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Yunir E, Adesta FEA, Rizka A, Tarigan TJE. Correlation between initial serum 25-hydroxyvitamin D and granulation growth in diabetic foot ulcers. J Wound Care 2024; 33:clii-clix. [PMID: 38850545 DOI: 10.12968/jowc.2021.0243] [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: 06/10/2024]
Abstract
OBJECTIVE To determine the correlation between initial serum 25-hydroxyvitamin D (25(OH)D) levels with granulation growth in diabetic foot ulcers (DFUs) after 21 days of treatment. METHOD This cohort study involved patients with type 2 diabetes who had a DFU treated at hospital. Blood samples were taken from patients on admission. The chemiluminescent immunoassay technique was used to measure 25(OH)D levels. Granulation tissue growth was analysed by comparing the photographs from the initial treatment to day 21 of treatment. RESULTS The median value of 25(OH)D levels at initial treatment was 8 ng/ml. The result showed no correlation between 25(OH)D levels and the granulation growth in DFUs (p=0.86). CONCLUSION The initial serum 25(OH)D level was not correlated with the growth of granulation tissue in DFUs.
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Affiliation(s)
- Em Yunir
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Fajar Englando Alan Adesta
- Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Aulia Rizka
- Division of Geriatric, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
| | - Tri Juli Edi Tarigan
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
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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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Al-Ishaq RK, Kubatka P, Brozmanova M, Gazdikova K, Caprnda M, Büsselberg D. Health implication of vitamin D on the cardiovascular and the renal system. Arch Physiol Biochem 2021; 127:195-209. [PMID: 31291127 DOI: 10.1080/13813455.2019.1628064] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Vitamin D regulates the calcium and phosphorus balance in the body. The activated form of vitamin D (1 α,25-dihydroxyvitamin D) binds to vitamin D receptor which regulates genes that control cell proliferation, differentiation and apoptosis. In the cardiovascular system, the vitamin D receptor is present in cardiomyocytes and the arterial wall. A clear correlation between vitamin D level and cardiovascular diseases is established. Vitamin D deficiency affects the renin-angiotensin system leading to ventricular hypertrophy and eventually to stroke. While clinical trials highlighted the positive effects of vitamin D supplements on cardiovascular disease these still need to be confirmed. This review outlines the association between vitamin D and cardiovascular and renal disease summarising the experimental data of selective cardiovascular disorders.
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Affiliation(s)
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
- Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University, in Bratislava, Martin, Slovakia
| | - Martina Brozmanova
- Department of Pathophysiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
- Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University, in Bratislava, Martin, Slovakia
| | - Katarina Gazdikova
- Department of Nutrition, Faculty of Nursing and Professional Health Studies, Slovak Medical University, Bratislava, Slovak
- Department of General Medicine, Faculty of Medicine, Slovak Medical University, Bratislava, Slovak
| | - Martin Caprnda
- 1st Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Dietrich Büsselberg
- Department of Physiology and Biophysics, Weill Cornell College of Medicine, Doha, Qatar
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Chen L, Zhang D, Shi L, Kalbaugh CA. Disparities in Peripheral Artery Disease Hospitalizations Identified Among Understudied Race-Ethnicity Groups. Front Cardiovasc Med 2021; 8:692236. [PMID: 34109228 PMCID: PMC8180581 DOI: 10.3389/fcvm.2021.692236] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
Background: To assess racial/ethnic differences in disease severity, hospital outcomes, length of stay and healthcare costs among hospitalized patients with peripheral artery disease (PAD). Methods: This study used data from the National Inpatient Sample (NIS) to explore the racial/ethnic disparities in PAD-related hospitalizations including presence of PAD with chronic limb threatened ischemia (CLI), amputation, in-hospital mortality, length of hospital stays and estimated medical costs. Race-ethnicity groups included non-Hispanic White, Black, Hispanic, Asian or Pacific Islander, Native American, and others (multiple races). Regression analyses adjusted for age, gender, Charlson Comorbidity Index, primary payer, patient location, bed size of the admission hospital, geographic region of the hospital, and rural/urban location of the hospital. Results: A total of 341,480 PAD hospitalizations were identified. Compared with non-Hispanic Whites, Native Americans had the highest odds of PAD with CLI (OR = 1.77, 95% CI: 1.61, 1.95); Black (OR = 1.71, 95% CI: 1.66, 1.76) and Hispanic (OR = 1.36, 95% CI: 1.31,1.41) patients had higher odds of amputation; Asian or Pacific Islanders had a higher mortality (OR = 1.20, 95% CI: 1.01,1.43), whereas Black (OR = 0.81, 95% CI: 0.76, 0.87) patients has a lower mortality; Asian or Pacific Islanders incurred higher overall inpatient costs (Margin = 30093.01, 95% CI: 28827.55, 31358.48) and most prolonged length of stay (IRR = 0.14, 95% CI: 0.09, 0.18). Conclusions: Our study identified elevated odds of amputation among Hispanic patients hospitalized with PAD as well as higher hospital mortality and medical expenses among Asian or Pacific Islander PAD inpatients. These two demographic groups were previously thought to have a lower risk for PAD and represent important populations for further investigation.
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Affiliation(s)
- LaiTe Chen
- Department of Cardiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Donglan Zhang
- Department of Health Policy and Management, University of Georgia, Athens, GA, United States
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
| | - Corey A Kalbaugh
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
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Kinney N, Kang L, Bains H, Lawson E, Husain M, Husain K, Sandhu I, Shin Y, Carter JK, Anandakrishnan R, Michalak P, Garner H. Ethnically biased microsatellites contribute to differential gene expression and glutathione metabolism in Africans and Europeans. PLoS One 2021; 16:e0249148. [PMID: 33765058 PMCID: PMC7993785 DOI: 10.1371/journal.pone.0249148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/11/2021] [Indexed: 12/28/2022] Open
Abstract
Approximately three percent of the human genome is occupied by microsatellites: a type of short tandem repeat (STR). Microsatellites have well established effects on (a) the genetic structure of diverse human populations and (b) expression of nearby genes. These lines of inquiry have uncovered 3,984 ethnically biased microsatellite loci (EBML) and 28,375 expression STRs (eSTRs), respectively. We hypothesize that a combination of EBML, eSTRs, and gene expression data (RNA-seq) can be used to show that microsatellites contribute to differential gene expression and phenotype in human populations. In fact, our previous study demonstrated a degree of mutual overlap between EBML and eSTRs but fell short of quantifying effects on gene expression. The present work aims to narrow the gap. First, we identify 313 overlapping EBML/eSTRs and recapitulate their mutual overlap. The 313 EBML/eSTRs are then characterized across ethnicity and tissue type. We use RNA-seq data to pursue validation of 49 regions that affect whole blood gene expression; 32 out of 54 affected genes are differentially expressed in Africans and Europeans. We quantify the relative contribution of these 32 genes to differential expression; fold change tends to be less than other differentially expressed genes. Repeat length correlates with expression for 15 of the 32 genes; two are conspicuously involved in glutathione metabolism. Finally, we repurpose a mathematical model of glutathione metabolism to investigate how a single polymorphic microsatellite affects phenotype. We conclude with a testable prediction that microsatellite polymorphisms affect GPX7 expression and oxidative stress in Africans and Europeans.
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Affiliation(s)
- Nick Kinney
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
- Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina, United States of America
- * E-mail:
| | - Lin Kang
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
- Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina, United States of America
| | - Harpal Bains
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Elizabeth Lawson
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Mesam Husain
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Kumayl Husain
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Inderjit Sandhu
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Yongdeok Shin
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
| | - Javan K. Carter
- University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Ramu Anandakrishnan
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
- Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina, United States of America
| | - Pawel Michalak
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
- Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina, United States of America
- Institute of Evolution, University of Haifa, Haifa, Israel
| | - Harold Garner
- Edward Via College of Osteopathic Medicine, Blacksburg, Virginia, United States of America
- Gibbs Cancer Center & Research Institute, Spartanburg, South Carolina, United States of America
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Vitamin D as A Protector of Arterial Health: Potential Role in Peripheral Arterial Disease Formation. Int J Mol Sci 2019; 20:ijms20194907. [PMID: 31623356 PMCID: PMC6801787 DOI: 10.3390/ijms20194907] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022] Open
Abstract
Atherosclerotic occlusive diseases and aneurysms that affect large and medium-sized arteries outside the cardiac and cerebral circulation are collectively known as peripheral arterial disease (PAD). With a rise in the rate of aging population worldwide, the number of people diagnosed with PAD is rapidly increasing. The micronutrient vitamin D is an important steroid hormone that acts on many crucial cellular mechanisms. Experimental studies suggest that optimal levels of vitamin D have beneficial effects on the heart and blood vessels; however, high vitamin D concentrations have been implicated in promoting vascular calcification and arterial stiffness. Observations from various clinical studies shows that deficiency of vitamin D has been associated with a greater risk of PAD. Epidemiological studies have often reported an inverse relation between circulating vitamin D status measured in terms of 25-hydroxivitamin D [25(OH)D] levels and increased cardiovascular disease risk; however, randomized controlled trials did not show a consistent positive effect of vitamin D supplementation on cardiovascular disease risk or events. Even though PAD shares all the major risk factors with cardiovascular diseases, the effect of vitamin D deficiency in PAD is not clear. Current evidence suggests a strong role of vitamin D in promoting genomic and epigenomic changes. This review summarises the current literature that supports the notion that vitamin D deficiency may promote PAD formation. A better understanding of underlying pathological mechanisms will open up new therapeutic possibilities which is the main unmet need in PAD management. Furthermore, epigenetic evidence shows that a more holistic approach towards PAD prevention that incorporates a healthy lifestyle, adequate exercise and optimal nutrition may be more effective in protecting the genome and maintaining a healthy vasculature.
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Farrell SW, DeFina L, Willis B, Barlow CE, Pavlovic A, Leonard D, Haskell W. Cardiorespiratory fitness, different measures of adiposity, and serum vitamin D levels in African-American adults. J Investig Med 2019; 67:1087-1090. [DOI: 10.1136/jim-2019-001071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2019] [Indexed: 01/04/2023]
Abstract
We examined the associations among cardiorespiratory fitness (CRF), adiposity, and serum 25-hydroxyvitamin D [25(OH)D) levels in African-American (AA) adults. 468 AA patients from the Cooper Clinic in Dallas, TX were examined between 2007 and 2018. Measures included body mass index (BMI), waist circumference (WC), percent body fat (%fat) via skinfolds, CRF via a maximal treadmill test, and 25(OH)D. Participants were classified by CRF based on age and sex, as well as by clinical categories of adiposity exposures and 25(OH)D. We examined trends of 25(OH)D across CRF and adiposity categories. We calculated OR with 95% CIs for 25(OH)D deficiency across categories of CRF and adiposity measures. We observed a significant positive trend for CRF (p=0.01) and a significant inverse trend for BMI (p=0.005) across ordered 25(OH)D categories. Adjusted mean 25(OH)D levels were higher across ordered CRF categories (p=0.03), and lower across ordered categories of BMI (p=0.02), WC (p=0.03) and %fat (p=0.04). When grouped into categories of fit and unfit (upper 80% and lower 20% of the CRF distribution, respectively), OR for vitamin D deficiency was significantly lower in fit compared with unfit men and women (OR=0.55, 95% CI: 0.35–0.87, p=0.01). Compared with normal weight BMI (referent), ORs for 25(OH)D deficiency were significantly higher for BMI-obese subjects (OR=1.70, 95% CI: 1.00–2.87, p=0.04). 25(OH)D levels are positively associated with CRF and negatively associated with different measures of adiposity in AA men and women. Because of the study design, causal inferences cannot be made and future prospective studies are needed.
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Yuan J, Jia P, Hua L, Xin Z, Yang JK. Vitamin D deficiency is associated with risk of developing peripheral arterial disease in type 2 diabetic patients. BMC Cardiovasc Disord 2019; 19:145. [PMID: 31208330 PMCID: PMC6580529 DOI: 10.1186/s12872-019-1125-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/02/2019] [Indexed: 12/26/2022] Open
Abstract
Background The relationship between vitamin D levels and peripheral arterial disease (PAD) remains unclear. We assessed the association of serum 25-hydroxyvitamin D (25(OH)D) levels with the prevalence of PAD in patients with type 2 diabetes mellitus(T2DM). Methods A total of 1018 T2DM patients participated in this cross-sectional study. Serum 25(OH)D levels were measured and risk factors of PAD were recorded. PAD was diagnosed as an ankle-brachial index (ABI) < 0.9. Results The mean age of the diabetic patients was 58.59 ± 11.34 years. Of all the patients, only 20.1% had a 25(OH)D level ≥ 20 ng/mL. Compared to patients without PAD, serum 25(OH)D levels were significantly lower in those with PAD (14.81 ± 8.43 vs. 11.55 ± 5.65 ng/mL, P < 0.001). The overall prevalence of PAD was 7.7%. From the highest level (≥ 20 ng/mL) to the lowest level (< 10 ng/mL) of serum 25(OH)D, the prevalence of PAD was 2.8, 7.5 and 10.7% respectively. After adjustment for age, sex, body mass index (BMI), smoking status and season, compared to patients with serum 25(OH)D levels ≥20 ng/mL, the odds ratios of PAD in patients with a level of 10 to < 20 ng/mL and < 10 ng/mL was 3.587(95% CI: 1.314–9.790) and 5.540(95% CI: 2.004–15.320), respectively. When further considering the influence of coronary heart disease (CHD), hypertension and cerebral infarction, the ratios changed to 3.824(95% CI: 1.378–10.615) and 5.729(95% CI: 2.028–16.187), respectively. And after further adjustment for the duration of diabetes, glycated hemoglobin (HbA1c) and glomerular filtration rate (GFR), the ratios changed to 3.489(95% CI: 1.100–11.062) and 3.872(95% CI: 1.168–12.841), respectively. Conclusions Reduced serum vitamin D levels were associated with an increased risk of PAD in T2DM patients. Randomized interventive clinical studies are required to verify the effects of vitamin D supplementation on PAD.
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Affiliation(s)
- Jing Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Pu Jia
- Department of Orthopaedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Lin Hua
- Department of Mathematics, School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China
| | - Zhong Xin
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China
| | - Jin-Kui Yang
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Xiang, Beijing, 100730, China.
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Greenhagen RM, Frykberg RG, Wukich DK. Serum vitamin D and diabetic foot complications. Diabet Foot Ankle 2019; 10:1579631. [PMID: 30815231 PMCID: PMC6383621 DOI: 10.1080/2000625x.2019.1579631] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 02/03/2019] [Indexed: 12/21/2022]
Abstract
Background: Foot complications such as ulceration and neuropathy are common complications of diabetes mellitus (DM). Previous reports have demonstrated a possible increased risk of these complications in diabetic patients with low levels of serum vitamin D.Objectctive: The purpose of this study is to compare serum vitamin D levels in diabetic patients with and without Charcot neuroarthropathy (CN), peripheral arterial disease (PAD), infection (DFI), ulceration (DFU), and peripheral neuropathy (DPN). Design: A retrospective chart review of all patients undergoing foot and ankle surgery with a history of DM over a 13 month period was performed. From this cohort, fifty subjects with CN were matched with 50 without CN and preoperative lab values were compared. A secondary evaluation was performed on the subjects' other comorbidities including PAD, DFI, DFU, and DPN. Results: Seventy-eight percent of our patients had vitamin D deficiency or insufficiency. Preoperative serum vitamin D levels were not significantly different between diabetic patients with and without CN (p = 0.55). Diabetic patients with PAD (p = 0.03), DFI (p = 0.0006), and DFU (p = 0.04) were all found to have significantly lower serum vitamin D levels than diabetic patients without these complications. Lower levels of serum albumin and higher serum creatinine were also noted with subjects with PAD, DFI, DPN, and DFU. While seasonal serum vitamin D level fluctuation was noted, this difference did not reach statistical significance with the numbers available. Conclusion: We found various lower extremity complications to be associated with low serum vitamin D including PAD, DFI, and DFU. While other studies have questioned the role of vitamin D and CN, we were unable to identify any significant difference between diabetic patients with and without Charcot neuroarthropathy. Level of evidence: Level 2.
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Affiliation(s)
- Robert M. Greenhagen
- Midwest Foot and Ankle Fellowship, Foot and Ankle Center of Nebraska, Omaha, NE, USA
| | - Robert G. Frykberg
- Midwestern University Program in Podiatric Medicine, Midwestern University, Fountain Hills, AZ, USA
| | - Dane K. Wukich
- Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA
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Abstract
Cardiovascular disease has earned its place as one of the leading noncommunicable diseases that has become a modern-day global epidemic. The increasing incidence and prevalence of chronic kidney disease (CKD) has added to this enormous burden, given that CKD is now recognized as an established risk factor for accelerated cardiovascular disease. In fact, cardiovascular disease remains the leading cause of death in the CKD population, with significant prognostic implications. Alterations in vitamin D levels as renal function declines has been linked invariably to the development of cardiovascular disease beyond a mere epiphenomenon, and has become an important focus in recent years in our search for new therapies. Another compound, cinacalcet, which belongs to the calcimimetic class of agents, also has taken center stage over the past few years as a potential cardiovasculoprotective agent. However, given limited well-designed randomized trials to inform us, our clinical practice for the management of cardiovascular disease in CKD has not been adequately refined. This article considers the biological mechanisms, regulation, and current experimental, clinical, and trial data available to help guide the therapeutic use of vitamin D and calcimimetics in the setting of CKD and cardiovascular disease.
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Affiliation(s)
- Kenneth Lim
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
| | - Takayuki Hamano
- Department of Comprehensive Kidney Disease Research, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Ravi Thadhani
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA
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Association of Vitamin D Status with Body Mass Index in Adolescents in Ukraine. ROMANIAN JOURNAL OF DIABETES NUTRITION AND METABOLIC DISEASES 2018. [DOI: 10.2478/rjdnmd-2018-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and aims: Vitamin D status in many health managements have been researched extensively, but its dependence with obesity still remains controversial. This article is devoted to examination of blood cholecalciferol levels in Ukrainian population with establishment the association of cholecalciferol levels and body mass index (BMI). Materials and methods: For this observed investigation, data were collected during the summer 2017, over a period of one week from three township areas in Carpathian region, Ukraine from 304 adults aged 19-78 years. Measured variables contained 25(OH)D level, weight and weight applied to check BMI degree. The average level of vitamin D among adolescents presented 23.1 ± 8.2 ng/ml. Female gender was associated with lower vitamin D concentrations (22.9 ± 9.3 ng/ml vs. 26.2 ± 8.5 ng/ml for men). Among the participants, 74.4% had a BMNI of 25 kg/m2 and over, and in 27.3% of them the number was 30 kg/m2 and over. Results: Violation of vitamin D status was detected in 90.5% persons. 1.8% people had been identified as severe 25(OH)D deficiency. Measurement of cholecalciferol demonstrated meaningful connection between its level and BMI only in persons with BMI 25-29.9 kg/m2. Average vitamin D concentrations in persons with BMI over30 kg/m2 did not vary to a significant range from data in persons with normal body weight. Conclusions: Vitamin D status among the adolescents in Ukraine is far from optimum. Our results confirm reliable association between cholecalciferol level and BMI in persons with overweight. Interchange between conservation of vitamin D and BMI needs additional surveys.
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Abstract
Vitamin D has been traditionally recognized as a vitamin quintessential for bone-mineral health. In the past 2 decades, numerous experimental and observational studies have highlighted the role of vitamin D in immunity, metabolic syndrome (obesity and diabetes), cancers, renal disease, memory, and neurological dysfunction. In this article, we review important studies that focused on the impact of vitamin D on blood pressure, myocardial infarction, peripheral arterial disease, heart failure, and statin intolerance. Amidst the current pool of ambiguous evidence, we intend to discuss the role of vitamin D in "high-value cardiovascular health care".
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Jukic AMZ, Hoofnagle AN, Lutsey PL. Measurement of Vitamin D for Epidemiologic and Clinical Research: Shining Light on a Complex Decision. Am J Epidemiol 2018; 187:879-890. [PMID: 29020155 DOI: 10.1093/aje/kwx297] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 08/03/2017] [Indexed: 01/08/2023] Open
Abstract
Vitamin D is a fat-soluble vitamin that is synthesized in the skin with exposure to sunlight or is ingested from dietary supplements or food. There has been a dramatic increase in research on vitamin D, linking it with health outcomes as varied as reproductive function, infection, cardiovascular disease, and cancer. The study of vitamin D has generated much excitement, partly because there is an ideal intervention: Low levels may be common and can be remedied with widely available supplements. Determination of vitamin D status is complex and has advanced dramatically in the past 5 years. In this paper, we begin by describing important considerations for measurement of total 25-hydroxyvitamin D (25(OH)D), the biomarker traditionally assessed in epidemiologic studies. While 25(OH)D remains the most commonly measured biomarker, emerging evidence suggests that other related analytes may contribute to the characterization of an individual's vitamin D status (e.g., vitamin D-binding protein, bioavailable and free 25(OH)D, the C-3 epimer of 25(OH)D, 1,25-dihydroxyvitamin D, and 24,25-dihydroxyvitamin D). The measurement of these analytes is also complex, and there are important considerations for deciding whether their measurement is warranted in new research studies. Herein we discuss these issues and provide the reader with an up-to-date synthesis of research on vitamin D measurement options and considerations.
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Affiliation(s)
- Anne Marie Z Jukic
- Department of Chronic Disease Epidemiology, Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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14
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Hong J, Hatchell KE, Bradfield JP, Bjonnes A, Chesi A, Lai CQ, Langefeld CD, Lu L, Lu Y, Lutsey PL, Musani SK, Nalls MA, Robinson-Cohen C, Roizen JD, Saxena R, Tucker KL, Ziegler JT, Arking DE, Bis JC, Boerwinkle E, Bottinger EP, Bowden DW, Gilsanz V, Houston DK, Kalkwarf HJ, Kelly A, Lappe JM, Liu Y, Michos ED, Oberfield SE, Palmer ND, Rotter JI, Sapkota B, Shepherd JA, Wilson JG, Basu S, de Boer IH, Divers J, Freedman BI, Grant SFA, Hakanarson H, Harris TB, Kestenbaum BR, Kritchevsky SB, Loos RJF, Norris JM, Norwood AF, Ordovas JM, Pankow JS, Psaty BM, Sanghera DK, Wagenknecht LE, Zemel BS, Meigs J, Dupuis J, Florez JC, Wang T, Liu CT, Engelman CD, Billings LK. Transethnic Evaluation Identifies Low-Frequency Loci Associated With 25-Hydroxyvitamin D Concentrations. J Clin Endocrinol Metab 2018; 103:1380-1392. [PMID: 29325163 PMCID: PMC6276579 DOI: 10.1210/jc.2017-01802] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/03/2018] [Indexed: 01/08/2023]
Abstract
Context Vitamin D inadequacy is common in the adult population of the United States. Although the genetic determinants underlying vitamin D inadequacy have been studied in people of European ancestry, less is known about populations with Hispanic or African ancestry. Objective The Trans-Ethnic Evaluation of Vitamin D (TRANSCEN-D) genomewide association study (GWAS) consortium was assembled to replicate genetic associations with 25-hydroxyvitamin D [25(OH)D] concentrations from the Study of Underlying Genetic Determinants of Vitamin D and Highly Related Traits (SUNLIGHT) meta-analyses of European ancestry and to identify genetic variants related to vitamin D concentrations in African and Hispanic ancestries. Design Ancestry-specific (Hispanic and African) and transethnic (Hispanic, African, and European) meta-analyses were performed with Meta-Analysis Helper software (METAL). Patients or Other Participants In total, 8541 African American and 3485 Hispanic American (from North America) participants from 12 cohorts and 16,124 European participants from SUNLIGHT were included in the study. Main Outcome Measures Blood concentrations of 25(OH)D were measured for all participants. Results Ancestry-specific analyses in African and Hispanic Americans replicated single nucleotide polymorphisms (SNPs) in GC (2 and 4 SNPs, respectively). An SNP (rs79666294) near the KIF4B gene was identified in the African American cohort. Transethnic evaluation replicated GC and DHCR7 region SNPs. Additionally, the transethnic analyses revealed SNPs rs719700 and rs1410656 near the ANO6/ARID2 and HTR2A genes, respectively. Conclusions Ancestry-specific and transethnic GWASs of 25(OH)D confirmed findings in GC and DHCR7 for African and Hispanic American samples and revealed findings near KIF4B, ANO6/ARID2, and HTR2A. The biological mechanisms that link these regions with 25(OH)D metabolism warrant further investigation.
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Affiliation(s)
- Jaeyoung Hong
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
| | - Kathryn E Hatchell
- Department of Population Health Sciences, University of Wisconsin–Madison
School of Medicine and Public Health, Madison, Wisconsin
| | - Jonathan P Bradfield
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrew Bjonnes
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
| | - Alessandra Chesi
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Chao-Qiang Lai
- USDA-ARS Human Nutrition Research Center on Aging at Tufts University, Boston,
Massachusetts
| | | | - Lingyi Lu
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Yingchang Lu
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota,
Minneapolis, Minnesota
| | - Solomon K Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson,
Mississippi
| | - Mike A Nalls
- Data Tecnica International, Glen Echo, Maryland
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes
of Health, Bethesda, Maryland
| | - Cassianne Robinson-Cohen
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Jeffery D Roizen
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Endocrinology, Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts
Lowell, Lowell, Massachusetts
| | - Julie T Ziegler
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Dan E Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University
School of Medicine, Baltimore, Maryland
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of
Washington, Seattle, Washington
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston, Houston, Texas
| | - Erwin P Bottinger
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
| | - Donald W Bowden
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Vicente Gilsanz
- Department of Radiology, Children’s Hospital of Los Angeles, Keck School of
Medicine, University of Southern California, Los Angeles, California
| | - Denise K Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric
Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children’s
Hospital Medical Center, Cincinnati, Ohio
| | - Andrea Kelly
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine at University of Pennsylvania, Philadelphia,
Pennsylvania
| | | | - Yongmei Liu
- Department of Epidemiology and Prevention, Division of Public Health Sciences,
Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Erin D Michos
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University
School of Medicine, Baltimore, Maryland
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Diabetes and Metabolism, Columbia
University Medical Center, New York, New York
| | | | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Department of
Pediatrics and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center,
Torrance, California
| | - Bishwa Sapkota
- Department of Pediatrics, College of Medicine, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma
| | - John A Shepherd
- University of California San Francisco School of Medicine, San Francisco,
California
| | - James G Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical
Center, Jackson, Mississippi
| | - Saonli Basu
- Division of Biostatistics, University of Minnesota, Minneapolis,
Minnesota
| | - Ian H de Boer
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Jasmin Divers
- Wake Forest School of Medicine, Winston-Salem, North Carolina
| | | | - Struan F A Grant
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Division of Endocrinology, Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, Pennsylvania
| | - Hakon Hakanarson
- Center for Applied Genomics, Division of Human Genetics, The Children’s
Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Perelman School of Medicine, University of
Pennsylvania, Philadelphia, Pennsylvania
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on
Aging, Bethesda, Maryland
| | - Bryan R Kestenbaum
- Kidney Research Institute, Division of Nephrology, Department of Medicine,
University of Washington, Seattle, Washington
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric
Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ruth J F Loos
- The Charles Bronfman Institute for Personalized Medicine, Icahn School of
Medicine at Mount Sinai, New York, New York
- The Mindich Child Health and Development Institute, Icahn School of Medicine
at Mount Sinai, New York, New York
| | - Jill M Norris
- Department of Epidemiology, Colorado School of Public Health, University of
Colorado Denver, Aurora, Colorado
| | - Arnita F Norwood
- Department of Medicine, University of Mississippi Medical Center, Jackson,
Mississippi
| | - Jose M Ordovas
- Nutrition and Genomics, JM-USDA Human Nutrition Research Center on Aging at
Tufts University, Boston, Massachusetts
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota,
Minneapolis, Minnesota
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Department of Medicine, University of
Washington, Seattle, Washington
- University of Washington and Department of Epidemiology and Health Sciences,
University of Washington, Seattle, Washington
- Kaiser Permanente Washington Health Research Institute, Seattle,
Washington
| | - Dharambir K Sanghera
- Department of Pediatrics, College of Medicine, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma
- Department of Pharmaceutical Sciences, College of Pharmacy, University of
Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Oklahoma Center for Neuroscience, Oklahoma City, Oklahoma
| | | | - Babette S Zemel
- The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine at University of Pennsylvania, Philadelphia,
Pennsylvania
| | - James Meigs
- Division of General Internal Medicine, Massachusetts General Hospital, Harvard
Medical School, Boston, Massachusetts
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
- National Heart, Lung, and Blood Institute’s Framingham Heart Study,
Framingham, Massachusetts
| | - Jose C Florez
- Center for Genomic Medicine, Massachusetts General Hospital, Boston,
Massachusetts
- Diabetes Unit, Massachusetts General Hospital, Boston, Massachusetts
- Programs in Metabolism and Medical & Population Genetics, Broad Institute,
Cambridge, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Ching-Ti Liu
- Department of Biostatistics, Boston University School of Public Health, Boston,
Massachusetts
| | - Corinne D Engelman
- Department of Population Health Sciences, University of Wisconsin–Madison
School of Medicine and Public Health, Madison, Wisconsin
| | - Liana K Billings
- NorthShore University HealthSystem, Evanston, Illinois
- University of Chicago Pritzker School of Medicine, Chicago, Illinois
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Iannuzzo G, Forte F, Lupoli R, Di Minno MND. Association of Vitamin D deficiency with peripheral arterial disease: a meta-analysis of literature studies. J Clin Endocrinol Metab 2018; 103:4951505. [PMID: 29590347 DOI: 10.1210/jc.2018-00136] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 03/19/2018] [Indexed: 02/04/2023]
Abstract
CONTEXT Vitamin D deficiency patients have an increased cardiovascular (CV) morbidity and mortality. Contrasting data are available about the association between peripheral arterial disease (PAD) and Vitamin D status. OBJECTIVE To perform a meta-analysis of studies evaluating the association between Vitamin D status and PAD. DATA SOURCES Studies were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases. RESULTS Ten studies with data on Vitamin D levels in 2,079 PAD patients and 18,233 non-PAD controls and 6 studies on the prevalence of PAD in 23,171 subjects with Vitamin D deficiency (<20 ng/ml), 48,311 subjects with Vitamin D insufficiency (20-30 ng/ml) and 27,910 with normal Vitamin D levels (>30 ng/ml) were included. Compared to controls, PAD patients showed significantly lower Vitamin D levels (MD: -2.24 ng/ml; 95%CI: -3.38, -1.10; p<0.001, I2=86.5%; p<0.001). Moreover, a higher prevalence of PAD was found both in subjects with Vitamin D insufficiency (OR: 1.098, 95%CI: 1.010-1.195, p=0.029, I2: 0%, p=0,600) and in subjects with Vitamin D deficiency (OR: 1.484, 95%CI: 1.348-1.635, p<0.001, I2: 7.65%, p=0,367) compared with controls with normal Vitamin D levels. Sensitivity analyses and the analysis of data on the cumulative risk of PAD according to Vitamin D levels derived from multivariate analysis consistently confirmed results. CONCLUSIONS PAD patients have lower vitamin D levels than controls and both Vitamin D deficiency and Vitamin D insufficiency are significantly associated with PAD. Reduced Vitamin D levels might represent an independent risk factor for PAD and, in turn, for CV events.
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Affiliation(s)
- Gabriella Iannuzzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Francesco Forte
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Roberta Lupoli
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, Naples, Italy
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16
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Robinson-Cohen C, Zelnick LR, Hoofnagle AN, Lutsey PL, Burke G, Michos ED, Shea SJC, Tracy R, Siscovick DS, Psaty B, Kestenbaum B, de Boer IH. Associations of Vitamin D-Binding Globulin and Bioavailable Vitamin D Concentrations With Coronary Heart Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA). J Clin Endocrinol Metab 2017; 102:3075-3084. [PMID: 28472285 PMCID: PMC5546864 DOI: 10.1210/jc.2017-00296] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 04/27/2017] [Indexed: 01/14/2023]
Abstract
CONTEXT Low 25-hydroxyvitamin D [25(OH)D] is associated with coronary heart disease (CHD) in people who are white and Chinese but not black or Hispanic. Vitamin D binding globulin (VDBG) avidly binds 25(OH)D, reducing its bioavailability, and differs in isoform and concentration by race. OBJECTIVE Evaluate associations of VDBG with CHD and whether accounting for VDBG or estimating bioavailable 25(OH)D explains the heterogeneity of the association of 25(OH)D with CHD. DESIGN AND SETTING We conducted a case-cohort study within the Multi-Ethnic Study of Atherosclerosis. Participants with an incident CHD event over 12 years of follow-up (n = 538) and a randomly assigned subcohort (n = 999) were included. We measured baseline 25(OH)D, VDBG, and isoforms using mass spectrometry and estimated bioavailable 25(OH)D from published equations. RESULTS VDBG was associated with an increased risk of CHD [hazard ratio, 1.77 (95% confidence interval, 1.46 to 2.14) per standard deviation increment, P < 0.0001], without evidence of heterogeneity by race or isoform (each P for interaction > 0.1). Low total 25(OH)D was differentially associated with CHD events, by race, with or without adjustment for VDBG (P for interaction = 0.04 or 0.05, respectively). Associations of 25(OH)D with CHD were strengthened with adjustment for VDBG among participants who were white or Chinese, and bioavailable 25(OH)D was associated with CHD events only among white participants. CONCLUSIONS High VDBG concentration was associated with CHD events in all racial and ethnic groups. Incorporation of VDBG strengthened existing associations of 25(OH)D with CHD but did not explain racial heterogeneity in associations of 25(OH)D with CHD.
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Affiliation(s)
- Cassianne Robinson-Cohen
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Leila R. Zelnick
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Andrew N. Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington 98195
| | - Pamela L. Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota 55455
| | - Gregory Burke
- School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27109
| | - Erin D. Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland 21218
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Steven J. C. Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York 10032
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York 10027
| | - Russell Tracy
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, Vermont 05405
- Department of Biochemistry, University of Vermont, Burlington, Vermont 05405
| | | | - Bruce Psaty
- Cardiovascular Health Research Unit, Departments of Epidemiology and Medicine, University of Washington, Seattle, Washington 98101
- Department of Health Services, University of Washington, Seattle, Washington 98195
- Group Health Research Institute, Seattle, Washington 98101
| | - Bryan Kestenbaum
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
| | - Ian H. de Boer
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington 98195
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Ogilvie RP, Lutsey PL, Heiss G, Folsom AR, Steffen LM. Dietary intake and peripheral arterial disease incidence in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 2017; 105:651-659. [PMID: 28077376 PMCID: PMC5320408 DOI: 10.3945/ajcn.116.137497] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/07/2016] [Indexed: 12/21/2022] Open
Abstract
Background: Peripheral arterial disease (PAD) is a costly source of morbidity and mortality among older persons in the United States. Dietary intake plays a role in the development of atherosclerotic cardiovascular disease; however, few studies have examined the relation of food intake or dietary patterns with PAD.Objective: We examined the relation between habitual dietary intake at midlife and incident PAD over ∼20 y of follow-up.Design: Among 14,082 participants enrolled in the ARIC (Atherosclerosis Risk in Communities) Study initially free of PAD, dietary intake was assessed at baseline in 1987-1989 by using a modified Harvard food-frequency questionnaire. Food groups were created, and principal components analysis was used to develop "healthy" and "Western" dietary patterns; both were categorized into quintiles or quartiles. Incident PAD was determined by an ankle-brachial index <0.9 assessed at 2 subsequent examinations and hospital discharge codes through 2012. Multivariate-adjusted Cox proportional hazards regression was used.Results: During a mean follow-up of 19.9 y, 1569 participants developed incident PAD. In models adjusted for demographic characteristics, behaviors, and food groups, the HRs (95% CIs) for incident PAD increased across quintiles of meat consumption [quintile 1: reference, quintile 2: 1.38 (1.16, 1.65), quintile 3: 1.38 (1.16, 1.65), quintile 4: 1.45 (1.20, 1.74), quintile 5: 1.66 (1.36, 2.03); P-trend <0.001]. Compared with those who drank no alcohol, those who had 1-6 drinks/wk had a lower risk of incident PAD [0.78 (0.68, 0.89)]. For coffee, ≥4 cups/d compared with none was inversely associated with incident PAD [quintile 5 compared with quintile 1: 0.84 (0.75, 1.00); P-trend = 0.014]. There was no association between other food groups or patterns and incident PAD.Conclusions: In this prospective cohort study, greater meat consumption was associated with a higher risk, and moderate alcohol consumption was associated with a lower risk of incident PAD. Whether these associations are causal remains to be seen. This trial was registered at clinicaltrials.gov as NCT00005131.
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Affiliation(s)
- Rachel P Ogilvie
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and
| | - Gerardo Heiss
- University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and,University of North Carolina-Chapel Hill, Chapel Hill, NC
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN; and
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Rapson IR, Michos ED, Alonso A, Hirsch AT, Matsushita K, Reis JP, Lutsey PL. Serum 25-hydroxyvitamin D is associated with incident peripheral artery disease among white and black adults in the ARIC study cohort. Atherosclerosis 2017; 257:123-129. [PMID: 28131046 PMCID: PMC5369771 DOI: 10.1016/j.atherosclerosis.2017.01.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/12/2016] [Accepted: 01/13/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Low 25-hydroxyvitamin D [25(OH)D] concentrations have been associated with peripheral artery disease (PAD). Prevalence of low 25(OH)D and PAD differ between whites and blacks. However, these associations have not been studied prospectively or in a population based cohort. We tested the hypothesis that low 25(OH)D is associated with greater risk of incident PAD in white and black adults. METHODS 25(OH)D was measured in serum collected at ARIC visit 2 (1990-1992). We followed 11,789 ARIC participants free of PAD at visit 2 through 2011 for incident PAD events. 25(OH)D (ng/mL) was categorized as deficient (<20), insufficient (20 to <30) or sufficient (≥30). PAD was defined by an ankle brachial index (ABI) of <0.9 at ARIC visits 3 or 4 or a hospital diagnosis with an ICD-9 code indicating PAD during follow-up. Analysis used multivariable-adjusted Cox proportional hazards regressions. RESULTS Over a mean follow-up of 17.1 years, 1250 incident PAD events were identified. 22% of whites and 61% of blacks were 25(OH)D deficient. After adjustment for demographic characteristics, the hazard ratio (95% CI) of PAD in participants with deficient versus sufficient 25(OH)D was 1.49 (1.26, 1.76). Inclusion of BMI, physical activity, and smoking status attenuated the association [1.25 (1.06, 1.48)]. The association between 25(OH)D and PAD was qualitatively stronger in blacks (p for interaction = 0.20). CONCLUSIONS Deficient 25(OH)D was associated with increased risk of PAD in black and white participants. Whether treatment of low vitamin D through supplementation or modest sunlight exposure prevents PAD is unknown.
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Affiliation(s)
- Ian R Rapson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
| | - Erin D Michos
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Alan T Hirsch
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Kunihiro Matsushita
- Welch Center for Prevention, Epidemiology, and Clinical Research, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD, United States
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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Lategan R, Van den Berg VL, Ilich JZ, Walsh CM. Vitamin D status, hypertension and body mass index in an urban black community in Mangaung, South Africa. Afr J Prim Health Care Fam Med 2016; 8:e1-e5. [PMID: 28155313 PMCID: PMC5105600 DOI: 10.4102/phcfm.v8i1.1210] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/31/2016] [Accepted: 08/06/2016] [Indexed: 11/23/2022] Open
Abstract
Background A strong relationship exists between hypertension and body weight. Research has linked both higher blood pressure and body weight with lower vitamin D status. Objective This study assessed the vitamin D status of a low-income, urban, black community in South Africa, to examine whether serum levels of 25-hydroxy vitamin D [25(OH)D] are associated with hypertension and body mass index (BMI). Methods Data collected from 339 adults (25–64 years) from the Assuring Health for All in the Free State (AHA-FS) study were analysed. Variables measured include serum 25(OH)D, blood pressure, weight and height to determine BMI, and HIV status. Results Mean 25(OH)D level was 38.4 ± 11.2 ng/mL for the group; 43.5 ± 11.8 ng/mL and 37.0 ± 10.6 ng/mL for males and females, respectively. Approximately 40% of the participants were HIV-positive and 63.4% hypertensive. Based on BMI, 11.8% were underweight, 33.0% normal weight, 23.0% overweight and 32.1% obese. HIV status showed no correlation with 25(OH)D levels when controlling for BMI. Poor inverse relationships were found between BMI and 25(OH)D (p = 0.01), and between mean arterial blood pressure and 25(OH)D (p = 0.05). When controlling for BMI, no correlation was found between 25(OH)D and the prevalence of hypertension or mean arterial blood pressure. Conclusion Approximately 96% of participants had an adequate vitamin D status, which could be attributed to latitude, sunny conditions and expected high levels of sun exposure because of living conditions. Results confirmed a poor inverse relationship between vitamin D status and hypertension, which seems to be dependent on BMI.
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Affiliation(s)
- Ronette Lategan
- Department of Nutrition and Dietetics, University of the Free State.
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20
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Căpuşa C, Stefan G, Stancu S, Ilyes A, Dorobanţu N, Mircescu G. Subclinical cardiovascular disease markers and vitamin D deficiency in non-dialysis chronic kidney disease patients. Arch Med Sci 2016; 12:1015-1022. [PMID: 27695492 PMCID: PMC5016586 DOI: 10.5114/aoms.2016.61911] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 03/02/2015] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Since 25-hydroxyvitamin D (25(OH)D) deficiency has been linked to an increased risk for cardiovascular disease (CVD) in the hemodialysis population, we aimed to determine the relationship between serum 25(OH)D level and markers of subclinical CVD in non-dialysis chronic kidney disease (CKD) patients. MATERIAL AND METHODS This cross-sectional, single-center study prospectively enrolled 87 clinically stable CKD patients (median age: 61 (57-66) years, 51% male, median estimated glomerular filtration rate (eGFR): 32 (27-37) ml/min). Five markers of subclinical CVD were assessed: intima-media thickness, abdominal aortic calcifications (AAC) using the Kauppila score, cardio-ankle vascular index, ankle-brachial index (ABI) and interventricular septum thickness. RESULTS Vascular (37%), glomerular (23%) and interstitial (18%) nephropathies were the main causes of CKD. 25(OH)D had a median value of 14 (12.5-17.1) ng/ml, and its levels decreased with eGFR (rs = 0.19; p = 0.04). Patients with 25(OH)D deficiency (54%) were older, had a higher serum alkaline phosphatase level, lower ABI and higher AAC score. There were no differences between the two groups regarding other traditional or non-traditional risk factors for atherosclerosis. The association between subclinical CVD markers and 25(OH)D was further evaluated in multivariable binomial logistic regression models adjusted for CV risk factors. Lower 25(OH)D level was retained as an independent predictor only for pathological ABI. CONCLUSIONS This is the first study to evaluate the relationship between a large set of subclinical CVD markers and 25(OH)D deficiency in non-dialysis CKD patients. We found that hypovitaminosis D is associated with subclinical peripheral arterial disease, independently of other cardiovascular risk factors.
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Affiliation(s)
- Cristina Căpuşa
- Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- “Dr Carol Davila” Teaching Hospital of Nephrology, Bucharest, Romania
| | - Gabriel Stefan
- Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- “Dr Carol Davila” Teaching Hospital of Nephrology, Bucharest, Romania
| | - Simona Stancu
- Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- “Dr Carol Davila” Teaching Hospital of Nephrology, Bucharest, Romania
| | - Andrea Ilyes
- “Dr Carol Davila” Teaching Hospital of Nephrology, Bucharest, Romania
| | | | - Gabriel Mircescu
- Nephrology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- “Dr Carol Davila” Teaching Hospital of Nephrology, Bucharest, Romania
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Oh SH, Kweon SS, Choi JS, Rhee JA, Lee YH, Nam HS, Jeong SK, Park KS, Ryu SY, Choi SW, Shin MH. Association between Vitamin D Status and Risk of Peripheral Arterial Disease: The Dong-gu Study. Chonnam Med J 2016; 52:212-6. [PMID: 27689032 PMCID: PMC5040771 DOI: 10.4068/cmj.2016.52.3.212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 07/15/2016] [Accepted: 07/19/2016] [Indexed: 01/29/2023] Open
Abstract
Low levels of vitamin D have been associated with increased cardiovascular disease risk. However, few studies have evaluated the association between vitamin D status and peripheral arterial disease (PAD). We therefore aimed to investigate whether low 25-hydroxyvitamin D (25(OH)D) levels were associated with increased risk of PAD in the Korean population. This cross-sectional study was conducted among 8,960 subjects aged 50 years or older without known myocardial infarction or stroke. PAD was defined by an ankle brachial blood pressure index <0.9. Multivariate logistic regression was used to evaluate the association between serum 25(OH)D levels and risk of PAD. Of the 8,960 subjects, 3.0% had PAD and the age and sex adjusted prevalence of PAD decreased with the increasing 25(OH)D quartile. After adjusting for potential confounders and parathyroid hormones, serum 25(OH)D levels were associated with a significantly decreased risk of PAD (OR for one SD increase, 0.98; 95% CI, 0.95-1.0, P for trend=0.040). Compared with the first 25(OH)D quartile, the odds of PAD were 0.86 (95% CI, 0.62-1.21), 0.67 (95% CI, 0.46-0.97), and 0.71 (95% CI, 0.49-1.04) for the second, third, and fourth quartiles, respectively. In this cross-sectional study, we found that low serum 25(OH)D levels were associated with an increased risk of PAD, independent of traditional cardiovascular risk factors and parathyroid hormone. Our findings suggest that low vitamin D levels may contribute to PAD in the Korean population.
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Affiliation(s)
- Su-Hyun Oh
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.; Jeonnam Regional Cancer Center, Chonnam National University, Hwasun Hospital, Hwasun, Korea
| | - Jin-Su Choi
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jung-Ae Rhee
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Hoon Lee
- Department of Preventive Medicine & Institute of Wonkwang Medical Science, Wonkwang University College of Medicine, Iksan, Korea
| | - Hae-Sung Nam
- Department of Preventive Medicine, Chungnam National University Medical School, Daejeon, Korea
| | - Seul-Ki Jeong
- Department of Neurology & Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Institute of Chonbuk National University Hospital, Jeonju, Korea
| | - Kyeong-Soo Park
- Department of Preventive Medicine, Seonam University College of Medicine, Namwon, Korea
| | - So-Yeon Ryu
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Seong-Woo Choi
- Department of Preventive Medicine, Chosun University Medical School, Gwangju, Korea
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
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Li DM, Zhang Y, Li Q, Xu XH, Ding B, Ma JH. Low 25-Hydroxyvitamin D Level Is Associated with Peripheral Arterial Disease in Type 2 Diabetes Patients. Arch Med Res 2016; 47:49-54. [PMID: 26854799 DOI: 10.1016/j.arcmed.2016.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 01/26/2016] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Patients with type 2 diabetes have an increased risk of atherosclerosis and vascular disease. Vitamin D deficiency is associated with vascular disease and is prevalent in diabetes patients. We undertook this study to determine the association between 25-hydroxyvitamin D (25[OH]D) levels and prevalence of peripheral arterial disease (PAD) in type 2 diabetes patients. METHODS A total of 1028 type 2 diabetes patients were recruited at Nanjing Medical University Affiliated Nanjing Hospital from November 2011 to October 2013. PAD was defined as an ankle-brachial index (ABI) < 0.9. Cardiovascular risk factors (blood pressure, HbA1c, lipid profile), comorbidities, carotid intima-media thickness (IMT) and 25(OH)D were assessed. RESULTS Overall prevalence of PAD and of decreased 25(OH)D (<30 ng/mL) were 20.1% (207/1028) and 54.6% (561/1028), respectively. PAD prevalence was higher in participants with decreased (23.9%) than in those with normal (15.6%) 25(OH)D (≥30 ng/mL, p <0.01). Decreased 25(OH)D was associated with increased risk of PAD (odds ratio [OR], 1.69, 95% CI: 1.17-2.44, p <0.001) and PAD was significantly more likely to occur in participants ≥65 years of age (OR, 2.56, 95% CI: 1.51 -4.48, vs. 1.21, 95% CI: 0.80-1.83, p-interaction = 0.027). After adjusting for known cardiovascular risk factors and potential confounding variables, the association of decreased 25(OH)D and PAD remained significant in patients <65 years of age (OR, 1.55; 95% CI: 1.14-2.12, p = 0.006). CONCLUSIONS Low serum 25(OH)D levels were significantly associated with a higher prevalence of PAD in type 2 diabetes patients <65 years of age. It may increase the risk of PAD independent of other known cardiovascular risk factors.
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Affiliation(s)
- Dong-mei Li
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
| | - Ying Zhang
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China
| | - Qian Li
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China
| | - Xiao-hua Xu
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China
| | - Bo Ding
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China
| | - Jian-hua Ma
- Department of Endocrinology, Nanjing Medical University Affiliated Nanjing Hospital (Nanjing First Hospital), Nanjing, China.
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Nsengiyumva V, Fernando ME, Moxon JV, Krishna SM, Pinchbeck J, Omer SM, Morris DR, Jones RE, Moran CS, Seto SW, Golledge J. The association of circulating 25-hydroxyvitamin D concentration with peripheral arterial disease: A meta-analysis of observational studies. Atherosclerosis 2015; 243:645-51. [PMID: 26554715 DOI: 10.1016/j.atherosclerosis.2015.10.011] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 09/15/2015] [Accepted: 10/05/2015] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS The association of vitamin D deficiency with cardiovascular disease is controversial. The present meta-analysis was performed to examine if circulating levels of 25-hydroxyvitamin D [25(OH)D] were lower in patients with peripheral artery disease (PAD) when compared to non-PAD controls. METHODS A comprehensive database search was conducted in Web of science, Scopus, PubMed, EMBASE and The Cochrane Library to identify observational studies reporting 25(OH)D concentrations in PAD patients and non-PAD participants. Data extraction and study quality assessments were conducted independently. A random-effects model was used to meta-analyse extracted data and generate standardized mean differences (SMDs) in circulating 25(OH)D levels between PAD patients and non-PAD controls. Subgroup analyses were conducted focussing on patients presenting with intermittent claudication (IC) and critical limb ischaemia (CLI). RESULTS Six case-control studies assessing 6418 individuals fulfilled the inclusion criteria. Two studies were considered to be of moderate methodological quality and four were considered to be of high quality. A meta-analysis of data from 1217 PAD patients and 5201 non-PAD participants showed that circulating 25(OH)D concentrations were lower in PAD patients compared with non-PAD participants (SMD = -0.32, 95% CI: -0.58, -0.05; P = 0.02). Subgroup analyses showed that 25(OH)D levels were significantly lower among PAD patients with CLI, but not IC, when compared to non-PAD controls (SMD = -1.29, 95% CI: -1.66, -0.91; P < 0.001 and SMD = -0.01, 95% CI: -0.15, 0.13; P=0.88, respectively). CONCLUSIONS This meta-analysis suggests that low levels of circulating 25(OH)D are associated with PAD presence, particularly in patients presenting with CLI. These data suggest the possibility that vitamin D insufficiency may contribute to the development of more advanced PAD although this remains to be confirmed.
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Affiliation(s)
- Vianne Nsengiyumva
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Malindu E Fernando
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Joseph V Moxon
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Smriti M Krishna
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Jenna Pinchbeck
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Safraz M Omer
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Dylan R Morris
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Rhondda E Jones
- Division of Medicine, Health and Molecular Sciences, James Cook University, Townsville, QLD, Australia
| | - Corey S Moran
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia
| | - Sai W Seto
- National Institute of Complementary Medicine (NICM), Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Jonathan Golledge
- The Vascular Biology Unit, Queensland Research Centre for Peripheral Arterial Diseases, College of Medicine & Dentistry, James Cook University, Townsville, QLD, Australia; Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, QLD, Australia.
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Schneider ALC, Lutsey PL, Selvin E, Mosley TH, Sharrett AR, Carson KA, Post WS, Pankow JS, Folsom AR, Gottesman RF, Michos ED. Vitamin D, vitamin D binding protein gene polymorphisms, race and risk of incident stroke: the Atherosclerosis Risk in Communities (ARIC) study. Eur J Neurol 2015; 22:1220-7. [PMID: 25962507 PMCID: PMC4496275 DOI: 10.1111/ene.12731] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 03/09/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Low vitamin D levels, measured by serum 25-hydroxyvitamin D [25(OH)D], are associated with increased stroke risk. Less is known about whether this association differs by race or D binding protein (DBP) single nucleotide polymorphism (SNP) status. Our objective was to characterize the associations of and interactions between 25(OH)D levels and DBP SNPs with incident stroke. It was hypothesized that associations of low 25(OH)D with stroke risk would be stronger amongst persons with genotypes associated with higher DBP levels. METHODS 25(OH)D was measured by mass spectroscopy in 12 158 participants in the Atherosclerosis Risk in Communities (ARIC) study (baseline 1990-1992, mean age 57 years, 57% female, 23% black) and they were followed through 2011 for adjudicated stroke events. Two DBP SNPs (rs7041, rs4588) were genotyped. Cox models were adjusted for demographic/behavioral/socioeconomic factors. RESULTS During a median of 20 years follow-up, 804 incident strokes occurred. The lowest quintile of 25(OH)D (<17.2 ng/ml) was associated with higher stroke risk [hazard ratio (HR) 1.34 (1.06-1.71) versus highest quintile]; this association was similar by race (P interaction 0.60). There was weak evidence of increased risk of stroke amongst those with 25(OH)D < 17.2 ng/ml and either rs7041 TG/GG [HR = 1.29 (1.00-1.67)] versus TT genotype [HR = 1.19 (0.94-1.52)] (P interaction 0.28) or rs4588 CA/AA [HR = 1.37 (1.07-1.74)] versus CC genotype [HR = 1.14 (0.91-1.41)] (P interaction 0.11). CONCLUSIONS Low 25(OH)D is a risk factor for stroke. Persons with low 25(OH)D who are genetically predisposed to high DBP (rs7041 G, rs4588 A alleles), who therefore have lower predicted bioavailable 25(OH)D, may be at greater risk for stroke, although our results were not conclusive and should be interpreted as hypothesis generating.
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Affiliation(s)
- A L C Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - P L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - E Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - T H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - A R Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - W S Post
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J S Pankow
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - A R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - R F Gottesman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E D Michos
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Reis JP, Michos ED, Selvin E, Pankow JS, Lutsey PL. Race, vitamin D-binding protein gene polymorphisms, 25-hydroxyvitamin D, and incident diabetes: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Clin Nutr 2015; 101:1232-40. [PMID: 25926504 PMCID: PMC4441813 DOI: 10.3945/ajcn.115.107334] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/24/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Low 25-hydroxyvitamin D [25(OH)D] is associated with diabetes, but few studies have examined racially diverse populations while also accounting for key vitamin D-binding protein (DBP) gene polymorphisms. OBJECTIVE We sought to evaluate whether the association between 25(OH)D and incident diabetes varied by race and important DBP single nucleotide polymorphisms (SNPs). DESIGN We studied 10,222 adults (8120 whites, 2102 blacks) aged 46-70 y at baseline (1990-1992) from the ARIC (Atherosclerosis Risk in Communities) Study with follow-up for incident diabetes ascertained during study visits conducted in 1993-1995 and 1996-1998. Adjusted HRs and their 95% CIs for diabetes were estimated according to 25(OH)D status. RESULTS During follow-up there were 750 incident cases of diabetes. The association of 25(OH)D with diabetes varied by race (P-interaction = 0.004). Among whites, the adjusted HR for diabetes corresponding to each additional SD higher 25(OH)D concentration (21.3 nmol/L) was 0.95 (95% CI: 0.91, 0.99). No significant association was observed among blacks (HR: 1.06; 95% CI: 0.99, 1.14). There was evidence that the A allele at rs4588 and the T allele at rs7041, which are reported to be associated with high and low DBP concentrations, respectively, modified the association between 25(OH)D and diabetes among whites (P-interaction < 0.05 for both) but not blacks (P-interaction > 0.50 for both). CONCLUSIONS In this large, community-based study, low 25(OH)D concentrations were associated with diabetes among whites but not blacks. Interactions by key DBP SNPs varied between genotypes associated with either high or low DBP concentrations among whites but not blacks. Nevertheless, the findings from this prospective study suggest that there are important differences in the association of 25(OH)D with incident diabetes between white and black adults.
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Affiliation(s)
- Jared P Reis
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL).
| | - Erin D Michos
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - Elizabeth Selvin
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - James S Pankow
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
| | - Pamela L Lutsey
- From the Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD (JPR); the Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (EDM); the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (ES); and the Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN (JSP and PLL)
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Lutsey PL, Michos ED, Misialek JR, Pankow JS, Loehr L, Selvin E, Reis JP, Gross M, Eckfeldt JH, Folsom AR. Race and Vitamin D Binding Protein Gene Polymorphisms Modify the Association of 25-Hydroxyvitamin D and Incident Heart Failure: The ARIC (Atherosclerosis Risk in Communities) Study. JACC-HEART FAILURE 2015; 3:347-356. [PMID: 25863973 DOI: 10.1016/j.jchf.2014.11.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 11/19/2014] [Accepted: 11/24/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study sought to determine if low serum 25-hydroxyvitamin D (25[OH]D) is associated with incident heart failure (HF) and if the association is: 1) partly mediated by traditional cardiovascular risk factors; 2) stronger among whites than blacks; and 3) stronger among those genetically predisposed to having high levels of vitamin D binding protein (DBP). BACKGROUND Suboptimal 25(OH)D is a potential cardiovascular risk factor. METHODS A total of 12,215 ARIC (Atherosclerosis Risk in Communities) study participants free of HF at baseline (1990 to 1992; median age, 56; 24% black) were followed through 2010. Total serum 25(OH)D was measured at baseline using liquid chromatography-mass spectrometry. Incident HF events were identified by a hospital discharge code of ICD9-428 and parallel International Classification of Diseases codes for HF deaths. RESULTS During 21 years of follow-up, 1,799 incident HF events accrued. The association between 25(OH)D and HF varied by race (p-interaction = 0.02). Among whites, risk was 2-fold higher for those in the lowest (≤17 ng/ml) versus highest (≥31 ng/ml) quintile of 25(OH)D. The association was attenuated but remained significant with covariate adjustment. In blacks there was no overall association. In both races, those with low 25(OH)D and the rs7041 G allele, which predisposes to high DBP, were at greater risk (p-interaction = 0.01). CONCLUSIONS Low serum 25(OH)D was independently associated with incident HF among whites, but not among blacks. However, in both races, low 25(OH)D was associated with HF risk among those genetically predisposed to high DBP. These findings provide novel insight into metabolic differences that may underlie racial variation in the association between 25(OH)D and cardiovascular risk.
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Affiliation(s)
- Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota.
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland
| | - Jeffrey R Misialek
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Laura Loehr
- Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth Selvin
- Departments of Epidemiology and Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Jared P Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
| | - Myron Gross
- Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - John H Eckfeldt
- Lab Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
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Veronese N, Rui MD, Bolzetta F, Toffanello ED, Coin A, Zambon S, Corti MC, Baggio G, Perissinotto E, Maggi S, Crepaldi G, Manzato E, Sergi G. Serum 25-Hydroxyvitamin D and the Incidence of Peripheral Artery Disease in the Elderly: The Pro.V.A Study. J Atheroscler Thromb 2015; 22:726-34. [DOI: 10.5551/jat.28134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nicola Veronese
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
| | - Marina De Rui
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
| | - Francesco Bolzetta
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
| | | | - Alessandra Coin
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
| | - Sabina Zambon
- Department of Medicine (DIMED); Clinica Medica 1, University of Padova
- National Research Council, Neuroscience Institute, Aging Branch
| | | | | | - Egle Perissinotto
- Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology, and Public Health Unit, University of Padova
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch
| | | | - Enzo Manzato
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
- National Research Council, Neuroscience Institute, Aging Branch
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Section, University of Padova
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Ashraf AP, Alvarez JA, Dudenbostel T, Calhoun D, Griffin R, Wang X, Hanks LJ, Gower BA. Associations between vascular health indices and serum total, free and bioavailable 25-hydroxyvitamin D in adolescents. PLoS One 2014; 9:e114689. [PMID: 25479358 PMCID: PMC4257727 DOI: 10.1371/journal.pone.0114689] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 11/08/2014] [Indexed: 11/22/2022] Open
Abstract
Objective The role of vitamin D in cardiovascular health remains debated as results have been inconsistent. Previous studies have not considered the bioavailability of 25-hydroxy vitamin D [25(OH)D]. Objectives of our study were to investigate the association between serum concentrations of total, free and bioavailable 25(OH)D and independent predictors of cardiovascular risk such as flow mediated dilatation (FMD) and augmentation index (AIx). Design This cross-sectional study included 47 post-menarchal, adolescent females [31 African American (AA) and 16 European American (EA)]. Methods AIx was standardized to a heart rate of 75 beats/min (AIx75). Free and bioavailable 25(OH)D concentrations were calculated from standard formulas. Results and Conclusions Mean age of the participants was 15.8±1.4 years and mean body mass index was 23.1±4.0 kg/m2. Serum total 25(OH)D was not associated with FMD, but was positively associated with AIx75 in the adjusted model (rho = 0.4, P = 0.03). AIx75 was positively associated with bioavailable 25(OH)D (rho = 0.4, P = 0.004) and free 25(OH)D (rho = 0.4, P = 0.009) and the associations persisted after adjusting for covariates. In race-specific analyses, total, free and bioavailable 25(OH)D were strongly positively associated with AIx75 in AA (rho = 0.5, 0.4, 0.4, respectively), which persisted even after adjusting for covariates. Whereas in EA there was an inverse association between total 25(OH)D and AIx75 in EA (rho = −0.6), which attenuated after adjusting for covariates. Conclusion Circulating total, free and bioavailable 25(OH)D were associated with arterial stiffness in adolescent girls, and these associations were race dependent. Notwithstanding, the implications of associations between vascular function indices and 25(OH)D remains unclear.
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Affiliation(s)
- Ambika P. Ashraf
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
- * E-mail:
| | - Jessica A. Alvarez
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Tanja Dudenbostel
- Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - David Calhoun
- Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Russell Griffin
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Xudong Wang
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Lynae J. Hanks
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - Barbara A. Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
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Amer M, Narotsky DL, Qayyum R. 25-Hydroxyvitamin D and ankle-brachial blood pressure index in adults without peripheral artery disease. Clin Transl Sci 2014; 7:391-5. [PMID: 25051887 DOI: 10.1111/cts.12185] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Inverse association between lower level of 25-hydroxyvitamin D [25(OH)D] and higher prevalence of peripheral arterial disease (PAD) among individuals with cardiovascular diseases (CVD) is known. Less is known about the relationship between 25(OH)D and ankle-brachial blood pressure index (ABPI) in asymptomatic adults. We hypothesized a nonlinear relationship between 25(OH)D and ABPI in asymptomatic adults without PAD. METHODS Data from the continuous NHANES (2001-2004) was used. Minimum of the two reported ABPI value was chosen for each individual (>18 years). Linear regression models with spline adjusted for demographic and traditional risk factors for CVD were used to examine nonlinear relationship between 25(OH)D and ABPI. Mean changes in ABPI per 10 ng/mL change in 25(OH)D were reported. RESULTS Mean (SD) age and 25(OH)D levels of 4979 participants (48% females) were 60.4 (13.22) years and 22.1 (8.68) ng/mL, respectively, while mean (SD) ABPI was 1.07 (0.15). We observed positive association between 25(OH)D and ABPI both in the univariable and multivariable regression models (all p < 0.05). In univariable regression with spline, a significant increase in ABPI (ß = 0.03, 95% CI: 0.02-0.04) was observed until 25(OH)D reached but not above 27 ng/mL. Similarly, in multivariable spline models, 25(OH)D was positively associated with ABPI (ß = 0.02, 95% CI: 0.01-0.03) only up to 27 ng/mL. CONCLUSIONS In asymptomatic adults without PAD, rising serum 25(OH)D concentration but not above 27 ng/mL was associated with statistically significant increase in ABPI.
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Affiliation(s)
- Muhammad Amer
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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Essien U, Goel N, Melamed ML. Role of vitamin D receptor activation in racial disparities in kidney disease outcomes. Semin Nephrol 2014; 33:416-24. [PMID: 24119847 DOI: 10.1016/j.semnephrol.2013.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
African Americans have lower 25-hydroxyvitamin D (25(OH)D) levels compared with whites. African Americans also have a higher risk of developing albuminuria and end-stage renal disease but a lower risk of death once they commence hemodialysis compared with whites. Vitamin D levels have been associated with multiple outcomes including albuminuria, progression to end-stage renal disease, and all-cause and cardiovascular mortality. In this review, we examine the evidence linking 25(OH)D to outcomes and the possibility that differential 25(OH)D may explain certain racial differences in outcomes.
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Affiliation(s)
- Utibe Essien
- Departments of Medicine and Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
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Lategan R, Van den Berg VL, Walsh CM. Body adiposity indices are associated with hypertension in a black, urban Free State community. Afr J Prim Health Care Fam Med 2014; 6:E1-7. [PMID: 26245400 PMCID: PMC4502881 DOI: 10.4102/phcfm.v6i1.581] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 12/27/2013] [Accepted: 11/28/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Non-communicable diseases, including hypertension, are increasing rapidly in resource-poor, developing countries amongst populations transitioning from traditional to westernised lifestyles; and are associated with excess weight. AIM To investigate the relationship between hypertension and various indices of body adiposity in a transitioning, urban, black population. SETTING Three hundred and thirty-nine adults (25-64 years) from a larger cross-sectional study (Assuring Health for All in the Free State) conducted in Mangaung, South Africa, were included. METHODS Standard techniques were used to determine blood pressure, HIV status, body mass index (BMI), waist-to-height ratio (WHtR) and body adiposity index (BAI). RESULTS Approximately 40% of the sample was HIV-positive and 63.4% hypertensive, with the greatest risk of hypertension being amongst older men. Based on BMI, 23.0% were overweight and 32.1% obese. Waist-to-height ratio showed that 58.6% had increased cardiovascular risk. Mean BAI was 34.1%, whilst 76.3% had a body fat percentage in the overweight/obese category. Waist circumference representing increased cardiovascular risk was found in 44.3% of women and 3.9% of men. Significant positive correlations between mean arterial bloodpressure and BMI (r = 0.261; p < 0.001), WHtR (r = 0.357; p < 0.001) and BAI (r = 0.245; p <0.001) were found. WHtR was a stronger predictor of mean arterial pressure than BMI or BAI. HIV status showed an inverse correlation with all adiposity indices (p < 0.001). CONCLUSION Our findings promote WHtR as a practical screening tool for increased hypertension risk in populations undergoing westernisation, and support weight loss as afirst-line intervention for the prevention and management of hypertension.
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Sakamoto R, Jaceldo-Siegl K, Haddad E, Oda K, Fraser G, Tonstad S. Relationship of vitamin D levels to blood pressure in a biethnic population. Nutr Metab Cardiovasc Dis 2013; 23:776-784. [PMID: 22770642 PMCID: PMC3522760 DOI: 10.1016/j.numecd.2012.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Revised: 04/07/2012] [Accepted: 04/25/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Accumulating epidemiological and clinical studies have suggested that vitamin D insufficiency may be associated with hypertension. Blacks tend to have lower vitamin D levels than Whites, but it is unclear whether this difference explains the higher blood pressure (BP) observed in Blacks in a population with healthy lifestyle practices. METHODS AND RESULTS We examined cross-sectional data in the Adventist Health Study-2 (AHS-2), a cohort of non-smoking, mostly non-drinking men and women following a range of diets from vegan to non-vegetarian. Each participant provided dietary, demographic, lifestyle and medical history data. Measurements of weight, height, waist circumference, percent body fat and blood pressure and fasting blood samples were obtained from a randomly selected non-diabetic sample of 284 Blacks and 284 Whites aged 30-95 years. Multiple regression analyses were used to assess independent relationships between blood pressure and 25(OH)D levels. Levels of 25(OH)D were inversely associated with systolic BP in Whites after control for age, gender, BMI, and use of BP-lowering medications (β-coefficient -0.23 [95% CI, -0.43, -0.03; p = 0.02]). This relationship was not seen in Blacks (β-coefficient 0.08 [95% CI, -0.14, 0.30; p = 0.4]). Results were similar when controlling for waist circumference or percentage body fat instead of BMI. No relationship between serum 25(OH)D and diastolic BP was seen. CONCLUSION Systolic BP is inversely associated with 25(OH)D levels in Whites but not in Blacks. Vitamin D may not be a major contributor to the White-Black differential in BP.
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Affiliation(s)
- R. Sakamoto
- Department of Health Promotion and Education, School of Public Health, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA 92350, USA
| | - K. Jaceldo-Siegl
- Department of Nutrition, School of Public Health, Loma Linda University, USA
| | - E. Haddad
- Department of Nutrition, School of Public Health, Loma Linda University, USA
| | - K. Oda
- Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, USA
| | - G.E. Fraser
- Department of Epidemiology and Biostatistics, School of Public Health, Loma Linda University, USA
| | - S. Tonstad
- Department of Health Promotion and Education, School of Public Health, Loma Linda University, 24951 North Circle Drive, Loma Linda, CA 92350, USA
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Jain SK, Micinski D. Vitamin D upregulates glutamate cysteine ligase and glutathione reductase, and GSH formation, and decreases ROS and MCP-1 and IL-8 secretion in high-glucose exposed U937 monocytes. Biochem Biophys Res Commun 2013; 437:7-11. [PMID: 23770363 DOI: 10.1016/j.bbrc.2013.06.004] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Glutathione is a major endogenous antioxidant and its deficiency is implicated in the etiology and progression of a number of human diseases. Vitamin D is important for the prevention of osteoporosis, cardiovascular disease, diabetes, autoimmune diseases, and some cancers. Using a monocyte cell model, this study examined the hypothesis that vitamin D upregulate glutamate cysteine ligase (GCLC) and glutathione reductase (GR), which catalyzes GSH biosynthesis. METHODS U937 monocytes were pretreated with and without 1,25 (OH)₂ vitamin D (10-25 nM) for 24 h and then exposed to control and high glucose (HG, 25 mM) for 4h. Levels of GSH determined using HPLC; GR activity by oxidation of NADPH; GCLC protein, MCP-1 and IL-8 using ELISA kits. RESULTS 1,25 (OH)₂ vitamin D supplementation significantly upregulated expression of GCLC and GR, levels of GCLC protein and GR activity, and formation of GSH in control and HG-treated monocytes. 1,25 (OH)₂ vitamin D caused significantly (p<0.05) lower secretion of IL-8 and MCP-1, and lower ROS levels in monocytes exposed to control and HG-treated monocytes. CONCLUSIONS This study demonstrates a positive link between vitamin D and GSH levels, and that some beneficial effects of vitamin D supplementation may be mediated by an improvement in the cellular GSH levels and a decrease in ROS and pro-inflammatory cytokines.
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Affiliation(s)
- Sushil K Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, United States.
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Williams SK, Fiscella K, Winters P, Martins D, Ogedegbe G. Association of racial disparities in the prevalence of insulin resistance with racial disparities in vitamin D levels: National Health and Nutrition Examination Survey (2001-2006). Nutr Res 2013; 33:266-71. [PMID: 23602243 PMCID: PMC3649515 DOI: 10.1016/j.nutres.2013.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Revised: 01/31/2013] [Accepted: 02/01/2013] [Indexed: 11/30/2022]
Abstract
We tested the hypothesis that racial differences in vitamin D levels are associated with racial disparities in insulin resistance between blacks and whites. Among 3628 non-Hispanic black and white adults in the National Health and Nutrition Examination Survey from 2001 to 2006, we examined the association between race and insulin resistance using the homeostasis assessment model for insulin resistance. We conducted analyses with and without serum 25-hydroxyvitamin D (25[OH]D). We adjusted for age, sex, educational level, body mass index, waist circumference, physical activity, alcohol intake, smoking, estimated glomerular filtration rate, and urinary albumin/creatinine ratio. Blacks had a lower mean serum 25(OH)D level compared with whites (14.6 [0.3] ng/mL vs 25.6 [0.4] ng/mL, respectively; P < .0001). Blacks had a higher odds ratio (OR) for insulin resistance without controlling for serum 25(OH)D levels (OR, 1.67; 95% confidence interval, 1.26-2.20). The association was not significant (OR, 1.28; 95% confidence interval, 0.90-1.82) after accounting for serum 25(OH)D levels. The higher burden of insulin resistance in blacks compared with whites may be partially mediated by the disparity in serum 25(OH)D levels.
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Affiliation(s)
- Stephen K Williams
- Department of Medicine, Center for Integrative Medicine, Weill Cornell Medical College of Cornell University, New York City, NY 10065, USA.
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Muzembo BA, Nagano Y, Dumavibhat N, Ngatu NR, Matsui T, Bhatti SA, Eitoku M, Hirota R, Ishida K, Suganuma N. Ankle-brachial pressure index and mini nutritional assessment in community-dwelling elderly people. J Nutr Health Aging 2013; 17:370-6. [PMID: 23538661 DOI: 10.1007/s12603-012-0412-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A low ankle-brachial pressure index (an ABPI value <0.90) is considered predictive of cardiovascular disease, and is widely thought to increase morbidity and mortality in the elderly. However, good nutrition is beneficial both for the health and the ability to resist and recover from the disease. OBJECTIVE The aim of the present study was to evaluate the relationship between the ankle-brachial pressure index and the nutritional status of the elderly in a city of Kochi prefecture, Japan. METHODS This was a cross-sectional study in which a total of 100 elderly people, both males and females, were screened for ankle-brachial pressure index (ABPI), nutritional status (through the use of the short form of the mini nutritional assessment), activities of daily living, lifestyle, gait speed (10MWT), postural stability (OLST), and functional mobility (TUG). RESULTS About 67% of the participants were found to have a normal nutritional status, 27% were at risk of malnutrition, and six percent were classified as malnourished. The mean ABPI of the participants was 1.08±0.10, and three participants had an ABPI lower than 0.90. The ABPI was statistically higher in well nourished participants compared with those at risk of malnutrition or the malnourished. The mean ABPI was significantly higher in non-smokers compared with former smokers. The ABPI was found to correlate negatively with gait speed and with TUG score. CONCLUSION Well-nourished elderly had a higher normal ankle-brachial pressure index as compared with the malnourished elderly. This study provides supportive evidence for the necessity of adequate nutrition for elderly people.
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Affiliation(s)
- B A Muzembo
- Division of Social Medicine, Department of Environmental Medicine, Kochi Medical School, Kochi University, Kochi, Japan.
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Gupta AK, Brashear MM, Johnson WD. Predisease conditions and serum vitamin D levels in healthy Mexican American adults. Postgrad Med 2013; 124:136-42. [PMID: 23095433 DOI: 10.3810/pgm.2012.09.2599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS To elucidate the relationship between low circulating serum vitamin D levels and predisease conditions (ie, prediabetes and prehypertension) in healthy Mexican American adults. METHODS Analyses were conducted using data from the United States National Health and Nutrition Examination Survey (NHANES) from 2001 through 2006. Free-living (ie, community-dwelling, nonimprisoned) adult Mexican American subjects (N = 788; men, n = 443; women, n = 345) who had provided written informed consent and had no history of diabetes, hypertension, dyslipidemia, metabolic syndrome, and/or cardiovascular disease were included in this report. Participants were not ingesting any prescription medications, nor did they exhibit any evidence of malabsorption. Participants were determined to be disease free. RESULTS The mean serum vitamin D level for Mexican American adults (N = 788) of 50.5 nmol/L was significantly higher (P < 0.0001) than the mean of 35.9 nmol/L for non-Hispanic black adults (n = 621), and significantly lower (P < 0.0001) than the mean of 65.0 nmol/L for non-Hispanic white adults (n = 1711). Although age, sex, and body mass index were all significantly associated with prehypertension and prediabetes, no such association was found for serum vitamin D levels. CONCLUSION A successive, incremental shift of approximately 15 nmol/L in vitamin D distribution was seen in the transition from the dark-skinned non-Hispanic black population to the brown-skinned Mexican American population, and from the brown-skinned Mexican American population to the non-Hispanic white population. In contrast to the non-Hispanic black and non-Hispanic white populations, wherein previous studies found that serum vitamin D levels below the 75th percentile were associated with prediabetes and prehypertension, no such association was detected among the Mexican American population. The reason for this lack of association among the Mexican American population is unclear.
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Affiliation(s)
- Alok K Gupta
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA.
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Kruger IM, Kruger MC, Doak CM, Schutte AE, Huisman HW, Van Rooyen JM, Schutte R, Malan L, Malan NT, Fourie CMT, Kruger A. The association of 25(OH)D with blood pressure, pulse pressure and carotid-radial pulse wave velocity in African women. PLoS One 2013; 8:e54554. [PMID: 23355878 PMCID: PMC3552848 DOI: 10.1371/journal.pone.0054554] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 12/12/2012] [Indexed: 01/20/2023] Open
Abstract
High susceptibility of the African population to develop cardiovascular disease obliges us to investigate possible contributing risk factors. Our aim was to determine whether low 25(OH)D status is associated with increased blood pressure and carotid-radial pulse wave velocity in black South African women. We studied 291 urban women (mean age: 57.56±9.00 yrs.). 25(OH)D status was determined by serum 25(OH)D levels. Women were stratified into sufficient (>30 ng/ml), and insufficient/deficient (<30 ng/ml) groups. Cardiovascular variables were compared between groups. Women with low 25(OH)D levels had significantly higher SBP (150.8±27.1 vs. 137.6±21.0), DBP (94.7±14.5 vs. 89.3±12.3) and PP (53.15(50.7;55.7) vs. 46.3(29.4;84.6)) compared to women with sufficient levels. No significant difference was observed with regards to c-rPWV. ANCOVA analyses still revealed significant differences between the two groups with regards to SBP, DBP as well as PP. Partial correlations revealed significant inverse association between SBP and 25(OH)D (p = .04;r = −.12). Women with low 25(OH)D levels were ∼2 times more likely to have high SBP (95% CI: 3.23;1.05). To conclude, women with deficient/insufficient 25(OH)D had significantly higher SBP compared to women with a sufficient 25(OH) status.
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Affiliation(s)
- Iolanthé M Kruger
- Africa Unit for Transdisciplinary Health Research-AUTHeR, North-West University, Potchefstroom Campus, Potchefstroom, South Africa.
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Gordon NP, Caan BJ, Asgari MM. Variation in vitamin D supplementation among adults in a multi-race/ethnic health plan population, 2008. Nutr J 2012; 11:104. [PMID: 23231734 PMCID: PMC3567957 DOI: 10.1186/1475-2891-11-104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 11/30/2012] [Indexed: 12/14/2022] Open
Abstract
Background Vitamin D may have a role in many chronic conditions in addition to bone health. Nutritional surveys among Americans have reported high levels of vitamin D insufficiency, especially among Blacks and Latinos. Our study examined variation in vitamin D supplementation practices in an adult health plan population by age, gender, and race-ethnicity. Methods Self-report data from a 2008 general health survey in a large Northern California health plan were used to characterize number and types of sources of vitamin D supplementation (multivitamin, calcium with D, singular D) among women and men aged 25-85, overall, by race-ethnicity, and for obese, diabetic, and hypertensive subgroups. Results In this population, 40% of women and 54% of men ≤ 50, and 24% of women and 53% of men aged 51-85 get no vitamin D from dietary supplements. Higher vitamin D supplementation among women > 50 is associated with higher reported intake of calcium with D. Black and Latina women aged 25-85 and Filipinas in the ≤ 50 age group were significantly less likely than non-Hispanic Whites to get vitamin D from supplements, whereas vitamin D supplementation practices among Chinese women did not significantly differ from non-Hispanic Whites. Among men, Latinos aged 25-85 and Black and Chinese ≤ 50 were significantly less likely than non-Hispanic Whites to get vitamin D from supplements. Similar race-ethnic differences in vitamin D supplementation patterns were observed for people in the obese, diabetic, and hypertensive groups. Conclusions Our survey results suggest that in 2008, a large percentage of women and an even larger percentage of men in a large Northern California health plan get no vitamin D from dietary supplements, and that Blacks and Latinos and obese adults, who are at higher risk of vitamin D deficiency, are also the least likely to get any vitamin D from dietary supplements.
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Affiliation(s)
- Nancy P Gordon
- Kaiser Permanente Northern California's Division of Research in Oakland, Oakland, CA, USA.
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Gouveri E, Papanas N, Hatzitolios AI, Maltezos E. Hypovitaminosis D and peripheral arterial disease: emerging link beyond cardiovascular risk factors. Eur J Intern Med 2012; 23:674-81. [PMID: 22835416 DOI: 10.1016/j.ejim.2012.07.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/18/2012] [Accepted: 07/01/2012] [Indexed: 12/31/2022]
Abstract
Vitamin D has received increasing interest for its beneficial effect on health. Beyond its conventional role in bone metabolism, emerging evidence suggests a possible link between low vitamin D levels and cardiovascular disease (CVD), including peripheral arterial disease (PAD), and cardiovascular risk factors. Vitamin D interacts either directly with the vascular tree or indirectly through its association with cardiovascular risk factors, but the exact mechanism remains controversial. This review outlines the association between hypovitaminosis D and PAD. Both entities are quite prevalent in the general population and, therefore, their potential association might have important clinical implications. Whether vitamin D deficiency represents a novel risk factor for PAD/CVD, and whether vitamin D supplementation would reduce the burden of CVD still remains to be answered. Until then, vitamin D intake is not recommended for PAD/CVD prevention. Outdoor physical activity, coupled with adequate but safe sun exposure, is a healthy lifestyle practice suggested for the prevention of both PAD and hypovitaminosis D.
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Affiliation(s)
- E Gouveri
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, University Hospital of Alexandroupolis, 68100, Greece.
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Gupta AK, Brashear MM, Johnson WD. Low vitamin D levels, prediabetes and prehypertension in healthy African American adults. Nutr Metab Cardiovasc Dis 2012; 22:877-882. [PMID: 22494807 DOI: 10.1016/j.numecd.2012.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 01/25/2012] [Accepted: 01/27/2012] [Indexed: 01/14/2023]
Abstract
AIMS To determine if customary lower serum vitamin D concentrations in healthy African American (AA) adults are associated with modest elevations in fasting plasma glucose (FPG) and/or resting blood pressure (BP). Numerous health disparities between African American (AA) and Caucasian American (CA) adults, especially those which increase cardiovascular morbidity and mortality, have been attributed to lower serum vitamin D concentrations in the AA. Prediabetes (PreDM) and prehypertension (PreHTN) are significantly more prevalent in healthy disease free CA adults with serum vitamin D concentrations below the 75th percentile for the Caucasian cohort. We hypothesized that despite overall lower serum vitamin D concentrations in AA, an increase in the prevalence for PreDM and PreHTN would be seen in those with low vitamin D levels. METHODS AND RESULTS Disease free AA adults in the National Health and Nutrition Examination Survey 2001-2006 were assessed. PreDM and PreHTN were diagnosed using the ADA and JNC 7 criteria: (FPG) 100-125 mg/dL and resting systolic (SBP) 120-139 and/or diastolic (DBP) 80-89 mm Hg, respectively. Logistic regression was employed to assess effects of low vitamin D concentrations on the odds for PreDM and PreHTN (n = 621). Age, gender and BMI adjusted odds ratio for co-morbid PreDM and PreHTN in AA men (n = 343) and women (n = 278) with vitamin D levels ≤45.4 versus >45.4 nmol/L was 2.02 (1.11, 3.68), (p < 0.021). CONCLUSIONS Evaluating serum vitamin D levels, with consideration for supplementation in seemingly healthy AA adults with prediabetes, prehypertension, or co-existing prediabetes and prehypertension, has merit.
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Affiliation(s)
- A K Gupta
- Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Rd., Baton Rouge, LA 70808, USA.
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Vitamin D Deficiency may be an Independent Risk Factor for Arterial Disease. Eur J Vasc Endovasc Surg 2012; 44:301-6. [DOI: 10.1016/j.ejvs.2012.06.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 06/20/2012] [Indexed: 11/19/2022]
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Brostow DP, Hirsch AT, Collins TC, Kurzer MS. The role of nutrition and body composition in peripheral arterial disease. Nat Rev Cardiol 2012; 9:634-43. [PMID: 22922595 DOI: 10.1038/nrcardio.2012.117] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Peripheral arterial disease (PAD) has not been as extensively investigated as other cardiovascular diseases. However, the available data suggest that nutrition-based treatment strategies have the potential to reduce the cost-economic burden of PAD substantially. Abdominal obesity is associated with PAD and prospective and cross-sectional studies have shown that a low dietary intake of folate and reduced synthesis of vitamin D are associated with an increased risk of PAD and severe walking impairment in patients who have the disease. However, dietary patterns that are associated with decreased cardiovascular risk might protect against PAD. A small number of clinical trials have provided evidence that increased intakes of niacin and insoluble fiber might be associated with decreased levels of LDL cholesterol and thrombogenic biomarkers, as well as increased serum levels of HDL cholesterol in patients with PAD. However, little evidence that antioxidants, vitamins B(6) and B(12), or essential fatty acid supplements improve clinical outcomes in these patients exists. Overall, data on the effects of nutrition, body composition, and nutritional supplementation on the risk, progression, and prognosis of PAD are scarce. Further research into these areas is required to allow the development of evidence-based nutritional guidelines for the prevention and treatment of the disease.
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Affiliation(s)
- Diana P Brostow
- Department of Food Science and Nutrition, University of Minnesota, 1334 Eckles Avenue, Saint Paul, MN 55108, USA
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Vitamin D beliefs and associations with sunburns, sun exposure, and sun protection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:2386-95. [PMID: 22851950 PMCID: PMC3407911 DOI: 10.3390/ijerph9072386] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Revised: 06/12/2012] [Accepted: 06/28/2012] [Indexed: 01/04/2023]
Abstract
The main objective of this study was to examine certain beliefs about vitamin D and associations with sun exposure, sun protection behaviors, and sunburns. A total of 3,922 lifeguards, pool managers, and parents completed a survey in 2006 about beliefs regarding vitamin D and sun-related behaviors. Multivariate ordinal regression analyses and linear regression analysis were used to examine associations of beliefs and other variables. Results revealed that Non-Caucasian lifeguards and pool managers were less likely to agree that they needed to go out in the sun to get enough vitamin D. Lifeguards and parents who were non-Caucasian were less likely to report that sunlight helped the body to produce vitamin D. A stronger belief about the need to go out in the sun to get enough vitamin D predicted more sun exposure for lifeguards. For parents, a stronger belief that they can get enough vitamin D from foods predicted greater sun protection and a stronger belief that sunlight helps the body produce vitamin D predicted lower sun exposure. This study provides information regarding vitamin D beliefs and their association with certain sun related behaviors across different demographic groups that can inform education efforts about vitamin D and sun protection.
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Alvarez JA, Gower BA, Calhoun DA, Judd SE, Dong Y, Dudenbostel T, Scholl J, Ashraf AP. Serum 25-hydroxyvitamin D and Ethnic Differences in Arterial Stiffness and Endothelial Function. J Clin Med Res 2012; 4:197-205. [PMID: 22719806 PMCID: PMC3376878 DOI: 10.4021/jocmr965w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2012] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Vitamin D reportedly influences vascular function, which is worse in African Americans (AAs) relative to European Americans (EAs). It is not clear if ethnic differences in 25(OH)D mediate differences in vascular function. This study examined the relationships of serum 25-hydroxyvitamin D (25(OH)D) with indicators of vascular function among healthy, young AA and EA adults. METHODS This is a cross sectional study involving 23 AAs and 22 EAs. The main outcomes were augmentation index (AIx75), central aortic pressure, pulse wave velocity (PWV), flow-mediated dilation (FMD), and seated and supine blood pressures. RESULTS Results indicated that 25(OH)D was inversely associated with AIx75, supine systolic blood pressure (SBP), central aortic SBP and central aortic diastolic blood pressure (DBP), independent of age, sex, and percent body fat (standardized β= -0.29 to -0.43, P < 0.05 for all). AAs had greater AIx75 (P = 0.04) and PWV (P = 0.07) and lower FMD (P = 0.02) compared to EA after adjusting for age and percent body fat; further adjustment for 25(OH)D reduced the ethnic differences (P = 0.44, 0.53, and 0.20, respectively). CONCLUSION The 25(OH)D was associated with vascular function in healthy adults, and lower 25(OH)D among AAs may contribute to their greater arterial stiffness and reduced endothelial function (Clinical trials.gov NCT01041365, NCT01041547).
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Affiliation(s)
- Jessica A Alvarez
- Department of Nutrition Sciences, University of Alabama Birmingham, Birmingham, AL, USA
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Hu P, Xuan Q, Hu B, Lu L, Wang J, Qin YH. Fibroblast growth factor-23 helps explain the biphasic cardiovascular effects of vitamin D in chronic kidney disease. Int J Biol Sci 2012; 8:663-71. [PMID: 22606047 PMCID: PMC3354624 DOI: 10.7150/ijbs.3886] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 02/23/2012] [Indexed: 12/16/2022] Open
Abstract
Hypovitaminosis D is highly prevalent in chronic kidney disease (CKD). Recently, vitamin D has sparked widespread interest because of its potential favorable benefits on cardiovascular disease (CVD). Evidence from clinical studies and animal models supports the existence of biphasic cardiovascular effects of vitamin D, in which lower doses suppress CVD and higher doses stimulate CVD. However, the mechanism for the different effects remains unclear. Fibroblast growth factor-23 (FGF-23) is a recently identified member of the FGF family, and thought to be actively involved in renal phosphate and vitamin D homeostasis. More specifically, Vitamin D stimulates FGF-23 secretion and is inhibited by increased FGF-23. Given this background, we hypothesize that FGF-23 may provide a unique tool to explain the biphasic cardiovascular effects of vitamin D in CKD. The data presented in this review support the hypothesis that FGF-23 may be linked with the high cardiovascular risk in CKD through accelerating the onset of vascular calcification, secondary hyperparathyroidism, left ventricular hypertrophy and endothelial dysfunction. Therefore, modulation of FGF-23 may become a potential therapeutic target to lowing cardiovascular risk in CKD. Several clinical interventions, including decreased phosphate intake, phosphate binders, cinacalcet plus concurrent low-dose vitamin D, C-terminal tail of FGF-23 and renal transplantation, have been employed to manipulate FGF-23.
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Affiliation(s)
- Peng Hu
- Department of Pediatrics, the First Affiliated Hospital of Anhui Medical University, No. 218 Ji-Xi Road, Hefei 230022, PR China.
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Michos ED, Reis JP, Post WS, Lutsey PL, Gottesman RF, Mosley TH, Sharrett AR, Melamed ML. 25-Hydroxyvitamin D deficiency is associated with fatal stroke among whites but not blacks: The NHANES-III linked mortality files. Nutrition 2012; 28:367-71. [PMID: 22261577 PMCID: PMC3304002 DOI: 10.1016/j.nut.2011.10.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Revised: 10/26/2011] [Accepted: 10/26/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Deficient 25-hydroxyvitamin D (25[OH]D) levels are associated with cardiovascular disease (CVD) events and mortality. 25(OH)D deficiency and stroke are more prevalent in blacks. We examined whether low 25(OH)D contributes to the excess risk of fatal stroke in blacks compared with whites. METHODS The Third National Health and Nutrition Examination Survey, a probability sample of U.S. civilians, measured 25(OH)D levels and CVD risk factors from 1988 through 1994. Vital status through December 2006 was obtained by a linkage with the National Death Index. In white and black adults without CVD reported at baseline (n = 7981), Cox regression models were fit to estimate hazard ratios (HR) for fatal stroke by 25(OH)D status and race. RESULTS During a median of 14.1 y, there were 116 and 60 fatal strokes in whites and blacks, respectively. The risk of fatal stroke was greater in blacks compared with whites in models adjusted for socioeconomic status and CVD risk factors (HR 1.60, 95% confidence interval 1.01-2.53). Mean baseline 25(OH)D levels were significantly lower in blacks compared with whites (19.4 versus 30.8 ng/mL, respectively). In multivariable-adjusted models, deficient 25(OH)D levels lower than 15 ng/mL were associated with fatal stroke in whites (HR 2.13, 1.01-4.50) but not blacks (HR 0.93, 0.49-1.80). CONCLUSIONS Vitamin D deficiency was associated with an increased risk of stroke death in whites but not in blacks. Although blacks had a higher rate of fatal stroke compared with whites, the low 25(OH)D levels in blacks were unrelated to stroke incidence. Therefore 25(OH)D levels did not explain this excess risk.
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Affiliation(s)
- Erin D Michos
- Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
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Murphy AB, Kelley B, Nyame YA, Martin IK, Smith DJ, Castaneda L, Zagaja GJ, Hollowell CMP, Kittles RA. Predictors of serum vitamin D levels in African American and European American men in Chicago. Am J Mens Health 2012; 6:420-6. [PMID: 22398989 DOI: 10.1177/1557988312437240] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vitamin D deficiency is epidemiologically linked to prostate, breast, and colon cancer. When compared with European American (EA) men, African American (AA) men have increased risk of prostate cancer, but few studies evaluate vitamin D status in AA men. The authors evaluate the biological and environmental predictors of vitamin D deficiency in AA and EA men in Chicago, Illinois, a low ultraviolet radiation environment. Blood samples were collected from 492 men, aged between 40 and 79 years, from urology clinics at three hospitals in Chicago, along with demographic and medical information, body mass index, and skin melanin content using a portable narrow-band reflectometer. Vitamin D intake and ultraviolet radiation exposure were assessed using validated questionnaires. The results demonstrated that Black race, cold season of blood draw, elevated body mass index, and lack of vitamin D supplementation increase the risk of vitamin D deficiency. Supplementation is a high-impact, modifiable risk factor. Race and sunlight exposure should be taken into account for recommended daily allowances for vitamin D intake.
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Affiliation(s)
- Adam B Murphy
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
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Dugassa B. Knowledge Construction: Untapped Perspective in Pursuit for Health Equity. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/sm.2012.24048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shehab D, Al-Jarallah K, Mojiminiyi OA, Al Mohamedy H, Abdella NA. Does Vitamin D deficiency play a role in peripheral neuropathy in Type 2 diabetes? Diabet Med 2012; 29:43-9. [PMID: 22050401 DOI: 10.1111/j.1464-5491.2011.03510.x] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM Despite recent reports linking vitamin D deficiency with increased risk of diabetes mellitus and complications, there is limited data on patients with diabetic peripheral neuropathy. We aimed to evaluate the incidence and associations of vitamin D deficiency in 210 patients with Type 2 diabetes with and without diabetic peripheral neuropathy. METHODS Renal, liver, lipid profile and HbA(1c) were measured. Vitamin D status was determined by measuring 25-dihydroxyvitamin D. Presence or absence of coronary heart disease was determined and early-morning urine microalbumin:creatinine ratio was measured. All patients were assessed clinically using neuropathy symptom score, neuropathy disability score and nerve conduction study. RESULTS Eighty-seven patients had diabetic peripheral neuropathy and these patients had significantly longer duration of diabetes and higher HbA(1c). Age, gender, incidence of retinopathy and coronary heart disease were not significantly different from those without neuropathy. Mean (SD) vitamin D was significantly lower in those with neuropathy [36.9 (39.9) nmol/l] compared with those without [58.32 (58.9) nmol/l] and 81.5% of patients with neuropathy had vitamin D deficiency compared with 60.4% of those without. Vitamin D showed significant (P < 0.05) correlations with total cholesterol, LDL-cholesterol and urine microalbumin:creatinine ratio. Binary logistic regression analysis showed that diabetic peripheral neuropathy was significantly associated with vitamin D deficiency (odds ratio = 3.47; 95% CI = 1.04-11.56, P = 0.043) after inclusion of potential confounders such as duration of diabetes, HbA(1c) and LDL-cholesterol. CONCLUSION Vitamin D deficiency is an independent risk factor for diabetic peripheral neuropathy, and further studies are required to confirm if Vitamin D supplementation could prevent or delay the onset.
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Affiliation(s)
- D Shehab
- Department of Medicine, Faculty of Medicine, Kuwait University Department of Medicine, Mubarak Al-Kabeer Hospital, Kuwait.
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Chua GT, Chan YC, Cheng SW. Vitamin D status and peripheral arterial disease: evidence so far. Vasc Health Risk Manag 2011; 7:671-5. [PMID: 22140318 PMCID: PMC3225350 DOI: 10.2147/vhrm.s24876] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Vitamin D deficiency has recently been implicated as a contributory factor in the development of peripheral arterial disease (PAD). Methods A review of the published literature on PAD and vitamin D was undertaken using Medline, PubMed, and Embase, and cross-referenced. All relevant published papers on the subject were reviewed. Results Published studies have shown that there is a significant association between vitamin D and PAD. Populations with lower vitamin D levels are more likely to develop PAD in a graded manner. Higher amputation rates are also observed among patients with PAD and lower vitamin D levels. In addition, vitamin D deficiency is significantly associated with increased risk of cardiovascular adverse events. This was also observed in the mouse model where low vitamin D led to the development of atherosclerosis. Conclusion This study shows that vitamin D deficiency could be an independent risk factor for the development of PAD and that this risk factor is easily correctable. Further studies should look into the effects of vitamin D supplementation in patients with PAD.
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Affiliation(s)
- G T Chua
- Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong
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