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Sofianopoulou E, Kaptoge SK, Afzal S, Jiang T, Gill D, Gundersen TE, Bolton TR, Allara E, Arnold MG, Mason AM, Chung R, Pennells LAM, Shi F, Sun L, Willeit P, Forouhi NG, Langenberg C, Sharp SJ, Panico S, Engström G, Melander O, Tong TYN, Perez-Cornago A, Norberg M, Johansson I, Katzke V, Srour B, Sánchez MJ, Redondo-Sánchez D, Olsen A, Dahm CC, Overvad K, Brustad M, Skeie G, Moreno-Iribas C, Onland-Moret NC, van der Schouw YT, Tsilidis KK, Heath AK, Agnoli C, Krogh V, de Boer IH, Kobylecki CJ, Çolak Y, Zittermann A, Sundström J, Welsh P, Weiderpass E, Aglago EK, Ferrari P, Clarke R, Boutron MC, Severi G, MacDonald C, Providencia R, Masala G, Zamora-Ros R, Boer J, Verschuren WMM, Cawthon P, Schierbeck LL, Cooper C, Schulze MB, Bergmann MM, Hannemann A, Kiechl S, Brenner H, van Schoor NM, Albertorio JR, Sacerdote C, Linneberg A, Kårhus LL, Huerta JM, Imaz L, Joergensen C, Ben-Shlomo Y, Lundqvist A, Gallacher J, Sattar N, Wood AM, Wareham NJ, Nordestgaard BG, Di Angelantonio E, Danesh J, Butterworth AS, Burgess S. Estimating dose-response relationships for vitamin D with coronary heart disease, stroke, and all-cause mortality: observational and Mendelian randomisation analyses. Lancet Diabetes Endocrinol 2024; 12:e2-e11. [PMID: 38048800 PMCID: PMC7615586 DOI: 10.1016/s2213-8587(23)00287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 09/05/2023] [Accepted: 09/27/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Randomised trials of vitamin D supplementation for cardiovascular disease and all-cause mortality have generally reported null findings. However, generalisability of results to individuals with low vitamin D status is unclear. We aimed to characterise dose-response relationships between 25-hydroxyvitamin D (25[OH]D) concentrations and risk of coronary heart disease, stroke, and all-cause mortality in observational and Mendelian randomisation frameworks. METHODS Observational analyses were undertaken using data from 33 prospective studies comprising 500 962 individuals with no known history of coronary heart disease or stroke at baseline. Mendelian randomisation analyses were performed in four population-based cohort studies (UK Biobank, EPIC-CVD, and two Copenhagen population-based studies) comprising 386 406 middle-aged individuals of European ancestries, including 33 546 people who developed coronary heart disease, 18 166 people who had a stroke, and 27 885 people who died. Primary outcomes were coronary heart disease, defined as fatal ischaemic heart disease (International Classification of Diseases 10th revision code I20-I25) or non-fatal myocardial infarction (I21-I23); stroke, defined as any cerebrovascular disease (I60-I69); and all-cause mortality. FINDINGS Observational analyses suggested inverse associations between incident coronary heart disease, stroke, and all-cause mortality outcomes with 25(OH)D concentration at low 25(OH)D concentrations. In population-wide genetic analyses, there were no associations of genetically predicted 25(OH)D with coronary heart disease (odds ratio [OR] per 10 nmol/L higher genetically-predicted 25(OH)D concentration 0·98, 95% CI 0·95-1·01), stroke (1·01, [0·97-1·05]), or all-cause mortality (0·99, 0·95-1·02). Null findings were also observed in genetic analyses for cause-specific mortality outcomes, and in stratified genetic analyses for all outcomes at all observed levels of 25(OH)D concentrations. INTERPRETATION Stratified Mendelian randomisation analyses suggest a lack of causal relationship for 25(OH)D concentrations with both cardiovascular and mortality outcomes for individuals at all levels of 25(OH)D. Our findings suggest that substantial reductions in mortality and cardiovascular morbidity due to long-term low-dose vitamin D supplementation are unlikely even if targeted at individuals with low vitamin D status. FUNDING British Heart Foundation, Medical Research Council, National Institute for Health Research, Health Data Research UK, Cancer Research UK, and International Agency for Research on Cancer.
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Affiliation(s)
- Emerging Risk Factors Collaboration/EPIC-CVD/Vitamin D Studies Collaboration
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Vitas Ltd, Oslo, Norway
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Italy
- Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
- Department of Odontology, Umeå University, Sweden
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health. University of Granada. Granada, Spain
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Denmark
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
- Epidemiology, Prevention and Promotion Health Service, Public Health Institute of Navarra, Spain
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
- School of Medicine, University of Ioannina, Greece
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
- Department of Medicine, University of Washington, USA
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Ruhr University Bochum, Germany
- Department of Medical Sciences, Uppsala University, Sweden
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
- International Agency for Research on Cancer, France
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
- Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy
- Institute of Health Informatics Research, University College London, London, UK
- Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Italy
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
- Research Institute, California Pacific Medical Center, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
- Cardiology Department, Nordsjælland University Hospital, Hillerød, Denmark
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Germany
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
- Coalition to End Loneliness, USA
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
- Public Health Division of Bizkaia, Ministry of Health of the Basque Government, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
- Steno Diabetes Center, Copenhagen, Denmark
- Population Health Sciences, University of Bristol, UK
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Oxford, Oxford, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- The Alan Turing Institute, UK
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, UK
| | - Eleni Sofianopoulou
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Stephen K Kaptoge
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Shoaib Afzal
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | - Tao Jiang
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Thomas R Bolton
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
| | - Elias Allara
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
| | - Matthew G Arnold
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Amy M Mason
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Ryan Chung
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
| | - Lisa AM Pennells
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Fanchao Shi
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Luanluan Sun
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Peter Willeit
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
| | - Claudia Langenberg
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, University of Cambridge, UK
| | - Salvatore Panico
- Dipartimento Di Medicina Clinica E Chirurgia, Federico II University, Italy
| | - Gunnar Engström
- Department of Clinical Sciences Malmö, Lund University, Sweden
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Tammy YN Tong
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Margareta Norberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | - Verena Katzke
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bernard Srour
- Department of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - María José Sánchez
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health. University of Granada. Granada, Spain
| | - Daniel Redondo-Sánchez
- EPIC Granada, Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Public Health, Aarhus University, Denmark
| | | | - Kim Overvad
- Department of Public Health, Aarhus University, Denmark
| | - Magritt Brustad
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - Guri Skeie
- Department of Community Medicine, Faculty of Health Sciences, UiT the Arctic University of Norway, Norway
| | - Conchi Moreno-Iribas
- The Public Dental Health Service Competence Centre of Northern Norway (TkNN), Tromsø, Norway
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
- School of Medicine, University of Ioannina, Greece
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, UK
| | - Claudia Agnoli
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Italy
| | - Ian H de Boer
- Department of Medicine, University of Washington, USA
| | - Camilla Jannie Kobylecki
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
| | - Yunus Çolak
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Ruhr University Bochum, Germany
| | | | - Paul Welsh
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | | | | | | | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, Oxford, UK
| | - Marie-Christine Boutron
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
| | - Gianluca Severi
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
- Department of Statistics, Computer Science and Applications "G. Parenti" (DISIA), University of Florence, Italy
| | - Conor MacDonald
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm U1018, Équipe "Exposome et Hérédité", CESP, Gustave Roussy, France
| | - Rui Providencia
- Institute of Health Informatics Research, University College London, London, UK
| | - Giovanna Masala
- Institute for Cancer Research, Prevention and Clinical Network – ISPRO, Italy
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Jolanda Boer
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
| | - WM Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Netherlands
- Centre for Nutrition and Health, National Institute for Public Health and the Environment (RIVM)
| | - Peggy Cawthon
- Research Institute, California Pacific Medical Center, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, USA
| | | | - Cyrus Cooper
- Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Matthias B Schulze
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- Institute of Nutritional Science, University of Potsdam, Germany
| | - Manuela M Bergmann
- German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Germany
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- VASCage, Research Centre on Vascular Ageing and Stroke, Innsbruck, Austria
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Natasja M van Schoor
- Department of Epidemiology and Data Science, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Netherlands
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città della Salute e della Scienza University-Hospital, Turin, Italy
| | - Allan Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - Line L Kårhus
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Denmark
| | - José María Huerta
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Department of Epidemiology, Murcia Regional Health Council, Instituto Murciano de Investigación Biosanitaria-Arrixaca, Murcia, Spain
| | - Liher Imaz
- Public Health Division of Bizkaia, Ministry of Health of the Basque Government, Spain
- Biodonostia Health Research Institute, Donostia-San Sebastian, Spain
| | | | | | | | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Angela M Wood
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- The Alan Turing Institute, UK
| | | | - Børge G Nordestgaard
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Denmark
- Faculty of Health and Medical Sciences, Copenhagen University, Denmark
- The Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen University Hospital
| | - Emanuele Di Angelantonio
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
| | - John Danesh
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, UK
| | - Adam S Butterworth
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- NIHR Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, UK
| | - Stephen Burgess
- BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- BHF Centre of Research Excellence, School of Clinical Medicine, Addenbrooke’s Hospital, University of Cambridge, UK
- Medical Research Council Biostatistics Unit, University of Cambridge, UK
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Guo J, Anthony K. A systematic literature review and meta-analysis of the effectiveness of vitamin D supplementation for patients with Duchenne muscular dystrophy. Neuromuscul Disord 2023; 33:835-844. [PMID: 37932186 DOI: 10.1016/j.nmd.2023.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/25/2023] [Accepted: 10/13/2023] [Indexed: 11/08/2023]
Abstract
We conducted a systematic literature review and meta-analysis on the effectiveness of vitamin D supplementation in maintaining or restoring vitamin D levels in Duchenne muscular dystrophy. Due to a lack of randomised controlled trials, cross-sectional and retrospective and prospective cohort studies were taken as the best available evidence. Inclusion criteria included reporting mean serum vitamin D levels in a supplement-taking group. After screening 102 records; 13 were included in a narrative synthesis and eight of these in a meta-analysis. We show that current dosing regimens are preventing severe deficiency but are not effective at maintaining sufficient vitamin D levels within the Duchenne population. Despite high levels of daily vitamin D supplementation (>1000 International Units), at least 20 % of people with Duchenne remain vitamin D deficient. No significant association between dose and serum vitamin D levels was found (r2 = 0.3, p = 0.237). A meta-analysis of mean serum vitamin D levels across eight studies also revealed substantial variability in response to vitamin D supplementation and high heterogeneity (I2 = 99.59 %). These data could impact on an individual's risk and severity of osteoporosis and vertebral fractures.
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Affiliation(s)
- Jing Guo
- Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds LS2 9JT, United Kingdom
| | - Karen Anthony
- Centre for Physical Activity and Life Sciences, University of Northampton, University Drive, Northampton NN1 5PH, United Kingdom.
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Batista AA, Lazzarin T, Pereira FW, Baccaro A, Rocha OM, Narimatsu KL, Souza JT, Modesto PN, Zanati Bazan SG, Tanni SE, Okoshi MP, Polegato BF, Paiva SA, Zornoff L, Minicucci MF, Azevedo PS. Serum Vitamin D Levels, Disease Activity Score-28 for Rheumatoid Arthritis with C-Reactive Protein (DAS28-CRP), and Cardiac Remodeling Determined by Ventricular Dimensions and Left Atrium Diameter in Patients with Rheumatoid Arthritis: A Prospective Observational Study. Med Sci Monit 2023; 29:e938989. [PMID: 36609557 PMCID: PMC9832721 DOI: 10.12659/msm.938989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) can cause extra-articular manifestations, and the myocardium can be a target. This study aimed to describe structural and functional cardiac echocardiographic variables in RA patients and to evaluate whether vitamin D (VD) levels and inflammation markers, evaluated by Disease Activity Score-28 for Rheumatoid Arthritis with C-reactive protein (DAS28-CRP), are associated with cardiac remodeling (CR) in this population. MATERIAL AND METHODS This prospective observational study evaluated 90 patients with RA in Botucatu University Hospital wards from 2014 to 2017. Clinical data were recorded, including demographic information, comorbidities, length of disease, and treatment type. Serum VD and C-reactive protein levels were measured, and the DAS28-CRP was calculated. A transthoracic echocardiography study was performed. The outcome evaluated was CR. This parameter was assessed by left ventricular geometric patterns and left atrium diameter. RESULTS We evaluated 90 RA patients. The mean age was 52.9±10.8 years, and 17.8% were male. The length of the disease was 96 (60-180) months. Serum VD levels were 30.7±10.4 ng/mL and the DAS28 was 2.7±0.9. Regarding the CR parameters, 56.7% had altered left ventricular geometric patterns and 25.8% had enlargement of left atrium diameter. Even in multivariate analysis, the left ventricular geometric patterns were not associated with the VD levels and the inflammation marker used. However, sufficient VD levels protect from left atrium enlargement (OR: 0.905; IC 95%: 0.843-0.973; P=0.007). CONCLUSIONS Low serum vitamin D values, but not inflammation, are associated with CR in patients with RA.
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Affiliation(s)
- Andrea A.P. Batista
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Taline Lazzarin
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Filipe W.L. Pereira
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Antonio Baccaro
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Oswaldo M. Rocha
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Karina L. Narimatsu
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Juli T. Souza
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Pamela N. Modesto
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Silméia Garcia Zanati Bazan
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Suzana E. Tanni
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Marina P. Okoshi
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Bertha F. Polegato
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School,, Botucatu, SP, Brazil
| | - Sergio A.R. Paiva
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Leonardo Zornoff
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Marcos F. Minicucci
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
| | - Paula S. Azevedo
- Department of Internal Medicine, São Paulo State University (UNESP), Botucatu Medical School, Botucatu, SP, Brazil
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NAVARRO I, GONZÁLEZ-LÓPEZ MA, SIERRA I, OLMOS JM, BLANCO R, HERNÁNDEZ JL. Bone Metabolism in Patients with Hidradenitis Suppurativa: A Case-control Study. Acta Derm Venereol 2022; 102:adv00825. [PMID: 36444563 PMCID: PMC9811290 DOI: 10.2340/actadv.v102.3504] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the hair follicles. The aim of this case-control study was to assess whether HS is associated with disturbances in trabecular bone score, bone mineral density, bone remodelling markers, and calciotropic hormones. A total of 81 patients and 79 controls of similar age and sex were included. Demographic, anthropometric, laboratory data, trabecular bone score, bone mineral density, serum 25-hydroxyvitamin D (25OHD), serum amino-terminal pro-peptide of type 1 collagen (PINP), and C-terminal telopeptide of type 1 collagen (CTX) concentrations were assessed in both groups. Patients with HS had lower serum 25OHD levels than controls, and approximately 62% of them had vitamin D deficiency. Serum PINP was increased and CTX was decreased in patients with HS. Fully adjusted trabecular bone score values were lower in patients with HS compared with controls. Adjusted lumbar bone mineral density was similar in HS and controls, whilst total hip bone mineral density was lower in patients with HS. There were no statistical differences regarding disease severity in terms of 25OHD, serum turnover markers, bone mineral density, or trabecular bone score values. This study shows that patients with HS have lower trabecular bone score and total hip bone mineral density values than population-based controls. In addition, the prevalence of vitamin D deficiency is high in subjects with HS.
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Affiliation(s)
- Iñigo NAVARRO
- Division of Dermatology, Hospital University Marqués de Valdecilla
| | - Marcos A. GONZÁLEZ-LÓPEZ
- Division of Dermatology, Hospital University Marqués de Valdecilla,Department of Medicine and Psychiatry, University of Cantabria,Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - Isabel SIERRA
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain
| | - José Manuel OLMOS
- Department of Medicine and Psychiatry, University of Cantabria,Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain,Division of Internal Medicine, Hospital University Marqués de Valdecilla
| | - Ricardo BLANCO
- Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain,Division of Rheumatology, Hospital University Marqués de Valdecilla
| | - José Luis HERNÁNDEZ
- Department of Medicine and Psychiatry, University of Cantabria,Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain,Division of Internal Medicine, Hospital University Marqués de Valdecilla
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Lee SH, Joo NS. Effects of narrowband ultraviolet B exposure on serum 25-hydroxyvitamin D concentrations: A pilot study. Medicine (Baltimore) 2022; 101:e29937. [PMID: 35984188 PMCID: PMC9387955 DOI: 10.1097/md.0000000000029937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
It is known that ultraviolet B exposure increases serum 25-hydroxyvitamin D(25(OH)D) concentrations. However, little is known about the influence of narrowband ultraviolet B exposure from a light-emitting diode (NBUVB-LED) on serum 25(OH)D levels. Thus, the purpose of this study was to investigate the effect of NBUVB-LED exposure on serum 25(OH)D concentrations. Two healthy adults were enrolled in this pilot study. Their skin was exposed to ultraviolet B light (60 mJ/cm2) 3 times a week for 4 weeks in the first intervention and every day for 4 weeks in the second intervention. Serum levels of 25(OH)D were measured every 2 weeks. Serum 25(OH)D levels were decreased in both subjects at the end of the first intervention (32.1 → 21.4 ng/mL, 33.9 → 21.4 ng/mL, respectively), whereas serum 25(OH)D levels were increased in the 2 weeks of the second intervention (29.5 and 28.0 ng/mL, respectively). At the end of the second intervention, the 25(OH)D concentrations were 19.0 and 20.4 ng/mL, respectively. NBUVB-LED exposure might increase serum 25(OH)D concentrations. Future studies should expand the number of participants and adjust for confounding factors.
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Affiliation(s)
- Seok-Hoon Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Nam-Seok Joo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
- *Correspondence: Nam-Seok Joo, Department of Family Practice and Community Health, Ajou University School of Medicine, 164 Worldcup-ro, Youngtong-gu, Suwon, Gyeonggi-do, Republic of Korea (e-mail: )
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Abstract
PURPOSE OF REVIEW Here, we review the most up-to-date understanding of the pathogenesis, prevention and treatment of vitamin D deficient rickets in children. This will include recent advances in the genetic determinants of abnormal vitamin D metabolism, with the intention of aiding clinicians with establishing the diagnosis and implementing treatment plans for children presenting with vitamin D deficiency rickets. RECENT FINDINGS Vitamin D deficiency rickets is a frequently encountered, but entirely preventable, disorder of bone mineral metabolism. Risk factors for developing vitamin D deficiency rickets include inadequate exposure to sunlight, exclusive breast feeding without vitamin D supplementation and inadequate intake of vitamin D, calcium or phosphorus. Other factors that may influence the development of vitamin D deficiency and/or rickets include genetic alterations or medications that alter vitamin D metabolism. SUMMARY Vitamin D levels in individuals are influenced by environmental factors, as well as genetic factors. A thorough understanding of these factors is critical for the evaluation and treatment of a child presenting with rickets. There remains a great need for additional research to determine ideal vitamin D status across diverse populations, and to better understand how vitamin D status affects overall health.
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Affiliation(s)
- Ashley J Stoffers
- The Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Gamonal SBL, Gamonal ACC, Marques NCV, Brandão MAF, Raposo NRB. 25-Hydroxyvitamin D as a biomarker of vitamin D status in plaque psoriasis and other dermatological diseases: a cross-sectional study. SAO PAULO MED J 2022; 141:131-137. [PMID: 35976371 PMCID: PMC10005464 DOI: 10.1590/1516-3180.2022.0164.r1.19052022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/19/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hypovitaminosis D is a public health problem associated with several chronic inflammatory and immunological diseases, including psoriasis. OBJECTIVES This study aimed to determine the prevalence of hypovitaminosis D in patients with plaque psoriasis. A comparison was made between vitamin D levels in patients with psoriasis and those with other non-inflammatory dermatoses without photosensitivity. In addition, it evaluated the effects of the patients' Fitzpatrick skin phototype and the season of the year on the serum levels of vitamin D. DESIGN AND SETTINGS A retrospective cross-sectional study was conducted at an outpatient clinic in a university center in Juiz de Fora (MG), Brazil. METHODS A review of dermatology patients' demographic data, including skin phototype and serum levels of 25-hydroxyvitamin D [25(OH)D], over 12 months in 2016. RESULTS This study included 554 patients: 300 patients allocated to the plaque psoriasis group and 254 control patients with other dermatological diseases. Regarding the season of the year, 229, 132, 62, and 131 participants were evaluated in summer, autumn, winter, and spring, respectively. As for the skin phototype, 397, 139, and 18 patients had phototypes III, IV, and V, respectively. The serum levels of 25(OH)D were significantly lower in the psoriasis group (24.91 ± 7.16 ng/mL) than in the control group (30.37 ± 8.14 ng/mL). CONCLUSIONS Hypovitaminosis D (< 30 ng/mL) was present in 76.66% of patients with psoriasis versus 53.94% of control patients. Vitamin D deficiency (< 20 ng/mL) was observed in 25% of the patients with psoriasis versus 8.66% in the control group (P < 0.001). The season and patient's skin phototype were independent predictors of serum vitamin D levels.
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Affiliation(s)
- Shirley Braga Lima Gamonal
- MD, MSc, PhD. Researcher, Physician and Professor, Núcleo de Pesquisa em Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil; and Researcher, Núcleo de Pesquisa e Inovação em Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Aloisio Carlos Couri Gamonal
- MD, MSc, PhD. Physician and Professor, Núcleo de Pesquisa em Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Nathália Couri Vieira Marques
- Undergraduate Student, Medicine, Núcleo de Pesquisa em Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Marcos Antônio Fernandes Brandão
- PhD. Pharmacist and Professor, Núcleo de Pesquisa e Inovação em Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Nádia Rezende Barbosa Raposo
- MSc, PhD. Pharmacist and Professor, Núcleo de Pesquisa e Inovação em Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora (MG), Brazil
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Gamonal SBL, Gamonal ACC, Marques NCV, Brandão MAF, Raposo NRB. Is vitamin D status relevant to psoriasis and psoriatic arthritis? A retrospective cross-sectional study. SAO PAULO MED J 2022; 141:e2022216. [PMID: 36214524 PMCID: PMC10065110 DOI: 10.1590/1516-3180.2022.0216.r1.01072022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Psoriasis is a systemic, immune-mediated disease characterized by inflammatory manifestations in the skin and joints. Vitamin D deficiency is currently considered a pandemic and is associated with comorbidities including psoriasis and psoriatic arthritis (PsA). OBJECTIVES To determine the prevalence of hypovitaminosis D [25(OH)D] in patients with plaque psoriasis, with and without PsA, and of independent predictors of serum 25(OH)D levels. DESIGN AND SETTING Retrospective cross-sectional study conducted among 300 patients at an outpatient clinic in a university center in Juiz de Fora, Minas Gerais, Brazil. METHODS Demographic and clinical data (psoriasis area and severity index [PASI], family history, age at onset, disease duration, and the presence of PsA according to Classification Criteria for Psoriatic Arthritis), skin phototype, and season of the year were reviewed. RESULTS Hypovitaminosis D (< 30 ng/mL) was highly prevalent in patients with psoriasis with and without PsA (82.2% and 74.9%, respectively). An inverse correlation between PASI and vitamin D was found (without PsA r = -0.59 and, PsA r = -0.52, P < 0.001), and multivariate regression revealed that hypovitaminosis D was associated with disease severity, season, and phototype. It was confirmed by binary logistic regression between PASI and vitamin D deficiency (< 30 ng/mL), (odds ratio, OR 1.78 CI: -0.20-0.53, P < 0.001). CONCLUSION Hypovitaminosis D (< 30 ng/mL) was highly prevalent in psoriatic patients with and without PsA. Season and skin phototype were associated with 25(OH)D levels. An inverse association between PASI and serum 25(OH)D levels was established.
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Affiliation(s)
- Shirley Braga Lima Gamonal
- MD, MSc, PhD. Researcher, Physician and Professor, Núcleo de
Pesquisa em Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz
de Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Aloisio Carlos Couri Gamonal
- MD, MSc, PhD. Physician and Professor, Núcleo de Pesquisa em
Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz de Fora
(UFJF), Juiz de Fora (MG), Brazil
| | - Nathália Couri Vieira Marques
- Undergraduate Student, Medicine, Núcleo de Pesquisa em
Dermatologia (NUPEDE), Faculty of Medicine, Universidade Federal de Juiz de Fora
(UFJF), Juiz de Fora (MG), Brazil
| | - Marcos Antônio Fernandes Brandão
- PhD. Pharmacist and Professor, Núcleo de Pesquisa e Inovação em
Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de
Fora (UFJF), Juiz de Fora (MG), Brazil
| | - Nádia Rezende Barbosa Raposo
- MSc, PhD. Pharmacist and Professor, Núcleo de Pesquisa e Inovação em
Ciências da Saúde (NUPICS), Faculty of Pharmacy, Universidade Federal de Juiz de
Fora (UFJF), Juiz de Fora (MG), Brazil
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Torrisi M, Bonanno L, Formica C, Arcadi FA, Cardile D, Cimino V, Bramanti P, Morini E. The role of rehabilitation and vitamin D supplementation on motor and psychological outcomes in poststroke patients. Medicine (Baltimore) 2021; 100:e27747. [PMID: 34766589 PMCID: PMC8589234 DOI: 10.1097/md.0000000000027747] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 10/25/2021] [Indexed: 01/05/2023] Open
Abstract
Post-Stroke depression affects between 12% and 72% of patients who have suffered a stroke. The association between low serum levels of 25-hydroxyvitamin D (25(OH) D) and increased risk of depression is reported in both stroke and non-stroke patients. Similarly, high 25(OH) D levels might be associated with greater functional improvement during rehabilitation program.We wanted to investigate the effects of an intensive rehabilitation on poststroke outcomes. We wondered if the daily rehabilitation of motor and cognitive functions could also have an effect on mood and functional abilities in addition to or as an alternative to vitamin D supplementation.We conducted a 12-week, randomized trial, double blind, parallel, monocentric clinical trial of 40 patients undergoing intensive neuro-rehabilitation treatment at a specialized care facility for ischemic or hemorrhagic brain stroke. Participants were randomly assigned, in a 1:1 ratio, to 1 of 2 parallel groups: in the experimental group, 2000 IU/day of oral cholecalciferol was administered; in the control group patients were not taking vitamin D supplementation. Patients underwent a text evaluation to investigate psychological and motor outcomes.Significant intra-group difference in outcomes measures was found but not between control group and experimental group. In the vitamin D group, we highlighted significant differences between T0 and T1 in calcium (P < .001), vitamin D (P < .001), in Montgomery Aasberg Depression Rating Scale (P = .001), and in Functional Independent Measures (P < .001). In the health control group, we found a significant difference in calcium (P = .003), vitamin D (P < .001), Montgomery Aasberg Depression Rating Scale (P = 0.006), in general self-efficacy (P = .009), and in Functional Independent Measures (P < .001).Our results show that the beneficial effect on mood and functional recovery is mainly due to neurorehabilitation rather than vitamin D supplementation.
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Simpson CA, Zhang JH, Vanderschueren D, Fu L, Pennestri TC, Bouillon R, Cole DE, Carpenter TO. 25-OHD response to vitamin D supplementation in children: effect of dose but not GC haplotype. Eur J Endocrinol 2021; 185:333-342. [PMID: 34128826 PMCID: PMC8284876 DOI: 10.1530/eje-21-0349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE GC/DBP effects on response to vitamin D supplementation have not been well-studied. Thus we assessed free and total 25-OHD after vitamin D treatment across the six common GC haplotypes. DESIGN This double-blind, randomized study compared two vitamin D3 doses in healthy, urban-dwelling 6-month to 10-year-old children at-risk for vitamin D deficiency. Randomization was stratified by GC haplotype. METHODS Children were randomized to receive 2800 or 7000 International Units of vitamin D3 weekly. 25-OHD and 1,25(OH)2D were sampled at baseline and after 1-6 months of supplementation. RESULTS AND CONCLUSIONS One hundred ninety-two of 225 enrolled subjects completed the study. After one month, total 25-OHD increased with both doses and were higher with 7000 IU/week (85.5 ± 22.8 nmol/L) compared to 2800 IU/week (76.8 ± 18.0 nmol/L), despite equivalent baseline levels. No further significant increase occurred at 6 months (89.8 ± 35.5 and 74.3 ± 18.3 nmol/L, respectively). Free 25-OHD similarly changed. 25-OHD differed among GC groups at baseline. Although no significant effects of individual GC haplotypes on incremental changes were evident, a trend toward an effect of combined 'at risk' GC alleles on response was evident (P = 0.06). Total 1,25(OH)2D showed modest increases, moreso with the larger dose. In urban-dwelling children at-risk for vitamin D deficiency, 1 month of vitamin D3 2800 IU/week increased 25-OHD across all GC haplotype groups, and somewhat enhanced with 7000 IU/week with no further significant increases after 6 months of supplementation. Free 25-OHD measures offer no monitoring advantage over total 25-OHD.
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Affiliation(s)
- Christine A. Simpson
- Departments of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Jane H. Zhang
- Veterans Administration Cooperative Studies Program Coordinating Center, VA Connecticut Healthcare System, West Haven, CT
| | - Dirk Vanderschueren
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Katholieke Universiteit Leuven, Belgium
| | - Lei Fu
- Department of Laboratory Medicine and Pathobiology, University of Toronto, and Department of Laboratory Medicine and Molecular Diagnostics, Sunnybrook Health Sciences Centre, Toronto, Ontario
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, Katholieke Universiteit Leuven, Belgium
| | - David E.C. Cole
- Departments of Laboratory Medicine and Pathobiology, Medicine, and Genetics, University of Toronto, and Sunnybrook Health Center, Toronto, Ontario
| | - Thomas O. Carpenter
- Pediatrics (Endocrinology), Yale University School of Medicine, New Haven, CT
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HARRISON SOPHIEE, OLIVER SAMUELJ, KASHI DANIELS, CARSWELL ALEXANDERT, EDWARDS JASONP, WENTZ LAURELM, ROBERTS ROSS, TANG JONATHANCY, IZARD RACHELM, JACKSON SARAH, ALLAN DONALD, RHODES LESLEYE, FRASER WILLIAMD, GREEVES JULIEP, WALSH NEILP. Influence of Vitamin D Supplementation by Simulated Sunlight or Oral D3 on Respiratory Infection during Military Training. Med Sci Sports Exerc 2021; 53:1505-1516. [PMID: 33481482 PMCID: PMC8208091 DOI: 10.1249/mss.0000000000002604] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to determine the relationship between vitamin D status and upper respiratory tract infection (URTI) of physically active men and women across seasons (study 1) and then to investigate the effects on URTI and mucosal immunity of achieving vitamin D sufficiency (25(OH)D ≥50 nmol·L-1) by a unique comparison of safe, simulated sunlight or oral D3 supplementation in winter (study 2). METHODS In study 1, 1644 military recruits were observed across basic military training. In study 2, a randomized controlled trial, 250 men undertaking military training received placebo, simulated sunlight (1.3× standard erythemal dose, three times per week for 4 wk and then once per week for 8 wk), or oral vitamin D3 (1000 IU·d-1 for 4 wk and then 400 IU·d-1 for 8 wk). URTI was diagnosed by a physician (study 1) and by using the Jackson common cold questionnaire (study 2). Serum 25(OH)D, salivary secretory immunoglobulin A (SIgA), and cathelicidin were assessed by liquid chromatography-mass spectrometry LC-MS/MS and enzyme-linked immunosorbent assay. RESULTS In study 1, only 21% of recruits were vitamin D sufficient during winter. Vitamin D-sufficient recruits were 40% less likely to suffer URTI than recruits with 25(OH)D <50 nmol·L-1 (OR = 0.6, 95% confidence interval = 0.4-0.9), an association that remained after accounting for sex and smoking. Each URTI caused, on average, three missed training days. In study 2, vitamin D supplementation strategies were similarly effective to achieve vitamin D sufficiency in almost all (≥95%). Compared with placebo, vitamin D supplementation reduced the severity of peak URTI symptoms by 15% and days with URTI by 36% (P < 0.05). These reductions were similar with both vitamin D strategies (P > 0.05). Supplementation did not affect salivary secretory immunoglobulin A or cathelicidin. CONCLUSION Vitamin D sufficiency reduced the URTI burden during military training.
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Affiliation(s)
- SOPHIE E. HARRISON
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - SAMUEL J. OLIVER
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - DANIEL S. KASHI
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
| | - ALEXANDER T. CARSWELL
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - JASON P. EDWARDS
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
| | - LAUREL M. WENTZ
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
- Department of Nutrition and Health Care Management, Appalachian State University, Boone, NC
| | - ROSS ROBERTS
- College of Human Sciences, Bangor University, Bangor, Gwynedd, UNITED KINGDOM
| | - JONATHAN C. Y. TANG
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
| | - RACHEL M. IZARD
- Headquarters Army Recruiting and Initial Training Command, Upavon, Wiltshire, UNITED KINGDOM
- Defence Science and Technology, Porton Down, Wiltshire, UNITED KINGDOM
| | - SARAH JACKSON
- Army Health and Physical Performance, Army HQ, Andover, Hampshire, UNITED KINGDOM
| | - DONALD ALLAN
- Medical Physics Department, Salford Royal NHS Foundation Trust, and University of Manchester, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - LESLEY E. RHODES
- Faculty of Biology, Medicine and Health, University of Manchester, and Dermatology Centre, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UNITED KINGDOM
| | - WILLIAM D. FRASER
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
- Departments of Endocrinology and Clinical Biochemistry, Norfolk and Norwich University Hospitals Trust, Norwich, UNITED KINGDOM
| | - JULIE P. GREEVES
- Norwich Medical School, University of East Anglia, Norwich, Norfolk, UNITED KINGDOM
- Army Health and Physical Performance, Army HQ, Andover, Hampshire, UNITED KINGDOM
- Division of Surgery and Interventional Science, UCL, London, UNITED KINGDOM
| | - NEIL P. WALSH
- Faculty of Science, Liverpool John Moores University, Liverpool, UNITED KINGDOM
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Subramanian A, Korsiak J, Murphy KE, Al Mahmud A, Roth DE, Gernand AD. Effect of vitamin D supplementation during pregnancy on mid-to-late gestational blood pressure in a randomized controlled trial in Bangladesh. J Hypertens 2021; 39:135-142. [PMID: 32773651 PMCID: PMC7752208 DOI: 10.1097/hjh.0000000000002609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/19/2020] [Accepted: 07/07/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the dose-dependent effect of maternal vitamin D during pregnancy on blood pressure from mid-to-late gestation within the context of a randomized, placebo-controlled trial of vitamin D supplementation in Bangladesh (n = 1298). METHODS Healthy women without hypertension were enrolled at 17-24 weeks gestation and randomized to one of four vitamin D doses during pregnancy: placebo, 4200, 16 800 or 28 000 IU/week. This substudy examined 1257 women with blood pressure measured at enrollment with at least one other timepoint (measurements included at 24 weeks, 30 weeks, and weekly from 36 weeks until delivery). Effects of vitamin D on SBP or DBP were analyzed using mixed-effects models. RESULTS Vitamin D did not have an effect on SBP or DBP at 24 or 30 weeks; blood pressure was higher at 36 weeks for the highest dose versus placebo [mean difference (95% CI) mmHg: SBP = 2.3 (0.9-3.7); DBP = 1.9 (0.7-3.0)]. The differences in changes in SBP and DBP between vitamin D groups and placebo across intervals were small (P > 0.10), but the difference for 28 000 IU/week versus placebo was the highest from 30 to 36 weeks [SBP 0.2 (-0.1 to 0.5) and DBP 0.2 (-0.0 to 0.4) mmHg]. CONCLUSION Vitamin D supplementation starting mid-pregnancy did not affect SBP or DBP until late gestation, and then only at the highest dose. These results do not support the clinical use of vitamin D in pregnancy to lower maternal blood pressure.
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Affiliation(s)
- Anita Subramanian
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Jill Korsiak
- Centre for Global Child Health, Hospital for Sick Children
- Department of Pediatrics, University of Toronto
| | - Kellie E. Murphy
- Department of Obstetrics and Gynecology, Mt. Sinai Hospital, Toronto, Canada
| | | | - Daniel E. Roth
- Centre for Global Child Health, Hospital for Sick Children
- Department of Pediatrics, University of Toronto
| | - Alison D. Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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Abstract
This study was conducted to estimate the 25-hydroxyvitamin D (25 (OH)D) levels and explore factors related to vitamin D deficiency/insufficiency. This was a multicenter, hospital-based, cross-sectional observational study. Children admitted to hospitals for health examination were included for vitamin D measurement and the 25(OH)D concentration results were categorized into 3 groups: deficiency (<30 nmol/L), insufficiency (30-50 nmol/L), and sufficiency (>50 nmol/L). Four lakh sixty thousand five hundred thirty-seven children in 825 hospitals from 18 provinces participated in this study. The prevalence of vitamin D deficiency, insufficiency, and sufficiency were 6.69%, 15.92%, and 77.39%, respectively. Vitamin D deficiency was the most severe in the central region, followed by the north, and southwest regions; however, data for the western region were lacking.Logistic regression showed that vitamin D status was worse in girls, newborns, and those visiting the hospital in the winter. In conclusion, the prevalence of vitamin D deficiency is high among Chinese children and adolescents. Studies on population estimates, cost-effective screening strategies, and interventions for high-risk cases are needed.
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Affiliation(s)
- Chunsong Yang
- Department of Pharmacy, Evidence-based Pharmacy Center, West China second hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education
- Department of Epidemiology, West China School of Public Health, and West China Fourth Hospital
| | - Meng Mao
- Department of Pediatrics, West China Second Hospital, Sichuan University
| | - Li Ping
- Department of Pediatrics, West China Second Hospital, Sichuan University
| | - Dan Yu
- Department of Children's Genetic Endocrinology and Metabolism, West China Second hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
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Ma L, Geng LM, Zhou XH. [A comparative analysis of the efficacy of two vitamin D supplementation regimens in preterm infants: a prospective randomized controlled study]. Zhongguo Dang Dai Er Ke Za Zhi 2020; 22:1061-1065. [PMID: 33059801 PMCID: PMC7568995 DOI: 10.7499/j.issn.1008-8830.2005062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To study the effect of different vitamin D supplementation regimens on the nutritional status of vitamin D on day 28 after birth in preterm infants with a gestational age of <34 weeks. METHODS A total of 59 preterm infants with a gestational age of <34 weeks who were born from October 2018 to October 2019 were enrolled and divided into an observation group with 30 infants and a control group with 29 infants. The infants in the observation group received a single-dose intramuscular injection of vitamin D3 (10 000 IU/kg), while those in the control group received oral vitamin D3 drops (900 IU/d) for 25 days. Venous blood samples were collected within 48 hours after birth (before vitamin D3 supplementation) and on day 28 after birth to measure the serum 25-hydroxyvitamin D [25(OH)D] level. RESULTS Within 48 hours after birth, the prevalence rate of vitamin D deficiency (≤15 ng/mL) was 78% among the 59 preterm infants. There were no significant differences in the serum 25(OH)D level and the prevalence rate of vitamin D deficiency between the two groups (P>0.05). Compared with the control group on day 28 after birth, the observation group had a significantly higher serum 25(OH)D level (P<0.05) and a significantly lower prevalence rate of vitamin D deficiency (P<0.05). There were no cases of vitamin D overdose or poisoning. CONCLUSIONS In preterm infants with a gestational age of <34 weeks, single-dose intramuscular injection of 10 000 IU/kg vitamin D3 can significantly increase serum 25(OH)D level on day 28 after birth and safely and effectively reduce the prevalence rate of vitamin D deficiency.
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Affiliation(s)
- Li Ma
- Department of Neonatology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
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15
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Moreira CA, Ferreira CEDS, Madeira M, Silva BCC, Maeda SS, Batista MC, Bandeira F, Borba VZC, Lazaretti-Castro M. Reference values of 25-hydroxyvitamin D revisited: a position statement from the Brazilian Society of Endocrinology and Metabolism (SBEM) and the Brazilian Society of Clinical Pathology/Laboratory Medicine (SBPC). Arch Endocrinol Metab 2020; 64:462-478. [PMID: 32813765 PMCID: PMC10522078 DOI: 10.20945/2359-3997000000258] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 03/01/2020] [Indexed: 11/23/2022]
Abstract
Hypovitaminosis D is a common condition with a negative impact on health. This statement, prepared by experts from the Brazilian Society of Endocrinology and Metabolism and the Brazilian Society of Clinical Pathology/Laboratory Medicine, includes methodological aspects and limitations of the measurement of 25-hydroxyvitamin D [25(OH)D] for identification of vitamin D status, and identifies individuals at increased risk for deficiency of this vitamin in whom 25(OH)D measurement is recommended. For the general population, 25(OH)D levels between 20 and 60 ng/mL are considered normal, while individuals with levels below 20 ng/mL are considered to be vitamin D deficient. This statement identifies potential benefits of maintaining 25(OH)D levels > 30 ng/mL in specific conditions, including patients aged > 65 years or pregnant, those with recurrent falls, fragility fractures, osteoporosis, secondary hyperparathyroidism, chronic kidney disease, or cancer, and individuals using drugs with the potential to affect the vitamin D metabolism. This statement also calls attention to the risk of vitamin D intoxication, a life-threatening condition that occurs at 25(OH)D levels above 100 ng/mL.
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Affiliation(s)
- Carolina Aguiar Moreira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Miguel Madeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Sergio Setsuo Maeda
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Francisco Bandeira
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
| | | | - Marise Lazaretti-Castro
- Departamento de Metabolismo Ósseo, Sociedade Brasileira de Endocrinologia e Metabologia, Brasil
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Kumar R, Gupta N, Singh V, Kumar V, Haq A, Mirza AA, Sharma A. Unveiling molecular associations of polymorphic variants of VDR gene (FokI, BsmI and ApaI) in multiple myeloma patients of Indian population. J Steroid Biochem Mol Biol 2020; 199:105588. [PMID: 32004705 DOI: 10.1016/j.jsbmb.2020.105588] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 12/20/2022]
Abstract
Multiple myeloma (MM) is a plasma cell malignancy frequently accompanied with skeletal co-morbidity. Vitamin D (1,25(OH)2D) is an important mediator of skeletal homeostasis that mediates its effect by binding to vitamin D receptor (VDR), a steroid family receptor and modulates various downstream pathways. Multiple polymorphisms have been determined in VDR gene that witnessed significant association with cancer development and progression. Therefore, in this maiden study, we recruited 75 newly diagnosed MM patients and 75 control subjects. 25-hydroxy vitamin D (25(OH)D) levels were measured in all recruited study subjects. Further, PCR-RFLP was performed in DNA samples of recruited study subjects. Results demonstrated significantly decreased 25(OH)D levels in MM patients compared to controls. Additionally, decreased 25(OH)D levels in MM patients inversely associated with disease severity. Further, single nucleotide polymorphism (SNP) analysis of VDR gene showed significantly higher risk of MM disease development in Ff + ff, Aa + aa, and Bb + bb genotypes. Additionally, FokI f, ApaI a and BsmI b alleles were significantly associated with MM occurrence. In conclusion, this study provided initial evidences of association between 25(OH)D insufficiency, VDR gene polymorphism and MM development. Thus, we suggest that a study involving assessment of 25(OH)D levels and VDR gene polymorphism in large patients' cohort might substantiate their role in MM development which would further provide impetus to give 25(OH)D supplementation along with conventional chemotherapeutic agents for myeloma treatment in future.
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Affiliation(s)
- Raman Kumar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India; Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Nidhi Gupta
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vishwajeet Singh
- Department of Biostatistics, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vimal Kumar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Afrozul Haq
- Department of Food Technology, Jamia Hamdard, New Delhi, India.
| | - Anissa Atif Mirza
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
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17
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Abstract
The relationship between coronary artery disease (CAD) and low serum 25-hydroxyvitamin D (25(OH)D) levels has emerged. Postmenopausal (PM) women are at increased risk of CAD and vitamin D (VitD) deficiency.To investigate the relationship between CAD and VitD levels in PM women.This case-control study included 93 consecutive female patients aged 50 to 79 years old undergoing coronary angiography for evaluation of CAD and 119 age-matched controls. Serum 25(OH)D concentrations were classed as adequate (serum 25(OH)D: ≥20 ng/mL); insufficient (serum 25(OH)D: 10 to <20 ng/mL); and deficient (serum 25(OH)D: <10 ng/mL). Major cardiovascular risk factors were also explored.CAD occurred in 67/127 (52.8%) patients with VitD deficiency; 21/66 (31.8%) patients that were VitD insufficient; and in 5/19 (26.3%) patients with adequate VitD levels. Multivariate regression analysis suggested that a deficiency of VitD increased CAD (odds ratio = 2.891; 95% confidence interval = 1.459-7.139, P < .001).VitD deficiency should be evaluated in PM women as a possible cause of CAD.
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Affiliation(s)
| | - Yan-Yan Li
- Department of cardiac surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
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18
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Gu JW, Liu JH, Xiao HN, Yang YF, Dong WJ, Zhang QB, Liu L, He CS, Wu BH. Relationship between plasma levels of 25-hydroxyvitamin D and arterial stiffness in elderly Chinese with non-dipper hypertension: An observational study. Medicine (Baltimore) 2020; 99:e19200. [PMID: 32049858 PMCID: PMC7035115 DOI: 10.1097/md.0000000000019200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Elderly individuals with non-dipper hypertension are at high risk of cardiovascular disease because of increased stiffness of peripheral arteries. Since, vitamin D deficiency is prevalent in elderly Chinese. We examined whether reduced plasma levels of 25-hydroxyvitamin D [25(OH)D] may help promote this stiffness.Hypertensive patients at least 60 years old without history of peripheral arterial disease at our hospital were retrospectively divided into dipper and non-dipper groups according to the results of 24-hour ambulatory blood pressure monitoring. Plasma levels of 25(OH)D were measured by enzyme immunoassay. Peripheral arterial stiffness was measured based on the cardio-ankle vascular index (CAVI).Of the 155 patients enrolled, 95 (61.3%) were diagnosed with non-dipper hypertension and these patients had significantly lower plasma levels of 25(OH)D than the 60 patients with dipper hypertension (19.58 ± 5.97 vs 24.36 ± 6.95 nmol/L, P < .01) as well as significantly higher CAVI (8.46 ± 1.65 vs 7.56 ± 1.08 m/s, P < .01). Vitamin D deficiency was significantly more common among non-dipper patients (57.9% vs 31.7%, P < .01). Multivariate regression showed that age and 25(OH)D were independently related to CAVI, with each 1-ng/ml decrease in 25(OH)D associated with a CAVI increase of +0.04 m/s.Non-dipper hypertension is associated with vitamin D deficiency and reduced plasma levels of 25(OH)D. The latter may contribute to stiffening of peripheral arteries, increasing the risk of cardiovascular disease.
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Affiliation(s)
- Jian-Wei Gu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Ju-Hua Liu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
- Department of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Hui-Neng Xiao
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Yun-Feng Yang
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Wen-Ju Dong
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Quan-Bo Zhang
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Li Liu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
| | - Cheng-Shi He
- Department of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu City, Sichuan Province, China
| | - Bi-Hua Wu
- Department of Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong City
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19
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Zhang B, Zhao W, Tu J, Wang X, Hao Y, Wang H, Zhao Y, Mizuno K, Tseng Y, Bu H. The relationship between serum 25-hydroxyvitamin D concentration and type 2 diabetic peripheral neuropathy: A systematic review and a meta-analysis. Medicine (Baltimore) 2019; 98:e18118. [PMID: 31770239 PMCID: PMC6890351 DOI: 10.1097/md.0000000000018118] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Vitamin D is a fat-soluble vitamin that is related to the health of the human body and is an indispensable nutrient for human beings. Some studies indicated that type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) may be associated with vitamin D deficiency, but the current understanding of this point of view remains controversial. This study aimed to evaluate the correlation between serum 25-hydroxyl vitamin D (25 [OH] D) concentration and DPN in patients with T2DM by a meta-analysis, and to provide a reference for doctors. METHODS Relevant studies were selected from the PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP databases, and Wanfang Data Knowledge Service Platform databases dating from 2000 to December 2017. A total of 75 articles related to serum 25 (OH) D and DPN were selected from 2000 to December 2017. Based on the inclusion and exclusion criteria of the literature, a quality assessment was conducted using the Newcastle-Ottawa scale, and a meta-analysis was performed by RevMan5.3 statistical software. RESULTS Thirteen studies that involved a total of 2814 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis results, heterogeneity test showed that, P < .000 01, I = 92%, calculation by random effect model revealed that, the serum concentration of 25 (OH) D in T2DM combined with DPN group was lower than that in the group without DPN (weighted mean difference = -0.74, 95% confidence interval: -1.03 to -0.46) CONCLUSIONS:: Vitamin D is associated with type 2 DPN (DPN), and vitamin D deficiency can lead to an increased risk of type 2 DPN. However, more high-quality research is needed.
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Affiliation(s)
- Binjie Zhang
- Graduate School, Tianjin University of Traditional Chinese Medicine
| | - Wenli Zhao
- Department of Neurology, Nankai Hospital, Tianjin Academy of Integrative Medicine, Tianjin, China
- Department of Acupuncture and Moxibustion, Suzuka University of Medical Science, Suzuka, Japan
| | - Jinli Tu
- Department of Language and Culture
| | - Xueying Wang
- Graduate School, Tianjin University of Traditional Chinese Medicine
| | | | - Hongwu Wang
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ye Zhao
- Department of Research and Development, Hangzhou DeBuYou Health Technology Co. Ltd., Hangzhou, Zhejiang, China
| | - Kaito Mizuno
- Faculty of Health Science, Suzuka University of Medical Science, Suzuka, Japan
| | - Yiider Tseng
- Department of Chemical Engineering, University of Florida, 1006 Center Drive, Gainesville, FL
| | - Huaien Bu
- College of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin
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20
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Abstract
Lower circulating vitamin D is common in older adults and may be a potential reversible risk factor for cardiovascular disease (CVD) in older adults, however, presented controversial results.Database was searched update to February 2018. Key data were extracted from eligible studies. Dose-response meta-analysis were conducted for synthesizing data from eligible studies.A total of 13 eligible studies involving 21,079 participants were included in this meta-analysis. Person with lower 25-hydroxyvitamin D status (25 (OH)D level <50 nmol/L) appeared to have higher mortality of CVD in older adults (RR = 1.54, 95% CI 1.24-1.91). Furthermore, a significantly higher mortality of CVD in older adults was observed for the deficient (<25 nmol/L; RR = 1.47, 95% CI 1.15-1.81) and insufficient (25-50 nmol/L; RR = 1.16, 95% CI 1.04-1.27) categories of 25 (OH)D, compared to the reference category of >75 nmol/L. Additionally, decrease of 10 nmol/L 25-hydroxyvitamin D was associated with a 7% incremental in the risk of CVD mortality in older adults.Considering these promising results, circulating vitamin D is associated with CVD mortality increment in older adults.
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Affiliation(s)
- Jun Yang
- Department of Medical College, Tianmen Vocational College
| | | | - Ji Huang
- Department of Neurology, Tianmen First People's Hospital, Tianmen, Hubei Province, China
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21
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Chen L, Dong Y, Bhagatwala J, Raed A, Huang Y, Zhu H. Effects of Vitamin D3 Supplementation on Epigenetic Aging in Overweight and Obese African Americans With Suboptimal Vitamin D Status: A Randomized Clinical Trial. J Gerontol A Biol Sci Med Sci 2019; 74:91-98. [PMID: 30256915 PMCID: PMC6612014 DOI: 10.1093/gerona/gly223] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Indexed: 01/21/2023] Open
Abstract
Background We have previously shown that vitamin D supplementation increases telomerase activity, suggesting an anti-aging effect. In this study, we aim to test the hypothesis that vitamin D supplementation would slow down epigenetic aging, a new marker of biological aging. Methods A randomized clinical trial was previously conducted among 70 overweight/obese African Americans with serum 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L, who were randomly assigned into four groups of 600 IU/d, 2,000 IU/d, 4,000 IU/d of vitamin D3 supplements or placebo followed by 16-week interventions. Whole genome-wide DNA methylation analysis was conducted in 51 participants. DNA methylation ages were calculated according to the Horvath and the Hannum methods. Methylation-based age acceleration index (∆Age) is defined as the difference between DNA methylation age and chronological age in years. Mixed-effects models were used to evaluate the treatment effects. Results Fifty-one participants (aged 26.1 ± 9.3 years, 16% are male) were included in the study. After the adjustment of multi-covariates, vitamin D3 supplementation of 4,000 IU/d was associated with 1.85 years decrease in Horvath epigenetic aging compared with placebo (p value = .046), and 2,000 IU/d was associated with 1.90 years decrease in Hannum epigenetic aging (p value = .044). Serum 25(OH)D concentrations were significantly associated with decreased Horvath ∆Age only (p values = .002), regardless of treatments. Conclusions Our results suggest that vitamin D supplementation may slow down Horvath epigenetic aging. But the effect on Hannum epigenetic aging is not conclusive. Large-scale and longer duration clinical trials are needed to replicate the findings.
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Affiliation(s)
- Li Chen
- Georgia Prevention Institute, Department of Population Sciences
| | - Yanbin Dong
- Georgia Prevention Institute, Department of Population Sciences
| | - Jigar Bhagatwala
- Department of Medicine, Medical College of Georgia, Augusta University
| | - Anas Raed
- Department of Medicine, Medical College of Georgia, Augusta University
| | - Ying Huang
- Georgia Prevention Institute, Department of Population Sciences
| | - Haidong Zhu
- Georgia Prevention Institute, Department of Population Sciences
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22
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Travis RC, Perez-Cornago A, Appleby PN, Albanes D, Joshu CE, Lutsey PL, Mondul AM, Platz EA, Weinstein SJ, Layne TM, Helzlsouer KJ, Visvanathan K, Palli D, Peeters PH, Bueno-de-Mesquita B, Trichopoulou A, Gunter MJ, Tsilidis KK, Sánchez MJ, Olsen A, Brenner H, Schöttker B, Perna L, Holleczek B, Knekt P, Rissanen H, Yeap BB, Flicker L, Almeida OP, Wong YYE, Chan JM, Giovannucci EL, Stampfer MJ, Ursin G, Gislefoss RE, Bjørge T, Meyer HE, Blomhoff R, Tsugane S, Sawada N, English DR, Eyles DW, Heath AK, Williamson EJ, Manjer J, Malm J, Almquist M, Marchand LL, Haiman CA, Wilkens LR, Schenk JM, Tangen CM, Black A, Cook MB, Huang WY, Ziegler RG, Martin RM, Hamdy FC, Donovan JL, Neal DE, Touvier M, Hercberg S, Galan P, Deschasaux M, Key TJ, Allen NE. A Collaborative Analysis of Individual Participant Data from 19 Prospective Studies Assesses Circulating Vitamin D and Prostate Cancer Risk. Cancer Res 2019; 79:274-285. [PMID: 30425058 PMCID: PMC6330070 DOI: 10.1158/0008-5472.can-18-2318] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/04/2018] [Accepted: 11/08/2018] [Indexed: 11/16/2022]
Abstract
Previous prospective studies assessing the relationship between circulating concentrations of vitamin D and prostate cancer risk have shown inconclusive results, particularly for risk of aggressive disease. In this study, we examine the association between prediagnostic concentrations of 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] and the risk of prostate cancer overall and by tumor characteristics. Principal investigators of 19 prospective studies provided individual participant data on circulating 25(OH)D and 1,25(OH)2D for up to 13,462 men with incident prostate cancer and 20,261 control participants. ORs for prostate cancer by study-specific fifths of season-standardized vitamin D concentration were estimated using multivariable-adjusted conditional logistic regression. 25(OH)D concentration was positively associated with risk for total prostate cancer (multivariable-adjusted OR comparing highest vs. lowest study-specific fifth was 1.22; 95% confidence interval, 1.13-1.31; P trend < 0.001). However, this association varied by disease aggressiveness (P heterogeneity = 0.014); higher circulating 25(OH)D was associated with a higher risk of nonaggressive disease (OR per 80 percentile increase = 1.24, 1.13-1.36) but not with aggressive disease (defined as stage 4, metastases, or prostate cancer death, 0.95, 0.78-1.15). 1,25(OH)2D concentration was not associated with risk for prostate cancer overall or by tumor characteristics. The absence of an association of vitamin D with aggressive disease does not support the hypothesis that vitamin D deficiency increases prostate cancer risk. Rather, the association of high circulating 25(OH)D concentration with a higher risk of nonaggressive prostate cancer may be influenced by detection bias. SIGNIFICANCE: This international collaboration comprises the largest prospective study on blood vitamin D and prostate cancer risk and shows no association with aggressive disease but some evidence of a higher risk of nonaggressive disease.
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Affiliation(s)
- Ruth C Travis
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
| | - Paul N Appleby
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Demetrius Albanes
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Alison M Mondul
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stephanie J Weinstein
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Tracy M Layne
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Kathy J Helzlsouer
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kala Visvanathan
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Domenico Palli
- Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network - ISPRO, Florence, Italy
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Bas Bueno-de-Mesquita
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), BA Bilthoven, the Netherlands
- Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, the Netherlands
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Pantai Valley, Kuala Lumpur, Malaysia
| | | | - Marc J Gunter
- Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France
| | - Konstantinos K Tsilidis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maria-Jose Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. Granada, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anja Olsen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Ben Schöttker
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
- Network Aging Research, University of Heidelberg, Heidelberg, Germany
| | - Laura Perna
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany
| | | | - Paul Knekt
- National Institute for Health and Welfare, Helsinki, Finland
| | - Harri Rissanen
- National Institute for Health and Welfare, Helsinki, Finland
| | - Bu B Yeap
- The Medical School, University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Australia
| | - Leon Flicker
- The Medical School, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- Department of Geriatric Medicine, Royal Perth Hospital, Perth, Australia
| | - Osvaldo P Almeida
- The Medical School, University of Western Australia, Perth, Australia
- Western Australian Centre for Health and Ageing, Centre for Medical Research, Harry Perkins Institute of Medical Research, Perth, Australia
- Department of Psychiatry, Royal Perth Hospital, Perth, Australia
| | - Yuen Yee Elizabeth Wong
- The Medical School, University of Western Australia, Perth, Australia
- Department of Geriatric Medicine, Fiona Stanley and Fremantle Hospitals Group, Perth, Australia
| | - June M Chan
- Departments of Epidemiology and Biostatistics and Urology, University of California, San Francisco, San Francisco, California
| | - Edward L Giovannucci
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Meir J Stampfer
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Giske Ursin
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Randi E Gislefoss
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Tone Bjørge
- Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Haakon E Meyer
- Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Division of Cancer Medicine, Department of Clinical Service, Oslo University Hospital, Oslo, Norway
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Dallas R English
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Darryl W Eyles
- Queensland Brain Institute, University of Queensland, Queensland, Australia
| | - Alicia K Heath
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, United Kingdom
| | - Elizabeth J Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jonas Manjer
- Department of Translational Medicine, Clinical Chemistry, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Johan Malm
- Department of Translational Medicine, Clinical Chemistry, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Martin Almquist
- Department of Surgery, Endocrine-Sarcoma Unit, Skåne University Hospital, Lund, Sweden
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Christopher A Haiman
- Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Lynne R Wilkens
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Jeannette M Schenk
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Research Centre, Seattle, Washington
| | - Cathy M Tangen
- SWOG (Formerly the Southwest Oncology Group) Statistical Center, Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Biostatistics, University of Washington, Seattle, Washington
| | - Amanda Black
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Wen-Yi Huang
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Regina G Ziegler
- Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, Maryland
| | - Richard M Martin
- Bristol Medical School Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Medical Research Council (MRC) University of Bristol Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, United Kingdom
- National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Freddie C Hamdy
- Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom
| | - Jenny L Donovan
- Bristol Medical School Department of Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - David E Neal
- Nuffield Department of Surgery, University of Oxford, Oxford, United Kingdom
| | - Mathilde Touvier
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Serge Hercberg
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Pilar Galan
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Mélanie Deschasaux
- Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153/Inra U1125/Cnam/Paris 13 University, Bobigny, France
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Naomi E Allen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
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Ge J, Sun D, Teng L, Su B, Niu X, Luo W. Effects of 25-hydroxyvitamin D on bone microstructure in T2MD rats. J Musculoskelet Neuronal Interact 2018; 18:525-529. [PMID: 30511956 PMCID: PMC6313039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aims to explore the effects of 25-hydroxyvitamin D on the bone microstructure of rats with type 2 diabetes mellitus (T2MD). METHODS 40 male Wistar rats were randomly selected for T2MD modeling and injected with streptozotocin solution. The rats in the control group (n=19) were fed with common feed. 25-hydroxyvitamin D was injected into rats with successful modeling results (Treatment group, n=15). The remaining rats were considered as the model group (n=16). The enzyme-linked immunosorbent assay was adopted to determine bone gla protein (BGP) and tartrate-resistant acid phosphatase (TRACP), and an X-ray bone densitometer were applied to observe the vertebral sections. RESULTS The activity levels of blood glucose, triglyceride, total cholesterol and TRACP in the model group were higher than those in the treatment group and the control group (p⟨0.01), while serum calcium, phosphorus, BGP, ALP, and glycosylated hemoglobin, various indicators of rats in the model group were lower than those in the treatment group and the control group (p⟨0.05). CONCLUSIONS It is feasible to treat rats with T2MD with 25-hydroxyvitamin D, which can maintain the integrity of bone microstructure and increase the bone health.
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Affiliation(s)
- Junbo Ge
- Department of Traumatic Orthopedics, Yantaishan Hospital, Yantai, P.R.China
| | - Dongning Sun
- Department of Traumatic Orthopedics, The Affiliated Qingdao Hiser Hospital of Qingdao University (Qingdao Hospital of Traditional Chinese Medicine), Qingdao, P.R.China
| | - Lili Teng
- Department of Outpatient, The People’s Hospital of Zhangqiu Area, Jinan, P.R.China
| | - Baifang Su
- Department of Science and Education, Jinan Zhangqiu District Hospital of TCM, Jinan, P.R.China
| | - Xinqing Niu
- Department of Electrocardiogram, The People’s Hospital of Zhangqiu Area, Jinan, P.R.China
| | - Wenming Luo
- Department of Traumatic Orthopedics, Weifang Peoples’s Hospital, Weifang, P.R.China,Corresponding author: Dr. Wenming Luo, Department of Traumatic Orthopedics, Weifang Peoples’s Hospital, No.151 Guangwen Street, Weifang 261000, P.R.China E-mail:
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Purdue-Smithe AC, Whitcomb BW, Manson JE, Hankinson SE, Troy LM, Rosner BA, Bertone-Johnson ER. Vitamin D Status Is Not Associated with Risk of Early Menopause. J Nutr 2018; 148:1445-1452. [PMID: 30107585 PMCID: PMC6454521 DOI: 10.1093/jn/nxy129] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 05/31/2018] [Indexed: 12/31/2022] Open
Abstract
Background Early natural menopause, the cessation of ovarian function before age 45 y, is positively associated with cardiovascular disease and other conditions. Dietary vitamin D intake has been inversely associated with early menopause; however, no previous studies have evaluated risk with regard to plasma 25-hydroxyvitamin D [25(OH)D] concentrations. Objective We prospectively evaluated associations of total and free 25(OH)D and vitamin D-binding protein (VDBP) concentrations and the risk of early menopause in a case-control study nested within the Nurses' Health Study II (NHS2). We also considered associations of 25(OH)D and VDBP with anti-Müllerian hormone (AMH) concentrations. Methods The NHS2 is a prospective study in 116,430 nurses, aged 25-42 y at baseline (1989). Premenopausal plasma blood samples were collected between 1996 and 1999, from which total 25(OH)D and VDBP concentrations were measured and free 25(OH)D concentrations were calculated. Cases experienced menopause between blood collection and age 45 y (n = 328) and were matched 1:1 by age and other factors to controls who experienced menopause after age 48 y (n = 328). Conditional logistic regression models were used to estimate ORs and 95% CIs for early menopause according to each biomarker. Generalized linear models were used to estimate AMH geometric means according to each biomarker. Results After adjusting for smoking and other factors, total and free 25(OH)D were not associated with early menopause. Quartile 4 compared with quartile 1 ORs were 1.04 (95% CI: 0.60, 1.81) for total 25(OH)D and 0.70 (95% CI: 0.41, 1.20) for free 25(OH)D. 25(OH)D was unrelated to AMH concentrations. VDBP was positively associated with early menopause; the OR comparing the highest with the lowest quartile of VDBP was 1.80 (95% CI: 1.09, 2.98). Conclusions Our findings suggest that total and free 25(OH)D are not importantly related to the risk of early menopause. VDBP may be associated with increased risk, but replication is warranted.
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Affiliation(s)
| | | | - JoAnn E Manson
- Channing Division of Network Medicine,Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA,Departments of Epidemiology
| | - Susan E Hankinson
- Departments of Biostatistics and Epidemiology,Channing Division of Network Medicine,Departments of Epidemiology
| | - Lisa M Troy
- Nutrition, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
| | - Bernard A Rosner
- Biostatistics, Harvard TH Chan School of Public Health, Boston, MA
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Wei H, Jing H, Wei Q, Wei G, Heng Z. Associations of the risk of lung cancer with serum 25-hydroxyvitamin D level and dietary vitamin D intake: A dose-response PRISMA meta-analysis. Medicine (Baltimore) 2018; 97:e12282. [PMID: 30212966 PMCID: PMC6155959 DOI: 10.1097/md.0000000000012282] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The associations of the risk of lung cancer with the vitamin D intake and serum level are controversial. We performed a comprehensive dose-response meta-analysis to evaluate the precise relationships between the above mentioned parameters.We performed a web search of the PubMed, Medline, and Embase databases to identify potential studies that evaluated the relationships between vitamin D intake or serum 25-hydroxyvitamin D (25([OH]D) levels and the risk of lung cancer on December 5, 2017. According to the inclusion and exclusive criteria, 16 studies were included in this meta-analysis. The pooled relative risks (RRs) with 95% confidence intervals (CIs) were used to assess the strength of the associations. A dose-response analysis was conducted to quantitate the relationship between the serum 25(OH)D or vitamin D intake and the risk of lung cancer.The pooled RR (highest level vs lowest level) showed that the serum 25(OH)D level was not associated with the risk of lung cancer (RR = 1.046, 95% CI = 0.945-1.159). A high vitamin D intake was inversely correlated with the lung cancer risk (RR = 0.854, 95% CI = 0.741-0.984). No significant dose-response relationship was observed between the serum 25(OH)D level and the lung cancer risk. The linearity model of the dose-response analysis indicated that with every 100 IU/day increase in vitamin D intake, the risk of lung cancer decreased by 2.4% (RR = 0.976, 95% CI = 0.957-0.995, P = .018).A high vitamin D intake provides limited protection against lung cancer carcinogenesis.
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Affiliation(s)
- Hu Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Hu Jing
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Qian Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Guo Wei
- Department of Radiology, the Fifth Hospital of Wuhan
| | - Zhou Heng
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China
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Kim KL, Park SP. Association between serum vitamin D deficiency and age-related macular degeneration in Koreans: Clinical case-control pilot study. Medicine (Baltimore) 2018; 97:e11908. [PMID: 30113489 PMCID: PMC6112886 DOI: 10.1097/md.0000000000011908] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022] Open
Abstract
The objective of this study was to evaluate the association between serum vitamin D deficiency and age-related macular degeneration (AMD) in Koreans through a clinical case-control pilot study. The study included 96 patients: 30 with late AMD, 32 with early AMD, and 34 normal controls. The patients with late AMD were divided into 2 subgroups based on the presence or absence of subretinal fibrosis on optical coherence tomography (OCT) images. We measured 25-hydroxyvitamin D levels in the serum of all patients during the same season to rule out seasonal variation of serum vitamin D level. Serum vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level below 20 ng/mL. Serum vitamin D deficiency had a tendency to increase the risk of early AMD, although with borderline significance [odds ratio (OR) = 3.59; 95% confidence interval (95% CI) 0.95-13.58; P = .060]. It was significantly associated with a greater risk of late AMD (OR = 3.61; 95%CI 1.04-12.51; P = .043). Among the 2 subgroups of patients with late AMD, those with subretinal fibrosis present on the OCT images showed a greater risk of serum vitamin D deficiency than the normal controls (OR = 7.54; 95% CI 1.34-42.51). However, there was no significant association between serum vitamin D deficiency and late AMD without subretinal fibrosis (OR = 1.89; 95% CI 0.40-8.92). Serum vitamin D deficiency may increase the risk of early and late AMD in Koreans, and may also be associated with subretinal fibrosis in this population.
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O'Callaghan KM, Hennessy Á, Hull GLJ, Healy K, Ritz C, Kenny LC, Cashman KD, Kiely ME. Estimation of the maternal vitamin D intake that maintains circulating 25-hydroxyvitamin D in late gestation at a concentration sufficient to keep umbilical cord sera ≥25-30 nmol/L: a dose-response, double-blind, randomized placebo-controlled trial in pregnant women at northern latitude. Am J Clin Nutr 2018; 108:77-91. [PMID: 29878035 PMCID: PMC6600055 DOI: 10.1093/ajcn/nqy064] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 10/30/2017] [Accepted: 03/14/2018] [Indexed: 12/14/2022] Open
Abstract
Background In the absence of dose-response data, Dietary Reference Values for vitamin D in nonpregnant adults are extended to pregnancy. Objective The aim was to estimate vitamin D intake needed to maintain maternal 25-hydroxyvitamin D [25(OH)D] in late gestation at a concentration sufficient to prevent newborn 25(OH)D <25-30 nmol/L, a threshold indicative of increased risk of nutritional rickets. Design We conducted a 3-arm, dose-response, double-blind, randomized placebo-controlled trial in Cork, Ireland (51.9oN). A total of 144 white-skinned pregnant women were assigned to receive 0, 10 (400 IU), or 20 (800 IU) µg vitamin D3/d from ≤18 wk of gestation. Vitamin D metabolites at 14, 24, and 36 wk of gestation and in cord sera, including 25(OH)D3, 3-epi-25(OH)D3, 24,25(OH)2D3, and 25(OH)D2 were quantified by liquid chromatography-tandem mass spectrometry. A curvilinear regression model predicted the total vitamin D intake (from diet and antenatal supplements plus treatment dose) that maintained maternal 25(OH)D in late gestation at a concentration sufficient to maintain cord 25(OH)D at ≥25-30 nmol/L. Results Mean ± SD baseline 25(OH)D was 54.9 ± 10.7 nmol/L. Total vitamin D intakes at the study endpoint (36 wk of gestation) were 12.1 ± 8.0, 21.9 ± 5.3, and 33.7 ± 5.1 µg/d in the placebo and 10-µg and 20-µg vitamin D3 groups, respectively; and 25(OH)D was 24.3 ± 5.8 and 29.2 ± 5.6 nmol/L higher in the 10- and 20-µg groups, respectively, compared with placebo (P < 0.001). For maternal 25(OH)D concentrations ≥50 nmol/L, 95% of cord sera were ≥30 nmol/L and 99% were >25 nmol/L. The estimated vitamin D intake required to maintain serum 25(OH)D at ≥50 nmol/L in 97.5% of women was 28.9 µg/d. Conclusions Thirty micrograms of vitamin D per day safely maintained serum 25(OH)D concentrations at ≥50 nmol/L in almost all white-skinned women during pregnancy at a northern latitude, which kept 25(OH)D at >25 nmol/L in 99% and ≥30 nmol/L in 95% of umbilical cord sera. This trial was registered at www.clinicaltrials.gov as NCT02506439.
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Affiliation(s)
- Karen M O'Callaghan
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - Áine Hennessy
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - George L J Hull
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Karina Healy
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - Christian Ritz
- Department of Nutrition, Exercise, and Sports, Faculty of Science, University of Copenhagen, Frederiksberg, Denmark
| | - Louise C Kenny
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
| | - Kevin D Cashman
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Department of Medicine, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
- Irish Center for Fetal and Neonatal Translational Research (INFANT)
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Guo Y, Ke HJ, Liu Y, Fu M, Ning J, Yu L, Xiao Y, Che D, Chen XY, Deng YH, Wu JL. Prevalence of vitamin D insufficiency among children in southern china: A cross-sectional survey. Medicine (Baltimore) 2018; 97:e11030. [PMID: 29923990 PMCID: PMC6023856 DOI: 10.1097/md.0000000000011030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Vitamin D deficiency is associated with numerous public health issues. Limited data are available for children in southern China, a region that receives abundant sunlight. We aimed to estimate the 25-hydroxyvitamin D (25(OH)D) levels in children in that area, and to determine seasonal variations in serum 25(OH)D levels. A total of 16,755 children aged 0 to 6 years, who visited the Guangdong Women and Children's Hospital for health examination between January 2016 and May 2017, were included in the present study. The serum 25(OH)D levels ranged from 10.5 to 307.4 nmol/L (mean ± standard deviation: 78.5 ± 26.3 nmol/L). The prevalence of vitamin D deficiency and insufficiency were 10.8% and 39.0%, respectively. The mean serum 25(OH)D level in spring (71.8 ± 24.9 nmol/L) was lower than that in other seasons. From January to April, we found a relatively high prevalence of vitamin D deficiency or insufficiency, both of which were also found to increase with age. Logistic regression analysis revealed that vitamin D deficiency and insufficiency were significantly associated with age and season. Deficiency and insufficiency of vitamin D are common among children in southern China, despite the area receiving sufficient sunlight.
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Affiliation(s)
- Yong Guo
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Hai-Jin Ke
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Ying Liu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Min Fu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Jing Ning
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Li Yu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu Xiao
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Di Che
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Xiao-Yan Chen
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
| | - Yu-Hong Deng
- School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jie-Ling Wu
- Department of Children's Health Care, Guangdong Women and Children Hospital, Guangzhou Medical University
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Best CM, Pressman EK, Queenan RA, Cooper E, Vermeylen F, O'Brien KO. Gestational Age and Maternal Serum 25-hydroxyvitamin D Concentration Interact to Affect the 24,25-dihydroxyvitamin D Concentration in Pregnant Adolescents. J Nutr 2018; 148:868-875. [PMID: 29796622 PMCID: PMC6014295 DOI: 10.1093/jn/nxy043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 02/13/2018] [Indexed: 11/13/2022] Open
Abstract
Background Interpretation of serum vitamin D biomarkers across pregnancy is complex due to limited understanding of pregnancy adaptations in vitamin D metabolism. During pregnancy, both gestational age and serum 25-hydroxyvitamin D [25(OH)D] concentrations may influence the concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D], 24,25-dihydroxyvitamin D [24,25(OH)2D], and parathyroid hormone (PTH). Objective We aimed to identify predictors of change in serum 25(OH)D across gestation in pregnant adolescents and to assess the contribution made by cholecalciferol (vitamin D3) supplementation. We sought to determine whether gestational age and 25(OH)D concentration interacted to affect serum 1,25(OH)2D, 24,25(OH)2D, or PTH. Methods Pregnant adolescents (n = 78, 59% African American, mean ± SD age: 17 ± 1 y) living in Rochester, NY (latitude 43°N) were supplemented with 200 IU or 2000 IU vitamin D3/d and allowed to continue their daily prenatal supplement that contained 400 IU vitamin D3. Serum was collected at study entry (18 ± 5 wk of gestation), halfway through study participation, and at delivery (40 ± 2 wk). Serum concentrations of the biochemical markers were modeled with linear mixed-effects regression models. Results Vitamin D3 supplement intake and season of delivery determined change in 25(OH)D across pregnancy. Fall-winter delivery was associated with a decline in 25(OH)D unless vitamin D3 supplement intake was >872 IU/d. The interaction of gestational age and 25(OH)D affected 24,25(OH)2D concentrations. For a given 25(OH)D concentration, model-predicted serum 24,25(OH)2D increased across gestation except when 25(OH)D was <13 ng/mL. Below this threshold, 24,25(OH)2D was predicted to decline over time. Mean serum 1,25(OH)2D was elevated (>100 pg/mL) throughout the study. Conclusion Our results suggest that when maternal serum 25(OH)D was low, its catabolism into 24,25(OH)2D decreased or remained stable as pregnancy progressed in order to maintain persistently elevated serum 1,25(OH)2D. Furthermore, in adolescents living at latitude 43°N, standard prenatal supplementation did not prevent a seasonal decline in 25(OH)D during pregnancy. This study was registered at clinicaltrials.gov as NCT01815047.
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Affiliation(s)
- Cora M Best
- Division of Nutritional Sciences, Cornell University, Ithaca, NY
| | - Eva K Pressman
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Ruth Anne Queenan
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | - Elizabeth Cooper
- Department of Obstetrics and Gynecology, University of Rochester School of Medicine and Dentistry, Rochester, NY
| | | | - Kimberly O O'Brien
- Division of Nutritional Sciences, Cornell University, Ithaca, NY,Address correspondence to KOO (e-mail: )
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Yang LR, Li H, Zhang T, Zhao RC. [Relationship between vitamin D deficiency and necrotizing enterocolitis in preterm infants]. Zhongguo Dang Dai Er Ke Za Zhi 2018; 20:178-183. [PMID: 29530115 PMCID: PMC7389789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 02/07/2018] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To evaluate the relationship of vitamin D level with the development of necrotizing enterocolitis (NEC) in preterm infants. METHODS A total of 429 preterm infants with a gestational age of <36 weeks, who were admitted to the department of neonatology within 2 hours after birth between January and December, 2016, were enrolled in the study. According to whether these infants developed NEC, the 429 subjects were divided into NEC group (n=22) and non-NEC group (n=407). Peripheral venous blood was collected from these preterm infants and their mothers at admission to measure the level of 25-hydroxyvitamin D (25-OHD). The two groups were compared in terms of the serum 25-OHD levels of preterm infants and their mothers. Pearson correlation analysis was used to investigate the correlation between the serum 25-OHD levels of preterm infants and their mothers. The distribution of vitamin D levels in preterm infants was compared between the two groups. The univariate logistic regression analysis was used to determine the risk factors for NEC in preterm infants. RESULTS The serum 25-OHD levels of preterm infants and their mothers in the NEC group were significantly lower than in the non-NEC group (P<0.001). In both groups, the serum 25-OHD levels of mothers and preterm infants were positively correlated with each other (P<0.001). The distribution of vitamin D levels (normal vitamin D level, low vitamin D level, vitamin D deficiency, and severe vitamin D deficiency) was significantly different between the NEC and non-NEC groups (P<0.001). The univariate logistic regression analysis showed that gestational age, birth weight, 25-OHD levels of preterm infants and their mothers, the duration of mechanical ventilation, the duration of oxygen inhalation, and the length of hospital stay were associated with the development of NEC (P<0.05). CONCLUSIONS The serum 25-OHD levels of preterm infants and their mothers may be related to the development of NEC in preterm infants, suggesting that vitamin D supplementation during pregnancy is important for preventing the development of NEC in preterm infants.
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Affiliation(s)
- Ling-Rong Yang
- Department of Pediatrics, Third People's Hospital of Chengdu/Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, China.
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Abstract
OBJECTIVE To investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels at birth and respiratory distress syndrome (RDS) in preterm infants. METHODS This retrospective study recruited preterm infants with gestational age of below 34 weeks who were born between January 2014 and December 2016. These preterm infants were divided into two groups: RDS (n=72) and control (n=40). Clinical data of the two groups were collected, including gestational age, birth weight, gender, delivery mode, Apgar scores at 1 minute and 5 minutes, incidence of maternal gestational diabetes mellitus, and use of prenatal steroid hormone. Peripheral blood samples were collected and 25(OH)D levels were measured by chemiluminescence immunoassay. The association between serum 25(OH)D levels at birth and RDS was analyzed by multivariate logistic regression. RESULTS Apgar scores at 1 minute and 5 minutes and serum 25(OH)D levels in the RDS group were significantly lower than those in the control group (P<0.05), while the rates of neonatal asphyxia and vitamin D deficiency were significantly higher than those in the control group (P<0.05). Multivariate logistic regression analysis showed that neonatal asphyxia (OR=2.633, 95%CI: 1.139-6.085) and vitamin D deficiency (OR=4.064, 95%CI: 1.625-10.165) were risk factors for RDS in preterm infants. CONCLUSIONS Vitamin D deficiency might be associated with increased risk of RDS in preterm infants. Reasonable vitamin D supplementation during pregnancy might reduce the incidence of RDS in preterm infants.
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Abstract
PURPOSE OF REVIEW The review summarizes recent epidemiological studies that examined the relationship between osteoporosis and sarcopenia to assess the impact of vitamin D status or supplementation on health outcomes related to these two medical conditions. RECENT FINDINGS Osteoporosis and sarcopenia are major public health problems, but whether these two diseases should be considered alone or combined into a single condition is not clear. No consensual definition of osteosarcopenia is largely accepted. Most observational studies demonstrate some relationship between muscle and bone health. Vitamin D status is generally lower in study participants with bone or muscle wasting. Studies on the effects of vitamin D supplementation on muscle or bone health have provided conflicting results, likely because of the heterogeneity between studies. However, the most positive results were observed in study participants with low vitamin D status and in studies that avoided massive boluses of vitamin D. SUMMARY More observational and interventional studies are needed to confirm the exact role of vitamin D in the pathophysiology and treatment of osteosarcopenia.
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Affiliation(s)
- Olivier Bruyère
- Department of Public Health, Epidemiology, and Health Economics
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
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Yu RQ, Chen DZ, Zhou Q, Wang M, Mei YZ, Jiang SY. [Association between serum 25(OH)D levels at birth and bronchopulmonary dysplasia in preterm infants]. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19:1051-1055. [PMID: 29046199 PMCID: PMC7389274 DOI: 10.7499/j.issn.1008-8830.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 08/18/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the association between serum 25-hydroxyvitamin D [25(OH)D] levels at birth and bronchopulmonary dysplasia (BPD) in preterm infants. METHODS This study recruited preterm infants with gestational age of below 34 weeks who were born between January 2014 and December 2016. These preterm infants were classified into two groups: BPD and control. The association between serum 25(OH)D levels at birth and BPD was analyzed. RESULTS Serum 25(OH)D levels in the BPD group was significantly lower than those in the control group [(37±17 nmol/L vs 47±20 nmol/L; P<0.05), and the rate of vitamin D deficiency was significantly higher than those in the control group (90.2% vs 74.0%; P<0.05). The level of serum 25(OH)D was negatively correlated with the incidence of BPD (r=-0.201, P=0.001). CONCLUSIONS Vitamin D deficiency at birth may be associated with BPD in preterm infants, but need to be further studied by multivariate analysis.
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Affiliation(s)
- Ren-Qiang Yu
- Department of Neonatology, Wuxi Maternity and Child Health Hospital Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214002, China.
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早产儿出生时维生素D水平及影响因素分析. Zhongguo Dang Dai Er Ke Za Zhi 2017; 19. [PMID: 28697835 DOI: 10.7499/j.issn.1008-8830.2017.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To investigate vitamin D level at birth and possible influencing factors in preterm infants. METHODS A total of 600 preterm infants were enrolled, and venous blood samples were collected within 24 hours after birth to measure the serum level of 25-hydroxyvitamin D [25(OH)D]. The effect of sex, birth weight, birth season, gestational age, mother's age, body mass index (BMI) in early pregnancy, delivery mode, and complications during pregnancy on serum 25(OH)D level was analyzed. RESULTS The rates of vitamin D deficiency, insufficiency, and sufficiency were 42.0%, 38.7%, and 19.3% respectively. The preterm infants born in summer and autumn had a significantly higher serum 25(OH)D level than those born in winter (P<0.05) and a significantly lower incidence rate of vitamin D deficiency than those born in spring and winter (P<0.003). Compared with those whose mothers were aged <30 years, the infants whose mothers were aged ≥30 years had a significantly higher serum 25(OH)D level (P<0.05) and a significantly lower incidence rate of vitamin D deficiency (P<0.017). Compared with those whose mothers were overweight or had normal body weight, the infants whose mothers were obese had a significantly lower serum 25(OH)D level (P<0.05) and a significantly higher incidence rate of vitamin D deficiency (P<0.006). Compared with those whose mothers had no preeclampsia, the infants whose mothers had preeclampsia during pregnancy had a significantly lower serum 25(OH)D level (P<0.05) and a significantly higher incidence rate of vitamin D deficiency (P<0.017). The multivariate analysis showed that birth in winter and spring, mother's age <30 years, and early-pregnancy BMI ≥28 kg/m2 were risk factors for vitamin D deficiency (P<0.05). CONCLUSIONS There is a high prevalence of vitamin D deficiency in preterm infants. Vitamin D supplementation should be given to the preterm infants with high-risk factors for vitamin D deficiency.
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Vaughan-Shaw PG, O'Sullivan F, Farrington SM, Theodoratou E, Campbell H, Dunlop MG, Zgaga L. The impact of vitamin D pathway genetic variation and circulating 25-hydroxyvitamin D on cancer outcome: systematic review and meta-analysis. Br J Cancer 2017; 116:1092-1110. [PMID: 28301870 PMCID: PMC5396104 DOI: 10.1038/bjc.2017.44] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/20/2017] [Accepted: 01/26/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D has been linked with improved cancer outcome. This systematic review and meta-analysis investigates the relationship between cancer outcomes and both vitamin D-related genetic variation and circulating 25-hydroxyvitamin D (25OHD) concentration. METHODS A systematic review and meta-analysis of papers until November 2016 on PubMed, EMBASE and Web of Science pertaining to association between circulating vitamin D level, functionally relevant vitamin D receptor genetic variants and variants within vitamin D pathway genes and cancer survival or disease progression was performed. RESULTS A total of 44 165 cases from 64 studies were included in meta-analyses. Higher 25OHD was associated with better overall survival (hazard ratio (HR=0.74, 95% CI: 0.66-0.82) and progression-free survival (HR=0.84, 95% CI: 0.77-0.91). The rs1544410 (BsmI) variant was associated with overall survival (HR=1.40, 95% CI: 1.05-1.75) and rs7975232 (ApaI) with progression-free survival (HR=1.29, 95% CI: 1.02-1.56). The rs2228570 (FokI) variant was associated with overall survival in lung cancer patients (HR=1.29, 95% CI: 1.0-1.57), with a suggestive association across all cancers (HR=1.26, 95% CI: 0.96-1.56). CONCLUSIONS Higher 25OHD concentration is associated with better cancer outcome, and the observed association of functional variants in vitamin D pathway genes with outcome supports a causal link. This analysis provides powerful background rationale to instigate clinical trials to investigate the potential beneficial effect of vitamin D in the context of stratification by genotype.
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Affiliation(s)
- P G Vaughan-Shaw
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - F O'Sullivan
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - S M Farrington
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - E Theodoratou
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - H Campbell
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - M G Dunlop
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
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Abstract
In this study, we investigated the distribution of vitamin D and its association with carotid atherosclerotic plaque (CP) in Chinese type 2 diabetic (T2D) patients. We performed a cross-sectional study in 210 T2D and 94 age- and gender-matched nondiabetic patients during winter months, by determining serum 25-hydroxyvitamin D (25(OH)D) levels in both diabetic and nondiabetic controls. We carried out measurements of B-mode ultrasonography of carotid arteries in each T2D patient. The 25(OH)D concentration was 26.25 nmol/L among the T2D patients. About 93.3% T2D patients suffered from hypovitaminosis D. First, we found a clear inverse correlation between the 25(OH)D concentration and CP (P <0.001). Second, an association between 25(OH)D and macrovascular disease was significant (P = 0.005). In multivariate logistic regression analysis, decreasing 25(OH)D concentration was markedly associated with CP in T2D patients. Third, after adjusting for the confounding factors, we also observed a positive correlation between low levels of 25(OH)D in T2D patients with CP, when the following parameters were measured: old age (odds ratio [OR] = 2.533, P = 0.013); smoking (OR = 3.872, P = 0.001); and high level of low-density lipoprotein (LDL) cholesterol (OR = 2.776, P = 0.009). Thus, we concluded that high prevalence of hypovitaminosis D exists in Chinese T2D patients. Further, we found a significant association between low concentration of serum 25(OH)D and the existence of high body mass index, and high circulating LDL to be substantially positive predictors of patients with CP in T2D.
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Affiliation(s)
- Ya-Hui Ding
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | - Tie-Ming Wei
- Department of Cardiology, Lishui Central Hospital, Lishui, Zhejiang Province
| | - Lin-Yan Qian
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | - Yuan Ma
- Department of Cardiology, Zhejiang Provincial People's Hospital
| | | | - Bin Yao
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Jie Pang
- Department of Cardiology, Zhejiang Provincial People's Hospital
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Ozgurhan G, Vehapoglu A, Vermezoglu O, Temiz RN, Guney A, Hacihamdioglu B. Risk assessment of obstructive sleep apnea syndrome in pediatric patients with vitamin D deficiency: A questionnaire-based study. Medicine (Baltimore) 2016; 95:e4632. [PMID: 27684795 PMCID: PMC5265888 DOI: 10.1097/md.0000000000004632] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The aim of the following study is to evaluate the risk of obstructive sleep apnea syndrome (OSAS) in subjects with vitamin D deficiency.Prospective and comparative study.We enrolled 240 subjects into the study. The participants were divided into 2 groups based on 25-hydroxyvitamin D (25[OH]D) levels: low level of 25(OH)D (<20 ng/mL) group (n = 120) and control (>20 ng/mL) group (n = 120). Subjects were classified as being at a high or low risk of developing OSAS by using the Berlin Questionnaire. Risk of developing OSAS, gender, age, and body mass index (BMI) z-score were assessed by comparing the low level of 25(OH)D group and control group.No statistically significant difference was observed between the low level of 25(OH)D group and control group in terms of gender, age, and BMI z-score distributions; P = 0.323, P = 0.387, and P = 0.093, respectively. There were 24 subjects with high risk of developing OSAS in 2 groups (17 subjects in the low level of 25[OH]D group and 7 subjects in the control group). In the low level of 25(OH)D group, the risk of developing OSAS was found to be significantly higher than the control group (P = 0.030). BMI z-score was found significantly higher in high-risk groups than low-risk groups (P = 0.034 for low-level 25[OH]D group and P = 0.023 for control group).The findings revealed that low level of 25(OH)D increases the risk of developing OSAS.
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Affiliation(s)
- Gamze Ozgurhan
- Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital
- Correspondence: Gamze Ozgurhan, Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital, Telsiz Mah, Balikli Kazlicesme Yolu No: 1, Zeytinburnu, 34020 Istanbul, Turkey (e-mail: )
| | - Aysel Vehapoglu
- Department of Pediatrics, Bezmialem Vakıf University, Faculty of Medicine, İstanbul, Turkey
| | - Oznur Vermezoglu
- Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital
| | - Rabia Nur Temiz
- Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital
| | - Asuman Guney
- Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital
| | - Bulent Hacihamdioglu
- Department of Pediatrics, Suleymaniye Maternity and Children's Training and Research Hospital
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Nylén H, Habtewold A, Makonnen E, Yimer G, Bertilsson L, Burhenne J, Diczfalusy U, Aklillu E. Prevalence and risk factors for efavirenz-based antiretroviral treatment-associated severe vitamin D deficiency: A prospective cohort study. Medicine (Baltimore) 2016; 95:e4631. [PMID: 27559961 PMCID: PMC5400328 DOI: 10.1097/md.0000000000004631] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Initiation of efavirenz-based combination antiretroviral therapy (cART) is associated with Vitamin D deficiency, but the risk factors including efavirenz pharmacokinetics for cART-induced severe vitamin D deficiency (SVDD) and the impact of anti-tuberculosis (TB) cotreatment are not explored. We investigated the prevalence of SVDD in HIV and TB-HIV coinfected patients and associated risk factors for treatment-induced SVDD.Treatment-naïve Ethiopian HIV patients with (n = 102) or without (n = 89) TB co-infection were enrolled prospectively and received efavirenz-based cART. In TB-HIV coinfected patients, rifampicin-based anti-TB treatment was initiated 4 or 8 weeks before starting cART. Plasma 25-hydroxyvitamin D (25 [OH]D), cholesterol and 4-beta hydroxycholesterol concentrations were measured at baseline, 4, 16, and 48 week of cART. Plasma efavirenz concentrations were determined at 4 and 16 weeks of cART.TB-HIV patients had significantly lower plasma 25 (OH)D3 levels than HIV-only patients at baseline. TB co-infection, low Karnofsky score, high viral load, and high CYP3A activity as measured by plasma 4β-hydroxycholesterol/cholesterol ratios were significant predictors of low 25 (OH)D3 levels at baseline. In HIV-only patients, initiation of efavirenz-based cART increased the prevalence of SVVD from 27% at baseline to 76%, 79%, and 43% at 4, 16, and 48 weeks of cART, respectively. The median 25 (OH)D3 levels declined from baseline by -40%, -50%, and -14% at 4, 16, and 48 weeks of cART, respectively.In TB-HIV patients, previous anti-TB therapy had no influence on 25 (OH)D3 levels, but the initiation of efavirenz-based cART increased the prevalence of SVDD from 57% at baseline to 70% and 72% at the 4 and 16 weeks of cART, respectively. Median plasma 25 (OH)D3 declined from baseline by -17% and -21% at week 4 and 16 of cART, respectively.Our results indicate low plasma cholesterol, high CYP3A activity, and high plasma efavirenz concentrations as significant predictors of early efavirenz-based cART-induced vitamin D deficiency. Low plasma 25 (OH)D3 level at baseline is associated with TB co-infection and HIV diseases progression. Initiation of efavirenz-based cART is associated with high incidence of SVDD, whereas rifampicin based anti-TB therapy co-treatment has no significant effect. Supplementary vitamin D during cART initiation may be beneficial for HIV patients regardless of TB coinfection.
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Affiliation(s)
- Hanna Nylén
- Department of Laboratory Medicine, Division of Clinical Chemistry, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Abiy Habtewold
- Department of Pharmacology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eyasu Makonnen
- Department of Pharmacology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Getnet Yimer
- Department of Pharmacology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Leif Bertilsson
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jürgen Burhenne
- Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany
| | - Ulf Diczfalusy
- Department of Laboratory Medicine, Division of Clinical Chemistry, Karolinska Institutet at Karolinska University Hospital, Stockholm, Sweden
| | - Eleni Aklillu
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Stockholm, Sweden
- Correspondence: Professor Eleni Aklillu, Division of Clinical Pharmacology, Department of Laboratory of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge C-168, SE-141 86 Stockholm, Sweden (e-mail: )
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Abstract
The aim of the study is to determine whether serum 25-hydroxyvitamin D (25(OH)D) deficiency in infants increased odds of urinary tract infection (UTI). A total of 238 infants including 132 patients experiencing a first episode of UTI and 106 controls, aged from 1 to 12 months, were enrolled. Serum 25(OH)D levels were tested through blood sampling. The serum 25(OH)D levels were significantly lower in cases with UTI than controls. The mean serum 25(OH)D levels were 29.09 ± 9.56 ng/mL in UTIs and 38.59 ± 12.41 ng/mL in controls (P < 0.001). Infants with acute pyelonephritis (APN) had lower serum 25(OH)D than those with lower UTI. The multivariate logistic regression analyses showed that serum 25(OH)D < 20 ng/mL (OR 5.619, 95% CI 1.469-21.484, P = 0.012) was positively related to an increased odds of UTI. Vitamin D supplementation (OR 0.298, 95% CI 0.150-0.591; P = 0.001) was associated with a decreased likelihood of UTI. Vitamin D deficiency in infants was associated with an increased odds of UTI. Interventional studies evaluating the role of vitamin D supplementation to reduce the burden of UTI are warranted.
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Affiliation(s)
- Jianhuan Yang
- Department of Pediatric, Zhujiang Hospital of Southern Medical University, Guangzhou
- Department of Pediatric, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang
| | - Guangdao Chen
- Department of Pediatric, Central Hospital of Panyu District, Guangzhou
| | - Dexuan Wang
- Department of Pediatric, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang
| | - Minguang Chen
- Department of Pediatric, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang
| | - Chao Xing
- Department of Clinical Laboratory, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Bin Wang
- Department of Pediatric, Zhujiang Hospital of Southern Medical University, Guangzhou
- Correspondence: Bin Wang, Department of Pediatrics, Zhujiang Hospital of Southern Medical University, Guangzhou, China (e-mail: )
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Shinkov A, Borissova AM, Dakovska L, Vlahov J, Kassabova L, Svinarov D, Krivoshiev S. Differences in the prevalence of vitamin D deficiency and hip fractures in nursing home residents and independently living elderly. Arch Endocrinol Metab 2016; 60:217-22. [PMID: 26910625 PMCID: PMC10522306 DOI: 10.1590/2359-3997000000109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the prevalence of vitamin D deficiency and fracture history in nursing home residents and community-dwelling elderly subjects and to explore the association of vitamin D levels with various characteristics. MATERIALS AND METHODS Sixty-six nursing home residents and 139 community-dwelling elderly subjects participated. Marital status, medical history, medication including vitamin D supplements, smoking, past fractures were assessed. Weight and height were measured and body mass index calculated. Serum 25-hydroxyvitamin D (25-OHD), PTH, Ca, phosphate, creatinine and eGFR were determined. RESULTS In the nursing home residents 25-OHD was lower (17.8 nmol/l, [9.4-28.6] vs. 36.7 nmol/l, [26.9-50], p < 0.001), PTH was higher (5.6 pmol/l, [3.9-8.9] vs. 4.7 pmol/l [3.6-5.8], P = 0.003) and 25-OHD deficiency was more prevalent (65.2% [53.7-76.7] vs. 22.3% [15.4-29.2], p < 0.001) as was elevated PTH (23% [12.8-33] vs. 5.8% [2-10], p = 0.001). 25-OHD correlated negatively with PTH (institutionalized r = -0.28, p = 0.025 and community-dwelling r = -0.36, p < 0.001). Hip fractures were reported by 8% of the residents and 2% of the independent elderly. The only predictor for hip fracture was elevated PTH (OR = 7.6 (1.5-36.9), p = 0.013). CONCLUSION The prevalence of vitamin D deficiency and secondary hyperparathyroidism was high in the institutionalized subjects. Hip fracture risk was associated with elevated PTH and not directly with vitamin D levels or the residency status.
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Affiliation(s)
- Alexander Shinkov
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Anna-Maria Borissova
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Lilia Dakovska
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Jordan Vlahov
- Department of Thyroid and Bone Mineral DiseasesUniversity Hospital of EndocrinologyMedical University of SofiaSofiaBulgariaDepartment of Thyroid and Bone Mineral Diseases, University Hospital of Endocrinology, Medical University of Sofia, Sofia, Bulgaria
| | - Lidia Kassabova
- Central Laboratory of Therapeutic Drug Management and Clinical PharmacologyAlexander University HospitalMedical University of SofiaSofiaBulgariaCentral Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Dobrin Svinarov
- Central Laboratory of Therapeutic Drug Management and Clinical PharmacologyAlexander University HospitalMedical University of SofiaSofiaBulgariaCentral Laboratory of Therapeutic Drug Management and Clinical Pharmacology, Alexander University Hospital, Medical University of Sofia, Sofia, Bulgaria
| | - Stefan Krivoshiev
- Department of HemodialysisQueen Jovanna HospitalMedical University of SofiaSofiaBulgariaDepartment of Hemodialysis, Queen Jovanna Hospital, Medical University of Sofia, Sofia, Bulgaria
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Gülez P, Korkmaz HA, Özkök D, Can D, Özkan B. Factors Influencing Serum Vitamin D Concentration in Turkish Children Residing in İzmir: A Single-Center Experience. J Clin Res Pediatr Endocrinol 2015; 7:294-300. [PMID: 26777040 PMCID: PMC4805218 DOI: 10.4274/jcrpe.1938] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the vitamin D status of children and to determine the factors influencing serum 25-hydroxyvitamin D [25(OH)D] concentration in Turkish infants living in İzmir. METHODS In this study, we examined the serum 25(OH)D levels of 100 infants aged 1 to 24 months and of 22 mothers from İzmir, Turkey. The study also included a questionnaire given to the mothers to acquire data on the demographic characteristics of the infants and their mothers as well as information on vitamin D supplementation, clothing habits, and sunlight exposure. RESULTS Vitamin D deficiency was present in 31% of infants and 81.8% of mothers. Twenty-four male (42.9%) and 7 female (15.9%) infants were found to be vitamin D deficient (<20 mg/dL); 9 male (16.1%) and 17 female (38.6%) infants to be vitamin D insufficient (20-30 mg/dL); and 23 male (41.1%) and 20 female (45.5%) infants were vitamin D sufficient (>30 mg/dL). Only 63% of the infants were receiving vitamin D supplementation and 52% were said to be having regular exposure to sunlight. Mean serum vitamin D levels were lower in infants whose mothers were dressed according to the culture of traditional covered clothing (44%) compared to those infants whose mothers' dressing style provided more exposure to sunlight. CONCLUSION We conclude that low exposure to sunlight, inadequate use of vitamin D supplementation, and large family size are factors influencing the vitamin D status of Turkish children living in the inner city of İzmir.
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Affiliation(s)
- Pamir Gülez
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Clinic of Pediatrics, İzmir, Turkey
| | - Hüseyin Anıl Korkmaz
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey Phone: +90 232 411 63 18 E-mail:
| | - Dilek Özkök
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Clinic of Pediatrics, İzmir, Turkey
| | - Demet Can
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Clinic of Pediatric Allergy and Immunology, İzmir, Turkey
| | - Behzat Özkan
- Dr. Behçet Uz Children Disease and Surgery Training and Research Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
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Muller DC, Scelo G, Zaridze D, Janout V, Holcatova I, Navratilova M, Mates D, Midttun Ø, Ueland PM, Brennan P, Johansson M. Circulating 25-hydroxyvitamin D3 and survival after diagnosis with kidney cancer. Cancer Epidemiol Biomarkers Prev 2015; 24:1277-81. [PMID: 26021552 PMCID: PMC4526455 DOI: 10.1158/1055-9965.epi-14-1351] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 05/18/2015] [Indexed: 11/16/2022] Open
Abstract
Prospective cohort studies have provided some evidence that circulating vitamin D is associated with risk of, and survival from, renal cell carcinoma (RCC), but it is unclear whether concentrations of vitamin D at the time of diagnosis of RCC are associated with prognosis. We conducted a case-cohort study of 630 RCC cases, including 203 deaths, from a multicenter case-control study in Eastern Europe. Vitamin D was assessed as 25-hydroxyvitamin D3 [25(OH)D3], and we used weighted Cox models to estimate hazard ratios (HR) and 95% confidence intervals (CI) by categories of season-adjusted 25(OH)D3. Higher concentrations of 25(OH)D3 were associated with lower risk of death after adjusting for stage, age, sex, and country (HR highest vs. lowest category 0.57; 95% CI, 0.34-0.97). The inverse associations of 25(OH)D3 with death were most notable among those who died from non-RCC causes and those diagnosed with early-stage disease. In summary, 25(OH)D3 concentration at diagnosis of RCC was inversely associated with all-cause mortality rates, but not specifically with RCC outcome.
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Affiliation(s)
- David C Muller
- International Agency for Research on Cancer (IARC), Lyon, France.
| | - Ghislaine Scelo
- International Agency for Research on Cancer (IARC), Lyon, France
| | - David Zaridze
- Russian N.N. Blokhin Cancer Research Centre, Moscow, Russian Federation
| | - Vladimir Janout
- Department of Preventive Medicine, Faculty of Medicine, Palacky University, Olomouc, Czech Republic
| | - Ivana Holcatova
- Charles University in Prague, First Faculty of Medicine, Institute of Hygiene and Epidemiology, Prague, Czech Republic
| | - Marie Navratilova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | | | - Per Magne Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway. Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Paul Brennan
- International Agency for Research on Cancer (IARC), Lyon, France
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Hansen JG, Gao W, Dupuis J, O'Connor GT, Tang W, Kowgier M, Sood A, Gharib SA, Palmer LJ, Fornage M, Heckbert SR, Psaty BM, Booth SL, Cassano PA. Association of 25-Hydroxyvitamin D status and genetic variation in the vitamin D metabolic pathway with FEV1 in the Framingham Heart Study. Respir Res 2015; 16:81. [PMID: 26122139 PMCID: PMC4491260 DOI: 10.1186/s12931-015-0238-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 06/15/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Vitamin D is associated with lung function in cross-sectional studies, and vitamin D inadequacy is hypothesized to play a role in the pathogenesis of chronic obstructive pulmonary disease. Further data are needed to clarify the relation between vitamin D status, genetic variation in vitamin D metabolic genes, and cross-sectional and longitudinal changes in lung function in healthy adults. METHODS We estimated the association between serum 25-hydroxyvitamin D [25(OH)D] and cross-sectional forced expiratory volume in the first second (FEV1) in Framingham Heart Study (FHS) Offspring and Third Generation participants and the association between serum 25(OH)D and longitudinal change in FEV1 in Third Generation participants using linear mixed-effects models. Using a gene-based approach, we investigated the association between 241 SNPs in 6 select vitamin D metabolic genes in relation to longitudinal change in FEV1 in Offspring participants and pursued replication of these findings in a meta-analyzed set of 4 independent cohorts. RESULTS We found a positive cross-sectional association between 25(OH)D and FEV1 in FHS Offspring and Third Generation participants (P=0.004). There was little or no association between 25(OH)D and longitudinal change in FEV1 in Third Generation participants (P=0.97). In Offspring participants, the CYP2R1 gene, hypothesized to influence usual serum 25(OH)D status, was associated with longitudinal change in FEV1 (gene-based P<0.05). The most significantly associated SNP from CYP2R1 had a consistent direction of association with FEV1 in the meta-analyzed set of replication cohorts, but the association did not reach statistical significance thresholds (P=0.09). CONCLUSIONS Serum 25(OH)D status was associated with cross-sectional FEV1, but not longitudinal change in FEV1. The inconsistent associations may be driven by differences in the groups studied. CYP2R1 demonstrated a gene-based association with longitudinal change in FEV1 and is a promising candidate gene for further studies.
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Affiliation(s)
- J G Hansen
- Division of Nutritional Sciences, Cornell University, 209 Savage Hall, Ithaca, NY, 14853, USA.
| | - W Gao
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
| | - J Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
- The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA.
| | - G T O'Connor
- The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, MA, USA.
- Pulmonary Center, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - W Tang
- Division of Nutritional Sciences, Cornell University, 209 Savage Hall, Ithaca, NY, 14853, USA.
| | - M Kowgier
- Ontario Institute for Cancer Research, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - A Sood
- University of New Mexico, Albuquerque, NM, USA.
| | - S A Gharib
- Computational Medicine Core, Center for Lung Biology, Division of Pulmonary & Critical Care Medicine, Department of Medicine, University of Washington, Seattle, WA, USA.
| | - L J Palmer
- School of Public Health, University of Adelaide, Adelaide, Australia.
| | - M Fornage
- Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
- Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - S R Heckbert
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.
| | - B M Psaty
- Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, USA.
- Department of Medicine, University of Washington, Seattle, WA, USA.
| | - S L Booth
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA.
| | - Patricia A Cassano
- Division of Nutritional Sciences, Cornell University, 209 Savage Hall, Ithaca, NY, 14853, USA.
- Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
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Usluogullari CA, Balkan F, Caner S, Ucler R, Kaya C, Ersoy R, Cakir B. The relationship between microvascular complications and vitamin D deficiency in type 2 diabetes mellitus. BMC Endocr Disord 2015; 15:33. [PMID: 26109389 PMCID: PMC4480442 DOI: 10.1186/s12902-015-0029-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 06/10/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Vitamin D deficiency is reported as a possible risk factor for the development of diabetes in several epidemiologic studies. In this study, we investigated the frequency of 25-OH vitamin D deficiency in type 2 diabetes mellitus and the relationship between 25-OH vitamin D deficiency and the prevalence of microvascular complications. METHODS In this retrospective study, we evaluated the medical records of 557 patients with type 2 diabetes admitted to the Endocrinology Outpatient Clinic from January to March 2010 and 112 healthy controls randomly selected from individuals admitted to the hospital for a check-up and who had a laboratory result for serum 25-OH vitamin D concentrations at screening. The levels of 25-OH vitamin D in patients with type 2 diabetes and the relationship between 25-OH vitamin D deficiency and microvascular complications were investigated. RESULTS No significant difference in serum 25-OH vitamin D concentrations was observed between the diabetic and control groups. No correlation was observed between HbA1C and serum 25-OH vitamin D levels. Serum 25-OH vitamin D levels were lower in diabetic patients with nephropathy, and patients not using any medication, i.e., those treated with dietary changes alone, had a higher prevalence of nephropathy. CONCLUSION Vitamin D deficiency is more common in diabetic patients with nephropathy. When microvascular complications were evaluated, vitamin D levels were found to be lower in patients in whom these complications were more severe. Vitamin D deficiency is therefore associated with microvascular complications in diabetic patients.
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Affiliation(s)
| | - Fevzi Balkan
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Sedat Caner
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Rifki Ucler
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Cafer Kaya
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Reyhan Ersoy
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
| | - Bekir Cakir
- Clinic of Endocrinology and Metabolism, Atatürk Training and Research Hospital, Ankara, Turkey.
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Abstract
Vitamin D promotes epithelial immunity by upregulating antimicrobial peptides, including LL-37, which have bactericidal activity against Staphylococcus aureus. We found that children with vitamin D deficiency or insufficiency [25-hydroxyvitamin D <30 ng/mL] were more likely to present with recurrent, rather than primary, S. aureus skin or soft tissue infection. Vitamin D sufficiency may be one of a myriad of host and environmental factors that can be directly impacted to reduce the frequency of S. aureus skin and soft tissue infection.
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Binkley N, Lappe J, Singh RJ, Khosla S, Krueger D, Drezner MK, Blank RD. Can vitamin D metabolite measurements facilitate a "treat-to-target" paradigm to guide vitamin D supplementation? Osteoporos Int 2015; 26:1655-60. [PMID: 25572049 PMCID: PMC4412341 DOI: 10.1007/s00198-014-3010-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED Substantial variability exists in the serum 25(OH)D increase observed in response to vitamin D supplementation. Measurement of circulating cholecalciferol and 24,25(OH)₂D, as indicators of vitamin D absorption and degradation, respectively, account for approximately half of the variation in serum 25(OH)D observed following supplementation. INTRODUCTION Vitamin D supplementation produces a variable response in serum 25(OH)D. This variability likely reflects, in part, differences in vitamin D absorption and/or degradation. Despite this variation in response, virtually all expert recommendations endorse a fixed vitamin D supplementation dose, an approach also used in most prospective studies. Such utilization of a single vitamin D dose does not assure attaining any pre-specified target 25(OH)D level, thereby compromising clinical care and prospective supplementation trials. This study begins addressing this weakness by exploring the feasibility of vitamin D metabolite measurements to predict serum 25(OH)D level attained following supplementation. METHODS Ninety-one community-dwelling postmenopausal women with baseline 25(OH)D of 10-30 ng/mL received oral vitamin D₃, 2300 or 2500 IU, daily for 4-6 months. Serum 25(OH)D, cholecalciferol (D₃), and 24,25(OH)₂D were measured before and at the end of supplementation to determine if metabolite concentrations allow prediction of the 25(OH)D level attained. RESULTS From baseline and follow-up data, we derived a multiple linear regression model predicting posttreatment 25(OH)D as follows: final 25(OH)D = 8.3 + (1.05*initial 25(OH)D) - (7.7*initial 24,25(OH)₂D) + (0.53*final D₃) + (4.2*final 24,25(OH)₂D). This model has an adjusted R(2) = 0.55, thus accounting for approximately half of the observed variance in the final 25(OH)D level. CONCLUSIONS The contributions of circulating cholecalciferol and 24,25(OH)₂D to this predictive model can be considered as indicators of intestinal absorption and clearance, respectively. This paradigm requires further study; it may allow efficient "treat-to-25(OH)D-target" strategies useful in optimizing prospective studies and clinical practice.
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Affiliation(s)
- N Binkley
- Osteoporosis Clinical Research Program, University of Wisconsin, 2870 University Avenue, Suite 100, Madison, WI, 53705, USA,
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Burris HH, Thomas A, Zera CA, McElrath TF. Prenatal vitamin use and vitamin D status during pregnancy, differences by race and overweight status. J Perinatol 2015; 35:241-5. [PMID: 25357099 PMCID: PMC4380518 DOI: 10.1038/jp.2014.198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE We aimed to study whether prenatal vitamin (PNV) use protects against low 25-hydroxyvitamin D (25[OH]D) levels in all women and particularly in obese and black women who are both at risk of vitamin D deficiency and poor pregnancy outcomes. STUDY DESIGN We studied 1019 women enrolled in a prospective study at Brigham and Women's Hospital in Boston, from 2007 to 2009. We used multivariable logistic regression to analyze associations of PNV use and odds of vitamin D deficiency defined as 25[OH]D levels <50 nmol l(-1). RESULT In all, 56% of black and 86% of white women reported pre- and/or postconceptional PNV use. In the first trimester, 75% of black and 19% of white women were vitamin D deficient. Lack of PNV use among black women was not associated with vitamin D deficiency (adjusted odds ratio (OR) 1.0, 95% confidence interval (CI) 0.4, 2.3) but was among white women (OR 3.5, 95% CI 2.1, 5.8) (interaction P<0.01). CONCLUSIONS Ongoing trials of vitamin D supplementation during pregnancy should consider potential effect modification by race/ethnicity.
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Affiliation(s)
- Heather H. Burris
- Department of Neonatology, Beth Israel Deaconess Medical Center and Division of Newborn Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Corresponding Author: Heather H. Burris, MD, MPH, BIDMC Neonatology, 330 Brookline Avenue, RO 318, Boston, MA, USA, 02215, Phone 617-667-3276, Fax 617-667-7074,
| | - Ann Thomas
- Division of Maternal Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chloe A. Zera
- Harvard Medical School, Boston, MA, USA,Division of Maternal Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Thomas F. McElrath
- Harvard Medical School, Boston, MA, USA,Division of Maternal Fetal Medicine, Brigham and Women’s Hospital, Boston, MA, USA
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Beauchet O, Launay CP, Fantino B, Annweiler C, Allali G. Motor imagery of gait in non-demented older community-dwellers: performance depends on serum 25-hydroxyvitamin D concentrations. Age (Dordr) 2015; 37:18. [PMID: 25701394 PMCID: PMC4336298 DOI: 10.1007/s11357-015-9755-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 02/05/2015] [Indexed: 06/04/2023]
Abstract
Hypovitaminosis D has been associated with poorer physical and cognitive performances in older adults. The objectives of this study were (1) to measure and compare the time to perform (pTUG) and to imagine (iTUG) the Timed "Up & Go" test (TUG) test, and the time difference between these two performances (i.e., TUG delta time) in non-demented community-dwelling older adults with and without lower serum 25-hydroxyvitamin D (25OHD) concentrations and (2) to examine the association between the TUG delta time and serum 25OHD concentrations. Durations of pTUG, iTUG and TUG delta time, and serum 25OHD concentrations (severe insufficiency <10 ng/mL; moderate insufficiency: 10-30 ng/mL; normal status >30 ng/mL) were measured in 359 non-demented participants (mean age 70.4 ± 4.8 years; 40.7 % women). Participants with severe 25OHD insufficiency (15.6 %) had higher TUG delta time compared to those with moderate insufficiency (P = 0.010) and normal status (P = 0.048). TUG delta time was negatively associated with serum 25OHD concentrations (P < 0.010). Accurate motor imagery of gait was explained in part by serum 25OHD concentrations, increased discrepancy between pTUG and iTUG being associated with lower serum 25OHD concentrations.
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Affiliation(s)
- Olivier Beauchet
- Department of Neuroscience, Division of Geriatric Medicine, UPRES EA 4638, UNAM, Angers University Hospital, Angers, Cedex 9, France,
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Gernand AD, Klebanoff MA, Simhan HN, Bodnar LM. Maternal vitamin D status, prolonged labor, cesarean delivery and instrumental delivery in an era with a low cesarean rate. J Perinatol 2015; 35:23-8. [PMID: 25102320 PMCID: PMC4281279 DOI: 10.1038/jp.2014.139] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 06/15/2014] [Accepted: 06/23/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the association between maternal 25-hydroxyvitamin D (25(OH)D) and adverse labor and delivery outcomes. STUDY DESIGN We measured serum 25(OH)D at ⩽ 26 weeks gestation in a random subsample of vertex, singleton pregnancies in women who labored (n=2798) from the 12-site Collaborative Perinatal Project (1959 to 1966). We used labor and delivery data to classify cases of adverse outcomes. RESULT Twenty-four percent of women were vitamin D deficient (25(OH)D <30 nmol l(-1)), and 4.5, 3.3, 1.9 and 7.5% of women had prolonged stage 1 labor, prolonged stage 2 labor, primary cesarean delivery or indicated instrumental delivery, respectively. After adjustment for prepregnancy body mass index, race and study site, 25(OH)D concentrations were not associated with risk of prolonged stage 1 or 2, cesarean delivery or instrumental delivery. CONCLUSION Maternal vitamin D status at ⩽ 26 weeks was not associated with risk of prolonged labor or operative delivery in an era with a low cesarean rate.
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Affiliation(s)
- Alison D. Gernand
- Department of Epidemiology, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA and Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA
| | - Mark A. Klebanoff
- Departments of Pediatrics and of Obstetrics and Gynecology, Ohio State University College of Medicine and The Research Institute, Nationwide Children’s Hospital, Columbus, OH
| | - Hyagriv N. Simhan
- Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh and Division of Maternal-Fetal Medicine, Magee-Womens Hospital, Pittsburgh, PA
| | - Lisa M. Bodnar
- Department of Epidemiology, Graduate School of Public Health and Department of Obstetrics and Gynecology, School of Medicine, University of Pittsburgh, Pittsburgh, PA Pittsburgh, PA
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Abstract
Vitamin D deficiency is widely prevalent in India, despite abundant sunshine. Fortification of staple foods with vitamin D is a viable strategy to target an entire population. Vitamin D fortification programs implemented in the United States and Canada have improved the vitamin D status in these countries, but a significant proportion of the population is still vitamin D deficient. Before fortification programs are designed and implemented in India, it is necessary to study the efficacy of the American and Canadian vitamin D fortification programs and then improve upon them to suit the Indian scenario. This review explores potential strategies that could be used for the fortification of foods in the Indian context. These strategies have been proposed considering the diverse dietary practices necessitated by social, economic, cultural and religious practices and the diverse climatic conditions in India. Fortification of staple foods, such as chapati flour, maida, rice flour and rice, may be more viable strategies. Targeted fortification strategies to meet the special nutritional needs of children in India are discussed separately in a review entitled, "Fortification of foods with vitamin D in India: Strategies targeted at children".
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Affiliation(s)
- Ritu G
- Charak Foundation, P.O. Box 3547, Cerritos, CA 90703, USA
| | - Ajay Gupta
- Charak Foundation, P.O. Box 3547, Cerritos, CA 90703, USA.
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