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Seneviratne R, Gunawardena N, Arambepola C. Prevalence of low vitamin D status in an urban district in Sri Lanka: a population-based study. BMC Nutr 2024; 10:115. [PMID: 39210458 PMCID: PMC11363535 DOI: 10.1186/s40795-024-00923-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Vitamin D deficiency (VDD) is conventionally associated with inadequate sunlight exposure. Ironically, recent evidence suggests a rising prevalence in urban areas of tropical regions like Sri Lanka, where comprehensive data are unavailable. This study aimed to estimate the prevalence of low vitamin D status in urban adults and its impact on serum calcium. METHODS A population-based cross-sectional study was conducted among 1260 adults aged 35-74 years, living in Colombo, the most urban district in Sri Lanka. They were recruited from 63 administrative divisions, using multi-stage, probability-proportionate-to-size, cluster sampling. Non-fasting venous blood was collected without tourniquet. Low vitamin D (< 30.0 ng/mL), VDD (< 20 ng/mL) and vitamin D insufficiency (20.0-29.9 ng/mL) were determined using chemiluminescence assay method, and serum calcium using Calcium Gen2 reagent. RESULTS Among the population (53.3% females; mean age = 51.8 years), the prevalence of low vitamin D was 93.9% (95% CI: 92.5-95.2). This was primarily due to VDD (67.5%; 95% CI: 64.9.0-70.1%), with some insufficiency (26.4%; 95% CI: 24.0-28.9%). Most VDD cases (53.9.0%) were 'mild' (10.0- < 20.0 ng/mL) in severity, with fewer 'moderate' (12.8%) and 'severe' (0.8%) cases. Prevalence of VDD was highest in females, aged 35-44-years, living in 'highly urban' areas and of Tamil ethnicity. Further, VDD showed a decreasing trend with older age groups, while it was significantly more prevalent in females than males (72.6% vs. 61.7%; p < 0.01), across all age groups. Low serum calcium levels were observed in 9.8% of adults with low vitamin D, compared to 22.4% with normal vitamin D, implying that there could be factors other than vitamin D in maintaining serum calcium levels. CONCLUSIONS Colombo District, representing urban settings in Sri Lanka faces a high prevalence of low vitamin D, primarily VDD, with higher rates in females, younger individuals and highly urban areas. These findings challenge assumptions about tropical regions being guaranteed of optimal vitamin D levels; and underscore the need for national vitamin D supplementation and food fortification programs, especially in high-risk urban settings in South Asian countries like Sri Lanka.
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Affiliation(s)
- Ruwanika Seneviratne
- Postgraduate Institute of Medicine, University of Colombo, Sri Lanka; No. 160, Professor Nandadasa Kodagoda Road, Colombo, 00700, Sri Lanka.
| | - Nalika Gunawardena
- World Health Organization-South-East Asia Regional Office, World Health House, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, 110 002, India
| | - Carukshi Arambepola
- Department of Community Medicine, Faculty of Medicine, University of Colombo, No. 25, Kynsey Road, Colombo, 00800, Sri Lanka
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Becerra-Cervera A, Argoty-Pantoja AD, Aparicio-Bautista DI, López-Montoya P, Rivera-Paredez B, Hidalgo-Bravo A, Velázquez-Cruz R. Proteomic Biomarkers Associated with Low Bone Mineral Density: A Systematic Review. Int J Mol Sci 2024; 25:7526. [PMID: 39062769 PMCID: PMC11277462 DOI: 10.3390/ijms25147526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/07/2024] [Accepted: 07/07/2024] [Indexed: 07/28/2024] Open
Abstract
Osteoporosis is a globally relevant public health issue. Our study aimed to summarize the knowledge on the proteomic biomarkers for low bone mineral density over the last years. We conducted a systematic review following the PRISMA guidelines; the scoured databases were PubMed, Web of Sciences, Scopus, and EBSCO, from inception to 2 June 2023. A total of 610 relevant studies were identified and 33 were assessed for eligibility. Finally, 29 studies met the criteria for this systematic review. The risk of bias was evaluated using the Joanna Briggs Institute Critical Appraisal Checklist tool. From the studies selected, 154 proteins were associated with changes of bone mineral density, from which only 10 were reported in at least two articles. The protein-protein network analysis indicated potential biomarkers involved in the skeletal system, immune system process, regulation of protein metabolic process, regulation of signaling, transport, cellular component assembly, cell differentiation, hemostasis, and extracellular matrix organization. Mass spectrometry-based proteomic profiling has allowed the discovery of new biomarkers with diagnostic potential. However, it is necessary to compare and validate the potential biomarkers in different populations to determine their association with bone metabolism and evaluate their translation to the clinical management of osteoporosis.
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Affiliation(s)
- Adriana Becerra-Cervera
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico; (A.B.-C.); (D.I.A.-B.); (P.L.-M.)
- National Council of Humanities, Science and Technology (CONAHCYT), Mexico City 03940, Mexico
| | - Anna D. Argoty-Pantoja
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico; (A.D.A.-P.); (B.R.-P.)
| | - Diana I. Aparicio-Bautista
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico; (A.B.-C.); (D.I.A.-B.); (P.L.-M.)
| | - Priscilla López-Montoya
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico; (A.B.-C.); (D.I.A.-B.); (P.L.-M.)
| | - Berenice Rivera-Paredez
- Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City 04510, Mexico; (A.D.A.-P.); (B.R.-P.)
| | - Alberto Hidalgo-Bravo
- Department of Genomic Medicine, National Institute of Rehabilitation, Mexico City 14389, Mexico;
| | - Rafael Velázquez-Cruz
- Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City 14610, Mexico; (A.B.-C.); (D.I.A.-B.); (P.L.-M.)
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Brennan MM, van Geffen J, van Weele M, Zgaga L, Shraim R. Ambient ultraviolet-B radiation, supplements and other factors interact to impact vitamin D status differently depending on ethnicity: A cross-sectional study. Clin Nutr 2024; 43:1308-1317. [PMID: 38663052 DOI: 10.1016/j.clnu.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND & AIMS Many determinants of vitamin D status have been well-described, yet supplementation guidelines largely follow a one-size-for-all model and deficiency remains common. We hypothesised that accounting accurately for ultraviolet-B (UVB) radiation and considering interactions could advance understanding of vitamin D status. METHODS Asian, Black, and White participants from the UK Biobank cohort were included (N = 438,978). The Tropospheric Emission Monitoring Internet Service provided UVB data which we linked to participants' place of residence. UVB dose over 135 days prior to blood draw was weighted and added, yielding cumulative and weighted UVB (CW-D-UVB). The association between 25(OH)D and selected variables was assessed in multivariable linear regression models with and without interactions, stratified by ethnicity. Predictors were ranked using standardised β-coefficients. RESULTS Median 25(OH)D differed by ethnicity (Asian: 25.4 nmol/L (10.2 ng/mL), Black: 30.6 nmol/L (12.2 ng/mL), White: 47.9 nmol/L (19.2 ng/mL), p-value < 0.001). CW-D-UVB was strongly associated with 25(OH)D in all ethnicities. It was the most important predictor in White (βAsian = 0.15, βBlack = 0.20, βWhite = 0.35), whereas supplementation was in Asian and Black participants (βAsian = 0.30, βBlack = 0.24, βWhite = 0.21). We identified statistically significant interactions between BMI:supplementation (all), CW-D-UVB:sex (Asian and White), and CW-D-UVB:age (Black and White), and in White population between CW-D-UVB and supplementation, BMI, and cholesterol. CONCLUSION Vitamin D deficiency was widespread, particularly among non-White individuals. UVB was a strong predictor of 25(OH)D and the effect was modified by other factors. Findings suggest that accurately measured ambient-UVB radiation and interactions could improve 25(OH)D prediction models, and support personalised approaches to vitamin D optimisation.
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Affiliation(s)
- Margaret M Brennan
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, D24 DH74 Dublin, Ireland.
| | - Jos van Geffen
- Royal Netherlands Meteorological Institute, 3731 GA De Bilt, the Netherlands.
| | - Michiel van Weele
- Royal Netherlands Meteorological Institute, 3731 GA De Bilt, the Netherlands.
| | - Lina Zgaga
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, D24 DH74 Dublin, Ireland.
| | - Rasha Shraim
- Department of Public Health and Primary Care, Institute of Population Health, Trinity College Dublin, D24 DH74 Dublin, Ireland; Department of Clinical Medicine, Trinity Translational Medicine Institute, Trinity College Dublin, D08 W9RT Dublin, Ireland; The SFI Centre for Research Training in Genomics Data Sciences, University of Galway, H91 CF50 Galway, Ireland.
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4
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Kift RC, Webb AR. Globally Estimated UVB Exposure Times Required to Maintain Sufficiency in Vitamin D Levels. Nutrients 2024; 16:1489. [PMID: 38794727 PMCID: PMC11124381 DOI: 10.3390/nu16101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
A paucity of vitamin D is a common deficiency globally, with implications for many aspects of health besides the well-known impact on musculoskeletal health. The two sources of vitamin D are through oral intake, or through endogenous synthesis in the skin when exposed to ultraviolet radiation in sunlight. Assessing nutritional needs, whether by food, food fortification or supplementation, is aided by an understanding of local potential for cutaneous synthesis of the vitamin, dependent on latitude and climate, personal skin type and local culture. To aid these discussions we provide indicative exposure times for the maintenance of vitamin D status as a function of latitude, month and skin type, for the clear-sky case and all-sky conditions, for an ambulatory person wearing modest skirt/shorts and T-shirt. At latitudes greater than ±40 degrees, lack of available sunlight limits vitamin D synthesis in some months for all, while at the equator exposure times range from 3 to 15 min at noontime, for white and black skin, respectively. Rather than a sun exposure prescription, the data are intended to show where nutritional vitamin D intake is necessary, advisable, or can be mitigated by sun exposure, and allows for such advice to be personalized to account for different sub-groups in a multicultural population.
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Affiliation(s)
| | - Ann R. Webb
- Department of Earth and Environmental Sciences, University of Manchester, Manchester M13 9PL, UK;
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Buzatu R, Luca MM, Bumbu BA. A Systematic Review of the Relationship between Serum Vitamin D Levels and Caries in the Permanent Teeth of Children and Adolescents. Dent J (Basel) 2024; 12:117. [PMID: 38668029 PMCID: PMC11048958 DOI: 10.3390/dj12040117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/18/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
This systematic review critically evaluates the association between serum Vitamin D levels and dental caries incidence in the permanent teeth of children and adolescents. The search strategy comprised three databases (PubMed, Scopus, Embase), up to November 2023, targeting studies on the correlation between Vitamin D and dental caries in permanent dentition. The eligibility criteria focused on observational studies involving children and adolescents aged 12 to 19 years with permanent dentition. The screening process, guided by the PRISMA guidelines and the Newcastle-Ottawa Scale for quality assessment, resulted in the inclusion of eight studies conducted across various global regions from 2013 to 2023. The analysis revealed that Vitamin D insufficiency and deficiency were prevalent among the study populations, ranging from 17.3% to 69.4%. Specifically, children and adolescents with Vitamin D insufficiency (<50 nmol/L) were found to have significantly higher odds of developing caries, with odds ratios (ORs) ranging from 1.13 to 2.57. Conversely, two studies indicated a protective effect of higher Vitamin D levels, with an OR of 0.80 and 0.59, respectively, for caries among children and adolescents with serum levels ≥ 50 nmol/L, suggesting an inverse relationship between Vitamin D status and caries risk. The results indicate both the protective role of adequate serum levels of Vitamin D above 20 ng/mL and the increased risk associated with insufficient levels below this threshold. However, the variations in study quality, methodologies and geographic settings underscore the challenges in drawing universal conclusions. Despite these limitations, our review suggests that improving Vitamin D status could be a beneficial component of preventive strategies against dental caries in children and adolescents, warranting further research to clarify the clinical significance of our findings.
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Affiliation(s)
- Roxana Buzatu
- Department of Dental Aesthetics, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Revolutiei Boulevard 9, 300041 Timisoara, Romania;
| | - Magda Mihaela Luca
- Department of Pediatric Dentistry, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Bogdan Andrei Bumbu
- Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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Mavar M, Sorić T, Bagarić E, Sarić A, Matek Sarić M. The Power of Vitamin D: Is the Future in Precision Nutrition through Personalized Supplementation Plans? Nutrients 2024; 16:1176. [PMID: 38674867 PMCID: PMC11054101 DOI: 10.3390/nu16081176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
In the last few decades, vitamin D has undeniably been one of the most studied nutrients. Despite our ability to produce vitamin D through sunlight exposure, its presence in several natural food sources and fortified foods, and its widespread availability as a dietary supplement, vitamin D deficiency is a serious public health problem, affecting nearly 50% of the global population. Low serum levels of vitamin D are being associated with increased susceptibility to numerous health conditions, including respiratory infections, mental health, autoimmune diseases, and different cancer types. Although the association between vitamin D status and health is well-established, the exact beneficial effects of vitamin D are still inconclusive and indefinite, especially when considering the prevention and treatment of different health conditions and the determination of an appropriate dosage to exert those beneficial effects in various population groups. Therefore, further research is needed. With constant improvements in our understanding of individual variations in vitamin D metabolism and requirements, in the future, precision nutrition and personalized supplementation plans could prove beneficial.
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Affiliation(s)
- Mladen Mavar
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Tamara Sorić
- Psychiatric Hospital Ugljan, Otočkih Dragovoljaca 42, 23275 Ugljan, Croatia;
| | - Ena Bagarić
- Almagea Ltd., Ulica Julija Knifera 4, 10020 Zagreb, Croatia;
| | - Ana Sarić
- School of Medicine, Catholic University of Croatia, Ilica 242, 10000 Zagreb, Croatia;
| | - Marijana Matek Sarić
- Department of Health Studies, University of Zadar, Splitska 1, 23000 Zadar, Croatia;
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Mahajan C, Singla N, Jain D. High Incidence of Vitamin D Deficiency (VDD) Among Indoor Workers: Association with Dietary and Lifestyle Factors. Ecol Food Nutr 2024; 63:40-62. [PMID: 38282295 DOI: 10.1080/03670244.2024.2306386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
The study evaluated the relationship of various dietary and lifestyle factors with vitamin D status and bone health of adults engaged in office jobs. A total of 100 subjects comprising of 50 males and 50 females (with their willingness to participate) in the age group of 30-50 years were purposively selected for the investigation, who were spending 8 hours in the offices. Results showed that most of the subjects had vitamin D deficit with mean serum vitamin D level as 13.2 ng/ml and 68% were osteopenic. Dietary phytates, sedentary lifestyle, higher body mass index were found to have a deleterious impact on vitamin D status. This silent epidemic needs to be addressed with effective public health initiatives, such as raising awareness about the availability of fortified foods, optimum time, and body surface area for sun exposure.
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Affiliation(s)
- Charvi Mahajan
- Food and Nutrition, Punjab Agricultural University, Ludhiana, India
| | - Neerja Singla
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, India
| | - Divya Jain
- Department of Food and Nutrition, Punjab Agricultural University, Ludhiana, India
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de Macêdo LP, de Castro Tavares R, Torres Braga M, Dos Santos LM, Donato G, Lima Júnior FASD, de Macêdo RP, Ugulino Netto A, Franke K, Vansant Oliveira Eugênio P, Batista Cezar-Junior A, Vilela Faquini I, Júnior Silva JL, de Carvalho Júnior EV, Almeida NS, Bandeira E Farias FA, Moraes Valença M, Rocha Cirne Azevedo-Filho H. The relationship between the level of vitamin D and ruptured intracranial aneurysms among patients with high sun exposure. Sci Rep 2024; 14:3555. [PMID: 38347057 PMCID: PMC10861505 DOI: 10.1038/s41598-024-53676-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/03/2024] [Indexed: 02/15/2024] Open
Abstract
Non-traumatic subarachnoid hemorrhage (SAH) accounts for 3-5% of acute strokes. Intracranial aneurysm is the most common cause of non-traumatic SAH. Vitamin D influences the cardiovascular system, including the formation and rupture of cerebral aneurysms. To evaluate the serum vitamin D level in patients living in the tropical zone who suffered aneurysmal subarachnoid hemorrhage and its correlation with demographic and neurological characteristics. This is an analytical cross-sectional study to assess the serum level of vitamin D in a study population of 99 patients treated and diagnosed with aSAH in a public hospital in Recife-PE over a period of 12 months. In the study sample, composed of individuals with high sun exposure due to the lifestyle they lead in a tropical region, we observed hypovitaminosis D (85.9%), with a median of 19.9 ng/ml, although the majority of individuals are skin with high concentration of melanin (Fitzpatrick skin type IV and V). In addition, rates of sun exposure are high to all patients (Solar Index 9.03 P50). Most individuals were female (79.8%); there was no statistical difference in solar exposure/solar index between genders. As for the neurological repercussions, there was no statistical relevance in the clinical prognostic scales evaluated. As the sample was composed mainly of individuals whose economic activity is agriculture, the values of solar index found are vastly higher than those of other studies conducted in high latitude regions. In line with the literature review, some aspects were raised with the objective of justifying such findings that go from the base of the poor diet of these individuals, the increase of melanin in the skin and genetic alterations that directs us to possible mechanisms of natural photoprotection to high sun exposure. Thus, we had a vast majority (85%) of hypovitaminosis D, which in fact makes us wonder if there is any influence of calcitriol on vitamin D receptors in vascular walls and in the cardiovascular system as a whole, which influence bleeding events of this nature. As for the neurological repercussions, measured using assessment scales (Glasgow coma scale, WFNS scale, Hunt-Hess and Fisher's tomographic scale) there was no significant difference in the results. As it is only a descriptive study, the causal relationship of the facts cannot be established. However, in a population exposed to high sun exposure and affected by aneurysmal SAH, there is a significant rate of hypovitaminosis D, which supports the hypothesis that vitamin D plays a role in vascular pathologies, such as cerebral aneurysms and SAH.
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Affiliation(s)
- Lívio Pereira de Macêdo
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil.
- Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
- , Recife, Brasil.
| | | | | | | | - Glaudir Donato
- Medical Student, Centro de Ciências Médicas, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | | | | | | | - Kauê Franke
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Igor Vilela Faquini
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Nivaldo S Almeida
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
| | | | | | - Hildo Rocha Cirne Azevedo-Filho
- Department of Neurosurgery, Hospital da Restauração, Recife, Pernambuco, Brazil
- Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Grygorieva N, Tronko M, Kovalenko V, Komisarenko S, Tatarchuk T, Dedukh N, Veliky M, Strafun S, Komisarenko Y, Kalashnikov A, Orlenko V, Pankiv V, Shvets O, Gogunska I, Regeda S. Ukrainian Consensus on Diagnosis and Management of Vitamin D Deficiency in Adults. Nutrients 2024; 16:270. [PMID: 38257163 PMCID: PMC10820145 DOI: 10.3390/nu16020270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/10/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D deficiency (VDD) is a global problem, however, there were no Ukrainian guidelines devoted to its screening, prevention, and treatment, which became the reason for the Consensus creation. This article aimed to present the Consensus of Ukrainian experts devoted to VDD management. Following the creation of the multidisciplinary Consensus group, consent on the formation process, drafting and fine-tuning of key recommendations, and two rounds of voting, 14 final recommendations were successfully voted upon. Despite a recent decrease in VDD prevalence in Ukraine, we recommend raising awareness regarding VDD's importance and improving the strategies for its decline. We recommend screening the serum 25-hydroxyvitamin D (25(OH)D) level in risk groups while maintaining a target concentration of 75-125 nmol/L (30-50 ng/mL). We recommend prophylactic cholecalciferol supplementation (800-2000 IU/d for youthful healthy subjects, and 3000-5000 IU/d for subjects from the risk groups). For a VDD treatment, we recommend a short-term administration of increased doses of cholecalciferol (4000-10,000 IU/d) with 25(OH)D levels monitored after 4-12 weeks of treatment, followed by the use of maintenance doses. Additionally, we recommend assessing serum 25(OH)D levels before antiosteoporotic treatment and providing vitamin D and calcium supplementation throughout the full course of the antiosteoporotic therapy.
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Affiliation(s)
- Nataliia Grygorieva
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Tronko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymir Kovalenko
- National Scientific Center «The M.D. Strazhesko Institute of Cardiology», Clinical and Regenerative Medicine, The National Academy of Medical Sciences of Ukraine, 03151 Kyiv, Ukraine
| | - Serhiy Komisarenko
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Tetiana Tatarchuk
- Institute of Pediatrics, Obstetrics and Gynecology Named after Academician O.M. Lukyanova, The National Academy of Medical Sciences of Ukraine, 04050 Kyiv, Ukraine
| | - Ninel Dedukh
- D.F. Chebotarev Institute of Gerontology, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Mykola Veliky
- Palladin Institute of Biochemistry, The National Academy of Sciences of Ukraine, 02000 Kyiv, Ukraine
| | - Serhiy Strafun
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Yulia Komisarenko
- Department of Endocrinology, O.O. Bogomolets National Medical University, 01601 Kyiv, Ukraine
| | - Andrii Kalashnikov
- Institute of Traumatology and Orthopedics, The National Academy of Medical Sciences of Ukraine, 01601 Kyiv, Ukraine
| | - Valeria Orlenko
- V.P. Komisarenko Institute of Endocrinology and Metabolism, The National Academy of Medical Sciences of Ukraine, 04114 Kyiv, Ukraine
| | - Volodymyr Pankiv
- Ukrainian Scientific and Practical Centre for Endocrine Surgery, Transplantation of Endocrine Organs and Tissues, Health Ministry of Ukraine, 01021 Kyiv, Ukraine
| | - Oleg Shvets
- Department of Public Health and Nutrition, National University of Life and Environmental Sciences of Ukraine, 03041 Kyiv, Ukraine
| | - Inna Gogunska
- O.S. Kolomiychenko Institute of Otolaryngology, The National Academy of Medical Sciences of Ukraine, 03057 Kyiv, Ukraine
| | - Svitlana Regeda
- Center of Innovative Medical Technologies, The National Academy of Sciences of Ukraine, 04053 Kyiv, Ukraine
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Fernandes TH, Bell V. The imprecision of micronutrient requirement values: the example of vitamin D. J Food Sci 2024; 89:51-63. [PMID: 38126105 DOI: 10.1111/1750-3841.16889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
Food, not nutrients, is the fundamental unit in nutrition. Nutrient requirement values and recommended daily intakes have long been determined and organized in tables by several regulators. These figures, however, overlook the complexity of mixing different foods in a diet and the mediation by human gut microbiota on digestion, metabolism, and health. The microbiome molecular mechanisms and its potential influence on nutrient requirements are far from clear. Guidelines should depend on the sort of intake, along with the dietary habits, rather than focusing on single nutrients. Despite many decades of attempts to investigate the proximate nutrient composition of foods consumed by different world populations, there are still neither standardization of food composition databases nor harmonized dietary intake methods of assessment of nutrients. No all-inclusive attempt was yet made to emphasize the requirements of the various micronutrients, phytonutrients, and non-nutrients on gut microbiota and vice versa, and thereafter reflected into dietary guidelines. New multifaceted methods have been advanced to reevaluate the way nutrients and nutrient requirements are assessed within the intricate biological systems. Our main goal here was to enhance the fact that existing food guidelines hold inherent strengths and limitations but fail, in many aspects, namely, in not taking into account essential geographical, ethnic and cultural differences, and the different stages of life, infant nutrition, and the microbiota impact on several micronutrient requirements. Vitamin D is given as an illustration on present inaccuracy of its requirements. Defining dietary reference intakes is therefore an ongoing process specific for each population.
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Affiliation(s)
| | - Victoria Bell
- Faculty of Pharmacy, University of Coimbra, Pólo das Ciências da Saúde, Coimbra, Portugal
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Indolfi C, Klain A, Dinardo G, Decimo F, Marrapodi MM, Licari A, Giudice MMD. Mini-Review on Vitamin D in Pediatric Population and its Role in Respiratory and Atopic Disorders. Mini Rev Med Chem 2024; 24:1386-1394. [PMID: 38415448 DOI: 10.2174/0113895575284873240212045431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/28/2023] [Accepted: 01/26/2024] [Indexed: 02/29/2024]
Abstract
In recent years, our comprehension of the function of vitamin D has significantly evolved. The ubiquitous presence of the vitamin D receptor (Vitamin D Receptor- VDR) in the body has led to its redefinition from a steroidal hormone primarily involved in skeletal functions to a hormone with pleiotropic effects, exerting its influence on the circulatory, nervous, and immune systems. This has prompted investigations into its potential use in preventing and treating chronic metabolic disorders, cardiovascular diseases, infections, and allergic and autoimmune diseases. This comprehensive review explores the various aspects of vitamin D, including its sources, synthesis, functions, and its impact on different physiological systems. It delves into the epidemiology of vitamin D deficiency, highlighting its occurrence among various age demographics and geographic regions. The impact of vitamin D on the immune system is also explored, elucidating its immunomodulatory and anti-inflammatory properties, particularly in the context of respiratory infections. The review discusses emerging evidence concerning the potential advantages of vitamin D in respiratory diseases, pediatric asthma and atopic dermatitis. It also addresses vitamin D supplementation recommendations for various pediatric populations, including term and preterm infants. The growing concern regarding the global health impacts of insufficient vitamin D levels necessitates further research to bridge gaps in knowledge, particularly in enhancing screening, prevention, and approaches to address vitamin D deficiency from birth onwards. In summary, this comprehensive overview underscores the vital role of vitamin D, highlighting the significance of understanding its multifaceted functions and the need for tailored supplementation strategies, especially in vulnerable populations.
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Affiliation(s)
- Cristiana Indolfi
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Angela Klain
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Giulio Dinardo
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Fabio Decimo
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Maria Maddalena Marrapodi
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Amelia Licari
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Michele Miraglia Del Giudice
- Department of woman, child and general and specialized surgery, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Hribar M, Pravst I, Pogačnik T, Žmitek K. Results of longitudinal Nutri-D study: factors influencing winter and summer vitamin D status in a Caucasian population. Front Nutr 2023; 10:1253341. [PMID: 38035360 PMCID: PMC10684958 DOI: 10.3389/fnut.2023.1253341] [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: 07/12/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Inadequate vitamin D status is a worldwide public health issue. In humans, vitamin D status is affected by diet, and even more by exposure to ultraviolet B (UVB) light and consequential endogenous synthesis. Various personal and environmental factors influence endogenous synthesis. Factors affecting vitamin D status were investigated in a prospective longitudinal cohort study with a summer and winter observation period. Methods The final sample included 292 adults, of those 111 (38%) males and 181 (62%) females, with a mean age of 38.2 (±11.8) years from Slovenia who were not supplementing vitamin D. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured in both periods; vitamin D intake, self-reported body mass index (BMI), and protective behaviors against sun were also recorded. Other measured parameters included measurements of constitutive skin color using the objective individual typology angle (ITA), and difference in the melanin index (ΔMI) for assessment of objective sun exposure. Results In winter a high prevalence (63.4%) of insufficient vitamin D status (< 50 nmoL/L) was observed with higher odds ratios (OR) for insufficiency in those with a higher BMI and light ITA. During summer, insufficiency prevalence was low (5.5%), but half of the participants (50.0%) had suboptimal 25(OH)D concentration (< 75 nmol/L). In summer OR for suboptimal status were higher in those with obesity, lower ΔMI, light ITA, low vitamin D intake, and protective clothing behaviors. Conclusion Using a series of measures, we showed that vitamin D status is hugely affected by several personal factors such as BMI, ITA, vitamin D intake, ΔMI, and protective behavior against the sun. This conclusion questions the usefulness of generalized population-level recommendations since personal factors are a major predictor of vitamin D status.
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Affiliation(s)
- Maša Hribar
- Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Igor Pravst
- Nutrition Institute, Ljubljana, Slovenia
- Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
- VIST – Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Tina Pogačnik
- VIST – Faculty of Applied Sciences, Ljubljana, Slovenia
| | - Katja Žmitek
- Nutrition Institute, Ljubljana, Slovenia
- VIST – Faculty of Applied Sciences, Ljubljana, Slovenia
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Scully H, Laird EJ, Healy M, Crowley V, Walsh JB, McCarroll K. Vitamin D: determinants of status, indications for testing and knowledge in a convenience sample of Irish adults. Br J Nutr 2023; 130:1144-1154. [PMID: 37675548 DOI: 10.1017/s0007114523000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Vitamin D deficiency is common in Irish adults, though there is limited research on its determinants, knowledge of vitamin D or indications for testing. We aimed to explore the determinants of vitamin D status in adults and examine knowledge and reasons for testing. The study population comprised adults who had serum 25-hydroxyvitamin D tested by general practitioners request at a Dublin Hospital in 2020. Questionnaires detailing dietary intake, sun exposure, ethnicity, biophysical factors and vitamin D knowledge were sent to a sample stratified by age, sex and vitamin D status. In total, there were 383 participants, mean age 56·0 (sd 16·6) years. Wintertime deficiency disproportionally affected non-white v. white (60 % v. 24 %, P < 0·001). The greatest predictors of deficiency were low vitamin D intake (< 10 μg/d) (P < 0·001) and non-white ethnicity (P = 0·006), followed by sun avoidance (P = 0·022). It was also more prevalent in those with lower body exposure when outdoors. The majority (86 %) identified vitamin D as important for bone health. However, 40 % were tested for non-clinical indications and half were not aware of the recommended daily allowance (RDA). Low vitamin D intake was the most important determinant of deficiency, but ethnicity and sun exposure habits were also significant predictors. The majority had no clear indication for testing and were not aware of the RDA. Public health policies to improve knowledge and vitamin D intake, especially for those of non-white ethnicity and with reduced sun exposure, should be considered.
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Affiliation(s)
- Helena Scully
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Eamon J Laird
- Department of Sport and Exercise, University of Limerick, Limerick, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Martin Healy
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Vivion Crowley
- Department of Biochemistry, St James's Hospital, Dublin, Republic of Ireland
| | - James Bernard Walsh
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
| | - Kevin McCarroll
- Trinity College Dublin School of Medicine, Dublin, Republic of Ireland
- Mercer's Institute for Research on Ageing, St James's Hospital, Dublin, Republic of Ireland
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Taderegew MM, Woldeamanuel GG, Wondie A, Getawey A, Abegaz AN, Adane F. Vitamin D deficiency and its associated factors among patients with type 2 diabetes mellitus: a systematic review and meta-analysis. BMJ Open 2023; 13:e075607. [PMID: 37798019 PMCID: PMC10565281 DOI: 10.1136/bmjopen-2023-075607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The study intended to assess the pooled prevalence of vitamin D deficiency (VDD) and its associated factors among patients with type 2 diabetes mellitus (T2DM). DESIGN The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were employed to plan and conduct this systematic review and meta-analysis. DATA SOURCES PubMed, Medline, Google Scholar, Web of Science, Science Direct and the Worldwide Science database were searched from their inception to 31 January 2023. METHODS Data were extracted using a standardised data extraction format prepared in Microsoft Excel. The inverse variance (I2) test was used to evaluate the presence of heterogeneity across the included studies. To identify the possible source of heterogeneity, subgroup analysis was carried out. Funnel plot symmetry, Begg's and Egger's tests were used to evaluate the existence of publication bias. In addition, factors associated with VDD among patients with T2DM were examined. All statistical analyses were carried out with STATA V.14 software. RESULTS A total of 54 studies with 38 016 study participants were included in the study. The pooled prevalence of VDD among patients with T2DM was found to be 64.2% (95% CI 60.6% to 67.8%) with a substantial level of heterogeneity (I2=98.2%; p<0.001). Results of the subgroup analysis indicated that the pooled prevalence of VDD among patients with T2DM was highest (70.9%) in African nations and lowest (57.1%) in Middle East countries. Being female (pooled OR (POR) 1.60, 95% CI 1.29 to 1.97), having poor glycaemic control (POR 2.50; 95% CI 1.74 to 3.59), hypertension (POR 1.21; 95% CI 1.08 to 1.36), obesity (body mass index ≥25) (POR 1.68; 95% CI 1.16 to 2.44), dyslipidaemia (POR 2.54, 95% CI 1.37 to 4.73), albuminuria (POR 2.22, 95% CI 1.71 to 2.95), nephropathy (POR 1.58; 95% CI 1.08 to 2.31) and retinopathy (POR 1.48: 95% CI 1.17 to 1.89) were predictors of VDD among patients with T2DM. CONCLUSIONS More than half of patients with T2DM were suffering from VDD. Being female, having poor glycaemic control, hypertension, obesity, dyslipidaemia, albuminuria, nephropathy and retinopathy were the predictors of VDD among patients with T2DM.
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Affiliation(s)
- Mitku Mammo Taderegew
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Gashaw Garedew Woldeamanuel
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Alemayehu Wondie
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Atsede Getawey
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Abera Nesiru Abegaz
- Department of Biomedical Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Fentahun Adane
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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Nagaria TD, Shinde RK, Shukla S, Acharya S, Acharya N, Jogdand SD. The Sunlight-Vitamin D Connection: Implications for Patient Outcomes in the Surgical Intensive Care Unit. Cureus 2023; 15:e46819. [PMID: 37954702 PMCID: PMC10636290 DOI: 10.7759/cureus.46819] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
This review delves into the intricate relationship between Vitamin D and patient outcomes in the Surgical Intensive Care Unit (SICU). Vitamin D, known for its multifaceted roles in immune modulation, inflammation regulation, and maintenance of calcium homeostasis, emerges as a pivotal factor in the care of critically ill patients. Our exploration reveals a high prevalence of Vitamin D deficiency in the SICU, primarily attributable to limited sunlight exposure, comorbidities, and medication use. Importantly, Vitamin D status impacts infection rates, mortality, and length of stay in the SICU, making it a clinically relevant consideration. Mechanistic insights into the immunomodulatory and anti-inflammatory effects of Vitamin D shed light on its potential benefits in critical care. However, challenges, including accurate assessment, individualised supplementation, and ethical considerations regarding sunlight exposure, are evident. The prospect of personalised Vitamin D supplementation strategies offers promise for optimising patient care. In conclusion, the Sunlight-Vitamin D Connection holds significant potential to improve outcomes in the SICU, emphasising the importance of further research and tailored approaches for the well-being of critically ill individuals.
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Affiliation(s)
- Tapesh D Nagaria
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Raju K Shinde
- General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Samarth Shukla
- Pathology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sourya Acharya
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Neema Acharya
- Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sangita D Jogdand
- Pharmacology and Therapeutics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Haghighat N, Sohrabi Z, Bagheri R, Akbarzadeh M, Esmaeilnezhad Z, Ashtary-Larky D, Barati-Boldaji R, Zare M, Amini M, Hosseini SV, Wong A, Foroutan H. A Systematic Review and Meta-Analysis of Vitamin D Status of Patients with Severe Obesity in Various Regions Worldwide. Obes Facts 2023; 16:519-539. [PMID: 37640022 PMCID: PMC10697766 DOI: 10.1159/000533828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 08/14/2023] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Managing nutritional deficiencies is an essential component in the treatment of severe obesity. Vitamin D deficiency is often reported in investigations in severely obese cohorts. However, no prior study has summarized findings on this topic. Consequently, the aim of this systematic review and meta-analysis was to investigate the 25-hydroxyvitamin D [25(OH)D] status in individuals with severe obesity in different regions worldwide. We also evaluated levels of calcium, parathyroid hormone (PTH), and magnesium as secondary outcome measures. METHODS We searched Medline, PubMed, Scopus, the Cochrane Library, and EMBASE for relevant observational studies published in English from 2009 to October 2021. The heterogeneity index among the studies was determined using the Cochran (Q) and I2 tests. Based on the heterogeneity results, the random-effect model was applied to estimate the prevalence of vitamin D deficiency. RESULTS We identified 109 eligible observational studies. Overall, 59.44% of patients had vitamin D deficiency [25(OH)D <20 ng/mL], whereas 26.95% had vitamin D insufficiency [25(OH)D 20-30 ng/mL]. Moreover, the mean 25(OH)D level was 18.65 ng/mL in 96 studies. The pooled mean estimate of the serum calcium, PTH, and magnesium was 9.26 mg/dL (95% confidence interval [CI]: 9.19-9.32, I2 = 99.7%, p < 0.001), 59.24 pg/mL (95% CI: 54.98, 63.51, I2 = 99.7%, p < 0.001), and 0.91 mg/dL (95% CI: 0.84, 0.98, I2 = 100.0%, p < 0.001), respectively. The results of the subgroup analysis indicated that the mean estimates of 25(OH)D were highest in North America (21.71 ng/mL [19.69, 23.74], [I2 = 97.2%, p < 0.001]) and lowest in Southeast Asia (14.93 ng/mL [14.54, 15.33], [I2 = 0.0%, p = 0.778]). CONCLUSION The results obtained showed a significant prevalence of vitamin D deficiency among severely obese individuals in various geographical regions, whereas the highest and lowest mean estimates were reported for North America and Southeast Asia, respectively.
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Affiliation(s)
- Neda Haghighat
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sohrabi
- Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan, Iran
| | - Marzieh Akbarzadeh
- Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Esmaeilnezhad
- Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Damoon Ashtary-Larky
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Barati-Boldaji
- Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Morteza Zare
- Department of Community Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Amini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, VA, USA
| | - Hamidreza Foroutan
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Turck D, Bohn T, Castenmiller J, de Henauw S, Hirsch‐Ernst K, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Lanham‐New S, Passeri G, Craciun I, Fabiani L, De Sousa RF, Martino L, Martínez SV, Naska A. Scientific opinion on the tolerable upper intake level for vitamin D, including the derivation of a conversion factor for calcidiol monohydrate. EFSA J 2023; 21:e08145. [PMID: 37560437 PMCID: PMC10407748 DOI: 10.2903/j.efsa.2023.8145] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
Following two requests from the European Commission (EC), the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) was asked to deliver a scientific opinion on the revision of the tolerable upper intake level (UL) for vitamin D and to propose a conversion factor (CF) for calcidiol monohydrate into vitamin D3 for labelling purposes. Vitamin D refers to ergocalciferol (vitamin D2), cholecalciferol (vitamin D3), and calcidiol monohydrate. Systematic reviews of the literature were conducted to assess the relative bioavailability of calcidiol monohydrate versus vitamin D3 on serum 25(OH)D concentrations, and for priority adverse health effects of excess vitamin D intake, namely persistent hypercalcaemia/hypercalciuria and endpoints related to musculoskeletal health (i.e. falls, bone fractures, bone mass/density and indices thereof). Based on the available evidence, the Panel proposes a CF for calcidiol monohydrates of 2.5 for labelling purposes. Persistent hypercalciuria, which may be an earlier sign of excess vitamin D than persistent hypercalcaemia, is selected as the critical endpoint on which to base the UL for vitamin D. A lowest-observed-adverse-effect-level (LOAEL) of 250 μg/day is identified from two randomised controlled trials in humans, to which an uncertainty factor of 2.5 is applied to account for the absence of a no-observed-adverse-effect-level (NOAEL). A UL of 100 μg vitamin D equivalents (VDE)/day is established for adults (including pregnant and lactating women) and for adolescents aged 11-17 years, as there is no reason to believe that adolescents in the phase of rapid bone formation and growth have a lower tolerance for vitamin D compared to adults. For children aged 1-10 years, a UL of 50 μg VDE/day is established by considering their smaller body size. Based on available intake data, European populations are unlikely to exceed the UL, except for regular users of food supplements containing high doses of vitamin D.
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Welford A, Darling AL, Allison S, Lanham-New SA, Greig CA. Response to letter by Lo et al.: Investigating seasonal association between vitamin D concentration, muscle mass and strength in postmenopausal women: a critical analysis. J Nutr Sci 2023; 12:e75. [PMID: 37457682 PMCID: PMC10345777 DOI: 10.1017/jns.2023.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Anneka Welford
- Leicester Diabetes Centre, University of Leicester, Leicester, UK
| | - Andrea L. Darling
- Department of Nutritional Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Sarah Allison
- Biosciences & Medicine, University of Surrey Ringgold Standard Institution, Guildford, Surrey GU2 7XH, UK
| | - Susan A. Lanham-New
- Department of Nutritional Sciences, University of Surrey, Guildford, Surrey GU2 7XH, UK
| | - Carolyn A. Greig
- School of Sport, Exercise and Rehabilitation Sciences, MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
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Crafa A, Cannarella R, Barbagallo F, Leanza C, Palazzolo R, Flores HA, La Vignera S, Condorelli RA, Calogero AE. Mechanisms Suggesting a Relationship between Vitamin D and Erectile Dysfunction: An Overview. Biomolecules 2023; 13:930. [PMID: 37371510 DOI: 10.3390/biom13060930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Vitamin D deficiency (VDD) and erectile dysfunction (ED) heavily burden the male population. The higher prevalence of both conditions in the elderly suggests a possible relationship between the two conditions. In addition, in vitro, animal, and human studies have revealed several mechanisms that may relate VDD to ED. The main mechanism by which vitamin D might exert its action on sexual function appears to be through the regulation of endothelial function. Indeed, VDD correlates with several markers of endothelial function. The action of vitamin D on the endothelium would be exercised both indirectly through its intervention in inflammatory processes and through the production of oxygen free radicals, and directly through the regulation of vascular stiffness, the production of nitric oxide, and the regulation of vessel permeability. Furthermore, the ubiquitous distribution of the vitamin D receptor in the human body means that this hormone can also exert a beneficial effect on erectile function by interfering with those comorbidities significantly associated with ED, such as hypertension, diabetes mellitus, hypercholesterolemia, chronic kidney disease, and hypogonadism. In this review, we thoroughly and carefully presented the evidence and mechanisms that would appear to relate vitamin D levels to erectile function. Furthermore, we have summarized the meta-analytic evidence for and against this association to provide a true representation of this topic. Data published to date suggest that low levels of vitamin D could contribute to worsening erectile function through several mechanisms. Therefore, vitamin D levels should be measured in patients with ED and maintained at adequate levels by specific supplementation in case of deficiency. However, the low quality and heterogeneity of clinical trials evaluating the effects of vitamin D administration on erectile function and ED-associated comorbidities do not allow for a univocal conclusion, and indicate the need for further studies to analyze these aspects.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Claudia Leanza
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Roberto Palazzolo
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Hunter Ausley Flores
- Scott Department of Urology, Baylor College of Medicine in Houston, Houston, TX 77030, USA
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95121 Catania, Italy
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Tran V, Janda M, Lucas RM, McLeod DSA, Thompson BS, Waterhouse M, Whiteman DC, Neale RE. Vitamin D and Sun Exposure: A Community Survey in Australia. Curr Oncol 2023; 30:2465-2481. [PMID: 36826149 PMCID: PMC9955356 DOI: 10.3390/curroncol30020188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Sun exposure carries both harms and benefits. Exposing the skin to the sun is the main modifiable cause of skin cancers, which exert a considerable health and economic burden in Australia. The most well-established benefit of exposure to ultraviolet (UV) radiation is vitamin D production. Australia has the highest incidence of skin cancer in the world but, despite the high ambient UV radiation, approximately one quarter of the population is estimated to be vitamin D deficient. Balancing the risks and benefits is challenging and requires effective communication. We sought to provide a snapshot of public knowledge and attitudes regarding sun exposure and vitamin D and to examine the associations between these factors and sun protective behaviors. In 2020 we administered an online survey; 4824 participants with self-reported fair or medium skin color were included in this analysis. Only 25% and 34% of participants were able to identify the amount of time outdoors needed to maintain adequate vitamin D status in summer and winter, respectively and 25% were concerned that sunscreen use inhibits vitamin D synthesis. This lack of knowledge was associated with suboptimal sun protection practices. Public education is warranted to prevent over-exposure, while supporting natural vitamin D production.
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Affiliation(s)
- Vu Tran
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
- The University of Queensland, Brisbane, QLD 4006, Australia
| | - Monika Janda
- The University of Queensland, Brisbane, QLD 4006, Australia
| | - Robyn M. Lucas
- The Australian National University, Canberra, ACT 2601, Australia
| | - Donald S. A. McLeod
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
- Royal Brisbane and Women’s Hospital, Brisbane, QLD 4029, Australia
| | - Bridie S. Thompson
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | - Mary Waterhouse
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
| | - David C. Whiteman
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
- The University of Queensland, Brisbane, QLD 4006, Australia
| | - Rachel E. Neale
- QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia
- The University of Queensland, Brisbane, QLD 4006, Australia
- Correspondence:
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Sun Exposure Score and Vitamin D Levels in Moroccan Women of Childbearing Age. Nutrients 2023; 15:nu15030688. [PMID: 36771395 PMCID: PMC9919642 DOI: 10.3390/nu15030688] [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: 12/14/2022] [Revised: 01/22/2023] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
Sunlight exposure is an essential source of vitamin D for many humans. However, hypovitaminosis D is a global public health problem. This study aimed to develop and validate a sun exposure score (SES) and correlate it with serum 25-hydroxyvitamin D levels in women of childbearing age. One hundred and sixty women aged 18 to 45 years residing in Meknes, Morocco, were included. A questionnaire estimating the sun exposure score and blood analysis of serum 25-OHD concentration were performed. The questionnaire's reliability and construct validity were evaluated using Cronbach's alpha and factor analysis. Spearman's test was used to assess the correlation between SES and 25-OHD levels. The score's reliability and construct validity were good, with Cronbach's alpha values >0.70 and factorial saturation ranging from 0.696 to 0.948. Serum 25-OHD levels were significantly associated with the total sun exposure score, and all SES domains (Rho was 0.615 (p < 0.0001), 0.307 (p < 0.0001), 0.605 (p < 0.0001), and 0.424 (p < 0.0001) for total SES, indoor exposure domain, outdoor exposure domain, and sun protection practice domain, respectively). In addition, median 25-OHD levels increased significantly when sun exposure was changed from insufficient to sufficient (p < 0.0001). The results suggest that the sun exposure score could be used as a clinical tool to assess vitamin D levels in women of childbearing age.
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Prevalence and Risk Factors for Vitamin D Deficiency in Children and Adolescents in the Kingdom of Bahrain. Nutrients 2023; 15:nu15030494. [PMID: 36771201 PMCID: PMC9919096 DOI: 10.3390/nu15030494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Vitamin D deficiency has reached pandemic levels in the Middle East and North Africa (MENA) region, even though sunshine is abundant all year round for the cutaneous synthesis of vitamin D through the skin. This study aimed to determine the prevalence of vitamin D deficiency and risk factors associated with serum 25-hydroxy vitamin D (25(OH)D) in children and adolescents aged from 10 to 19 years, as well as the possible associations of vitamin D with calcium, magnesium and phosphate levels. METHODS A multi-center, cross-sectional study was conducted between May and August 2019 at the Ministry of Health in the Kingdom of Bahrain. A total of 383 boys and girls were selected from five health centers from five different regions in the Kingdom of Bahrain. Information about sex, age, education level, weight, height, degree of sunlight exposure, and physical activity levels was recorded. A blood sample was taken from each participant to test serum levels of 25(OH)D, calcium, magnesium and phosphate. RESULTS The results revealed that 92.1% of the participants were deficient in vitamin D. A significantly higher percentage of boys (96.2%) were vitamin D deficient (<20 ng/mL) than girls (88.3%) (p value = 0.004). Vitamin D deficiency were more prevalent among overweight (96.8%) and obese (96.2%) participants than normal body weight and wasted participants (p value < 0.001). Being male, overweight, or obese was significantly positively associated with a risk of vitamin D deficiency. Vitamin D deficiency was significantly associated with low serum levels of magnesium. No significant associations were detected between vitamin D deficiency and calcium and phosphate serum levels. However, vitamin D deficiency was significantly associated with low serum level of magnesium (p value = 0.017). CONCLUSIONS Our study revealed that vitamin D deficiency was more prevalent among overweight and obese adolescents and mostly boys rather than girls. Magnesium and phosphate were lower in adolescents and children with lower serum 25(OH)D, showing a clear association between these biomarkers and the 25(OH)D.
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Feng C, Song X, Chalamaiah M, Ren X, Wang M, Xu B. Vitamin D Fortification and Its Effect on Athletes' Physical Improvement: A Mini Review. Foods 2023; 12:foods12020256. [PMID: 36673348 PMCID: PMC9857868 DOI: 10.3390/foods12020256] [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: 11/10/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 01/09/2023] Open
Abstract
Poor vitamin D status is a widespread problem regardless of age and sex, emphasizing the necessity of new food sources to improve vitamin D levels. Currently, approximately 60% of dietary vitamin D consumption occurs via fortified foods. Vitamin D insufficiency (50-90%) is widespread according to age and region, despite different levels of sunlight exposure. The food industry must identify more effective strategies to increase normal dietary vitamin D intake and improve overall health. Strategies for vitamin D fortification include bioaddition, wherein a vitamin D-rich food source is added to staple foods during processes. These bioadditive strategies expand the range of vitamin D-containing foods and appeal to different preferences, cultures, and economic statuses. In several countries, vitamin D deficiency places athletes at a high risk of disease susceptibility. Due to low sun exposure, athletes in countries with higher and lower levels of sunlight have similar risks of vitamin D deficiency. In this review, we summarize recent technical advances to promote vitamin D utilization by humans during sports activities and in relation to the normal practices of athletes.
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Affiliation(s)
- Cong Feng
- Department of Physical Education, Jiangsu University, Zhenjiang 212013, China
| | - Xinjie Song
- School of Biological and Chemical Engineering, Zhejiang University of Science and Technology, Hangzhou 310023, China
- Correspondence:
| | - Meram Chalamaiah
- Department of Agricultural, Food and Nutritional Science (AFNS), 4-10 Ag/For Centre, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Xiaofeng Ren
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
| | - Mingxing Wang
- Department of Business Administration, School of Business, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Baoguo Xu
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang 212013, China
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Liyanage G, Jayathunga S, Amarasekara T. Vitamin D knowledge and sun exposure practices among Sri Lankan healthcare undergraduates. PLoS One 2022; 17:e0279480. [PMID: 36574411 PMCID: PMC9794041 DOI: 10.1371/journal.pone.0279480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Although overexposure to ultraviolet radiation may lead to skin cancer, inadequate exposure results in vitamin D deficiency (VDD). We explored vitamin D-related knowledge and sun exposure practices among Sri Lankan healthcare undergraduates. METHODS The sampling frame consisted of medical and allied health undergraduates in a single centre. A newly developed, pre-piloted, self-administered questionnaire collected data on vitamin D knowledge, sun avoidance behaviour and outdoor time. Univariate and multivariate logistic regression analysis examined the factors related to outdoor time. RESULTS A total of 482 were included in the analysis. The mean (SD) vitamin D knowledge score (0-100% scale) was 31.3% (18%). Only 17.8% scored ≥50% for knowledge. At least one sun avoidance measure was used by 59.3% of the undergraduates. A lower knowledge score was observed with a higher number of sun-avoidance behaviour (mean difference 0.84, p = 0.03). The majority (66%) spent outdoors <30 minutes per day between 9 am-3 pm. The odds of having low outdoor time were 1.6 higher for the female sex (OR:1.61, 95%CI:1.039, 2.492, p<0.001) and studying in the final year (OR:1.63, 95%CI:1.020, 2.602, p = 0.04). Medical students had a higher likelihood of low outdoor time (OR:0.55, 95%CI: 0.361, 0.835, p = 0.005). CONCLUSIONS The healthcare undergraduates had low vitamin D knowledge and outdoor time while having increased sun avoidance. Gender, course of study, and academic year appeared to affect outdoor time. Support and guidance should improve knowledge and sun exposure habits that suit academic work and lifestyle in this population. Also, universities can actively promote positive sun exposure by organizing outdoor events.
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Affiliation(s)
- Guwani Liyanage
- Department of Paediatrics, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
- * E-mail:
| | - Sanjana Jayathunga
- Department of Nursing, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Thamara Amarasekara
- Department of Nursing, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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Cherrie JW, Cherrie MPC. Workplace exposure to UV radiation and strategies to minimize cancer risk. Br Med Bull 2022; 144:45-56. [PMID: 35973164 PMCID: PMC9744745 DOI: 10.1093/bmb/ldac019] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Workplace exposure to solar ultraviolet (UV) causes malignant melanoma and non-melanoma skin cancer. The evidence for beneficial effects of solar UV exposure in reducing the risks for other cancers is increasing. The intensity of UV radiation at the Earth's surface is dependent on latitude, but even in northern European countries exposure can be high enough for outdoor work to cause skin cancer. GROWING POINTS Awareness of the health risks and benefits of occupational solar UV exposure is poor. Actions to reduce the risk of skin cancer have been identified and employers should recognize their responsibility to actively manage these risks. There is evidence for reduced risks for breast, ovarian and colorectal cancer and possibly other cancers linked to solar UV exposure. SOURCES OF DATA This narrative review draws on published scientific articles and material designed to assist identifying strategies to protect workers from solar UV exposure. AREAS OF AGREEMENT Solar UV exposure can be harmful. Wavelengths in the UVB range are more effective in causing erythema and DNA damage. Solar UV is the main source of vitamin D for most people. Primary and secondary prevention for skin cancer can potentially eliminate these risks but the evidence for effectiveness is limited. AREAS OF CONTROVERSY Potential health benefits of UV exposure, particularly for reduced cancer risk. Determining and communicating optimal exposure to maximize health benefits. The risk of non-melanoma skin cancers may be more than doubled for some workers in temperate latitudes. AREAS TIMELY FOR DEVELOPING RESEARCH Exposure-response epidemiological studies; studies of the health benefits of occupational UV exposure; studies of the effectiveness of intervention strategies to prevent skin cancer. Use of low-cost UV sensors in workplaces.
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Affiliation(s)
- J W Cherrie
- IOM, Research Avenue North, Edinburgh EH14 4AP, UK.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK
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Overstreet DS, Strath LJ, Hasan FN, Sorge RE, Penn T, Rumble DD, Aroke EN, WIggins AM, Dembowski JG, Bajaj EK, Quinn TL, Long DL, Goodin BR. Racial Differences in 25-Hydroxy Vitamin D and Self-Reported Pain Severity in a Sample of Individuals Living with Non-Specific Chronic Low Back Pain. J Pain Res 2022; 15:3859-3867. [PMID: 36514480 PMCID: PMC9741831 DOI: 10.2147/jpr.s386565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction Considerable evidence suggests that there are significant ethnic/racial differences in the experience of pain among individuals suffering from chronic musculoskeletal conditions. Additionally, low levels of vitamin D have been associated with pain severity. Further, vitamin D deficiency is more prevalent in Non-Hispanic Black (NHB) individuals compared to Non-Hispanic Whites (NHW). Objective The aim of this study was to investigate the associations among race, pain severity, and serum levels of vitamin D in a sample of patients with chronic low back pain (cLBP). Methods All study participants (n = 155) self-identified their race/ethnicity as either NHB or NHW. Blood samples were collected to assess circulating levels of serum 25- hydroxy vitamin D. Vitamin D levels were categorized as optimal (≥20 ng/mL), insufficient (12-19 ng/mL) or deficient (<12 ng/mL). Participants then self-reported their pain severity using the Brief Pain Inventory - Short Form. Results Results showed that a greater proportion of NHB versus NHW participants were categorized as Vitamin D deficient (χ 2 (2, N = 155) = 16.79, p < 0.001). An analysis of covariance (ANCOVA) revealed that NHBs reported significantly greater pain severity relative to NHWs (F(1150) = 6.45) p = 0.012. Further, self-reported pain severity significantly differed according to Vitamin D clinical categories (F(2150) = 4.19, p = 0.013). Participants with deficient vitamin D reported significantly greater pain severity in comparison to participants with optimal vitamin D (F(1101) = 7.28, p = 0.008). Conclusion The findings suggest that Vitamin D deficiency may be linked to greater pain severity in a sample of individuals with cLBP, especially for those who identify as NHB.
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Affiliation(s)
- Demario S Overstreet
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Larissa J Strath
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Fariha N Hasan
- School of Public Health, Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert E Sorge
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Terence Penn
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Deanna D Rumble
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Edwin N Aroke
- School of Nursing, Nurse Anesthesia Program, Department of Acute, Chronic, & Continuing Care, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Asia M WIggins
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jonas G Dembowski
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eeshaan K Bajaj
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tammie L Quinn
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - D Leann Long
- School of Public Health, Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
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Shah K, Varna VP, Sharma U, Mavalankar D. Does vitamin D supplementation reduce COVID-19 severity?: a systematic review. QJM 2022; 115:665-672. [PMID: 35166850 PMCID: PMC9383458 DOI: 10.1093/qjmed/hcac040] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The evidence regarding the efficacy of vitamin D supplementation in reducing severity of COVID-19 is still insufficient. This is partially due to the lack of primary robust trial-based data and heterogeneous study designs. AIM This evidence summary, aims to study the effect of vitamin D supplementation on morbidity and mortality in hospitalized COVID-19 patients.Design: Evidence summary of systematic reviews. METHODS For this study, systematic reviews and meta-analysis published from December 2019 to January 2022 presenting the impact of vitamin D supplementation on COVID-19 severity were screened and selected from PubMed and Google scholar. After initial screening, 10 eligible reviews were identified and quality of included reviews were assessed using AMSTAR and GRADE tools and overlapping among the primary studies used were also assessed. RESULTS The number of primary studies included in the systematic reviews ranged from 3 to 13. Meta-analysis of seven systematic reviews showed strong evidence that vitamin D supplementation reduces the risk of mortality (Odds ratio: 0.48, 95% CI: 0.346-0.664; P < 0.001) in COVID patients. It was also observed that supplementation reduces the need for intensive care (Odds ratio: 0.35; 95%CI: 0.28-0.44; P < 0.001) and mechanical ventilation (Odds ratio: 0.54; 95% CI: 0.411-0.708; P < 0.001) requirement. The findings were robust and reliable as level of heterogeneity was considerably low. However the included studies were of varied quality. Qualitative analysis showed that supplements (oral and IV) are well tolerated, safe and effective in COVID patients. CONCLUSION The findings of this study show that vitamin D supplementation is effective in reducing the COVID-19 severity. Hence, vitamin D should be recommended as an adjuvant therapy for COVID-19.However, more robust and larger trials are required to substantiate it further.
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Affiliation(s)
- K Shah
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - V P Varna
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - U Sharma
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - D Mavalankar
- From the Indian Institute of Public Health, Gujarat 382042, India
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Vitamin D Levels in Ethnic Minority Adolescents in Primary Care. J Pediatr Health Care 2022; 36:443-448. [PMID: 35654708 DOI: 10.1016/j.pedhc.2022.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This pilot study examined the distribution of low vitamin D levels among ethnic minority adolescents in primary care to elucidate the clinical needs of this diverse population. METHOD A cross-sectional study was conducted using a retrospective patient chart review. Participants were a consecutive sample of 119 ethnically diverse adolescents aged 12-18 years, attending a primary care clinic, who had a wellness examination in 2018 and documented vitamin D levels on the basis of previously collected blood work. RESULTS Sixty-one percent of adolescents had low vitamin D levels. Vitamin D deficiency increased with age, independently of ethnicity or gender. DISCUSSION A significant number of ethnically diverse adolescents presented with low vitamin D levels. A need exists to raise awareness among clinicians regarding social determinants of health and culturally sensitive dietary practices to improve vitamin D levels and prevent long-term complications, focusing on adolescent at-risk ethnic groups.
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Dosi MCMC, McGorum BC, Kirton RD, Cillán‐García E, Mellanby RJ, Keen JA, Hurst EA, Morgan RA. The effect of season, management and endocrinopathies on vitamin D status in horses. Equine Vet J 2022. [DOI: 10.1111/evj.13873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Miranda C. M. C. Dosi
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
| | - Bruce C. McGorum
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
| | | | - Eugenio Cillán‐García
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
| | - Richard J. Mellanby
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
- The Roslin Institute University of Edinburgh Roslin Midlothian UK
| | - John A. Keen
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
| | - Emma A. Hurst
- The Roslin Institute University of Edinburgh Roslin Midlothian UK
- Mass Spectrometry Core, Edinburgh Clinical Research Facility, Queen’s Medical Research Institute University of Edinburgh Edinburgh UK
| | - Ruth A. Morgan
- Royal (Dick) School of Veterinary Studies University of Edinburgh, Roslin Midlothian UK
- Queen’s Medical Research Institute The University of Edinburgh, Little France Crescent Edinburgh UK
- Scotland’s Rural College Edinburgh UK
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Manuck TA, Eaves LA, Rager JE, Sheffield-abdullah K, Fry RC. Nitric oxide-related gene and microRNA expression in peripheral blood in pregnancy vary by self-reported race. Epigenetics 2022; 17:731-745. [PMID: 34308756 PMCID: PMC9336489 DOI: 10.1080/15592294.2021.1957576] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 12/12/2022] Open
Abstract
Adverse pregnancy outcomes disproportionately affect non-Hispanic (NH) Black patients in the United States. Structural racism has been associated with increased psychosocial distress and inflammation and may trigger oxidative stress. Thus, the nitric oxide (NO) pathway (involved in the regulation of inflammation and oxidative stress) may partly explain the underlying disparities in obstetric outcomes.Cohort study of 154 pregnant patients with high-risk obstetric histories; n = 212 mRNAs and n = 108 microRNAs (miRNAs) in the NO pathway were evaluated in circulating white blood cells. NO pathway mRNA and miRNA transcript counts were compared by self-reported race; NH Black patients were compared with women of other races/ethnicities. Finally, miRNA-mRNA expression levels were correlated.Twenty-two genes (q < 0.10) were differentially expressed in self-identified NH Black individuals. Superoxide dismutase 1 (SOD1), interleukin-8 (IL-8), dynein light chain LC8-type 1 (DYNLL1), glutathione peroxidase 4 (GPX4), and glutathione peroxidase 1 (GPX1) were the five most differentially expressed genes among NH Black patients compared to other patients. There were 63 significantly correlated miRNA-mRNA pairs (q < 0.10) demonstrating potential miRNA regulation of associated target mRNA expression. Ten miRNAs that were identified as members of significant miRNA-mRNA pairs were also differentially expressed among NH Black patients (q < 0.10).These findings support an association between NO pathway and inflammation and infection-related mRNA and miRNA expression in blood drawn during pregnancy and patient race/ethnicity. These findings may reflect key differences in the biology of inflammatory gene dysregulation that occurs in response to the stress of systemic racism and that underlies disparities in pregnancy outcomes.
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Affiliation(s)
- Tracy A. Manuck
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina-Chapel Hill, Chapel Hill, NC, United States
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Lauren A. Eaves
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Julia E Rager
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
| | | | - Rebecca C. Fry
- Institute for Environmental Health Solutions, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
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Lanham‐New SA, Buttriss JL, Gibson‐Moore H, Staines KA, Webb AR, Cashman KD, Hewison M, Martineau AR, Smith CP, Butler‐Laporte G, Bouillon R. UK
Nutrition Research Partnership ‘Hot Topic’ workshop: Vitamin D—A multi‐disciplinary approach to (1) elucidate its role in human health and (2) develop strategies to improve vitamin D status in the
UK
population. NUTR BULL 2022; 47:246-260. [DOI: 10.1111/nbu.12557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Susan A. Lanham‐New
- Department of Nutritional Sciences School of Biosciences and Medicine Faculty of Health and Medical Sciences University of Surrey Guildford UK
| | | | | | | | - Ann R. Webb
- Earth and Environmental Sciences University of Manchester Manchester UK
| | - Kevin D. Cashman
- School of Food and Nutritional Sciences University College Cork Cork Ireland
| | - Martin Hewison
- Institute of Metabolism and Systems Research University of Birmingham Birmingham UK
| | - Adrian R. Martineau
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Colin P. Smith
- Department of Nutritional Sciences School of Biosciences and Medicine Faculty of Health and Medical Sciences University of Surrey Guildford UK
- School of Pharmacy and Biomolecular Sciences University of Brighton Brighton UK
| | - Guillaume Butler‐Laporte
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing KU Leuven Leuven Belgium
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Santana KVDSD, Oliver SL, Mendes MM, Lanham-New S, Charlton KE, Ribeiro H. Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health. EClinicalMedicine 2022; 47:101400. [PMID: 35497056 PMCID: PMC9043392 DOI: 10.1016/j.eclinm.2022.101400] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/21/2022] [Accepted: 03/31/2022] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been documented to be prevalent, even in low latitude regions; and this may be related to sun exposure behaviors. The aim of the current study was to assess the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lifestyle-related factors in a sample of Brazilian women living at latitude 21º 8' S. METHODS A cross-sectional study was undertaken in 101 women aged 35 years or older in July 2019 to assess the association between 25(OH)D concentration and level of exposure to ultraviolet radiation (UVR), smoking habits, alcohol consumption, and physical activity levels. Age, body mass index (BMI), and postmenopausal status were investigated. FINDINGS According to the slope coefficient for individual daily UVR levels, the concentration of 25(OH)D increased by 5 nmol / L for each extra Standard Erythema Dose of UVR, regardless of age and BMI (p < 0·001). Postmenopausal women had a significantly higher mean concentration of 25(OH)D (p = 0·01), higher UVR exposure (p = 0·01) and lower BMI (p = 0·005) compared with younger women, independent of other confounders including smoking, alcohol, occupation and physical activity. INTERPRETATION Although postmenopausal women from Brazil had higher mean concentrations of 25(OH)D than younger women, more studies are necessary to understand how sun exposure and lifestyle variables interfere with these levels. These findings have important public health implications since they suggest that vitamin D deficiency in older age is not inevitable. FUNDING This study was funded by an award received by Universities Global Partnership Network - UGPN. KVSS and SLO receive scholarship from CAPES, Brazilian Ministry of Education. HR receives a productivity grant from CNPq.
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Affiliation(s)
- Keila Valente de Souza de Santana
- Programa de Pós-Graduação em Saúde Global e Sustentabilidade, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sofia Lizarralde Oliver
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcela Moraes Mendes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Susan Lanham-New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Wollongong, Australia NSW and Illawarra Health and Medical Research Institute, Wollongong, Australia NSW
| | - Helena Ribeiro
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
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Schou A, Jørgensen NR, Maro VP, Kilonzo K, Ramaiya K, Sironga J, Jensen AK, Christensen DL, Schwarz P. The circadian rhythm of calcium and bone homeostasis in Maasai. Am J Hum Biol 2022; 34:e23756. [PMID: 35481615 PMCID: PMC9539595 DOI: 10.1002/ajhb.23756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Ethnic groups differ in prevalence of calcium-related diseases. Differences in the physiology and the endogenous circadian rhythm (CR) of calcium and bone homeostasis may play a role. Thus, we aimed to investigate details of CR pattern in calcium and bone homeostasis in East African Maasai. METHODS Ten clinically healthy adult Maasai men and women from Tanzania were examined. Blood samples were collected every 2nd hour for 24 h. Serum levels of total calcium, albumin, parathyroid hormone (PTH), 25(OH)D, creatinine, C-terminal telopeptide (CTX), bone-specific alkaline phosphatase (BSAP), procollagen type 1 N-terminal propeptide (P1NP), and osteocalcin were measured. Circadian patterns were derived from graphic curves of medians, and rhythmicity was assessed with Fourier analysis. RESULTS PTH-levels varied over the 24 h exhibiting a bimodal pattern. Nadir level corresponded to 65% of total 24-h mean. CTX and P1NP showed 24-h variations with a morning nadir and nocturnal peak with nadir levels corresponding to 23% and 79% of the 24-h mean, respectively. Albumin-corrected calcium level was held in a narrow range and alterations were corresponding to alterations in PTH. There was no distinct pattern in 24-h variations of 25(OH)D, creatinine, osteocalcin, or BSAP. CONCLUSIONS All participants showed pronounced 24-h variations in PTH and bone turnover markers CTX and P1NP. These findings support that Maasai participants included in this study have typical patterns of CR in calcium and bone homeostasis consistent with findings from other ethnic populations.
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Affiliation(s)
- Anne Schou
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet Glostrup, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Venance Phillip Maro
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kajiru Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kaushik Ramaiya
- Department of Internal Medicine, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - Joseph Sironga
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Internal Medicine, Monduli District Hospital, Monduli, Tanzania
| | - Andreas Kryger Jensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dirk Lund Christensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Schwarz
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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Racial/ethnic disparities on inflammation and response to methylprednisolone in severe COVID-19 pneumonia. BMC Infect Dis 2022; 22:254. [PMID: 35287602 PMCID: PMC8919360 DOI: 10.1186/s12879-022-07237-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background Racial/ethnic minorities are at higher risk for severe COVID-19. This may be related to social determinants that lead to chronic inflammatory states. The aims of the study were to determine if there are racial/ethnic disparities with inflammatory markers and association of methylprednisolone to in hospital survival. Methods This was a secondary analysis of a retrospective cohort study of patients ≥ 18 years of age and admitted for severe COVID-19 pneumonia between March and June 2020 in 13 Hospitals in New Jersey, United States. Patients who received other formulation of corticosteroids were not included. Area under the receiver operating characteristics curves were performed to test for discriminatory ability of each inflammatory makers. Univariate and multivariate Cox regression assessed the association of variables to in hospital survival. Results Propensity matched sample (n = 759) between no methylprednisolone (n = 380) and methylprednisolone (n = 379) had 338 Whites, 102 Blacks, 61 Asian/Indians, and 251 non-Black non-White Hispanics. Compared to CRP, area under receiving operating characteristic curve for d-dimer in Hispanics (0.742) was statistically different (DeLong Test P = 0.0041). Multivariate cox regression showed that different variables in Blacks [age ≥ 60 years (HR = 3.71, P = 0.0281), mechanical ventilation (HR = 5.07, P = 0.0281) and creatinine ≥ 1.5 mg/dL (HR = 3.61, P = 0.0007)], Whites [cancer (HR = 1.68, P = 0.0213), qSOFA score of 1 (HR = 1.81, P = 0.0213), qSOFA score of 2 (HR = 5.16, P < 0.0001), qSOFA score of 3 (HR = 11.81, P < 0.0001) and creatinine ≥ 1.5 mg/dL (HR = 2.16, P = 0.0006)], Hispanics [hypertension (HR = 2.52, P = 0.0007), cancer (HR = 2.99, P = 0.0244 and D-dimer ≥ 2 mcg/mL (HR = 2.22, P = 0.0077)], and Asian/Indians [
chronic kidney disease (HR = 6.36, P = 0.0031) and CRP > 20 mg/L (HR = 5.02, P = 0.0032)] were statistically significant for mortality. Low dose and high dose methylprednisolone were significantly associated with prolonged survival in Whites [low dose (HR = 0.37, P < 0.0001) and high dose (HR = 0.48, P < 0.0183)] and Asian/Indians [low dose (HR = 0.13, P = 0.0101) and high dose (HR = 0.15, P = 0.01)]. However, high dose was not associated with improved survival compared to low dose. Methylprednisolone was not associated with prolonged survival in Blacks and Hispanics. Conclusion Racial/Ethnic disparities with inflammatory markers preclude the use of one marker as a predictor of survival. Methylprednisolone is associated with prolonged survival in Asian/Indians and Whites. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07237-1.
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Physiological significance of vitamin D produced in skin compared with oral vitamin D. J Nutr Sci 2022; 11:e13. [PMID: 35291276 PMCID: PMC8889086 DOI: 10.1017/jns.2022.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 01/01/2023] Open
Abstract
Abstract
Since the discovery of vitamin D, it has been accepted that its physiological supply is either from food or by endogenous synthesis in skin exposed to solar UV light. Yet vitamin D is a component of very few foods and its supply as a natural nutrient is unable to maintain good vitamin D status for human populations. One aspect of vitamin D physiology that has been ignored is that the mechanisms for its transport and processing from these two sources are quite different. Excess intake of vitamin D causes hypercalcaemic toxicity. However, experiments with different animal species have shown that long-term supply of oral vitamin D in apparently non-toxic amounts causes atherosclerosis in large arteries. A mechanism for this toxicity is proposed. Alternative strategies for addressing widespread vitamin D deficiency by food fortification should be considered in light of the angiotoxicity caused by oral vitamin D in animal experiments.
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Uday S, Högler W. The burden of vitamin D deficiency in household members of children presenting with symptomatic vitamin D deficiency. Front Endocrinol (Lausanne) 2022; 13:958422. [PMID: 36111298 PMCID: PMC9468761 DOI: 10.3389/fendo.2022.958422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Micronutrient deficiencies are common among household/family members due to shared lifestyle and dietary habits. The extent of biochemical abnormalities in household members of children presenting with symptomatic vitamin D deficiency remains unknown. AIM Investigate the prevalence of vitamin D deficiency and biochemical osteomalacia in the mothers and siblings of children presenting with symptomatic vitamin D deficiency. METHODS All mothers and sibling of children referred to a single tertiary endocrine centre between January 2018 and December 2021, with symptomatic vitamin D deficiency were investigated prospectively for vitamin D deficiency [defined as 25 hydroxyvitamin D (25OHD) < 30nmol/L] and biochemical osteomalacia [vitamin D deficiency and elevated alkaline phosphatase (ALP) and/or parathormone (PTH)] as per clinical guidelines. REULTS Ninety-seven family members (68 siblings and 29 mothers) of 29 index cases (median age 1.7 years, 55.5% male) were investigated. The majority (65.5%, n=19) were of Asian ethnic background. The mean (SD) 25OHD levels of the index, maternal and sibling cohorts were 15 (10), 15 (7) and 20 (10) nmol/L respectively. Vitamin D deficiency was noted in 93% of the maternal and 79% of the sibling cohorts. Biochemical osteomalacia was present in 72% of the maternal and 79% of the sibling cohorts. Mothers of infants had significantly lower mean 25OHD levels compared to mothers of older children [11 (n=12) vs 18 nmol/L (n=17) respectively, p=0.006)], most of whom were symptomatic (66.6%, n=8/12). None of the mothers had hypocalcaemia. Among the 10% (n=7) of the siblings with hypocalcaemia, 86% (n=6/7) had concurrent dietary calcium deficiency and 71.4% (n= 5/7) reported symptoms in retrospect. Hypocalcaemic siblings had significantly lower 25OHD (7 vs 15 nmol/L, p<0.001), higher PTH (175 vs 58 ng/L, p<0.001) and ALP (846 vs 318 IU/L, p<0.001), respectively compared to normocalcaemic siblings. CONCLUSIONS In view of the substantial morbidity uncovered in household/family members of children diagnosed with symptomatic vitamin D deficiency, we recommend universal supplementation of all risk groups. Biochemical testing and treatment is indicated to replenish stores only in those at highest risk such as mothers of infants, individuals with concurrent dietary calcium deficiency and those with clinical symptoms.
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Affiliation(s)
- Suma Uday
- Department of Endocrinology and Diabetes, Birmingham Women’s and Children’s Hospital, Birmingham, United Kingdom
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Suma Uday,
| | - Wolfgang Högler
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Department of Paediatrics and Adolescent Medicine, Johannes Kepler University Linz, Linz, Austria
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Matthews SW, Heitkemper MM, Kamp K. Early Evidence Indicates Vitamin D Improves Symptoms of Irritable Bowel Syndrome: Nursing Implications and Future Research Opportunities. Gastroenterol Nurs 2021; 44:426-436. [PMID: 34690298 DOI: 10.1097/sga.0000000000000634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022] Open
Abstract
Irritable bowel syndrome (IBS) affects approximately 11.2% of the population. Yet, full understanding of its etiology and optimal treatment remains elusive. Understanding of the underlying pathophysiology of IBS has been limited. However, research is beginning to identify the cause as multifactorial (e.g., low-grade local mucosal inflammation, systemic immune activation, altered intestinal permeability, intestinal hypersensitivity, altered central nervous system processing, changes in intestinal microbiota). Understanding of the role of vitamin D in intestinal inflammation, immunity, and gastrointestinal conditions is increasing but is not yet fully understood. Growing evidence has linked vitamin D deficiency with a variety of gastrointestinal disorders, including inflammatory bowel disease, diverticulitis, colorectal cancer, and IBS. Several studies have demonstrated that individuals with IBS are more likely to have vitamin D deficiency than healthy controls. Recent vitamin D supplementation studies have shown improvement in quality of life and reduction in IBS symptoms (including abdominal pain, distention, flatulence, constipation, and visceral sensitivity) but the mechanism remains unclear. Nurses are well positioned to educate patients about the importance of sufficient vitamin D for overall health in individuals with IBS as well as participate in well-designed therapeutic studies to explore whether enhanced vitamin D status will ultimately help treat IBS more effectively.
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Affiliation(s)
- Sarah W Matthews
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
| | - Margaret M Heitkemper
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
| | - Kendra Kamp
- Sarah W. Matthews, DNP, MN, BSN, APRN, FNP-BC, is Assistant Professor, Department of Child, Family, and Population Health Nursing, University of Washington, School of Nursing, Seattle; and Nurse Practitioner, Kaiser Permanente Washington, Bellevue
- Margaret M. Heitkemper, PhD, MN, BSN, RN, FAAN, is Professor and Chairperson, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
- Kendra Kamp, PhD, BSN, RN, is Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, University of Washington, School of Nursing, Seattle
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Webb AR, Alghamdi R, Kift R, Rhodes LE. 100 YEARS OF VITAMIN D: Dose-response for change in 25-hydroxyvitamin D after UV exposure: outcome of a systematic review. Endocr Connect 2021; 10:R248-R266. [PMID: 34519278 PMCID: PMC8558903 DOI: 10.1530/ec-21-0308] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
A systematic review of publications addressing change in vitamin D status (25-hydroxyvitamin D (25OHD)) after exposure to UV radiation identified 2001 independent peer-reviewed publications. Of these, 21 used artificial sources of UV radiation, met all inclusion criteria and were quality assured; 13 publications used solar radiation and met sufficient inclusion criteria to be retained as supporting evidence; 1 further included publication used both solar and artificial sources. The review consistently identified that low dose, sub-erythemal doses are more effective for vitamin D synthesis than doses close to a minimum erythema dose; increasing skin area exposed increases the amount of vitamin D synthesised although not necessarily in a linear manner; constant dosing leads to a dose-dependent plateau in 25OHD, and dose-response is greatest at the start of a dosing regime; there is a large interpersonal variation in response to UV exposure. Fourteen of the studies using artificial sources of radiation were used to determine a dose-response relationship for change in 25OHD on whole-body exposure to repeated sub-erythemal doses of UV radiation, taking the form Δ25OHD (nmol/L) = A ln(standard vitamin D dose) + B. This helps quantify our understanding of UV as a source of vitamin D and enables exposure regimes for safe synthesis of vitamin D to be assessed. Specific studies of people with pigmented skin (Fitzpatrick skin types 5 and 6) were rare, and this dose-response relationship is only applicable to white-skinned individuals as skin type is a determinant of response to UV radiation. Findings provide information for vitamin D guidance updates.
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Affiliation(s)
- Ann R Webb
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Rehab Alghamdi
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Richard Kift
- Department of Earth and Environmental Sciences, University of Manchester, Manchester, UK
| | - Lesley E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester, UK
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Nikooyeh B, Neyestani TR. Contribution of vitamin D status as a determinant of cardiometabolic risk factors: a structural equation model, National Food and Nutrition Surveillance. BMC Public Health 2021; 21:1819. [PMID: 34627185 PMCID: PMC8501625 DOI: 10.1186/s12889-021-11839-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 09/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Structural equation modeling (SEM) is a method used to evaluate linear causal relationships among variables. This study aimed to investigate the direct and indirect effects of serum 25(OH) D on certain cardiovascular risk factors using SEM. Methods An analytical cross-sectional study was conducted in six provinces of Iran. Subjects (n = 922), aged 19–65 years, were selected from National Food and Nutrition Surveillance. The assessments were sun-exposure behavior, anthropometric and biochemical measurements. A series of SEM models were tested and the model with the best fit indices was considered for use in the structural part of the model. Based on the literature review of previous theoretical models and supporting bivariate analyses, an overall SEM examined direct or indirect associations among observed and latent variables. We put the demographic, duration of sun exposure, anthropometric and metabolic variables in our model. Results The paths between serum 25(OH) D and BMI were inverse and statistically significant, whereas age showed a positive association with BMI (B = 0.06, p < 0.001), both direct (st. effect = 0.11, p = 0.01) and indirect via vitamin D (st. effect = − 0.02, p = 0.01). The results confirmed that serum 25(OH) D concentration is a predictor for latent variable of lipid profile (B = − 0.13, p = 0.01) both through direct (p = 0.02) and indirect effects via BMI (p = 0.01). Conclusion Serum 25(OH) D concentration is a predictor of BMI and also a latent variable of lipid profile via direct and indirect effects. It can also attenuate the harmful effect of age on BMI and lipid profile particularly in women.
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Affiliation(s)
- Bahareh Nikooyeh
- National Nutrition and Food Technology Research Institute and Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, 1981619573, Iran
| | - Tirang R Neyestani
- National Nutrition and Food Technology Research Institute and Faculty of Nutrition Science and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, 1981619573, Iran.
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Erem AS, Razzaque MS. Vitamin D-independent benefits of safe sunlight exposure. J Steroid Biochem Mol Biol 2021; 213:105957. [PMID: 34329737 DOI: 10.1016/j.jsbmb.2021.105957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/15/2021] [Accepted: 07/25/2021] [Indexed: 01/10/2023]
Abstract
This review examines the beneficial effects of ultraviolet radiation on systemic autoimmune diseases, including multiple sclerosis and type I diabetes, where the epidemiological evidence for the vitamin D-independent effects of sunlight is most apparent. Ultraviolet radiation, in addition to its role in the synthesis of vitamin D, stimulates anti-inflammatory pathways, alters the composition of dendritic cells, T cells, and T regulatory cells, and induces nitric oxide synthase and heme oxygenase metabolic pathways, which may directly or indirectly mitigate disease progression and susceptibility. Recent work has also explored how the immune-modulating functions of ultraviolet radiation affect type II diabetes, cancer, and the current global pandemic caused by SARS-CoV-2. These diseases are particularly important amidst global changes in lifestyle that result in unhealthy eating, increased sedentary habits, and alcohol and tobacco consumption. Compelling epidemiological data shows increased ultraviolet radiation associated with reduced rates of certain cancers, such as colorectal cancer, breast cancer, non-Hodgkins lymphoma, and ultraviolet radiation exposure correlated with susceptibility and mortality rates of COVID-19. Therefore, understanding the effects of ultraviolet radiation on both vitamin D-dependent and -independent pathways is necessary to understand how they influence the course of many human diseases.
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Affiliation(s)
- Anna S Erem
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Mohammed S Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
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Mariño-Ramírez L, Ahmad M, Rishishwar L, Nagar SD, Lee KK, Norris ET, Jordan IK. Vitamin D and socioeconomic deprivation mediate COVID-19 ethnic health disparities. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.09.20.21263865. [PMID: 34611667 PMCID: PMC8491858 DOI: 10.1101/2021.09.20.21263865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Ethnic minorities in developed countries suffer a disproportionately high burden of COVID-19 morbidity and mortality, and COVID-19 ethnic disparities have been attributed to social determinants of health. Vitamin D has been proposed as a modifiable risk factor that could mitigate COVID-19 health disparities. We investigated the relationship between vitamin D and COVID-19 susceptibility and severity using the UK Biobank, a large progressive cohort study of the United Kingdom population. Structural equation modelling was used to evaluate the ability of vitamin D, socioeconomic deprivation, and other known risk factors to mediate COVID-19 ethnic health disparities. Asian ethnicity is associated with higher COVID-19 susceptibility, compared to the majority White population, and Asian and Black ethnicity are both associated with higher COVID-19 severity. Socioeconomic deprivation mediates all three ethnic disparities and shows the highest overall signal of mediation for any COVID-19 risk factor. Vitamin supplements, including vitamin D, mediate the Asian disparity in COVID-19 susceptibility, and serum 25-hydroxyvitamin D (calcifediol) levels mediate Asian and Black COVID-19 severity disparities. Several measures of overall health also mediate COVID-19 ethnic disparities, underscoring the importance of comorbidities. Our results support ethnic minorities' use of vitamin D as both a prophylactic and a supplemental therapeutic for COVID-19.
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Affiliation(s)
- Leonardo Mariño-Ramírez
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
| | - Maria Ahmad
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Lavanya Rishishwar
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia, USA
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Shashwat Deepali Nagar
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Kara K. Lee
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Emily T. Norris
- National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia, USA
| | - I. King Jordan
- PanAmerican Bioinformatics Institute, Valle del Cauca, Cali, Colombia
- IHRC-Georgia Tech Applied Bioinformatics Laboratory, Atlanta, Georgia, USA
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, Georgia, USA
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Parikh R, Sorek E, Parikh S, Michael K, Bikovski L, Tshori S, Shefer G, Mingelgreen S, Zornitzki T, Knobler H, Chodick G, Mardamshina M, Boonman A, Kronfeld-Schor N, Bar-Joseph H, Ben-Yosef D, Amir H, Pavlovsky M, Matz H, Ben-Dov T, Golan T, Nizri E, Liber D, Liel Y, Brenner R, Gepner Y, Karnieli-Miller O, Hemi R, Shalgi R, Kimchi T, Percik R, Weller A, Levy C. Skin exposure to UVB light induces a skin-brain-gonad axis and sexual behavior. Cell Rep 2021; 36:109579. [PMID: 34433056 PMCID: PMC8411113 DOI: 10.1016/j.celrep.2021.109579] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/12/2021] [Accepted: 07/30/2021] [Indexed: 12/11/2022] Open
Abstract
Ultraviolet (UV) light affects endocrinological and behavioral aspects of sexuality via an unknown mechanism. Here we discover that ultraviolet B (UVB) exposure enhances the levels of sex-steroid hormones and sexual behavior, which are mediated by the skin. In female mice, UVB exposure increases hypothalamus-pituitary-gonadal axis hormone levels, resulting in larger ovaries; extends estrus days; and increases anti-Mullerian hormone (AMH) expression. UVB exposure also enhances the sexual responsiveness and attractiveness of females and male-female interactions. Conditional knockout of p53 specifically in skin keratinocytes abolishes the effects of UVB. Thus, UVB triggers a skin-brain-gonadal axis through skin p53 activation. In humans, solar exposure enhances romantic passion in both genders and aggressiveness in men, as seen in analysis of individual questionaries, and positively correlates with testosterone level. Our findings suggest opportunities for treatment of sex-steroid-related dysfunctions. UVB exposure increases circulating sex-steroid levels in mice and humans UVB exposure enhances female attractiveness and receptiveness toward males UVB exposure increases females’ estrus phase, HPG axis hormones, and follicle growth Skin p53 regulates UVB-induced sexual behavior and ovarian physiological changes
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Affiliation(s)
- Roma Parikh
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Eschar Sorek
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Shivang Parikh
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Keren Michael
- Department of Human Services, The Max Stern Yezreel Valley Academic College, Jezreel Valley 1930600, Israel
| | - Lior Bikovski
- The Myers Neuro-Behavioral Core Facility, Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; School of Behavioral Sciences, Netanya Academic College, Netanya 4223587, Israel
| | - Sagi Tshori
- Research Authority, Kaplan Medical Center, Rehovot, Israel; Department of Biochemistry and Molecular Biology, Institute for Medical Research Israel-Canada, The Hebrew University, Jerusalem, Israel
| | - Galit Shefer
- Research Authority, Kaplan Medical Center, Rehovot, Israel
| | | | - Taiba Zornitzki
- Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University in Jerusalem, Rehovot, Israel
| | - Hilla Knobler
- Diabetes, Endocrinology and Metabolic Disease Institute, Kaplan Medical Center, Hadassah School of Medicine, Hebrew University in Jerusalem, Rehovot, Israel
| | - Gabriel Chodick
- Maccabitech, Maccabi Healthcare Services, Tel Aviv, Israel; Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Mariya Mardamshina
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Arjan Boonman
- School of Zoology, Faculty of Life Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Noga Kronfeld-Schor
- School of Zoology, Faculty of Life Sciences and the Sagol School of Neuroscience, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Hadas Bar-Joseph
- The TMCR Unit, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Dalit Ben-Yosef
- IVF Lab & Wolfe PGD-Stem Cell Lab, Fertility Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Department of Cell Biology and Development, Sackler Faculty of Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Hadar Amir
- Fertility Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Mor Pavlovsky
- Department of Dermatology, Tel Aviv Sourasky (Ichilov) Medical Center, Tel Aviv 6423906, Israel
| | - Hagit Matz
- Department of Dermatology, Tel Aviv Sourasky (Ichilov) Medical Center, Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Tom Ben-Dov
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Department of Otolaryngology, Head and Neck surgery, Meir Medical Center, Kfar Saba 4428164, Israel
| | - Tamar Golan
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Eran Nizri
- Department of Dermatology, Tel Aviv Sourasky (Ichilov) Medical Center, Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Daphna Liber
- Faculty of Humanities, Education and Social Sciences, Ono Academic College, Kiryat Ono, Israel
| | - Yair Liel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ronen Brenner
- Institute of Pathology, E. Wolfson Medical Center, Holon 58100, Israel
| | - Yftach Gepner
- School of Public Health, Sackler Faculty of Medicine and Sylvan Adams Sports Institute, Tel Aviv University, Tel Aviv 69978, Israel
| | - Orit Karnieli-Miller
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Rina Hemi
- Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Ruth Shalgi
- Department of Cell and Developmental Biology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Tali Kimchi
- Department of Neurobiology, Weizmann Institute of Science, Rehovot, Israel
| | - Ruth Percik
- Sackler School of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Aron Weller
- Department of Psychology and the Gonda Brain Research Center, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Carmit Levy
- Department of Human Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
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Dhatt SS, Kumar V, Neradi D, Sodavarapu P, Meetei TT, Goni V. Need for Testing and Supplementation of Vitamin D3 After Release of COVID-19 Lockdown in Patients with Increased Musculoskeletal Pain. Indian J Orthop 2021; 55:1046-1049. [PMID: 33716314 PMCID: PMC7936236 DOI: 10.1007/s43465-021-00376-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 02/03/2021] [Indexed: 02/04/2023]
Abstract
AIMS To evaluate vitamin D3 levels in patients who presented with increased musculo-skeletal pain after release of lockdown period when compared to pre-lockdown status. INTRODUCTION During this COVID pandemic, many countries have implemented lockdown measures and people have to work from home and many students and workers have to restrict themselves to home. During this period, their outdoor activities were limited. After the partial release of this lockdown many of them started to have some kind of physical activity and started experiencing body pains. We evaluated such patients for vitamin D3 levels and symptoms of fibromyalgia. METHODS This is a retrospective analysis of patients from age group 18-60 presented to outpatient department or on telephonic consultation after partial release of lockdown. All patients who had mild back ache before lockdown and had symptoms exaggerated during this lockdown release were included. All patients were investigated for vitamin D3, PTH, thyroid profile, liver functional and kidney functional tests. RESULTS Out of 120 patients presented to us in a period of 3 months, 31 patients had increased symptoms when compared to pre-lockdown status. 20 out of 31 patients had low vitamin D3 levels. 14 patients also developed symptoms of fibromyalgia. CONCLUSION There might be many reasons for increased pain during lockdown, but we focussed specially only on vitamin D3 because of its association with increased symptoms of COVID-19. This is a gentle reminder to test for vitamin D3 levels and supplement if found deficient. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-021-00376-8.
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Affiliation(s)
| | - Vishal Kumar
- Department of Orthopedics, PGIMER, Chandigarh, India
| | - Deepak Neradi
- Department of Orthopedics, PGIMER, Chandigarh, India
| | | | | | - Vijay Goni
- Department of Orthopedics, PGIMER, Chandigarh, India
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Zgliczyński WS, Rostkowska OM, Sarecka-Hujar B. Vitamin D Knowledge, Attitudes and Practices of Polish Medical Doctors. Nutrients 2021; 13:2443. [PMID: 34371953 PMCID: PMC8308710 DOI: 10.3390/nu13072443] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Background Vitamin D deficiency occurs in as much as 90-95% of the Polish population, although this condition is known to cause negative long-term health implications. The role of medical doctors in advising proper supplementation, monitoring and correcting the levels of 25-hydroxyvitamin D in individuals is of great importance and should be used to help mitigate its common deficits. The aim of this study was to evaluate knowledge, attitudes and practices of Polish physicians regarding vitamin D supplementation in order to identify areas for improvement and determinants for the knowledge gaps. Methods The study group comprised 701 medical doctors aged 32.1 ± 5.3 years on average, mostly women (71.61%). An original survey questionnaire was developed for the purpose of the study. Results The mean vitamin D knowledge score was 6.8 ± 2.3 (in a scale 0-13) and was related to gender (p < 0.001), type of specialization (p = 0.032), D3 supplements use (p < 0.001), recommending supplementation to patients (p = 0.005), to relatives and friends (p < 0.001) and to healthy adults (p < 0.001). In terms of self-administration, 14% of respondents take vitamin D all-year-round while 24% only in autumn and winter. 25% of respondents monitor their vitamin D (25-hydroxyvitamin D) serum concentration. Most participants (61%) did not recommend supplementing vitamin D to their patients on a regular basis. Conclusions The study indicates that medical doctors in Poland need to have more training and education on vitamin D supplementation in order to better address the problem of its deficits in the population.
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Affiliation(s)
- Wojciech Stefan Zgliczyński
- Center of Postgraduate Medical Education, Department of Lifestyle Medicine, School of Public Health, 01-826 Warsaw, Poland
| | - Olga Maria Rostkowska
- Department of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, 02-006 Warsaw, Poland;
| | - Beata Sarecka-Hujar
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, 41-200 Sosnowiec, Poland;
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45
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Non-Musculoskeletal Benefits of Vitamin D beyond the Musculoskeletal System. Int J Mol Sci 2021; 22:ijms22042128. [PMID: 33669918 PMCID: PMC7924658 DOI: 10.3390/ijms22042128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D, a fat-soluble prohormone, is endogenously synthesized in response to sunlight or taken from dietary supplements. Since vitamin D receptors are present in most tissues and cells in the body, the mounting understanding of the role of vitamin D in humans indicates that it does not only play an important role in the musculoskeletal system, but has beneficial effects elsewhere as well. This review summarizes the metabolism of vitamin D, the research regarding the possible risk factors leading to vitamin D deficiency, and the relationships between vitamin D deficiency and numerous illnesses, including rickets, osteoporosis and osteomalacia, muscle weakness and falls, autoimmune disorders, infectious diseases, cardiovascular diseases (CVDs), cancers, and neurological disorders. The system-wide effects of vitamin D and the mechanisms of the diseases are also discussed. Although accumulating evidence supports associations of vitamin D deficiency with physical and mental disorders and beneficial effects of vitamin D with health maintenance and disease prevention, there continue to be controversies over the beneficial effects of vitamin D. Thus, more well-designed and statistically powered trials are required to enable the assessment of vitamin D’s role in optimizing health and preventing disease.
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Nikolac Gabaj N, Unic A, Miler M, Pavicic T, Culej J, Bolanca I, Herman Mahecic D, Milevoj Kopcinovic L, Vrtaric A. In sickness and in health: pivotal role of vitamin D. Biochem Med (Zagreb) 2021; 30:020501. [PMID: 32550812 PMCID: PMC7271749 DOI: 10.11613/bm.2020.020501] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/19/2020] [Indexed: 12/15/2022] Open
Abstract
Within the last several years, frequency of vitamin D testing has multiplied substantially all over the world, since it has been shown to have an important role in many diseases and conditions. Even though liquid chromatography - tandem mass spectrometry (LC-MS/MS) has been identified as "gold standard" method for vitamin D measurement, most laboratories still use immunochemistry methods. Besides analytical problems (hydrophobicity, low circulating concentrations, ability to bind to lipids, albumins and vitamin D binding protein, presence of multiple vitamin D metabolites and variable ratios of 25(OH)D2 and 25(OH)D3 in the blood), vitamin D shows great preanalytical variability, since its concentration is drastically influenced by seasonal changes, exposure to sun, type of clothes or sun block creams. Vitamin D is mostly measured in serum or plasma, but new studies are showing importance of measuring vitamin D in pleural effusions, breast milk, urine, synovial fluid and saliva. Besides the main role in calcium homeostasis and bone metabolism, many studies linked vitamin D deficiency with cancer, cardiovascular diseases, diabetes, fertility and many other conditions. However, even though initial observational studies indicated that supplementation with vitamin D might be beneficial in disease development and progression; first results of well-designed randomized controlled prospective studies did not find differences in frequency of cardiovascular events or invasive cancer between patients taking vitamin D supplementation compared to placebo. In the light of these recent findings, validity of excessive vitamin D testing remains an open question.
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Affiliation(s)
- Nora Nikolac Gabaj
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.,Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Adriana Unic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Marijana Miler
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Tomislav Pavicic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Jelena Culej
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ivan Bolanca
- Department of Human Reproduction, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Davorka Herman Mahecic
- Department for Endocrinology, Dieabetes and Metabolism, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Lara Milevoj Kopcinovic
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Alen Vrtaric
- Department of Clinical Chemistry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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Neville JJ, Palmieri T, Young AR. Physical Determinants of Vitamin D Photosynthesis: A Review. JBMR Plus 2021; 5:e10460. [PMID: 33553995 PMCID: PMC7839826 DOI: 10.1002/jbm4.10460] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022] Open
Abstract
Vitamin D synthesis by exposure of skin to solar ultraviolet radiation (UVR) provides the majority of this hormone that is essential for bone development and maintenance but may be important for many other health outcomes. This process, which is the only well-established benefit of solar UVR exposure, depends on many factors including genetics, age, health, and behavior. However, the most important factor is the quantity and quality of UVR reaching the skin. Vitamin D synthesis specifically requires ultraviolet B (UVB) radiation that is the minority component (<5%) of solar UVR. This waveband is also the most important for the adverse effects of solar exposure. The most obvious of which is sunburn (erythema), but UVB is also the main cause of DNA damage to the skin that is a prerequisite for most skin cancers. UVB at the Earth's surface depends on many physical and temporal factors such as latitude, altitude, season, and weather. Personal, cultural, and behavioral factors are also important. These include skin melanin, clothing, body surface area exposed, holiday habits, and sunscreen use. There is considerable disagreement in the literature about the role of some of these factors, possibly because some studies have been done by researchers with little understanding of photobiology. It can be argued that vitamin D supplementation obviates the need for solar exposure, but many studies have shown little benefit from this approach for a wide range of health outcomes. There is also increasing evidence that such exposure offers health benefits independently of vitamin D: the most important of which is blood-pressure reduction. In any case, public health advice must optimize risk versus benefit for solar exposure. It is fortunate that the individual UVB doses necessary for maintaining optimal vitamin D status are lower than those for sunburn, irrespective of skin melanin. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jonathan J Neville
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Tommaso Palmieri
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
| | - Antony R Young
- St John's Institute of Dermatology, School of Basic & Medical Biosciences King's College London London United Kingdom
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Tanner A, Tiwari D, Allen S. Covid-19 Susceptibility and Severity Might be Modified by Vitamin D Status: Theoretical and Practical Considerations. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1568009620999200924155221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background:
The recently identified SARS-CoV-2 coronavirus has resulted in the
Covid-19 pandemic with severe morbidity and high mortality, particularly in certain sections of the
population. The co-morbidity patterns associated with adverse outcomes are multiple and complex
and there is emerging epidemiological, nutritional and molecular biological evidence that an inadequate
vitamin D status is a contributing factor.
Objective:
The aim was to review the role of vitamin D in immune function with particular reference
to the mechanisms whereby it supports immune efficiency, host protection and immune modulation.
The evidence for the possible benefit of vitamin D supplementation to ameliorate the severity
of respiratory infection by SARS-CoV-2 and other pathogens was also reviewed with a view to
making a recommendation.
Methods:
PubMed, MEDLINE and Google Scholar were searched using the terms: Covid-19, coronavirus,
SARS-CoV-2, vitamin D, calcitriol, deficiency, adaptive immunity, innate immunity, ventilation,
critical care, intensive care, acute respiratory distress syndrome, cytokine storm, respiratory
viruses, respiratory tract infection, respiratory syncytial virus, influenza, supplementation. Papers
for inclusion were selected on the basis of relevance and quality.
Findings:
Vitamin D insufficiency is widespread in many parts of the world. Vitamin D is needed
for normal protective and surveillance immune function and there is evidence that deficiency increases
the risk of some respiratory infections, probably including Covid-19. By binding with dedicated
receptors on immune cells vitamin D influences several strands of immune function, including
the production of anti-microbial peptides and several cytokines that promote an appropriate immune
response. Vitamin D supplementation probably reduces the risk of respiratory infection, with
persuasive biological, epidemiological and observational evidence for possible benefit against
Covid-19.
Conclusion:
Despite the lack of direct evidence specific to Covid-19 a cogent theoretical case can
be made for giving adults from selected groups, and arguably all adults, routine supplementation
with vitamin D to improve immune efficiency and reduce the incidence and severity of respiratory
infections. This could be particularly important in sections of the population with a high prevalence
of vitamin D insufficiency. Targeted research is required to provide firm evidence to guide practice.
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Affiliation(s)
- Alex Tanner
- The Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Divya Tiwari
- The Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Stephen Allen
- The Royal Bournemouth Hospital, Dorset, United Kingdom
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Ong JS, Dixon-Suen SC, Han X, An J, Liyanage U, Dusingize JC, Schumacher J, Gockel I, Böhmer A, Jankowski J, Palles C, O'Mara T, Spurdle A, Law MH, Iles MM, Pharoah P, Berchuck A, Zheng W, Thrift AP, Olsen C, Neale RE, Gharahkhani P, Webb PM, MacGregor S. A comprehensive re-assessment of the association between vitamin D and cancer susceptibility using Mendelian randomization. Nat Commun 2021; 12:246. [PMID: 33431812 PMCID: PMC7801600 DOI: 10.1038/s41467-020-20368-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Previous Mendelian randomization (MR) studies on 25-hydroxyvitamin D (25(OH)D) and cancer have typically adopted a handful of variants and found no relationship between 25(OH)D and cancer; however, issues of horizontal pleiotropy cannot be reliably addressed. Using a larger set of variants associated with 25(OH)D (74 SNPs, up from 6 previously), we perform a unified MR analysis to re-evaluate the relationship between 25(OH)D and ten cancers. Our findings are broadly consistent with previous MR studies indicating no relationship, apart from ovarian cancers (OR 0.89; 95% C.I: 0.82 to 0.96 per 1 SD change in 25(OH)D concentration) and basal cell carcinoma (OR 1.16; 95% C.I.: 1.04 to 1.28). However, after adjustment for pigmentation related variables in a multivariable MR framework, the BCC findings were attenuated. Here we report that lower 25(OH)D is unlikely to be a causal risk factor for most cancers, with our study providing more precise confidence intervals than previously possible.
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Affiliation(s)
- Jue-Sheng Ong
- Statistical Genetics Group, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.
| | - Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Rd, Melbourne, VIC, 3004, Australia
| | - Xikun Han
- Statistical Genetics Group, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Jiyuan An
- Institute for Future Environments, Queensland University of Technology, QLD, Brisbane, QLD, 4001, Australia
| | | | | | - Upekha Liyanage
- Cancer and Population Studies Group, Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, 4006, Australia
| | - Jean-Cluade Dusingize
- Cancer Control Group, Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Johannes Schumacher
- Institute of Human Genetics, Philipps University of Marburg, Marburg, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Anne Böhmer
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Janusz Jankowski
- Centre for Medicine and Health Sciences, University of Arab Emirates University, Abu Dhabi, UAE.,Comprehensive Clinical Trials Unit, University College London, London, UK
| | - Claire Palles
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, UK
| | - Tracy O'Mara
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Amanda Spurdle
- Molecular Cancer Epidemiology Group, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Matthew H Law
- Statistical Genetics Group, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia
| | - Mark M Iles
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Paul Pharoah
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Andrew Berchuck
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Box 3079, Durham, NC, 27710, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Aaron P Thrift
- Section of Epidemiology and Population Sciences, Department of Medicine, and Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | - Catherine Olsen
- Faculty of Medicine, University of Queensland, Brisbane, Australia.,Cancer Control Group, Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Rachel E Neale
- Cancer Aetiology and Prevention Group, Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Puya Gharahkhani
- Statistical Genetics Group, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia
| | - Penelope M Webb
- Gynaecological Cancer Group, Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD, Australia
| | - Stuart MacGregor
- Statistical Genetics Group, Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, 300 Herston Road, Brisbane, QLD, 4006, Australia
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Abstract
Vitamin D is essential for bone health and is known to be involved in immunomodulation and cell proliferation. Vitamin D status remains a significant health issue worldwide. However, there has been no clear consensus on vitamin D deficiency and its measurement in serum, and clinical practice of vitamin D deficiency treatment remains inconsistent. The major circulating metabolite of vitamin D, 25-hydroxyvitamin D (25(OH)D), is widely used as a biomarker of vitamin D status. Other metabolic pathways are recognised as important to vitamin D function and measurement of other metabolites may become important in the future. The utility of free 25(OH)D rather than total 25(OH)D needs further assessment. Data used to estimate the vitamin D intake required to achieve a serum 25(OH)D concentration were drawn from individual studies which reported dose-response data. The studies differ in their choice of subjects, dose of vitamin D, frequency of dosing regimen and methods used for the measurement of 25(OH)D concentration. Baseline 25(OH)D, body mass index, ethnicity, type of vitamin D (D2 or D3) and genetics affect the response of serum 25(OH)D to vitamin D supplementation. The diversity of opinions that exist on this topic are reflected in the guidelines. Government and scientific societies have published their recommendations for vitamin D intake which vary from 400-1000 IU/d (10-25 μg/d) for an average adult. It was not possible to establish a range of serum 25(OH)D concentrations associated with selected non-musculoskeletal health outcomes. To recommend treatment targets, future studies need to be on infants, children, pregnant and lactating women.
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