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Zhang H, Wang J, Meng X, Shu B, Yuan C, Xie X, Liao Z, Jiang X, Chen B, Lin X, Wei X, Leng X, Lu S, Shi Q, Kan H, Tang D, Cai J, Wang Y. Parathyroid hormone mediates the adverse impact of air pollution exposure on serum 25-hydroxyvitamin D: A nationwide cross-sectional study in China. ENVIRONMENTAL RESEARCH 2024; 263:120063. [PMID: 39341536 DOI: 10.1016/j.envres.2024.120063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Revised: 09/23/2024] [Accepted: 09/24/2024] [Indexed: 10/01/2024]
Abstract
BACKGROUND Maintaining normal levels of 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH) is crucial for preserving skeletal health. However, evidence regarding the associations of exposure to air pollution with serum 25(OH)D and PTH were limited and ambiguous. Hence, the objective of this cross-sectional study was to systematically evaluate the association between air pollution [particulate matter ≤ 2.5 μm (PM2.5) and ozone (O3)] exposure and serum 25(OH)D and PTH levels in males aged 50 and above and postmenopausal female. MATERIALS AND METHODS This study is multicenter, cross-sectional study within the framework of the ongoing China Community-based Cohort of Osteoporosis. The 1-year-average PM2.5 and O3 exposures prior to the baseline survey were estimated using random forest models with relatively high accuracy. Multiple linear regression models were employed to assess the associations between PM2.5 and O3 concentrations with the serum levels of 25(OH)D and PTH. Furthermore, mediation analysis was performed to scrutinize the potential mediating role of PTH in the interplay between PM2.5, O3, and serum 25(OH)D. RESULTS A total of 13194 participants were included. Our analysis showed that every 10 μg/m3 increase in the 1-year average PM2.5, were associated with -0.32 units (95% CI: 0.48, -0.17) of change in the 25(OH)D and 0.15 units (95% CI: 0.11, 0.19) of change in the PTH, respectively. Every 10 μg/m3 increase in the 1-year average O3, were associated with -0.78 units (95% CI: 1.05, -0.51) of change in the 25(OH)D and 0.50 units (95% CI: 0.43, 0.57) of change in the PTH, respectively. Estimates of the mediation ratio indicated that increased PTH mediated a 50.48% negative correlation between PM2.5 exposure and circulating 25(OH)D level. Increased PTH mediated 69.61% of the negative effects of O3 exposure on circulating 25(OH)D level. CONCLUSIONS Exposure to PM2.5 and O3 significantly diminished 25(OH)D while elevating PTH levels. Notably, the elevated PTH concentration partially mediates the associations between PM2.5 and O3 exposure and 25(OH)D level.
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Affiliation(s)
- Haitao Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Jing Wang
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Shanghai Geriatric Institute of Chinese Medicine, Shanghai, 201203, China
| | - Xia Meng
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Bing Shu
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Chunchun Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Xingwen Xie
- Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, 730099, China
| | - Zhangyu Liao
- Ganzhou Nankang District Traditional Chinese Medicine Hospital, Ganzhou, 341499, China
| | - Xiaobing Jiang
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, China
| | - Bolai Chen
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Xinchao Lin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 101121, China
| | - Xu Wei
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Xiangyang Leng
- Hospital Affiliated to Changchun University of Traditional Chinese Medicine, Changchun, 130021, China
| | - Sheng Lu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Qi Shi
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Haidong Kan
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Dezhi Tang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China.
| | - Jing Cai
- School of Public Health, Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China.
| | - Yongjun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China; Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, 201203, China; Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, 201203, China; Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China.
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Chan Y, Cai D, Guo R, Zhou X, He G, Li H, Geng Z, Guo Y, Lin J, Wang R, Jiang L, Zhu B. Evaluation of the deficiency status of 25-hydroxyvitamin D and associated factors in Southwest China: A hospital-based retrospective cross-sectional analysis of a low-latitude, high-altitude, multiracial region. NUTR BULL 2023; 48:535-545. [PMID: 37864477 DOI: 10.1111/nbu.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
Abstract
Vitamin D deficiency is widespread in different populations and regions worldwide and has become a global health issue. The vitamin D status of the population in the Yunnan Province of Southwest China has not been evaluated to date. Therefore, in this study, we evaluated the vitamin D status according to the serum concentrations of 25-hydroxyvitamin D (25(OH)D) in individuals of Yunnan Province, a low-latitude, high-altitude and multiracial region in China. The data on 25(OH)D concentrations from October 2012 to December 2017 were retrospectively collected and assessed using the laboratory information system from 52 950 hospital-based participants (age, 1 day-96 years; females, 73.74%). The serum concentration of 25(OH)D was evaluated using a chemiluminescent immunoassay. The analysis was stratified by sex, age, sampling season, testing year, minority, residential district, latitude, altitude and meteorological factors. Vitamin D status was classified as follows: severe deficiency: <10 ng/mL; deficiency: <20 ng/mL; insufficiency: <30 ng/mL; and sufficiency: ≥30 ng/mL. The results showed that vitamin D deficiency is highly prevalent in Yunnan Province in a hospital-based cohort, with a deficiency and severe deficiency rate of 65.1% and a sufficiency rate of 5.30%. Significantly lower vitamin D levels and sufficiency rates were observed in females than in males (20.13 ± 7.22 ng/mL vs. 17.56 ± 6.66 ng/mL and 8.20% vs. 4.20%; p < 0.01, respectively); in spring and winter (16.93 ± 6.24 ng/mL; 2.97% and 16.38 ± 6.43 ng/mL; 3.06%, respectively) than in summer and autumn (20.23 ± 7.14 ng/mL; 8.02% and 19.10 ± 6.97 ng/mL; 6.61% [p < 0.01], respectively); and in older individuals (0-6 years: 28.29 ± 13.13 ng/mL vs. >60 years: 14.88 ± 8.39 ng/mL; p < 0.01). Relatively higher vitamin D levels were observed in individuals of Yi, Zhuang, Hani, Dai, Miao and Lisu minorities and lower levels in individuals of Hui and Zang minorities compared with those of the Han nationality (p < 0.01). The mean sunlight duration, mean air temperature, maximum ultraviolet value and latitude were significantly correlated with vitamin D levels (r = -0.53, 0.60, 0.31, -0.68, respectively; p < 0.05). These results suggest that vitamin D status is influenced by sex, age, minority, latitude and some meteorological factors in areas with high and low altitudes. Hence, new public health policies, such as advice on sunshine exposure, food fortification and nutrition education, as well as the implementation of vitamin D supplementation programmes must be considered to alleviate vitamin D deficiency in Yunnan province, Southwest China.
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Affiliation(s)
- Ying Chan
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Dongling Cai
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Rongfen Guo
- Yunnan Meteorological Service Center, Kunming, China
| | - Xiaoyan Zhou
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Guangyu He
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Huiping Li
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Zibiao Geng
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Yan Guo
- School of Medicine, Kunming University of Science and Technology, Kunming, China
| | - Junyue Lin
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Ruihong Wang
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
| | - Lihong Jiang
- School of Medicine, Kunming University of Science and Technology, Kunming, China
- Department of Cardiothoracic Surgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Baosheng Zhu
- Department of Medical Genetics, NHC Key Laboratory of Periconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, The First People's Hospital of Yunnan Province, Kunming, China
- School of Medicine, Kunming University of Science and Technology, Kunming, China
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Tian Y, Hu Y, Hou X, Tian F. Impacts and mechanisms of PM 2.5 on bone. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2023-0024. [PMID: 37527559 DOI: 10.1515/reveh-2023-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023]
Abstract
Osteoporosis is a metabolic bone disease, which is characterized by a decreased bone mass and deterioration of bone microstructure, resulting in increased bone fragility and a higher risk of fracture. The main pathological process of osteoporosis is the dynamic imbalance between bone absorption and bone formation, which can be caused by various factors such as air pollution. Particulate matter (PM)2.5 refers to the fine particles in the atmosphere, which are small in volume and large in specific surface area. These particles are prone to carrying toxic substances and have negative effects on several extrapulmonary organs, including bones. In this review, we present relevant data from studies, which show that PM2.5 is associated with abnormal bone turnover and osteoporosis. PM2.5 may cause or aggravate bone loss by stimulating an inflammatory response, inducing oxidative damage, reducing estrogen efficiency by competitive binding to estrogen receptors, or endocrine disorder mediated by binding with aromatic hydrocarbon receptors, and affecting the synthesis of vitamin D to reduce calcium absorption. The cellular and molecular mechanisms involved in these processes are also summarized in this review.
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Affiliation(s)
- Yuqing Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Yunpeng Hu
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiaoli Hou
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, China
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Yu XH, Cao HW, Bo L, Lei SF, Deng FY. Air pollution, genetic factors and the risk of osteoporosis: A prospective study in the UK biobank. Front Public Health 2023; 11:1119774. [PMID: 37026121 PMCID: PMC10071034 DOI: 10.3389/fpubh.2023.1119774] [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: 12/09/2022] [Accepted: 03/02/2023] [Indexed: 04/08/2023] Open
Abstract
Purpose To reveal relationship between air pollution exposure and osteoporosis (OP) risk. Methods Based on large-scale data from the UK Biobank, we evaluated the relationship between OP risk and several air pollutants. Then air pollution scores (APS) were constructed to assess the combined effects of multiple air pollutants on OP risk. Finally, we constructed a genetic risk score (GRS) based on a large genome-wide association study of femoral neck bone mineral density and assessed whether single or combined exposure to air pollutants modifies the effect of genetic risk on OP and fracture risk. Results PM2.5, NO2, NOx, and APS were significantly associated with an increased risk of OP/fracture. OP and fracture risk raised with increasing concentrations of air pollutants: compared to the lowest APS quintile group, subjects in the highest quintile group had a hazard ratio (HR) (95% CI) estimated at 1.140 (1.072-1.213) for OP and 1.080 (1.026-1.136) for fracture. Moreover, participants with low GRS and the highest air pollutant concentration had the highest risk of OP, the HRs (95% CI) of OP were 1.706 (1.483-1.964), 1.658 (1.434-1.916), 1.696 (1.478-1.947), 1.740 (1.506-2.001) and 1.659 (1.442-1.908), respectively, for PM2.5, PM10, PM2.5-10, NO2, and NOx. Similar results were also observed for fractures. Finally, we assessed the joint effect of APS and GRS on the risk of OP. Participants with higher APS and lower GRS had a higher risk of developing OP. Similar results were observed in the joint effect of GRS and APS on fracture. Conclusions We found that exposure to air pollution, individually or jointly, could improve the risk of developing OP and fractures, and increased the risk by interacting with genetic factors.
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Affiliation(s)
- Xing-Hao Yu
- School of Public Health, Center for Genetic Epidemiology and Genomics, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Jiangsu, China
| | - Han-Wen Cao
- School of Public Health, Center for Genetic Epidemiology and Genomics, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Jiangsu, China
| | - Lin Bo
- Department of Rheumatology, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Shu-Feng Lei
- School of Public Health, Center for Genetic Epidemiology and Genomics, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Jiangsu, China
- Collaborative Innovation Center of Bone and Immunity Between Sihong Hospital and Soochow University, Jiangsu, China
- Shu-Feng Lei
| | - Fei-Yan Deng
- School of Public Health, Center for Genetic Epidemiology and Genomics, Medical College of Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Jiangsu, China
- *Correspondence: Fei-Yan Deng
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Kim B, Hwang J, Lee H, Chae GM, Kim S, Kim HS, Park B, Kim HJ. Associations between ambient air pollution, obesity, and serum vitamin D status in the general population of Korean adults. BMC Public Health 2022; 22:1766. [PMID: 36115935 PMCID: PMC9482201 DOI: 10.1186/s12889-022-14164-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Background Although a growing body of evidence suggests air pollution is associated with low serum vitamin D status, few studies have reported whether obesity status affects this relationship. The aim of this study was to identify associations between ambient air pollution exposure, obesity, and serum vitamin D status in the general population of South Korea. Methods This study was conducted in a cross-sectional design. A total of 30,242 Korean adults from a nationwide general population survey were included for our final analysis. Air pollutants included particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), and carbon monoxide (CO). We measured serum 25-hydroxyvitamin D concentration to assess vitamin D status for each participant. Multiple linear and logistic regression analyses were performed to identify associations between ambient air pollution and vitamin D status in each subgroup according to body mass index level. Results The annual average concentrations of PM10, NO2, and CO were significantly associated with a lower serum vitamin D concentration and higher risk of vitamin D deficiency. The results show a significant association between serum vitamin D status and PM10 exposure in obese subgroup. Based on the gender, females with obesity showed more strong association (negative) between different air pollutants and low serum vitamin D concentration and a higher risk of vitamin D deficiency. However, this pattern was not observed in men. Conclusions This study provides the first evidence that women with obesity may be more vulnerable to vitamin D deficiency in the context of persistent exposure to air pollution. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14164-y.
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Al-Qahtani SM, Shati AA, Alqahtani YA, Dawood SA, Siddiqui AF, Zaki MSA, Khalil SN. Prevalence and Correlates of Vitamin D Deficiency in Children Aged Less than Two Years: A Cross-Sectional Study from Aseer Region, Southwestern Saudi Arabia. Healthcare (Basel) 2022; 10:healthcare10061064. [PMID: 35742114 PMCID: PMC9222582 DOI: 10.3390/healthcare10061064] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Vitamin D is an essential nutrient for bone growth, mineralization, and other metabolic processes in the human body. Hence, insufficiency or deficiency of this vitamin can have long-term effects, particularly for children. Objectives: The aims of this study were to determine the prevalence of vitamin D deficiency in children up to 2 years of age and investigate the independent predictors of vitamin D deficiency. Methodology: This cross-sectional study was conducted among 484 children aged up to two years who were admitted to the hospital for the treatment of any acute condition from January to November 2021. Serum 25(OH)D was used to determine the level of vitamin D. The serum 25(OH)D was categorized into 3 groups: Sufficiency (>30 ng/mL), insufficiency (20−30 ng/mL), and the deficiency (<20 ng/mL). Results: Overall, vitamin D deficiency was observed in 70.5% of the children, of whom 45.9% had insufficient levels, and one-fourth (24.6%) showed deficiency. The children aged 2−12 months (infants) were more likely to be vitamin deficient compared to children aged 12 months and above. The children who lived in urban areas had a threefold increased risk of vitamin D deficiency (aOR = 3.0, 95% CI 1.78−5.08). The children who were exposed to sunlight for less than 3 days per week experienced a higher risk of developing vitamin D deficiency (aOR = 4.17, 95% CI 2.04−10.88). Children who had received only breast milk were more than two times more likely to experience vitamin D deficiency (aOR = 2.42, 95% CI 1.12−5.23) compared to their counterparts. Conclusion: Our study reveals a high prevalence of vitamin D deficiency among children aged up to two years. Infants, urban dwellers, only breastfed, and exposure to sunlight for less than three days per week were identified to be the independent risk factors for vitamin D deficiency. The results of this work call for enhancing awareness to ensure adequate levels of vitamin D for better health of the children in this region of Saudi Arabia.
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Affiliation(s)
- Saleh M. Al-Qahtani
- Department of Child Health, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (S.M.A.-Q.); (Y.A.A.); (S.A.D.)
| | - Ayed A. Shati
- Department of Child Health, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (S.M.A.-Q.); (Y.A.A.); (S.A.D.)
- Correspondence:
| | - Youssef A. Alqahtani
- Department of Child Health, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (S.M.A.-Q.); (Y.A.A.); (S.A.D.)
| | - Samy A. Dawood
- Department of Child Health, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (S.M.A.-Q.); (Y.A.A.); (S.A.D.)
| | - Aesha F. Siddiqui
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (A.F.S.); (S.N.K.)
| | - Mohamed Samir A. Zaki
- Department of Anatomy, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia;
- Department of Histology and Cell Biology, College of Medicine, Zagazig University, Zagazig P.O. Box 31527, Egypt
| | - Shamsun N. Khalil
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha P.O. Box 62529, Saudi Arabia; (A.F.S.); (S.N.K.)
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Liu W, Hu J, Fang Y, Wang P, Lu Y, Shen N. Vitamin D status in Mainland of China: A systematic review and meta-analysis. EClinicalMedicine 2021; 38:101017. [PMID: 34308318 PMCID: PMC8283334 DOI: 10.1016/j.eclinm.2021.101017] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/13/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Low vitamin D (VitD) status is becoming a global health issue. Previous heterogenous results are urging a meta-analysis to delineate a panorama of VitD conditions in the general population in Mainland of China. METHODS We performed a systematic review and meta-analysis by searching PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure, WanFang, and VIP databases up to June 4, 2021. The inclusion criteria were as follows: (1) original articles or dissertations focused on VitD status of people in Mainland of China; and (2) studies were population-based, cross-sectional, or longitudinal cohort with baseline data. The outcomes were serum 25(OH)D concentration and the prevalence of low VitD status. Low VitD status included VitD deficiency (< 30 nmol/L) and VitD inadequacy (< 50 nmol/L). Data were estimated by Hierarchical Bayesian methods. All included studies were cross-sectional or longitudinal cohort studies about VitD status of people in Mainland of China. (Registration: PROSPERO CRD42021226130). FINDINGS A total of 105 eligible studies including 234,519 subjects were included. In adults, the overall mean 25(OH)D concentration was 44.3 nmol/L (95% Credible Interval [CrI]: 39.8-48.7). The pooled prevalence of VitD deficiency and inadequacy was 20.7% (95% CrI: 11.9-32.9) and 63.2% (95% CrI: 53.5-72.3), respectively. In children and adolescents, the overall mean 25(OH)D concentration was 52.2 nmol/L (95% CrI: 46.7-57.5). The pooled prevalence of VitD deficiency and inadequacy was 23.0% (95% CrI: 8.9-44.3) and 46.8% (95% CrI: 37.2-56.6), respectively. Specially, we identified that the prevalence of VitD inadequacy increased with age in populations with age ≤ 18 years and ≥ 60 years. INTERPRETATION Low VitD status is prominent in general population of Mainland of China, especially for adults. FUNDING National Major Scientific and Technological Special Project for "Significant New Drugs Development" (2017ZX09304022).
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Affiliation(s)
- Wenhua Liu
- Clinical Research Center,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (HUST), Wuhan, China
| | - Jing Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, HUST, Wuhan, China
| | - Yuanyuan Fang
- Department of Neurology, Tongji Hospital,Tongji Medical College, HUST, Wuhan, China
| | - Peng Wang
- Institute and Department of Infectious Disease, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Yanjun Lu
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
| | - Na Shen
- Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, HUST, Wuhan, China
- Corresponding author.
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Ambient Air Pollutions Are Associated with Vitamin D Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136887. [PMID: 34198962 PMCID: PMC8297026 DOI: 10.3390/ijerph18136887] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
Evidence on the effect of ambient air pollution on vitamin D is limited. This study aimed to examine the association of air pollution exposure with serum levels of 25-hydroxyvitamin D (25OHD) using UK Biobank health datasets. A total of 448,337 subjects were included in this analysis. Land Use Regression was applied to assess individual exposures to particulate matter with diameters ≤2.5 µm (PM2.5), ≤10 µm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Linear regression models evaluated the associations between air pollutants and serum vitamin D levels after adjustment of a series of confounders. All analyzed air pollutants were negatively associated with serum vitamin 25OHD levels. After adjusting for potential confounders, a 10 μg/m3 increase in concentrations of PM2.5, PM10, NOx, and NO2 was associated with −9.11 (95%CI: −13.25 to −4.97), −2.47 (95%CI: −4.51 to −0.43), −0.56 (95%CI: −0.82 to −0.30), and −1.64 (95%CI: −2.17 to −1.10) nmol/L decrease in serum vitamin 25OHD levels, respectively. Interaction analyses suggested that the effects of air pollution were more pronounced in females. In conclusion, long-term exposures to ambient PM2.5, PM10, NOx, and NO2 were associated with vitamin D status in a large UK cohort.
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