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Ahmed A, Saleem MA, Saeed F, Afzaal M, Imran A, Akram S, Hussain M, Khan A, Al Jbawi E. A comprehensive review on the impact of calcium and vitamin D insufficiency and allied metabolic disorders in females. Food Sci Nutr 2023; 11:5004-5027. [PMID: 37701195 PMCID: PMC10494632 DOI: 10.1002/fsn3.3519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 09/14/2023] Open
Abstract
Calcium is imperative in maintaining a quality life, particularly during later ages. Its deficiency results in a wide range of metabolic disorders such as dental changes, cataracts, alterations in brain function, and osteoporosis. These deficiencies are more pronounced in females due to increased calcium turnover throughout their life cycle, especially during pregnancy and lactation. Vitamin D perform a central role in the metabolism of calcium. Recent scientific interventions have linked calcium with an array of metabolic disorders in females including hypertension, obesity, premenstrual dysphoric disorder, polycystic ovary syndrome (PCOS), multiple sclerosis, and breast cancer. This review encompasses these female metabolic disorders with special reference to calcium and vitamin D deficiency. This review article aims to present and elaborate on available data regarding the worldwide occurrence of insufficient calcium consumption in females and allied health risks, to provide a basis for formulating strategies and population-level scientific studies to adequately boost calcium intake and position where required.
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Affiliation(s)
- Aftab Ahmed
- Department of Nutritional SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Muhammad Awais Saleem
- Department of Nutritional SciencesGovernment College University FaisalabadFaisalabadPakistan
- Department of Human Nutrition and DieteticsMirpur University of Science and TechnologyMirpurPakistan
| | - Farhan Saeed
- Department of Food SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Muhammad Afzaal
- Department of Food SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Ali Imran
- Department of Food SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Sidra Akram
- Department of Nutritional SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Muzzamal Hussain
- Department of Food SciencesGovernment College University FaisalabadFaisalabadPakistan
| | - Aqsa Khan
- Department of Nutritional SciencesGovernment College University FaisalabadFaisalabadPakistan
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Piotrowska A, Zaucha R, Król O, Żmijewski MA. Vitamin D Modulates the Response of Patient-Derived Metastatic Melanoma Cells to Anticancer Drugs. Int J Mol Sci 2023; 24:ijms24098037. [PMID: 37175742 PMCID: PMC10178305 DOI: 10.3390/ijms24098037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Melanoma is considered a lethal and treatment-resistant skin cancer with a high risk of recurrence, making it a major clinical challenge. Our earlier studies documented that 1,25(OH)2D3 and its low-calcaemic analogues potentiate the effectiveness of dacarbazine and cediranib, a pan-VEGFR inhibitor. In the current study, a set of patient-derived melanoma cultures was established and characterised as a preclinical model of human melanoma. Thus, patient-derived cells were preconditioned with 1,25(OH)2D3 and treated with cediranib or vemurafenib, a BRAF inhibitor, depending on the BRAF mutation status of the patients enrolled in the study. 1,25(OH)2D3 preconditioning exacerbated the inhibition of patient-derived melanoma cell growth and motility in comparison to monotherapy with cediranib. A significant decrease in mitochondrial respiration parameters, such as non-mitochondrial oxygen consumption, basal respiration and ATP-linked respiration, was observed. It seems that 1,25(OH)2D3 preconditioning enhanced cediranib efficacy via the modulation of mitochondrial bioenergetics. Additionally, 1,25(OH)2D3 also decreased the viability and mobility of the BRAF+ patient-derived cells treated with vemurafenib. Interestingly, regardless of the strict selection, cancer-derived fibroblasts (CAFs) became the major fraction of cultured cells over time, suggesting that melanoma growth is dependent on CAFs. In conclusion, the results of our study strongly emphasise that the active form of vitamin D, 1,25(OH)2D3, might be considered as an adjuvant agent in the treatment of malignant melanoma.
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Affiliation(s)
- Anna Piotrowska
- Department of Histology, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Renata Zaucha
- Department of Oncology and Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Oliwia Król
- Department of Biochemistry, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
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Boucher BJ. Vitamin D deficiency in British South Asians, a persistent but avoidable problem associated with many health risks (including rickets, T2DM, CVD, COVID-19 and pregnancy complications): the case for correcting this deficiency. Endocr Connect 2022; 11:e220234. [PMID: 36149836 PMCID: PMC9641767 DOI: 10.1530/ec-22-0234] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022]
Abstract
High vitamin D deficiency rates, with rickets and osteomalacia, have been common in South Asians (SAs) arriving in Britain since the 1950s with preventable infant deaths from hypocalcaemic status-epilepticus and cardiomyopathy. Vitamin D deficiency increases common SA disorders (type 2 diabetes and cardiovascular disease), recent trials and non-linear Mendelian randomisation studies having shown deficiency to be causal for both disorders. Ethnic minority, obesity, diabetes and social deprivation are recognised COVID-19 risk factors, but vitamin D deficiency is not, despite convincing mechanistic evidence of it. Adjusting analyses for obesity/ethnicity abolishes vitamin D deficiency in COVID-19 risk prediction, but both factors lower serum 25(OH)D specifically. Social deprivation inadequately explains increased ethnic minority COVID-19 risks. SA vitamin D deficiency remains uncorrected after 70 years, official bodies using 'education', 'assimilation' and 'diet' as 'proxies' for ethnic differences and increasing pressures to assimilate. Meanwhile, English rickets was abolished from ~1940 by free 'welfare foods' (meat, milk, eggs, cod liver oil), for all pregnant/nursing mothers and young children (<5 years old). Cod liver oil was withdrawn from antenatal clinics in 1994 (for excessive vitamin A teratogenicity), without alternative provision. The take-up of the 2006 'Healthy-Start' scheme of food-vouchers for low-income families with young children (<3 years old) has been poor, being inaccessible and poorly publicised. COVID-19 pandemic advice for UK adults in 'lockdown' was '400 IU vitamin D/day', inadequate for correcting the deficiency seen winter/summer at 17.5%/5.9% in White, 38.5%/30% in Black and 57.2%/50.8% in SA people in representative UK Biobank subjects when recruited ~14 years ago and remaining similar in 2018. Vitamin D inadequacy worsens many non-skeletal health risks. Not providing vitamin D for preventing SA rickets and osteomalacia continues to be unacceptable, as deficiency-related health risks increase ethnic health disparities, while abolishing vitamin D deficiency would be easier and more cost-effective than correcting any other factor worsening ethnic minority health in Britain.
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Piotrowska A, Beserra FP, Wierzbicka JM, Nowak JI, Żmijewski MA. Vitamin D Enhances Anticancer Properties of Cediranib, a VEGFR Inhibitor, by Modulation of VEGFR2 Expression in Melanoma Cells. Front Oncol 2022; 11:763895. [PMID: 35004285 PMCID: PMC8740239 DOI: 10.3389/fonc.2021.763895] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 12/01/2021] [Indexed: 01/12/2023] Open
Abstract
Regardless of the recent groundbreaking introduction of personalized therapy, melanoma continues to be one of the most lethal skin malignancies. Still, a substantial proportion of patients either fail to respond to the therapy or will relapse over time, representing a challenging clinical problem. Recently, we have shown that vitamin D enhances the effectiveness of classical chemotherapeutics in the human malignant melanoma A375 cell line. In search for new combination strategies and adjuvant settings to improve melanoma patient outcomes in the current study, the effects of cediranib (AZD2171), an oral tyrosine kinase inhibitor of VEGFR1-3, PDGFR, and c-KIT, used in combination either with 1,25(OH)2D3 or with low-calcemic analog calcipotriol were tested on four human malignant melanoma cell lines (A375, MNT-1, RPMI-7951, and SK-MEL-28). Melanoma cells were pretreated with vitamin D and subsequently exposed to cediranib. We observed a marked decrease in melanoma cell proliferation (A375 and SK-MEL-28), G2/M cell cycle arrest, and a significant decrease in melanoma cell mobility in experimental conditions used (A375). Surprisingly, concurrently with a very desirable decrease in melanoma cell proliferation and mobility, we noticed the upregulation of VEGFR2 at both protein and mRNA levels. No effect of vitamin D was observed in MNT-1 and RPMI-7951 melanoma cells. It seems that vitamin D derivatives enhance cediranib efficacy by modulation of VEGFR2 expression in melanoma cells expressing VEGFR2. In conclusion, our experiments demonstrated that vitamin D derivatives hold promise as novel adjuvant candidates to conquer melanoma, especially in patients suffering from vitamin D deficiency. However, further extensive research is indispensable to reliably assess their potential benefits for melanoma patients.
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Affiliation(s)
- Anna Piotrowska
- Department of Histology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Joanna Irena Nowak
- Department of Histology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Mazess RB, Bischoff‐Ferrari HA, Dawson‐Hughes B. Vitamin D: Bolus Is Bogus-A Narrative Review. JBMR Plus 2021; 5:e10567. [PMID: 34950828 PMCID: PMC8674779 DOI: 10.1002/jbm4.10567] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
In this review we summarize the impact of bolus versus daily dosing of vitamin D on 25(OH)D and 1,25(OH)2D levels, as well as on key countervailing factors that block vitamin D functions at the cellular level. Further, we discuss the role of bolus versus daily dosing of vitamin D for several health outcomes, including respiratory infections and coronavirus disease 2019 (COVID-19), rickets, falls and fractures, any cancer, and cancer-related mortality. This discussion appears timely because bolus doses continue to be tested for various disease outcomes despite a growing amount of evidence suggesting lack of efficacy or even detrimental effects of bolus dosing of vitamin D for outcomes where daily dosing at modest levels was effective in the vitamin D deficient. As a result, these discordant results may bias health recommendations for vitamin D if the recommendations are based on meta-analyses combining both daily and bolus dosing trials. © 2021 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)
| | - Heike A. Bischoff‐Ferrari
- Department of Aging Medicine and Aging ResearchUniversity of ZurichZurichSwitzerland
- City Hospital ZurichUniversity Clinic for Aging MedicineZurichSwitzerland
| | - Bess Dawson‐Hughes
- Jean Mayer US Department of Agriculture (USDA) Human Nutrition Research Center on AgingTufts UniversityBostonMAUSA
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Easty DJ, Farr CJ, Hennessy BT. New Roles for Vitamin D Superagonists: From COVID to Cancer. Front Endocrinol (Lausanne) 2021; 12:644298. [PMID: 33868174 PMCID: PMC8045760 DOI: 10.3389/fendo.2021.644298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/10/2021] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is a potent steroid hormone that induces widespread changes in gene expression and controls key biological pathways. Here we review pathophysiology of vitamin D with particular reference to COVID-19 and pancreatic cancer. Utility as a therapeutic agent is limited by hypercalcemic effects and attempts to circumvent this problem have used vitamin D superagonists, with increased efficacy and reduced calcemic effect. A further caveat is that vitamin D mediates multiple diverse effects. Some of these (anti-fibrosis) are likely beneficial in patients with COVID-19 and pancreatic cancer, whereas others (reduced immunity), may be beneficial through attenuation of the cytokine storm in patients with advanced COVID-19, but detrimental in pancreatic cancer. Vitamin D superagonists represent an untapped resource for development of effective therapeutic agents. However, to be successful this approach will require agonists with high cell-tissue specificity.
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Affiliation(s)
- David J. Easty
- Department of Medical Oncology, Our Lady of Lourdes Hospital, Drogheda, Ireland
| | - Christine J. Farr
- Department of Genetics, University of Cambridge, Cambridge, United Kingdom
| | - Bryan T. Hennessy
- Department of Molecular Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Oncology, Our Lady of Lourdes Hospital, Drogheda, Ireland
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Ames BN, Grant WB, Willett WC. Does the High Prevalence of Vitamin D Deficiency in African Americans Contribute to Health Disparities? Nutrients 2021; 13:499. [PMID: 33546262 PMCID: PMC7913332 DOI: 10.3390/nu13020499] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/24/2021] [Accepted: 01/28/2021] [Indexed: 02/06/2023] Open
Abstract
African Americans have higher incidence of, and mortality from, many health-related problems than European Americans. They also have a 15 to 20-fold higher prevalence of severe vitamin D deficiency. Here we summarize evidence that: (i) this health disparity is partly due to insufficient vitamin D production, caused by melanin in the skin blocking the UVB solar radiation necessary for its synthesis; (ii) the vitamin D insufficiency is exacerbated at high latitudes because of the combination of dark skin color with lower UVB radiation levels; and (iii) the health of individuals with dark skin can be markedly improved by correcting deficiency and achieving an optimal vitamin D status, as could be obtained by supplementation and/or fortification. Moderate-to-strong evidence exists that high 25-hydroxyvitamin D levels and/or vitamin D supplementation reduces risk for many adverse health outcomes including all-cause mortality rate, adverse pregnancy and birth outcomes, cancer, diabetes mellitus, Alzheimer's disease and dementia, multiple sclerosis, acute respiratory tract infections, COVID-19, asthma exacerbations, rickets, and osteomalacia. We suggest that people with low vitamin D status, which would include most people with dark skin living at high latitudes, along with their health care provider, consider taking vitamin D3 supplements to raise serum 25-hydroxyvitamin D levels to 30 ng/mL (75 nmol/L) or possibly higher.
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Affiliation(s)
- Bruce N. Ames
- Molecular and Cell Biology, Emeritus, University of California, Berkeley, CA 94720, USA;
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA 94164-1603, USA
| | - Walter C. Willett
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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8
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Griñan-Lison C, Blaya-Cánovas JL, López-Tejada A, Ávalos-Moreno M, Navarro-Ocón A, Cara FE, González-González A, Lorente JA, Marchal JA, Granados-Principal S. Antioxidants for the Treatment of Breast Cancer: Are We There Yet? Antioxidants (Basel) 2021; 10:205. [PMID: 33572626 PMCID: PMC7911462 DOI: 10.3390/antiox10020205] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/15/2022] Open
Abstract
Breast cancer is the most frequent cancer and the leading cause of cancer death in women. Oxidative stress and the generation of reactive oxygen species (ROS) have been related to cancer progression. Compared to their normal counterparts, tumor cells show higher ROS levels and tight regulation of REDOX homeostasis to maintain a low degree of oxidative stress. Traditionally antioxidants have been extensively investigated to counteract breast carcinogenesis and tumor progression as chemopreventive agents; however, there is growing evidence indicating their potential as adjuvants for the treatment of breast cancer. Aimed to elucidate whether antioxidants could be a reality in the management of breast cancer patients, this review focuses on the latest investigations regarding the ambivalent role of antioxidants in the development of breast cancer, with special attention to the results derived from clinical trials, as well as their potential use as plausible agents in combination therapy and their power to ameliorate the side effects attributed to standard therapeutics. Data retrieved herein suggest that antioxidants play an important role in breast cancer prevention and the improvement of therapeutic efficacy; nevertheless, appropriate patient stratification based on "redoxidomics" or tumor subtype is mandatory in order to define the dosage for future standardized and personalized treatments of patients.
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Affiliation(s)
- Carmen Griñan-Lison
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, 18100 Granada, Spain; (C.G.-L.); (J.A.M.)
- Instituto de Investigación Biosanitaria Ibs.GRANADA, University Hospitals of Granada-University of Granada, 18100 Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, 18100 Granada, Spain
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Jose L. Blaya-Cánovas
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Araceli López-Tejada
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Marta Ávalos-Moreno
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Alba Navarro-Ocón
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Francisca E. Cara
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Adrián González-González
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
| | - Jose A. Lorente
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
- Department of Legal Medicine, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Juan A. Marchal
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, 18100 Granada, Spain; (C.G.-L.); (J.A.M.)
- Instituto de Investigación Biosanitaria Ibs.GRANADA, University Hospitals of Granada-University of Granada, 18100 Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, 18100 Granada, Spain
- Department of Human Anatomy and Embryology, School of Medicine, University of Granada, 18016 Granada, Spain
| | - Sergio Granados-Principal
- Instituto de Investigación Biosanitaria Ibs.GRANADA, University Hospitals of Granada-University of Granada, 18100 Granada, Spain
- GENYO, Centre for Genomics and Oncological Research, Pfizer/University of Granada/Andalusian Regional Government, 18016 Granada, Spain; (J.L.B.-C.); (A.L.-T.); (M.Á.-M.); (A.N.-O.); (F.E.C.); (A.G.-G.); (J.A.L.)
- Department of Biochemistry and Molecular Biology II, School of Pharmacy, University of Granada, 18011 Granada, Spain
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Amrein K, Scherkl M, Hoffmann M, Neuwersch-Sommeregger S, Köstenberger M, Tmava Berisha A, Martucci G, Pilz S, Malle O. Vitamin D deficiency 2.0: an update on the current status worldwide. Eur J Clin Nutr 2020; 74:1498-1513. [PMID: 31959942 PMCID: PMC7091696 DOI: 10.1038/s41430-020-0558-y] [Citation(s) in RCA: 640] [Impact Index Per Article: 160.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 12/17/2019] [Accepted: 01/06/2020] [Indexed: 02/06/2023]
Abstract
Vitamin D testing and the use of vitamin D supplements have increased substantially in recent years. Currently, the role of vitamin D supplementation, and the optimal vitamin D dose and status, is a subject of debate, because large interventional studies have been unable to show a clear benefit (in mostly vitamin D replete populations). This may be attributed to limitations in trial design, as most studies did not meet the basic requirements of a nutrient intervention study, including vitamin D-replete populations, too small sample sizes, and inconsistent intervention methods regarding dose and metabolites. Vitamin D deficiency (serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L or 20 ng/ml) is associated with unfavorable skeletal outcomes, including fractures and bone loss. A 25(OH)D level of >50 nmol/L or 20 ng/ml is, therefore, the primary treatment goal, although some data suggest a benefit for a higher threshold. Severe vitamin D deficiency with a 25(OH)D concentration below <30 nmol/L (or 12 ng/ml) dramatically increases the risk of excess mortality, infections, and many other diseases, and should be avoided whenever possible. The data on a benefit for mortality and prevention of infections, at least in severely deficient individuals, appear convincing. Vitamin D is clearly not a panacea, and is most likely efficient only in deficiency. Given its rare side effects and its relatively wide safety margin, it may be an important, inexpensive, and safe adjuvant therapy for many diseases, but future large and well-designed studies should evaluate this further. A worldwide public health intervention that includes vitamin D supplementation in certain risk groups, and systematic vitamin D food fortification to avoid severe vitamin D deficiency, would appear to be important. In this narrative review, the current international literature on vitamin D deficiency, its relevance, and therapeutic options is discussed.
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Affiliation(s)
- Karin Amrein
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.
- Thyroid Endocrinology Osteoporosis Institute Dobnig, Graz, Austria.
| | - Mario Scherkl
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Magdalena Hoffmann
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
- Executive Department for Quality and Risk Management, University Hospital Graz, Graz, Austria
- Research Unit for Safety in Health, Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Stefan Neuwersch-Sommeregger
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria
- Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010, Graz, Austria
| | - Markus Köstenberger
- Department of Anaesthesiology and Intensive Care Medicine, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria
- Immunology and Pathophysiology, Otto Loewi Research Center, Medical University of Graz, Heinrichstrasse 31a, A-8010, Graz, Austria
| | - Adelina Tmava Berisha
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Gennaro Martucci
- Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Oliver Malle
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
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Grant WB, Baggerly CA, Lahore H. Reply: "Vitamin D Supplementation in Influenza and COVID-19 Infections. Comment on: Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths Nutrients 2020, 12(4), 988". Nutrients 2020; 12:E1620. [PMID: 32492787 PMCID: PMC7352449 DOI: 10.3390/nu12061620] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
We thank Dr [...].
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | | | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA;
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11
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Grant WB, Boucher BJ. Yes, vitamin D can be a magic bullet. Clin Nutr 2020; 39:1627. [DOI: 10.1016/j.clnu.2020.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 03/22/2020] [Indexed: 12/26/2022]
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12
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de Oliveira CL, Cureau FV, Cople-Rodrigues CDS, Giannini DT, Bloch KV, Kuschnir MCC, de Carvalho KMB, Schaan BD. Prevalence and factors associated with hypovitaminosis D in adolescents from a sunny country: Findings from the ERICA survey. J Steroid Biochem Mol Biol 2020; 199:105609. [PMID: 32006587 DOI: 10.1016/j.jsbmb.2020.105609] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 01/27/2020] [Accepted: 01/28/2020] [Indexed: 12/14/2022]
Abstract
Vitamin D plays a role in bone and metabolic health in life long, however hypovitaminosis D is common in different settings. The aim of this study was to describe vitamin D status among adolescents from a large sunny country and analyze associated factors. This was a multicenter, cross-sectional, school-based study. A total of 1152 adolescents age 12-17 from four Brazilian cities, Rio de Janeiro, Fortaleza, Brasília, and Porto Alegre, were included. Anthropometric variables, diet, type of school, race and season of data collection were evaluated. Serum concentrations of 25-hydroxyvitamin D [25(OH)D] were measured and categorized into three levels: ≤ 20 ng/mL, 21-29 ng/mL and ≥ 30 ng/mL. Ordered logistic regression models were used to explore the factors associated with hypovitaminosis D. The prevalence of vitamin D levels below 20 ng/mL, between 21 and 29 ng/mL and above 30 ng/mL was 21 % (95 %CI: 19 %-24 %), 42 % (95 %CI: 39 %-46 %) and 37 % (95 %CI: 33 %-40 %), respectively. In the final adjusted model, hypovitaminosis D was positively associated with gender, center (latitudes), data collected in winter or spring, non-whites, and private school students. A higher proportional odds ratio (POR) for hypovitaminosis D was found among obese boys (POR = 2.2, 95 %CI: 1.1-4.5), but not girls. Adequate dietary intake of vitamin D was a protective factor (POR = 0.4, 95 %CI: 0.2-0.6) against hypovitaminosis D. In conclusion, there is a high prevalence of Brazilian adolescents at risk of hypovitaminosis D, independent of region. Due to their potential benefits, lifestyle changes should be stimulated, including healthier food choices and spending more time outdoors (with sun protection).
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Affiliation(s)
| | - Felipe Vogt Cureau
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | | | - Denise Tavares Giannini
- Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Katia Vergetti Bloch
- Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Beatriz D Schaan
- Faculty of Medicine, Graduate Program in Cardiology and Cardiovascular Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Endocrine division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Faculty of Medicine, Graduate Program in Endocrinology, Universidade Federal do Rio Grande do Sul, Brazil
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13
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Carlberg C, Muñoz A. An update on vitamin D signaling and cancer. Semin Cancer Biol 2020; 79:217-230. [DOI: 10.1016/j.semcancer.2020.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022]
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14
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Reijven PLM, Soeters PB. Reply to Letter to Editor: Yes, vitamin D can be a magic bullet. Clin Nutr 2020; 39:1626. [PMID: 32278592 DOI: 10.1016/j.clnu.2020.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/22/2020] [Indexed: 11/15/2022]
Affiliation(s)
- P L M Reijven
- Maastricht University Medical Centre, Faculty of Health Medicine and Life Science, the Netherlands.
| | - P B Soeters
- Maastricht University Medical Centre, Faculty of Health Medicine and Life Science, the Netherlands
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15
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Grammatikopoulou MG, Gkiouras K, Nigdelis MP, Bogdanos DP, Goulis DG. Efficacy of Vitamin D 3 Buccal Spray Supplementation Compared to Other Delivery Methods: A Systematic Review of Superiority Randomized Controlled Trials. Nutrients 2020; 12:E691. [PMID: 32143526 PMCID: PMC7146176 DOI: 10.3390/nu12030691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/22/2020] [Accepted: 02/29/2020] [Indexed: 12/14/2022] Open
Abstract
(1) Background: Vitamin D deficiency is an important public health concern and supplementation is common for this deficiency. Many different modes of delivering supplementation have been proposed in order to enhance absorption and utilization. The present review compared the efficacy of vitamin D3 buccal spray against other forms of supplementation delivery. (2) Methods: The protocol was registered at PROSPERO (CRD42019136146). Medline/PubMed, CENTRAL and clinicaltrials.gov were searched from their inception until September 2019, for randomized controlled trials (RCTs) that compare vitamin D3 delivery via sublingual spray against other delivery methods. Eligible RCTs involved humans, of any age and health status, published in any language that evaluated changes in plasma 25(OH)D concentrations. Three reviewers independently extracted data, assessed risk of bias (RoB) and the quality of the trials. (3) Results: Out of 9759 RCTs, four matched the predefined criteria. Intervention duration ranged from 30 days to 3 months whereas vitamin D3 dosage ranged between 800 and 3000 IU/day. One RCT advocated for the superiority of buccal spray in increasing plasma 25(OH)D concentrations, although several limitations were recorded in that trial. The rest failed to report differences in post-intervention 25(OH)D concentrations between delivery methods. Considerable clinical heterogeneity was observed due to study design, intervention duration and dosage, assays and labs used to perform the assays, population age and health status, not allowing for synthesis of the results. (4) Conclusions: Based on the available evidence, delivery of vitamin D3 via buccal spray does not appear superior to the other modes of delivery. Future RCTs avoiding the existing methodological shortcomings are warranted.
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Affiliation(s)
- Maria G. Grammatikopoulou
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa GR41110, Greece; (K.G.); (D.P.B.)
| | - Konstantinos Gkiouras
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa GR41110, Greece; (K.G.); (D.P.B.)
- Laboratory of Clinical Pharmacology, Medical School, University Campus, Aristotle University of Thessaloniki, Thessaloniki GR54124, Greece
| | - Meletios P. Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki GR56429, Greece; (M.P.N.); (D.G.G.)
| | - Dimitrios P. Bogdanos
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa GR41110, Greece; (K.G.); (D.P.B.)
- Division of Transplantation, Immunology and Mucosal Biology, MRC Centre for Transplantation, King′s College London Medical School, London SE5 9RS, UK
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki GR56429, Greece; (M.P.N.); (D.G.G.)
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16
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Grant WB, Al Anouti F, Moukayed M. Targeted 25-hydroxyvitamin D concentration measurements and vitamin D 3 supplementation can have important patient and public health benefits. Eur J Clin Nutr 2020; 74:366-376. [PMID: 31996793 DOI: 10.1038/s41430-020-0564-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 01/08/2020] [Accepted: 01/15/2020] [Indexed: 02/06/2023]
Abstract
Over the past two decades, many studies reported the benefits of higher 25-hydroxyvitamin D [25(OH)D] concentrations for nonskeletal effects. Researchers found significant benefits in reducing risk of acute respiratory tract infections, many types of cancer, type 2 diabetes mellitus, premature death, and adverse pregnancy and birth outcomes. In addition, 25(OH)D concentrations are low for various reasons in several categories of people, including the obese, those with dark skin living at higher latitudes, the elderly, and those who do not eat much eggs, fish, meat, or vitamin D fortified milk. Measuring 25(OH)D concentrations is one way to both increase the awareness of vitamin D's importance in maintaining good health and to encourage vitamin D supplementation or increased solar ultraviolet-B exposure to sustain well-being throughout life by reducing disease incidence. Although 20 ng/ml seems adequate to reduce risk of skeletal problems and acute respiratory tract infections, concentrations above 30 ng/ml have been associated with reduced risk of cancer, type 2 diabetes mellitus, and adverse pregnancy and birth outcomes. Thus, judicious testing of 25(OH)D concentrations could reduce disease incidence and make treatment expenditures more cost-effective.
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Affiliation(s)
- William B Grant
- Director, Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA, 94164-1603, USA.
| | - Fatme Al Anouti
- College of Natural and Health Sciences, Department of Public Health and Nutrition, Zayed University, P.O. Box 4783, Abu Dhabi, UAE
| | - Meis Moukayed
- School of Arts and Sciences, American University in Dubai, P.O. Box 28282, Dubai, UAE
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17
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A Review of the Potential Benefits of Increasing Vitamin D Status in Mongolian Adults through Food Fortification and Vitamin D Supplementation. Nutrients 2019; 11:nu11102452. [PMID: 31615079 PMCID: PMC6835745 DOI: 10.3390/nu11102452] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/02/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023] Open
Abstract
Serum 25-hydroxyvitamin D (25(OH)D) concentrations are low in Mongolia, averaging 22 ng/mL in summer and only 8 ng/mL in winter. Mongolians have high incidence and/or prevalence of several diseases linked to low 25(OH)D concentrations, including ischemic heart disease, malignant neoplasms, cirrhosis of the liver, ischemic stroke, lower respiratory tract infections, preterm birth complications, and diabetes mellitus. Fortifying regularly consumed foods such as flour, milk, and edible oils with vitamin D3 could raise 25(OH)D concentrations by about 10 ng/mL. However, to achieve 25(OH)D concentrations of 30–40 ng/mL in adults, vitamin D intakes of 1000 to 4000 IU/day would be required, making personal supplement use necessary. On the basis of prospective observational studies and clinical trials of disease incidence or known mortality rates and adverse pregnancy and birth outcomes, raising mean serum 25(OH)D concentrations to 40 ng/mL would likely reduce incidence and mortality rates for those and other diseases, reduce the rate of adverse pregnancy and birth outcomes, and increase mean life expectancy by one year or more.
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18
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Reply to "Why Secondary Analyses in Vitamin D Clinical Trials Are important and How to Improve Vitamin D Clinical Trial Outcome Analyses-A Comment on "Extra-Skeletal Effects of Vitamin D", Nutrients 2019, 11, 1460". Nutrients 2019; 11:nu11092188. [PMID: 31514394 PMCID: PMC6770170 DOI: 10.3390/nu11092188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 09/05/2019] [Indexed: 12/28/2022] Open
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