter months, which have been described in many countries. This phenomenon likely contributes to the numbers of deaths occurring in winter. The implications of this finding are important for testing the relative importance of the proposed mechanisms. Understanding the influence of season and other factors is essential when seeking to implement effective public health measures.
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Affiliation(s)
- Auda Fares
- Department of Internal Medicine, Uinversity Hospital Bochum, Bedburg, Germany
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Abstract
The authors briefly review the biological effects of vitamin D on the heart and discuss the experimental and clinical studies related to the potential protective effect of vitamin D on the cardiovascular system. Experimental and observational studies in man strongly suggest that vitamin D supplementation can benefit heart failure patients and improve cardiovascular health in the population. However, presently there are limited randomized controlled studies. The authors highlight the hypothesis that vitamin D-induced mechanisms activating calcium channels may represent a novel target for therapy in patients with heart failure.
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Affiliation(s)
- Marcello Camici
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Ronco C, Cozzolino M. Mineral metabolism abnormalities and vitamin D receptor activation in cardiorenal syndromes. Heart Fail Rev 2013; 17:211-20. [PMID: 21327712 DOI: 10.1007/s10741-011-9232-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Over the last decade, it has become increasingly clear that the cardiovascular and renal systems are interdependent. Primary disorders of either system have been shown to disturb the other system. As a result, a class of cardiorenal syndromes (CRS) has been identified wherein a vicious cycle is established as an acute/chronic dysfunction of either the kidney or the heart exacerbates the loss of function in the other organ. Progressive loss of kidney function observed in patients with CRS (mostly types 2 and 4) leads to reduced production of calcitriol (active vitamin D) and an imbalance in calcium and phosphorus levels, which are correlated with increased rates of cardiovascular events and mortality. In addition, hypocalcemia can lead to prolonged and excessive secretion of parathyroid hormone (PTH), eventually leading to development of secondary hyperparathyroidism. Therefore, based on this important mechanism of organ damage, one of the major goals of therapy for patients with CRS is to restore regulatory control of PTH. Although administration of calcitriol increases serum calcium levels and reduces PTH levels, it is also associated with elevated serum levels of calcium-phosphorus product. Therefore, compounds that selectively activate vitamin D receptors, potentially reducing calcium × phosphate toxicity, are likely to enhance cardiorenal protection and provide significant clinical benefit.
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Affiliation(s)
- Claudio Ronco
- Department of Nephrology Dialysis and Transplantation, International Renal Research Institute, Ospedale San Bortolo-ULSS 6, Viale Rodolfi 37, 36100 Vicenza, Italy.
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Cheng KH, Huang SP, Huang CN, Lee YC, Chu CS, Chang CF, Lai WT, Liu CC. The impact of estradiol and 1,25(OH)2D3 on metabolic syndrome in middle-aged Taiwanese males. PLoS One 2013; 8:e60295. [PMID: 23555948 PMCID: PMC3610656 DOI: 10.1371/journal.pone.0060295] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 02/26/2013] [Indexed: 12/24/2022] Open
Abstract
In addition to adipocytokines, estradiol (E2) and vitamin D have been reported to affect insulin sensitivity, glucose homeostasis and body weight. However, studies about the impact of E2 and vitamin D on metabolic syndrome (MetS) are still limited. The aim of this study is to clarify the roles of circulating E2 and vitamin D on the risk of MetS in middle-aged Taiwanese males. A total of 655 male volunteers, including 243 subjects with MetS (mean age: 56.7±5.8 years) and 412 normal controls (mean age: 55.1±3.6 years), were evaluated. Subjects with MetS had significantly lower circulating E2, 1,25(OH)2D3, and adiponectin, and higher leptin than those without MetS (P<0.001 for all comparisons). E2 and 1,25(OH)2D3 were significantly associated with 4 individual components of MetS; more than adiponectin and leptin that were only associated with 3 individual components. In multivariate regression analysis, E2 (beta = −0.216, P<0.001) and 1,25(OH)2D3 (beta = 0.067, P = 0.045) were still significant predictors of MetS independent of adiponectin and leptin. Further large studies are needed to confirm our preliminary results and elucidate the possible mechanism.
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Affiliation(s)
- Kai-Hung Cheng
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chun-Nung Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Chin Lee
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Sheng Chu
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chu-Fen Chang
- Department of Physical Therapy, Tzu Chi University, Hualien, Taiwan
| | - Wen-Ter Lai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (WTL); (CCL)
| | - Chia-Chu Liu
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Pingtung Hospital, Department of Health, Executive Yuan, Pingtung, Taiwan
- * E-mail: (WTL); (CCL)
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Ferder M, Inserra F, Manucha W, Ferder L. The world pandemic of vitamin D deficiency could possibly be explained by cellular inflammatory response activity induced by the renin-angiotensin system. Am J Physiol Cell Physiol 2013; 304:C1027-39. [PMID: 23364265 DOI: 10.1152/ajpcell.00403.2011] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This review attempts to show that there may be a relationship between inflammatory processes induced by chronic overstimulation of the renin-angiotensin system (RAS) and the worldwide deficiency of vitamin D (VitD) and that both disorders are probably associated with environmental factors. Low VitD levels represent a risk factor for several apparently different diseases, such as infectious, autoimmune, neurodegenerative, and cardiovascular diseases, as well as diabetes, osteoporosis, and cancer. Moreover, VitD insufficiency seems to predispose to hypertension, metabolic syndrome, left ventricular hypertrophy, heart failure, and chronic vascular inflammation. On the other hand, inappropriate stimulation of the RAS has also been associated with the pathogenesis of hypertension, heart attack, stroke, and hypertrophy of the left ventricle and vascular smooth muscle cells. Because VitD receptors (VDRs) and RAS receptors are almost distributed in the same tissues, a possible link between VitD and the RAS is even more plausible. Furthermore, from an evolutionary point of view, both systems were developed simultaneously, actively participating in the regulation of inflammatory and immunological mechanisms. Changes in RAS activity and activation of the VDR seem to be inversely related; thus any changes in one of these systems would have a completely opposite effect on the other, making it possible to speculate that the two systems could have a feedback relationship. In fact, the pandemic of VitD deficiency could be the other face of increased RAS activity, which probably causes lower activity or lower levels of VitD. Finally, from a therapeutic point of view, the combination of RAS blockade and VDR stimulation appears to be more effective than either RAS blockade or VDR stimulation individually.
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Affiliation(s)
- Marcelo Ferder
- Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
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Schierbeck LL, Rejnmark L, Tofteng CL, Stilgren L, Eiken P, Mosekilde L, Køber L, Jensen JEB. Vitamin D deficiency in postmenopausal, healthy women predicts increased cardiovascular events: a 16-year follow-up study. Eur J Endocrinol 2012; 167:553-60. [PMID: 22875588 DOI: 10.1530/eje-12-0283] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate the relationship between vitamin D status in healthy women and cardiovascular outcome. DESIGN AND METHODS Between 1990 and 1993, 2016 healthy, recently postmenopausal women were enrolled in the Danish Osteoporosis Prevention Study. Serum levels of 25-hydroxyvitamin D (25(OH)D, nmol/l) were measured at baseline. Participants were followed for 16 years. The primary end point was a combination of death, heart failure, myocardial infarction (MI) and stroke. Vitamin D deficiency was defined as serum 25(OH)D<50 nmol/l. The primary end point was adjusted for other risk factors of adverse cardiovascular events (age, smoking, blood pressure, hip-waist ratio, education and family history of MI). RESULTS At baseline, mean age was 50 years and BMI 25. Women with vitamin D deficiency (n=788) had more cardiovascular risk factors than vitamin D-replete women (n=1225). Compared with vitamin D-replete women, women with low 25(OH)D levels had significantly higher BMI and triglycerides, lower HDL and hip-waist ratio and less education. More were smokers among the vitamin D deficient (47 vs 38%). A primary end point was experienced by 118 (15%) with vitamin D deficiency and by 125 (10%) of the vitamin D replete. Hazard ratio (HR) was 1.49 (95% confidence interval: 1.16-1.92; P=0.002) in the vitamin D deficient. Adjusted HR was 1.32 (1.02-1.71; P=0.03). In total, 135 women died; of these, 65 (8%) were of the vitamin D deficient and 70 (6%) in the vitamin D-replete group; unadjusted HR was 1.44 (1.02-2.01; P=0.04) for vitamin D deficiency. CONCLUSION Healthy women with vitamin D deficiency have increased risk of adverse cardiovascular outcome.
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Affiliation(s)
- Louise Lind Schierbeck
- Department of Endocrinology, Hvidovre Hospital, afd. 541, Kettegård alle 30, 2650 Hvidovre, Denmark.
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McKeag NA, McKinley MC, Woodside JV, Harbinson MT, McKeown PP. The role of micronutrients in heart failure. J Acad Nutr Diet 2012; 112:870-86. [PMID: 22709814 DOI: 10.1016/j.jand.2012.01.016] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 01/19/2012] [Indexed: 02/07/2023]
Abstract
Heart failure is a common condition in the Western world, particularly among elderly persons and with an ever-aging population, the incidence is expected to increase. Diet in the setting of heart failure is important--patients with this condition are advised to consume a low-salt diet and monitor their weight closely. Nutritional status of patients with heart failure also is important--those with poor nutritional status tend to have a poor long-term prognosis. A growing body of evidence suggests an association between heart failure and micronutrient status. Reversible heart failure has been described as a consequence of severe thiamine and selenium deficiency. However, contemporary studies suggest that a more subtle relationship may exist between micronutrients and heart failure. This article reviews the existing literature linking heart failure and micronutrients, examining studies that investigated micronutrient intake, micronutrient status, and the effect of micronutrient supplementation in patients with heart failure, and focusing particularly on vitamin A, vitamin C, vitamin E, thiamine, other B vitamins, vitamin D, selenium, zinc, and copper.
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Affiliation(s)
- Nicholas A McKeag
- Centre for Public Health, Queen’s University Belfast, Institute of Clinical Science B, Belfast, United Kingdom.
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Whayne TF. Vitamin d: popular cardiovascular supplement but benefit must be evaluated. Int J Angiol 2012; 20:63-72. [PMID: 22654467 DOI: 10.1055/s-0031-1279679] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Vitamin D deficiency is prevalent in the United States. Understanding any relationship between this deficiency and cardiovascular disease is essential. Vitamin D, as used, refers to both D(2) and D(3); both are present in over-the-counter supplements, whereas D(2) is the prescription product in the United States. In the liver, both D(2) and D(3) are converted to 25-hydroxyvitamin D, the major circulating metabolite that is measured to assess activity. The actual active form at a cellular level is 1,25-dihydroxyvitamin D; however, it does not correlate well with overall activity. Estimated vitamin D deficiency is, at times, more than 50%. Despite absence of placebo-controlled randomized trials, much information associates vitamin D deficiency with cardiovascular risk and supports benefit from vitamin D supplementation. There are also reports that explain how this benefit from vitamin D may occur. Vitamin D appears to cause only minimal changes in low- and high-density lipoprotein levels. Therefore, any cardiovascular benefit that may exist from vitamin D probably has an explanation other than an effect on levels of these lipoproteins. There is more association of vitamin D deficiency with metabolic syndrome components such as an increase in blood pressure, elevated plasma triglycerides, and impaired insulin metabolism. Possible documentation of cardiovascular benefit from vitamin D includes some evidence for endothelial stabilization and decreased inflammation in arteries. If the clinician decides that recommendation of vitamin D supplementation is warranted, it is reassuring that toxicity is rare. Furthermore, this toxicity involves doses exceeding those of most clinical trials and mainly has involved hypercalcemia. Vitamin D supplementation is easy and can be taken as a dose of 2000 IU daily on an indefinite basis. In 1997, the Food and Nutrition Board of the U.S. Institute of Medicine considered this the safe tolerable upper limit, but this is not based on current evidence. Some practitioners, especially endocrinologists, recommend vitamin D at a dose of 50,000 IU per week for 8 weeks, repeated if necessary to achieve a normal level of vitamin D. It appears appropriate to assess low vitamin D as a possible cardiovascular risk factor, but potential benefit of supplementation must be weighed against the current absence of definitive outcomes studies.
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Affiliation(s)
- Thomas F Whayne
- Professor of Medicine (Cardiology), Gill Heart Institute, University of Kentucky, Lexington, KY
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Chaudhari SA, Sacerdote A, Bahtiyar G. 1-α hydroxylation defect in postural orthostatic tachycardia syndrome: remission with calcitriol supplementation. BMJ Case Rep 2012; 2012:bcr.02.2012.5730. [PMID: 22891006 DOI: 10.1136/bcr.02.2012.5730] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 37-year-old woman presented with a history of reactive hypoglycaemia, non-classic adrenal hyperplasia (NCAH), osteopenia and fibromyalgia. After several months of palpitations, postural orthostatic tachycardia syndrome (POTS) was diagnosed by tilt table studies. Her heart rate (HR) reached 191 bpm at 60 degrees from horizontal. Investigation suggested increase in epinephrine and norepinephrine levels in response to tilt table. Her 25(OH) vitamin D level measured by immunoextraction radioimmunoassay was 35 pg/ ml (normal 9-54 pg/ml) while her 1,25(OH)(2) vitamin D3 level was 24 pg/ml (normal 30-67 pg/ml). Accordingly, she was started on calcitriol 0.25 mcg orally daily. At her next visit after 5 months, she reported remarkable improvement in her palpitations and had been working full time for the past 4 months. HR both seated and upright was 72 bpm. After 3 months, her 1,25(OH)(2) vitamin D3 level on calcitriol was 40 pg/ml. The authors suggest that 1-α hydroxylation defects should be sought and treated, if present, with calcitriol in patients with POTS.
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Jorgensen MJ, Rudel LL, Nudy M, Kaplan JR, Clarkson TB, Pajewski NM, Schnatz PF. 25(OH)D3 and cardiovascular risk factors in female nonhuman primates. J Womens Health (Larchmt) 2012; 21:959-65. [PMID: 22876774 DOI: 10.1089/jwh.2011.3416] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine if interindividual differences in plasma concentrations of 25-hydroxyvitamin D(3) (25(OH)D(3)) have pathophysiologic significance, we evaluated a cohort of female monkeys, seeking to identify associations with clinically relevant cardiovascular risk factors, including age, abdominal obesity (waist circumference), and high-density lipoprotein cholesterol (HDL-C). METHODS One hundred fifty-five female vervet monkeys (Chlorocebus aethiops sabaeus) aged 3-25 years consumed a typical western diet for 7-8 weeks that provided a woman's equivalent of approximately 1000 IU/day of vitamin D(3). Measurements of vitamin D(3) and HDL-C concentrations, as well as waist circumference, were obtained. RESULTS Among young monkeys (aged 3-5 years), compared to older monkeys (aged 16-25 years), the mean plasma 25(OH)D(3) concentrations were 82.3±3.2 ng/mL and 58.6±2.9 ng/mL (p<0.0001), respectively. Plasma 25(OH)D(3) concentrations had a range of 19.6-142.0 ng/mL (mean±standard error [SE] 66.4±1.7 ng/mL). 25(OH)D(3) concentrations were inversely associated with age (p<0.0001) and waist circumference (p=0.016) and were positively correlated with HDL-C (p=0.01). However, when statistically controlling for age, none of these relationships remained significant. CONCLUSIONS Higher plasma concentrations of 25(OH)D(3) were associated with more favorable cardiovascular risk factors, with inverse associations observed between 25(OH)D(3) and abdominal obesity, HDL-C, and age. These associations were no longer significant when controlling for age.
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Affiliation(s)
- Matthew J Jorgensen
- Department of Pathology/Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Whayne TF, Maulik N. Nutrition and the healthy heart with an exercise boost. Can J Physiol Pharmacol 2012; 90:967-76. [DOI: 10.1139/y2012-074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In this era of potent medications and major cardiovascular (CV) procedures, the value of nutrition can be forgotten. A healthy diet is essential, regardless of CV risk. Caloric balance is inherent to a good diet. Despite patients who say they eat little, ideal weight can be maintained if calories are burned. Composition is another component of a healthy diet. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets provide proof of CV benefit from their specific content. Metabolic syndrome (MS) is associated with poor diet and obesity. A healthy diet with good nutrition benefits the MS patient and associated conditions such as obesity and diabetes. Exercise, in conjunction with a healthy diet and good nutrition, helps maintain optimal weight and provides CV benefit such as decreased inflammation and increased vasodilatation. Whether vitamins or other nutritional supplements are important in a healthy diet is unproven. Nevertheless, the most promising data of added benefit to a healthy diet is with vitamin D. Some dietary supplements also have promise. Alcohol, in moderation, especially red wine, has nutritional and heart protective benefits. Antioxidants, endogenous or exogenous, have received increased interest and appear to play a favorable nutritional role. CV health starts with good nutrition.
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Affiliation(s)
- Thomas F. Whayne
- Gill Heart Institute, University of Kentucky, 326 Wethington Building, 900 South Limestone Street, Lexington, KY 40536-0200, USA
| | - Nilanjana Maulik
- Molecular Cardiology and Angiogenesis Laboratory, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-1110, USA
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Shor R, Tirosh A, Shemesh L, Krakover R, Bar Chaim A, Mor A, Boaz M, Golik A. 25 hydroxyvitamin D levels in patients undergoing coronary artery catheterization. Eur J Intern Med 2012; 23:470-3. [PMID: 22726379 DOI: 10.1016/j.ejim.2012.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Revised: 01/12/2012] [Accepted: 01/23/2012] [Indexed: 12/20/2022]
Abstract
INTRODUCTION A growing body of evidence suggests that vitamin D deficiency is associated with increased cardiovascular morbidity and mortality. The present study assessed the association between low serum 25-hydroxyvitamin D (25(OH)D) and coronary artery disease status defined by coronary catheterization findings. METHODS An observational study of 101 consecutive patients admitted to Assaf Harofeh Medical Center during 2009, and scheduled to undergo coronary catheterization was undertaken. Blood was collected for parathyroid hormone, 25(OH)D and high sensitivity C reactive protein (hsCRP). 25(OH)D deficiency was defined as <20 ng/ml. Patients were divided into two groups: patients with normal or non-significant coronary artery disease and patients with a significant coronary artery disease as found during cardiac catheterization. Logistic regression model was used to compare pathological coronary catheterization findings, including 25(OH)D levels dichotomized to low (serum 25(OH)D levels<20 ng/ml) vs. high (serum 25(OH)D levels ≥ 20 ng/ml) and other confounders. RESULTS Patients with pathological coronary catheterization had 25(OH)D deficiency (75% vs 55.1%, p=0.036). Pathological coronary catheterization was more prevalent among patients with 25(OH)D deficiency (Odds ratio (OR) 2.44, 95% confidence interval (CI) 1.05-5.68, p=0.038). This difference was more pronounced after controlling for sex, age, BMI, ethnicity and present smoking (OR 2.92, 95% CI 1.01-8.46, p=0.016). CONCLUSIONS 25(OH)D deficiency is significantly associated with pathological cardiac catheterization findings. This association is strengthened further by controlling for other cardiovascular disease risk factors.
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Affiliation(s)
- R Shor
- Internal Medicine A Department, Assaf-Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Israel.
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Abstract
PURPOSE OF REVIEW To offer a comprehensive overview of the best available evidence linking vitamin D status, including the effect of vitamin D supplementation, to the risk of cardiovascular events. RECENT FINDINGS There is an abundance of plausible mechanisms by which vitamin D might have a favorable effect on the cardiovascular risk profile in the general population. Epidemiological data strongly support such beneficial effects of vitamin D, but initial enthusiasm is giving way to skepticism as larger, well conducted, longitudinal observational trials fail to show an association between serum vitamin D levels and mortality from cardiovascular events. Moreover, the few existing prospective randomized controlled trials with vitamin D supplementation that report the incidence of cardiovascular events show no effect. Fortunately, larger and better designed prospective trials are underway. Nonetheless, one should also acknowledge that true vitamin D deficiency [<25 nmol/l (10 ng/ml)] remains prevalent in the general population and is convincingly associated with overall adverse outcomes. SUMMARY Currently, robust clinical data are lacking to support raising intake requirements and target vitamin D plasma levels based on a role for vitamin D in preventing cardiometabolic diseases. Nonetheless, the high prevalence of vitamin D deficiency in the general population remains alarming and requires implementation of clear supplementation guidelines.
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Affiliation(s)
- Bart J Van der Schueren
- Laboratory and Clinic of Experimental Medicine and Endocrinology, University Hospital Leuven, Catholic University of Leuven, Leuven, Belgium
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Simpson RU. Selective knockout of the vitamin d receptor in the heart results in cardiac hypertrophy: is the heart a drugable target for vitamin D receptor agonists? Circulation 2011; 124:1808-10. [PMID: 22025636 DOI: 10.1161/circulationaha.111.061234] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Bertone-Johnson ER, Powers SI, Spangler L, Brunner RL, Michael YL, Larson JC, Millen AE, Bueche MN, Salmoirago-Blotcher E, Liu S, Wassertheil-Smoller S, Ockene JK, Ockene I, Manson JE. Vitamin D intake from foods and supplements and depressive symptoms in a diverse population of older women. Am J Clin Nutr 2011; 94:1104-12. [PMID: 21865327 PMCID: PMC3173027 DOI: 10.3945/ajcn.111.017384] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Vitamin D may plausibly reduce the occurrence of depression in postmenopausal women; however, epidemiologic evidence is limited, and few prospective studies have been conducted. OBJECTIVE We conducted a cross-sectional and prospective analysis of vitamin D intake from foods and supplements and risk of depressive symptoms. DESIGN Study participants were 81,189 members of the Women's Health Initiative (WHI) Observational Study who were aged 50-79 y at baseline. Vitamin D intake at baseline was measured by food-frequency and supplement-use questionnaires. Depressive symptoms at baseline and after 3 y were assessed by using the Burnam scale and current antidepressant medication use. RESULTS After age, physical activity, and other factors were controlled for, women who reported a total intake of ≥800 IU vitamin D/d had a prevalence OR for depressive symptoms of 0.79 (95% CI: 0.71, 0.89; P-trend < 0.001) compared with women who reported a total intake of <100 IU vitamin D/d. In analyses limited to women without evidence of depression at baseline, an intake of ≥400 compared with <100 IU vitamin D/d from food sources was associated with 20% lower risk of depressive symptoms at year 3 (OR: 0.80; 95% CI: 0.67, 0.95; P-trend = 0.001). The results for supplemental vitamin D were less consistent, as were the results from secondary analyses that included as cases women who were currently using antidepressant medications. CONCLUSIONS Overall, our findings support a potential inverse association of vitamin D, primarily from food sources, and depressive symptoms in postmenopausal women. Additional prospective studies and randomized trials are essential in establishing whether the improvement of vitamin D status holds promise for the prevention of depression, the treatment of depression, or both.
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Dinizulu T, Griffin D, Carey J, Mulkerrin E. Vitamin D supplementation versus combined calcium and vitamin D in older female patients - an observational study. J Nutr Health Aging 2011; 15:605-8. [PMID: 21968853 DOI: 10.1007/s12603-011-0094-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In most developed countries overt vitamin D deficiency, characterized by rickets or osteomalacia, is now uncommon. However, subclinical vitamin D insufficiency is extremely common and may contribute to the development of skeletal and non-skeletal problems. Standard practice involves supplementation with a combination of vitamin D and calcium although the benefit of adding calcium to vitamin D supplements has not been fully established and may reduce adherence due to its bulky and chalky consistency. PURPOSE OF STUDY To compare the effects of vitamin D alone versus vitamin D/calcium supplements on vitamin D levels, bone profile and parathyroid hormone level. POPULATION Older (> 65 years) female patients living in the community and long term care institutions. INTERVENTIONS Either 800 iu of vitamin D3 or a composite supplement of 800 iu vitamin D3 and 1000 mg calcium were given to patients in an open-labelled observational study. Serum 25-hydroxy-vitamin D, parathyroid hormone, calcium, phosphate and alkaline phosphatase levels were assessed at baseline and after 3 months of treatment. RESULTS Serum 25-hydroxy-vitamin D levels rose from baseline levels of 25 ± 16 to 79 ± 16 in those treated with vitamin D alone and from 35 ± 24 nmol/L to 70 ± 24 nmol/L in those treated with vitamin D and calcium. Serum PTH levels fell by similar amounts in both groups. In both community dwellers and institutionalised patients, those treated with vitamin D alone were at least as likely to achieve normalisation of serum vitamin D levels as those on combined calcium/vitamin D treatment. CONCLUSION Vitamin D alone appears as effective as combined calcium/vitamin D treatment in restoring serum vitamin D levels in older community dwelling and institutionalised patients. A prospective randomised trial would help confirm these findings.
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Affiliation(s)
- T Dinizulu
- Department of Medicine for the Elderly, University Hospital Galway
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Brock KE, Huang WY, Fraser DR, Ke L, Tseng M, Mason RS, Stolzenberg-Solomon RZ, Freedman DM, Ahn J, Peters U, McCarty C, Hollis BW, Ziegler RG, Purdue MP, Graubard BI. Diabetes prevalence is associated with serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in US middle-aged Caucasian men and women: a cross-sectional analysis within the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Br J Nutr 2011; 106:339-44. [PMID: 21736838 PMCID: PMC3515777 DOI: 10.1017/s0007114511001590] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hypovitaminosis D may be associated with diabetes, hypertension and CHD. However, because studies examining the associations of all three chronic conditions with circulating 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)(2)D) are limited, we examined these associations in the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial (n 2465). Caucasian PLCO participants selected as controls in previous nested case-control studies of 25(OH)D and 1,25(OH)(2)D were included in this analysis. Diabetes, CHD and hypertension prevalence, risk factors for these conditions and intake of vitamin D and Ca were collected from a baseline questionnaire. Results indicated that serum levels of 25(OH)D were low (< 50 nmol/l) in 29 % and very low (< 37 nmol/l) in 11 % of subjects. The prevalence of diabetes, hypertension and CHD was 7, 30 and 10 %, respectively. After adjustment for confounding by sex, geographical location, educational level, smoking history, BMI, physical activity, total dietary energy and vitamin D and Ca intake, only diabetes was significantly associated with lower 25(OH)D and 1,25(OH)(2)D levels. Caucasians who had 25(OH)D ≥ 80 nmol/l were half as likely to have diabetes (OR 0·5 (95 % CI 0·3, 0·9)) compared with those who had 25(OH)D < 37 nmol/l. Those in the highest quartile of 1,25(OH)(2)D (≥ 103 pmol/l) were less than half as likely to have diabetes (OR 0·3 (95 % CI 0·1, 0·7)) than those in the lowest quartile (< 72 pmol/l). In conclusion, the independent associations of 25(OH)D and 1,25(OH)(2)D with diabetes prevalence in a large population are new findings, and thus warrant confirmation in larger, prospective studies.
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Affiliation(s)
- Kaye E Brock
- Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia.
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Tare M, Emmett SJ, Coleman HA, Skordilis C, Eyles DW, Morley R, Parkington HC. Vitamin D insufficiency is associated with impaired vascular endothelial and smooth muscle function and hypertension in young rats. J Physiol 2011; 589:4777-86. [PMID: 21807617 DOI: 10.1113/jphysiol.2011.214726] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Increasing evidence links vitamin D deficiency and cardiovascular dysfunction in human adults. There is a worldwide increase in the prevalence of vitamin D deficiency in women of reproductive age, particularly dark-skinned and/or veiled women and their infants. We used a rat model to determine the functional impact of vitamin D deficiency during intra uterine and early life on resistance artery reactivity and blood pressure in the offspring as young adults. Rat dams were maintained on vitamin D deficient or replete chow before and during pregnancy and lactation. The offspring were maintained on the same chow until studied at 7-8 weeks of age. Conscious blood pressure was measured. Endothelial and smooth muscle function were tested in mesenteric arteries on a pressure myograph. Vitamin D deficient male and female offspring had a 10-fold lower serum 25-hydroxyvitamin D (P < 0.0001) and markedly elevated blood pressures (11-20 mmHg, P < 0.001) and heart rates (21-40 beats min(-1), P < 0.02) than control fed offspring. Serum calcium was unchanged. Mesenteric artery myogenic tone was doubled in vitamin D deficiency. Endothelium-derived nitric oxide-evoked dilation was halved in arteries from vitamin D deficient males and dioestrous females. Dilation attributed to endothelium-derived hyperpolarizing factor was all but abolished in vitamin D deficient oestrous females. Nitroprusside-evoked dilation was unaltered in arteries from males, but was markedly reduced in vessels of vitamin D deplete females. In conclusion, early life vitamin D deficiency is associated with endothelial vasodilator dysfunction, and this is likely to contribute to the accompanying elevation in blood pressure and an increased cardiovascular disease risk.
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Affiliation(s)
- Marianne Tare
- Department of Physiology, Monash University, Victoria 3800, Australia
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Moyano Peregrín C, López Rodríguez F, Castilla Castellano MDM. [Vitamin D and hypertension]. Med Clin (Barc) 2011; 138:397-401. [PMID: 21703643 DOI: 10.1016/j.medcli.2011.04.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 04/13/2011] [Accepted: 04/14/2011] [Indexed: 12/19/2022]
Abstract
Low levels of vitamin D, defined as levels of 25-hydroxyvitamin D < 20-30 ng/ml, is a prevalent problem in the general population. Besides the classic relation with musculoskeletal disease, vitamin D has been also related to autoimmune diseases, cancer, metabolic diseases or cardiovascular diseases. High blood pressure, as the main cardiovascular risk factor, also has been related to vitamin D deficiency, constituting two prevalent worldwide health problems. Therefore, this article reviews the most important studies that combine both pathologies, the biological mechanism that relate them and the current evidence about the effect of vitamin D supplementation on hypertension.
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Molinari C, Uberti F, Grossini E, Vacca G, Carda S, Invernizzi M, Cisari C. 1α,25-dihydroxycholecalciferol induces nitric oxide production in cultured endothelial cells. Cell Physiol Biochem 2011; 27:661-8. [PMID: 21691084 DOI: 10.1159/000330075] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2011] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Recently, 1α,25-dihydroxycholecalciferol (vitD) has received increasing interest for its effects on many tissues and organs other than bone. A number of experimental studies have shown that vitD may have an important role in modifying risk for cardiovascular disease. AIMS This study was planned to test the effects of vitD on endothelial nitric oxide (NO) production and to study the intracellular pathways leading to NO release. METHODS In human umbilical vein endothelial cells (HUVEC) cultures the effects of vitD on NO production and p38, Akt, ERK and eNOS phosphorylations were examined in absence or in presence of the NO synthase inhibitor L-NAME and protein kinases specific inhibitors SB203580, wortmannin and UO126. RESULTS VitD caused a concentration-dependent increase in NO production. The maximum effect was observed at a concentration of 1 nM and the optimal time of stimulation was 1 min. Effects induced by vitD were abolished by L-NAME and by pre-treatment with protein kinases inhibitors. To verify the effective involvement of vitD receptor (VDR) in the action mechanism of vitD, experiments were repeated in presence of the specific VDR ligands ZK159222 and ZK191784. CONCLUSIONS The results of this study demonstrate that vitD can induce a significant increase in endothelial NO production. VitD interaction with VDR caused the phosphorylation of p38, AKT and ERK leading to eNOS activation.
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Affiliation(s)
- Claudio Molinari
- Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy.
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Abstract
Evolving data indicate that vitamin D deficiency is associated with an increased risk of cardiovascular disease (CVD). The purpose of this article is to increase NPs' awareness of the link between vitamin D deficiency and CVD, and to assist with recommendations for screening and treatment in at-risk patients.
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