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Lai J, Hao M, Huang X, Chen S, Yan D, Li H. Novel Model Predicts Type 2 Diabetes Mellitus Patients Complicated With Metabolic Syndrome Using Retrospective Dataset From First Affiliated Hospital of Shenzhen University, China. Int J Endocrinol 2025; 2025:9558141. [PMID: 40313395 PMCID: PMC12045690 DOI: 10.1155/ije/9558141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 03/23/2025] [Accepted: 04/01/2025] [Indexed: 05/03/2025] Open
Abstract
Objective: Metabolic syndrome (MS) is the most important risk factor for Type 2 diabetes mellitus (T2DM) and cardiovascular disease. This study used a retrospective dataset from the First Affiliated Hospital of Shenzhen University and aimed to develop and validate a novel model nomogram based on clinical parameters to predict MS in patients with T2DM. Methods: A total of 2854 patients with T2DM between January 2014 and May 2022 were selected and divided into a training dataset (n = 2114) and a validation dataset (n = 740). This study used multivariate logistic regression analysis to develop a nomogram for predicting MS in patients with T2DM that included candidates selected in the LASSO regression model. The data were set standardized before LASSO regression. The area under the receiver operating characteristic curve (AUC-ROC) was used to assess discrimination in the prediction model. The calibration curve is used to evaluate the calibration of the calibration nomogram, and the clinical decision curve is used to determine the clinical utility of the calibration diagram. The validation dataset is used to evaluate the performance of predictive models. Results: A total of 2854 patients were eligible for this study. There were 1941 (68.01%) patients with MS. The training dataset included 20 potential risk factors of the patient's demographic, clinical, and laboratory indexes in the LASSO regression analysis. Gender, hypertension, BMI, WC, HbA1c, TG, LDL, and HDL were multivariate models. We obtained a model for estimating MS in patients with T2DM. The AUC-ROC of the training dataset in our model is 0.886, and the 95% CI is 0.871-0.901. Similar to the results obtained from the training dataset, the AUC-ROC of the validation dataset in our model is 0.859, and the 95% CI is 0.831-0.887, thus proving the robustness of the model. The prediction model is as follows: logit (MS) = -9.18209 + 0.14406 ∗ BMI (kg/m2) + 0.09218 ∗ WC (cm) + 1.05761 ∗ TG (mmol/L)-3.30013 ∗ HDL (mmol/L). The calibration plots of the predicted probabilities show excellent agreement with the observed MS rates. Decision curve analysis demonstrated that the new nomogram provided significant net benefits in clinical applications. Conclusion: The prediction model of this study covers four clinically easily obtained parameters: BMI, WC, TG, and HDL, and shows a high accuracy rate in the validation dataset. Our predictive model may provide an effective method for large-scale epidemiological studies of T2DM patients with MS and offer a practical tool for the early detection of MS in clinical work.
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Affiliation(s)
- Jinghua Lai
- Department of Endocrinology, Shenzhen Second People's Hospital, Health Science Center of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and Prevention, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Mingyu Hao
- Department of Endocrinology, Shenzhen Second People's Hospital, Health Science Center of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and Prevention, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xiaohong Huang
- Department of Endocrinology, Shenzhen Baoan Shiyan People's Hospital, Shenzhen, China
| | - Shujuan Chen
- Department of Endocrinology, Shenzhen Second People's Hospital, Health Science Center of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and Prevention, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Dewen Yan
- Department of Endocrinology, Shenzhen Second People's Hospital, Health Science Center of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and Prevention, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Haiyan Li
- Department of Endocrinology, Shenzhen Second People's Hospital, Health Science Center of Shenzhen University, Shenzhen Clinical Research Center for Metabolic Diseases, Shenzhen Center for Diabetes Control and Prevention, The First Affiliated Hospital of Shenzhen University, Shenzhen, China
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Abe T, Watanabe Y, Kitamura K, Kabasawa K, Saito T, Takahashi A, Takachi R, Kobayashi R, Oshiki R, Tsugane S, Watanabe K, Nakamura K. Association Between Low Blood 25-Hydroxyvitamin D and High C-Reactive Protein Levels in Community-Dwelling Japanese People Aged 40-74 Years. TOHOKU J EXP MED 2025; 265:193-200. [PMID: 39231724 DOI: 10.1620/tjem.2024.j088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
Low blood 25-hydroxyvitamin D (25[OH]D) levels at which C-reactive protein (CRP) levels begin to rise vary. This study investigated the association between blood 25(OH)D and elevated CRP levels and determine the cut-off of low 25(OH)D for elevated CRP in middle-aged and older individuals in the Murakami cohort, Japan. This study used a cross-sectional study design with 2,863 subjects aged 40-74 years living in the community. Plasma 25(OH)D levels were determined with the Liaison® 25OH Vitamin D Total Assay, and serum high sensitivity CRP (hs-CRP) levels were determined with a latex nephelometry assay using an automatic analyzer. Multivariate logistic regression analysis was used to calculate odds ratios (ORs) for high hs-CRP (≥ 3 mg/L) with covariates including sex, age, BMI, physical activity, smoking, drinking, and disease history. Median age of subjects was 65 years, and median 25(OH)D level was 47.4 nmol/L. The proportion of subjects with high hs-CRP levels was 4.1%. The adjusted OR of 25(OH)D < 20 nmol/L was higher (OR = 3.22, 95% CI: 1.42-7.31) than that of the reference (25[OH]D 40-49 nmol/L). In subgroup analysis, the adjusted OR of 25(OH)D < 20 nmol/L was significantly higher than the reference in the BMI ≥ 22.8 (median) group (OR = 4.52) but not in the BMI < 22.8 group (OR = 1.61) (P for interaction = 0.0892), and the adjusted OR was significantly higher in the age ≥ 65 group (OR = 8.51) but not in the age < 65 group (OR = 2.22). Low blood 25(OH)D and high CRP levels were associated, with 25(OH)D 20 nmol/L being the cut-off, which was lower than previously reported values.
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Affiliation(s)
- Takuya Abe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
- Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Toshiko Saito
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Akemi Takahashi
- Department of Rehabilitation, Niigata University of Rehabilitation
| | - Ribeka Takachi
- Department of Food Science and Nutrition, Nara Women's University Graduate School of Humanities and Sciences
| | | | - Rieko Oshiki
- Department of Rehabilitation, Niigata University of Rehabilitation
| | - Shoichiro Tsugane
- International University of Health and Welfare Graduate School of Public Health
| | - Kei Watanabe
- Division of Orthopaedic Surgery, Niigata University Graduate School of Medical and Dental Sciences
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
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Madanchi N, Fava A, Goldman DW, Magder LS, Petri M. Association Between 25-hydroxyvitamin D Levels and Adverse Pregnancy Outcomes in Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 2025; 77:432-439. [PMID: 39313480 PMCID: PMC11929614 DOI: 10.1002/acr.25440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/13/2024] [Accepted: 08/16/2024] [Indexed: 09/25/2024]
Abstract
OBJECTIVE We evaluated the association of 25-hydroxyvitamin D (25(OH)D) levels with adverse pregnancy outcomes in systemic lupus erythematosus (SLE). METHODS The Hopkins Lupus Cohort includes visits of pregnant patients, including assessment of 25(OH)D levels at each visit. We examined the relationship between 25(OH)D levels and adverse pregnancy outcomes (miscarriage, preterm delivery, and small for gestational age). We also used a time-to-event analysis to assess whether time-varying of 25(OH)D levels were associated with time to miscarriage or preterm delivery. RESULTS In subgroups of patients defined by the average of 25(OH)D levels, we observed significantly different risks of miscarriage (P = 0.0045), preterm delivery (P = 0.0007), and the composite measure of all three adverse pregnancy outcomes (P = 0.011). The highest risks were observed among those with the lowest or highest levels of vitamin D. Nine of 10 pregnant patients with low vitamin D levels during the second trimester resulted in having a premature delivery. The time-to-event model confirmed the same U-shaped association after adjustment for SLE disease activity; however, the increased risk among those with highest levels of vitamin D was not statistically significant. Body mass index did not appear to be a confounding factor. CONCLUSION Our study is not able to prove causation, but the results strongly suggest an association of 25(OH)D at both lower and higher levels with adverse pregnancy outcomes. We recommend the monitoring of maternal serum 25(OH)D levels during SLE pregnancies, aiming for the ideal range of 40 to 59 ng/mL.
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Affiliation(s)
| | - Andrea Fava
- Johns Hopkins University, Baltimore, MD 21205, USA
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Jiang J, Chen G, Li Y, Zhao Q, Chen Z. Serum calcium levels and the risk of sarcopenia in young adults: insights from NHANES 2011-2018. Front Nutr 2025; 12:1526879. [PMID: 40161296 PMCID: PMC11951309 DOI: 10.3389/fnut.2025.1526879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 02/27/2025] [Indexed: 04/02/2025] Open
Abstract
Background Sarcopenia, the accelerated loss of muscle mass and function, is commonly associated with aging, especially in older adults. While low serum calcium has been linked to muscle loss in individuals over 50, its relationship with sarcopenia in younger adults (20-60 years) is unclear. This study examines this association using data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. Methods This population-based, cross-sectional study analyzed participants aged 20-60 from NHANES 2011-2018. Individuals with missing data were excluded. Sarcopenia was assessed using appendicular skeletal muscle (ASM) measured by dual-energy X-ray absorptiometry, defined by ASM/BMI or ASM/Weight. Multiple logistic regression and stratified analyses were used to explore the correlation between serum calcium levels and sarcopenia prevalence. Results Among 7,309 adults, 578 (7.91%) had sarcopenia by ASM/BMI and 1,363 (18.65%) by ASM/Weight. Higher serum calcium levels were significantly associated with a lower risk of sarcopenia (ASM/BMI: OR 0.07, 95% CI 0.02-0.20; ASM/Weight: OR 0.09, 95% CI 0.04-0.19). The trend was consistent across age, gender, education, poverty income ratio, and race, with some exceptions. Conclusion This study highlights a negative association between serum calcium and sarcopenia risk in young and middle-aged adults, suggesting that calcium interventions could be beneficial in preventing sarcopenia in this population. However, the cross-sectional design precludes any inference of causality, and further longitudinal studies are warranted to confirm these findings.
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Affiliation(s)
| | | | | | - Qinggang Zhao
- Department of Orthopedics and Traumatology, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China
| | - Zhong Chen
- Department of Orthopedics and Traumatology, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China
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Zhang N, Wang Y, Li W, Wang Y, Zhang H, Xu D, Chen R, Tang L, Tang H. Association between serum vitamin D level and cardiovascular disease in Chinese patients with type 2 diabetes mellitus: a cross-sectional study. Sci Rep 2025; 15:6454. [PMID: 39987347 PMCID: PMC11846893 DOI: 10.1038/s41598-025-90785-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2024] [Accepted: 02/17/2025] [Indexed: 02/24/2025] Open
Abstract
The relationship between 25-hydroxyvitamin D (25(OH)D) status and cardiovascular disease (CVD) in the diabetes population still needs to be clarified. This study aimed to explore the association of 25(OH)D with CVD and cardiometabolic risk factors in Chinese population with type 2 diabetes mellitus (T2DM). This cross-sectional study was performed with 1378 hospitalized patients with T2DM. Participants were classified into three groups according to the serum 25(OH)D levels: vitamin D adequate, vitamin D insufficiency and vitamin D deficient. Multivariate logistic regression analysis, stratified analysis and interaction analysis were performed to determine the relationship between serum 25(OH)D levels and CVD outcome. After adjusting for confounders, serum 25(OH)D levels were significantly negatively associated with cardiovascular disease in type 2 diabetic patients [OR: 0.97 (0.94, 0.99), p = 0.0131]. Taking the vitamin D-sufficient group (≥ 20 ng/mL) as a reference, the vitamin D-deficiency group (< 12 ng/mL) was associated with a significantly higher risk of cardiovascular disease, with a 1.25-fold increased risk after adjusting for all potential confounders [OR: 2.25 (1.33, 3.79), p = 0.0023]. Stratification analysis showed that the association between vitamin D deficiency and increased risk of cardiovascular disease was particularly significant in women [OR: 4.32 (1.54, 12.12), p = 0.0055], older adults [OR: 4.14 (1.10, 15.56), p = 0.0355], normal-weight [OR: 4.09 (1.51, 11.10), p = 0.0056] and obese subjects [OR: 3.66 (1.03, 13.05), p = 0.0453]. Vitamin D deficiency was significantly associated with an increased risk of overweight/obesity [OR: 1.57 (1.10, 2.24), p = 0.0134], hypertension [OR: 1.81 (1.30, 2.51), p = 0.0004], hypertriglyceridemia [OR: 1.56 (1.12, 2.16), p = 0.0078] and reduced HDL-C [OR: 1.67 (1.19, 2.35), p = 0.0033]. Serum 25(OH)D levels were significantly negatively associated with CVD in T2DM patients and vitamin D deficiency was significantly associated with an increased risk of overweight/obesity, hypertension and dyslipidemia.
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Affiliation(s)
- Ningjie Zhang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 4500552, China
| | - Wei Li
- Department of Rheumatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Yongjun Wang
- Department of Blood Transfusion, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Hui Zhang
- Hunan Provincial Key Laboratory of the Traditional Chinese Medicine Agricultural Biogenomics, Department of Basic Medical Sciences, Changsha Medical University, Changsha, 410000, China
| | - Danning Xu
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Ruohong Chen
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Lingli Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Haoneng Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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Li Y, Shen Q, Chen C, Yin X, Wang X, Yang X, Zhang X, Chen L, Xu J, Gong G. A synergistic effect of secondhand smoke with vitamin D deficiency on cognitive impairment in older adults: a cross sectional study. Front Nutr 2025; 12:1533193. [PMID: 40008315 PMCID: PMC11852840 DOI: 10.3389/fnut.2025.1533193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Accepted: 01/27/2025] [Indexed: 02/27/2025] Open
Abstract
Objectives To investigate whether exposure to secondhand smoke (SHS) aggravates the detrimental effect of vitamin D deficiency (VDD) on cognitive performance in the elderly. Methods Based on National Health and Nutrition Examination Surveys (NHANES) 2011-2014, 1,446 non-smoking participants (≥ 60 years old) with detailed serum 25-hydroxyvitamin D [25(OH)D], concentration of cotinine and tests score of cognitive function were included. Cognitive impairment was defined as having a cognitive score in the lowest quartile. The possible synergistic effect of SHS with VDD on cognitive impairment was evaluated by using a multivariable logistic regression model. Results VDD was independently associated with risk of low the Digit Symbol Substitution Test (DSST) scores, increased by nearly 60% [< 34, adjusted odds ratio (aOR) = 1.62, 95% CI: 1.03 ~ 2.53]. Although it only had an association with cognitive impairment indicated by DSST and the Animal Fluency test (AFT) in the crude model, SHS exposure showed significant synergistic effects with VDD on DSST (aOR: 3.03, 95% CI: 1.57 ~ 5.83, Pinteraction = 0.001) and AFT (aOR: 2.40, 95% CI: 1.34 ~ 4.29, Pinteraction = 0.003), respectively, after adjusting for the possible confounders. In further stratified analysis, a more obvious synergistic effect of SHS with VDD on DSST (aOR: 4.73, 95%CI:1.77 ~ 12.68, Pinteraction = 0.002) and AFT (aOR: 5.30, 95%CI: 1.63 ~ 17.24, Pinteraction = 0.006) was found in obese and overweight subjects, respectively. Conclusion SHS exposure had synergistic effect with VDD on cognitive impairment among elderly and the interaction effect was more obvious in overweight and obese individuals.
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Affiliation(s)
- Yan Li
- School of Public Health, Qingdao University, Qingdao, China
| | - Qianqian Shen
- School of Public Health, Peking University, Beijing, China
| | - Chengyu Chen
- School of Public Health, Qingdao University, Qingdao, China
| | - Xueru Yin
- School of Public Health, Qingdao University, Qingdao, China
| | - Xinru Wang
- School of Public Health, Qingdao University, Qingdao, China
| | - Xiyue Yang
- School of Public Health, Qingdao University, Qingdao, China
| | - Xueqian Zhang
- School of Public Health, Qingdao University, Qingdao, China
| | - Lei Chen
- School of Public Health, Qingdao University, Qingdao, China
| | - Jian Xu
- Department of Elderly Health Management, Shenzhen Center for Chronic Disease Control, Shenzhen, China
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Dai S, Wang P, Wang S, Chen H, Cui Z, Lu W, Zhou Z, Zhang N, Wang Z, Lin T, Song Y, Liu L, Huang X, Chen P, Tang G, Duan Y, Zhang H, Wang B, Yang Y, Tian Z. Association between fat-soluble vitamin co-exposure patterns and blood pressure in people with hypertension: a cross-sectional study. Front Nutr 2025; 11:1502139. [PMID: 39916804 PMCID: PMC11801223 DOI: 10.3389/fnut.2024.1502139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Accepted: 12/16/2024] [Indexed: 02/09/2025] Open
Abstract
Background Existing epidemiological studies investigated the association between a single vitamin and hypertension. However, the potential relationship between the level of circulating multivitamins and blood pressure has not been explored. We aimed to investigate the association between multiple fat-soluble vitamin levels and blood pressure. Methods A total of 2052 participants with essential hypertension were sampled nationwide. The plasma concentrations of fat-soluble vitamins (A, E, D, and K) were assessed using liquid chromatography coupled with the mass spectrometry method. Participants were categorized into different co-exposure patterns using the unsupervised K-means clustering method. The multiple linear regression model was used for subsequent analyses. Results Participants were classified into two co-exposure patterns of fat-soluble vitamins. The levels of vitamins were relatively low in pattern 1, compared to pattern 2. Participants in pattern 2 had no significantly different blood pressure levels compared to pattern 1. However, the plasma 25-hydroxyvitamin D3 (VD3) levels were negatively associated with SBP (logarithmic 10 transformed) (β = -0.002, 95% CI: -0.004, 0); participants in the fourth α-tocopherol quartile had mean SBP levels that were 1.02% (95% CI: 0.43, 1.61%) greater than those in the lowest quartile (p for trend <0.01). In addition, no significant relationships were found between plasma VA/VK concentrations and blood pressure. Discussion Although no significant association between fat-soluble vitamin co-exposure patterns and blood pressure was found, further analyses could imply that plasma α-tocopherol levels may offset the potential protective effect of plasma VD3 on blood pressure among hypertensive adults. This provided a novel perspective for exploring the joint effects of fat-soluble vitamins on blood pressure. Further studies are warranted to better understand the implications.
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Affiliation(s)
- Suming Dai
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Ping Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Sijia Wang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
- Shenzhen Luohu District Chronic Disease Prevention and Treatment Hospital, Shenzhen, China
| | - Hong Chen
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Zhixin Cui
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
| | - Wenhai Lu
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
- Pingdi Public Health Service Center, Shenzhen, China
| | - Ziyi Zhou
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Nan Zhang
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Zhuo Wang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Tengfei Lin
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Yun Song
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
| | - Lishun Liu
- Graduate School at Shenzhen, Tsinghua University, Shenzhen, China
- Shenzhen Evergreen Medical Institute, Shenzhen, China
| | - Xiao Huang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ping Chen
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Genfu Tang
- School of Heath Administration, Anhui Medical University, Hefei, China
| | - Yong Duan
- Yunnan Key Laboratory of Laboratory Medicine, Kunming, China
- Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hao Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Ministry of Education, Department of Nutrition and Health, College of Food Sciences and Nutritional Engineering, China Agricultural University, Beijing, China
| | - Binyan Wang
- Shenzhen Evergreen Medical Institute, Shenzhen, China
- Institute of Biomedicine, Anhui Medical University, Hefei, China
- National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Yang
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, China
- Guangdong Provincial Engineering Laboratory for Nutrition Translation, Guangzhou, China
| | - Zezhong Tian
- School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Sun Yat-sen University, Shenzhen, China
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Bauzon J, Jin J, Noureldine S, Wang SZ, Beck T, Romero-Velez G. Association of Obesity on Rates of Multiglandular Disease in Primary Hyperparathyroidism: A Cohort Study. J Surg Res 2025; 305:349-355. [PMID: 39733472 DOI: 10.1016/j.jss.2024.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2024] [Revised: 12/02/2024] [Accepted: 12/08/2024] [Indexed: 12/31/2024]
Abstract
INTRODUCTION Primary hyperparathyroidism (PHPT) is more prevalent in populations with obesity. Obesity-related vitamin D deficiency may affect rates of multigland parathyroid disease, but this relationship is less clear. We aimed to assess the relationship between obesity and the rate of multigland disease in patients with PHPT. METHODS Patients who underwent parathyroidectomy from 2015 to 2021 for sporadic PHPT at a tertiary center were retrospectively analyzed. The primary outcome was rates of single-gland versus four-gland parathyroid hyperplasia in relation to obesity. Secondary outcomes included analysis of serum biochemistries [parathyroid hormone (PTH), calcium, 25(OH) vitamin D (25OHD)] before and 6 mo postoperatively based on obesity classification: no obesity (body mass index [BMI] <30 kg/m2), Class 1 (BMI 30-34.9 kg/m2), Class 2 (BMI 35-39.9 kg/m2), Class 3 (BMI ≥40 kg/m2). Statistical analysis was performed using Chi-square, Mann-Whitney U, and Kruskal-Wallis tests where applicable. RESULTS Of 2634 patients who underwent parathyroidectomy, a total of 1173 had obesity. Obesity did not confer any differences in the proportion of four-gland versus single-gland hyperplasia (25 versus 26%, P = 0.79). Compared to patients without obesity, preoperative PTH levels were higher in patients with Class 2 [86 (interquartile range [IQR] 66-118) versus 95 (IQR 70-137) pg/mL, P = 0.001] and Class 3 [86 (IQR 66-118) versus 104 (76-150) pg/mL, P < 0.001] obesity. Conversely, 25OHD before surgery was lower across obesity subclasses [no obesity: 36.0 (25.3-49.3), Class 1: 32.5 (24.0-46.0), Class 2: 32.9 (22.0-44.6), Class 3: 31.7 (20.4-45.0) ng/mL, P < 0.001]. Postoperative PTH and 25OHD improved in all cohorts. No calcium-related differences were found among patients based on obesity classification. CONCLUSIONS Obesity is not associated with an increased rate of four-gland hyperplasia in patients with PHPT, and therefore should not alter surgical management. The levels of 25OHD in patients with obesity should be monitored for vitamin deficiency preoperatively and postoperatively.
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Affiliation(s)
- Justin Bauzon
- Cleveland Clinic Foundation, Department of Endocrine Surgery, Cleveland, Ohio
| | - Judy Jin
- Cleveland Clinic Foundation, Department of Endocrine Surgery, Cleveland, Ohio
| | - Salem Noureldine
- Section of Endocrine Surgery, Department of Surgery, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Sarah Ziqi Wang
- Cleveland Clinic Foundation, Department of Endocrine Surgery, Cleveland, Ohio
| | - Tim Beck
- Cleveland Clinic Foundation, Department of Endocrine Surgery, Cleveland, Ohio
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Xu H, Qiu S, Lin P, Liao X, Lin Y, Sun Y, Zheng B. Vitamin D has therapeutic effects on obesity and hyperandrogenemia in PCOS mouse model induced by low dose DHEA and high-fat diet. BMC Womens Health 2024; 24:601. [PMID: 39521978 PMCID: PMC11549824 DOI: 10.1186/s12905-024-03445-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 11/06/2024] [Indexed: 11/16/2024] Open
Abstract
Polycystic ovary syndrome (PCOS) is the most complex and common reproductive endocrine disease among reproductive age women. This study aimed to investigate the effects of vitamin D (Vit.D) in a PCOS mouse model induced by low dose DHEA and high-fat diet. Prepubertal female mice were divided into 4 groups randomly: control, PCOS, PCOS with low dose Vit.D(LDVD), and PCOS with high dose Vit.D(HDVD) groups (n = 10 per group). PCOS mice were administrated with high-fat diet and subcutaneous injection with 6 mg/kg/day dehydroepiandrosterone throughout the study. After the first 30 days, 1,25(OH)2D3 was intend to be administered by intraperitoneal injection for 40 consecutive days, 1.3 µg/kg/week in LDVD group, and 13 µg/kg /week in HDVD group. However, the mice in HDVD group appeared to be fatigue and anorexic after the Vit.D injections, then all died within two weeks. The body weights and testosterone levels in PCOS group were significantly higher than those in the control and LDVD groups (P < 0.001). The total cholesterol levels in the control group were lower than those in PCOS and LDVD groups (P < 0.001). Further, the ratio of liver to body weight was different among groups (P < 0.001). Our data illustrates that Vit.D has therapeutic effects on obesity and hyperandrogenemia in PCOS mouse model induced by low dose DHEA and high-fat diet. However, over dose of Vit.D is toxic. Further researches are needed to elucidate the mechanisms.
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Affiliation(s)
- Huiling Xu
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China
| | - Shumin Qiu
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China
| | - Peiyang Lin
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China
| | - Xiuhua Liao
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China
| | - Yunhong Lin
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China
| | - Yan Sun
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China.
- Fujian Maternal-Fetal Clinical Medicine Research Center, Fuzhou, China.
| | - Beihong Zheng
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No.18 Daoshan Road, Fuzhou, China.
- Fujian Key Laboratory of Prenatal Diagnosis and Birth Defect, Fuzhou, China.
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10
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Hertiš Petek T, Homšak E, Svetej M, Marčun Varda N. Metabolic Syndrome, Inflammation, Oxidative Stress, and Vitamin D Levels in Children and Adolescents with Obesity. Int J Mol Sci 2024; 25:10599. [PMID: 39408928 PMCID: PMC11476559 DOI: 10.3390/ijms251910599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 09/22/2024] [Accepted: 09/28/2024] [Indexed: 10/20/2024] Open
Abstract
Metabolic syndrome (MetS) is associated with systemic inflammation, oxidative stress, and hypovitaminosis D. Our aim was to determine whether vitamin D mediates inflammation and oxidative stress, assessed through selected biomarkers, in children with obesity and/or MetS. Eighty children with normal weight, overweight, or obesity were analyzed for serum vitamin D, C-reactive protein, leukocytes, adiponectin, monocyte chemoattractant protein-1, myeloperoxidase, interferon-inducible T-cell alpha chemoattractant (I-TAC/CXCL11), superoxide dismutase-1, fasting lipid and glucose levels, ultrasound-measured abdominal fat thickness, waist circumference, body mass index and blood pressure. Children with obesity or overweight had lower vitamin D levels, increased blood pressure, visceral and subcutaneous fat thickness, and higher leukocytes, C-reactive protein, and myeloperoxidase levels. Those with MetS also had lower adiponectin levels. Vitamin D levels are negatively correlated with body mass index, waist circumference, and visceral and subcutaneous fat thickness. Correlation, mediation, and regression analyses showed no link between vitamin D and inflammatory/oxidative stress variables. The novel biomarker I-TAC did not correlate with obesity or vitamin D status. Our results indicate that vitamin D does not significantly mediate inflammation or oxidative stress in children and adolescents with obesity and/or MetS. Selected inflammation/oxidative stress biomarkers appear to be altered primarily due to obesity rather than vitamin D status.
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Affiliation(s)
- Tjaša Hertiš Petek
- Department of Pediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
| | - Evgenija Homšak
- Department of Laboratory Diagnostics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia; (E.H.); (M.S.)
| | - Mateja Svetej
- Department of Laboratory Diagnostics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia; (E.H.); (M.S.)
| | - Nataša Marčun Varda
- Department of Pediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia;
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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11
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Gligorevic S, Brezic N, Petcu A, Sviggum E, Dumic I. Pulmonary Blastomycosis in Two Immunocompetent Patients: The Role of Obesity and Vitamin D Deficiency. Cureus 2024; 16:e70366. [PMID: 39469362 PMCID: PMC11513615 DOI: 10.7759/cureus.70366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2024] [Indexed: 10/30/2024] Open
Abstract
This case report depicts two patients with morbid obesity who presented to the ED with signs and symptoms of community-acquired pneumonia and were treated accordingly. Despite empiric antibiotic therapy, their symptoms did not subside, prompting further evaluation, which revealed pulmonary blastomycosis. Both patients were also found to have severe vitamin D deficiency. Treatment with amphotericin B followed by itraconazole, along with aggressive vitamin D supplementation, led to clinical improvement and resolution of lung lesions in both cases. Although blastomycosis is not rare in immunocompetent individuals, its severe forms are usually associated with underlying immunosuppression or significantly high inoculum. Blastomycosis presents a diagnostic challenge due to its nonspecific symptoms and radiographic findings. This case series underscores the importance of considering blastomycosis in the differential diagnosis of persistent pneumonia in obese individuals, particularly in endemic areas. It also suggests that vitamin D deficiency may play a role in disease susceptibility and severity. This report contributes to existing medical literature by emphasizing the potential link between obesity, vitamin D deficiency, and the risk of blastomycosis, highlighting the need for further research into this association.
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Affiliation(s)
| | - Nebojsa Brezic
- Anesthesiology, Resuscitation, and Critical Care, University Clinical Center of Serbia, Belgrade, SRB
| | - Andrew Petcu
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, USA
| | - Erik Sviggum
- Radiology, Mayo Clinic Alix School of Medicine, Rochester, USA
| | - Igor Dumic
- Hospital Medicine, Mayo Clinic Health System, Eau Claire, USA
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12
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Yin C, Yan J, Wang J, Wang T, Li H, Wang Y, Wang H, Feng S, Liang Y. Spatial analysis of the prevalence of abdominal obesity in middle-aged and older adult people in China: exploring the relationship with meteorological factors based on gender differences. Front Public Health 2024; 12:1426295. [PMID: 39100945 PMCID: PMC11294229 DOI: 10.3389/fpubh.2024.1426295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
Background In recent years, the incidence of abdominal obesity among the middle-aged and older adult population in China has significantly increased. However, the gender disparities in the spatial distribution of abdominal obesity incidence and its relationship with meteorological factors among this demographic in China remain unclear. This gap in knowledge highlights the need for further research to understand these dynamics and inform targeted public health strategies. Methods This study utilized data from the 2015 China Health and Retirement Longitudinal Study (CHARLS) to analyze the incidence of abdominal obesity among the middle-aged and older adult population in China. Additionally, meteorological data were collected from the National Meteorological Information Center. Using Moran's I index and Getis-Ord Gi* statistical methods, the spatial distribution characteristics of abdominal obesity incidence were examined. The influence of various meteorological factors on the incidence of abdominal obesity in middle-aged and older adult males and females was investigated using the q statistic from the Geodetector method. Furthermore, Multi-Scale Geographically Weighted Regression (MGWR) analysis was employed to explore the impact of meteorological factors on the spatial heterogeneity of abdominal obesity incidence from a gender perspective. Results The spatial distribution of abdominal obesity among middle-aged and older adult individuals in China exhibits a decreasing trend from northwest to southeast, with notable spatial autocorrelation. Hotspots are concentrated in North and Northeast China, while cold spots are observed in Southwest China. Gender differences have minimal impact on spatial clustering characteristics. Meteorological factors, including temperature, sunlight, precipitation, wind speed, humidity, and atmospheric pressure, influence incidence rates. Notably, temperature and sunlight exert a greater impact on females, while wind speed has a reduced effect. Interactions among various meteorological factors generally demonstrate bivariate enhancement without significant gender disparities. However, gender disparities are evident in the influence of specific meteorological variables such as annual maximum, average, and minimum temperatures, as well as sunlight duration and precipitation, on the spatial heterogeneity of abdominal obesity incidence. Conclusion Meteorological factors show a significant association with abdominal obesity prevalence in middle-aged and older adults, with temperature factors playing a prominent role. However, this relationship is influenced by gender differences and spatial heterogeneity. These findings suggest that effective public health policies should be not only gender-sensitive but also locally adapted.
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Affiliation(s)
- Chaohui Yin
- School of Resources and Environment, Henan Agricultural University, Zhengzhou, Henan, China
| | - Jinlong Yan
- Department of Geography and Spatial Information Techniques, Ningbo University, Ningbo, China
| | - Junqi Wang
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Tianyi Wang
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - Hangyu Li
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Yuan Wang
- College of Acu-moxibustion and Massage, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Haifeng Wang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xianyang, China
| | - Shixing Feng
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Xianyang, China
- Centre France Chine de la Médecine Chinoise, Selles sur Cher, France
| | - Yafeng Liang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Qiu L, Ren Y, Li J, Li M, Li W, Qin L, Zhang J, Gao F. The correlation of obesity status with serum 25-hydroxyvitamin D in US Asian adults: NHANES 2011-2018. PLoS One 2024; 19:e0301327. [PMID: 38626143 PMCID: PMC11020701 DOI: 10.1371/journal.pone.0301327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/14/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND There is a correlation between obesity and 25-hydroxyvitamin D (25OHD) that tends to be negative. However, this relationship varies among different races. In this study, Asian adults with and without obesity were compared in terms of their levels of 25OHD. METHODS We carried out a cross-sectional analysis on 2664 non-Hispanic Asian adults who participated in the National Health and Nutrition Examination Survey (NHANES) conducted between 2011 and 2018. To examine the connection between obese status, body mass index (BMI), waist circumference (WC) and weight, and 25OHD, we ran multivariate linear regression models and multivariate logistic regression models. RESULTS After adjusting for all confounding factors, obesity status shows a significant positive correlation with vitamin D deficiency (model 3: OR = 2.318, 95% CI:1.317, 4.082). This positive correlation remains significant in males (males: OR = 2.713, 95% CI: -13.398, 5.217). In all three models, a negative association was observed between obesity status and 25OHD (model 1: β = -4.535, 95% CI: -6.987, -2.083; model 2 β = -4.249, 95% CI: -6.549, -2.039; model 3 β = -1.734, 95% CI: -7.285, 3.816). After controlling for covariates, there was a significant negative correlation between WC and 25OHD when stratified by gender and obesity status in both males with and without obesity (males with obesity: β = -1.461, 95% CI: -2.485, -0.436; males without obesity: β = -0.855. 95% CI: -1.499, -0.210). In males with obesity, there was a very strong positive connection between body weight and 25OHD (β = 0.912, 95% CI: 0.227, 1.597). In addition, neither gender's obese individuals showed a significant link between BMI and 25OHD. CONCLUSION This study demonstrated a positive correlation between obesity and vitamin D deficiency and a negative correlation between obesity and 25OHD in Asian American adults. Additionally, among male obese individuals, there was a significant negative correlation between WC and 25OHD, an observation that needs to be validated in further prospective studies.
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Affiliation(s)
- Linjie Qiu
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yan Ren
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jixin Li
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Meijie Li
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wenjie Li
- Graduate school, Shanxi University of Chinese Medicine, Shanxi, China
| | - Lingli Qin
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jin Zhang
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Feng Gao
- Prevention and Treatment Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Sedin Å, Landin-Olsson M, Cloetens L. Nutrient intake and adherence to the Nordic nutrition recommendations in a Swedish cohort with abdominal obesity. Nutr Health 2024; 30:167-174. [PMID: 35656784 PMCID: PMC10924704 DOI: 10.1177/02601060221105751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Nordic Nutrition Recommendations (NNR) are developed to promote public health and to prevent food-related diseases such as obesity and cardiovascular diseases. OBJECTIVE To investigate the nutrient intake and adherence to the NNR in a Swedish cohort with abdominal obesity. DESIGN Dietary intake data were collected using 3-day food diaries and anthropometry and clinical chemistry parameters were measured at baseline of a long-term intervention studying weight-loss management. RESULTS Eighty-seven subjects with abdominal obesity successfully completed a 3-day food diary. Twelve of these subjects were excluded for further analysis due to implausible low-energy reporting. The remaining 75 subjects (76% females) had mean age of 52.3 ± 10.1 years and a mean body mass index of 34.3 ± 3.1 kg/m2. Mean total fat intake (41.2 ± 7.0E%) was exceeded by 56% of the sample size compared to the maximum recommended intake (RI) of 40E%, whereas mean carbohydrate intake (40.4 ± 8.0E%) was lower than the RI (45-60E%). The intake of saturated fatty acids was high compared to the NNR with only 2 women and none of men reported intakes within the RI of <10 E%. Adherence to the RI for dietary fibre was very low (16.0% and 13.3% when expressed as g/d and g/MJ, respectively). Analyses of micronutrient intake showed lowest adherences for vitamin D and sodium. CONCLUSIONS The nutrient intake in our subjects compared to NNR was rather low with a high total fat intake, particularly too high intake of saturated fatty acids, high salt consumption, and very low dietary fibre and vitamin D intake. More effort is clearly needed to promote healthy dietary habits among subjects with obesity.
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Affiliation(s)
- Åsa Sedin
- Biomedical nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
| | - Mona Landin-Olsson
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Endocrinology, Skåne University Hospital, Lund, Sweden
| | - Lieselotte Cloetens
- Biomedical nutrition, Pure and Applied Biochemistry, Lund University, Lund, Sweden
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Zhang F, Huang J, Zhang G, Dai M, Yin T, Huang C, Liu J, Zhang Y. No evidence of a causal relationship between miscarriage and 25-hydroxyvitamin D: a Mendelian randomization study. Hum Reprod Open 2024; 2024:hoae011. [PMID: 38456064 PMCID: PMC10918637 DOI: 10.1093/hropen/hoae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/28/2024] [Indexed: 03/09/2024] Open
Abstract
STUDY QUESTION Is there a causal relationship between 25-hydroxyvitamin D (25OHD) and miscarriage? SUMMARY ANSWER In this study, little evidence of a causal relationship was found between low serum 25OHD concentration or vitamin D deficiency and the risk of miscarriages. WHAT IS KNOWN ALREADY Associations between low vitamin D levels and increased risk of miscarriage have been reported, but causality is unclear. STUDY DESIGN SIZE DURATION The latest and largest genome-wide association studies (GWAS) for serum 25OHD concentration (n = 417 580), vitamin D deficiency (426 cases and 354 812 controls), miscarriage (16 906 cases and 149 622 controls), and the number of miscarriages (n = 78 700) were used to explore the causal association between serum vitamin D levels and miscarriage by two-sample Mendelian randomization analysis. PARTICIPANTS/MATERIALS SETTING METHODS This study was based on summary GWAS results from the FinnGen database and the UK Biobank. The random-effect inverse-variance weighted method was regarded as the primary analysis; MR-Egger, weighted median, weighted mode, simple mode, and MR-pleiotropy residual sum and outlier (MR-PRESSO) were further employed as complementary methods. MR-Egger intercept analysis and MR-PRESSO were employed to test pleiotropy, and Cochran's Q statistic and leave-one-out sensitivity analysis were used to determine the heterogeneity and robustness of the overall estimates, respectively. MAIN RESULTS AND THE ROLE OF CHANCE There was insufficient evidence of causal associations between serum 25OHD concentration and miscarriage (odds ratio (OR) = 0.995, 95% CI: 0.888 to 1.114, P = 0.927), or the number of miscarriages (β = -0.004, 95% CI: -0.040 to 0.032, P = 0.829). Furthermore, little evidence of causality between genetically determined vitamin D deficiency to miscarriage (OR = 0.993, 95% CI: 0.966 to 1.021, P = 0.624), or the number of miscarriages (β = 0.001, 95% CI: -0.009 to 0.011, P = 0.828), was observed. The results of the sensitivity analysis were robust, and no significant heterogeneity or horizontal pleiotropy was found. LIMITATIONS REASONS FOR CAUTION This study is limited by the absence of female-specific GWAS data and the limited amount of GWAS data available for this study, as well as the need for caution in generalizing the findings to non-European ethnic groups. WIDER IMPLICATIONS OF THE FINDINGS These findings enhance the current understanding of the intricate association between vitamin D and pregnancy outcomes, challenging prevailing beliefs regarding the strong association with miscarriage. The results provide a special perspective that may prompt further exploration and potentially offer insights for guiding future research and informing clinical guidelines pertaining to the management of miscarriage. STUDY FUNDING/COMPETING INTERESTS This project was supported by the Hubei Provincial Natural Science Foundation Program General Surface Project (2022CFB200), the Key Research & Developmental Program of of Hubei Province (2022BCA042), the Fundamental Research Funds for the Central Universities (2042022gf0007, 2042022kf1210), and the Interdisciplinary Innovative Talents Foundation from Renmin Hospital of Wuhan University (JCRCWL-2022-001, JCRCYG-2022-009). All authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Feng Zhang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jingtao Huang
- Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Gangting Zhang
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- Wuhan Meizhao Health Management Co, Ltd, Wuhan, Hubei, China
| | - Mengyang Dai
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Tailang Yin
- Reproductive Medical Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chunyu Huang
- Shenzhen Key Laboratory for Reproductive Immunology of Peri-implantation, Shenzhen Zhongshan Institute for Reproduction and Genetics, Shenzhen Zhongshan Obstetrics & Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital), Shenzhen, Guangdong, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yan Zhang
- Department of Clinical Laboratory, Institute of Translational Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Cominacini M, Fumaneri A, Ballerini L, Braggio M, Valenti MT, Dalle Carbonare L. Unraveling the Connection: Visceral Adipose Tissue and Vitamin D Levels in Obesity. Nutrients 2023; 15:4259. [PMID: 37836543 PMCID: PMC10574699 DOI: 10.3390/nu15194259] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/20/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Vitamin D deficiency and insufficiency are widespread on a global scale, with multiple factors playing a role in their development, such as limited exposure to sunlight, inadequate dietary consumption, as well as obesity and abdominal fat accumulation. Abdominal obesity, assessed with waist circumference (WC), is associated with metabolic syndrome and has been linked to low vitamin D levels. This study aimed to investigate the relationship between visceral adipose tissue (VAT) and vitamin D levels, particularly examining the potential threshold for vitamin D storage and sequestration using adipose tissue. The study was conducted between 2020 and 2022 with 58 patients from an internal medicine outpatient department. Patients with certain medical conditions and those taking medications affecting bone metabolism were excluded. Blood samples were collected at baseline and after 6 months of monthly cholecalciferol supplementation. Ultrasonography was used to evaluate adipose tissue measurements, including subcutaneous adipose tissue thickness, VAT, preperitoneal adipose tissue (PPAT), and prerenal adipose tissue (PRAT). Anthropometric measures such as the waist-to-hip ratio and waist-to-height ratio were also assessed. The results showed that all subjects had significant hypovitaminosis D at baseline. After 6 months of supplementation, the mean increase in vitamin D levels was 9.6 ng/mL, with 55.2% of subjects becoming deficient. The study revealed a significant correlation between follow-up vitamin D levels and waist circumference, hip circumference, and VAT. VAT exhibited a strong correlation not only with vitamin D levels but also with waist circumference. When analyzing gender differences, males showed a higher weight and waist-to-hip ratio, while females had higher body adiposity indexes and subcutaneous adipose tissue measurements. In conclusion, this study highlights the relationship between VAT and vitamin D levels, emphasizing the potential role of adipose tissue in vitamin D availability. Waist circumference was identified as a surrogate measure for VAT evaluation. Furthermore, the study showed variations in vitamin D response to supplementation between genders, with a higher percentage of males reaching normal vitamin D levels. Predictive factors for vitamin D levels differed between genders, with waist circumference being a significant predictor in males and body adiposity index in females.
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Affiliation(s)
- Mattia Cominacini
- Section of Biomedicine, Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy; (M.C.); (A.F.); (L.B.); (M.B.); (L.D.C.)
| | - Alessia Fumaneri
- Section of Biomedicine, Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy; (M.C.); (A.F.); (L.B.); (M.B.); (L.D.C.)
| | - Linda Ballerini
- Section of Biomedicine, Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy; (M.C.); (A.F.); (L.B.); (M.B.); (L.D.C.)
| | - Michele Braggio
- Section of Biomedicine, Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy; (M.C.); (A.F.); (L.B.); (M.B.); (L.D.C.)
| | - Maria Teresa Valenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - Luca Dalle Carbonare
- Section of Biomedicine, Department of Engineering for Innovation Medicine, University of Verona, 37134 Verona, Italy; (M.C.); (A.F.); (L.B.); (M.B.); (L.D.C.)
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Renzetti S, Gennings C, Calza S. A weighted quantile sum regression with penalized weights and two indices. Front Public Health 2023; 11:1151821. [PMID: 37533534 PMCID: PMC10392701 DOI: 10.3389/fpubh.2023.1151821] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/02/2023] [Indexed: 08/04/2023] Open
Abstract
Background New statistical methodologies were developed in the last decade to face the challenges of estimating the effects of exposure to multiple chemicals. Weighted Quantile Sum (WQS) regression is a recent statistical method that allows estimating a mixture effect associated with a specific health effect and identifying the components that characterize the mixture effect. Objectives In this study, we propose an extension of WQS regression that estimates two mixture effects of chemicals on a health outcome in the same model through the inclusion of two indices, one in the positive direction and one in the negative direction, with the introduction of a penalization term. Methods To evaluate the performance of this new model we performed both a simulation study and a real case study where we assessed the effects of nutrients on obesity among adults using the National Health and Nutrition Examination Survey (NHANES) data. Results The method showed good performance in estimating both the regression parameter and the weights associated with the single elements when the penalized term was set equal to the magnitude of the Akaike information criterion of the unpenalized WQS regression. The two indices further helped to give a better estimate of the parameters [Positive direction Median Error (PME): 0.022; Negative direction Median Error (NME): -0.044] compared to the standard WQS without the penalization term (PME: -0.227; NME: 0.215). In the case study, WQS with two indices was able to find a significant effect of nutrients on obesity in both directions identifying sodium and magnesium as the main actors in the positive and negative association, respectively. Discussion Through this work, we introduced an extension of WQS regression that improved the accuracy of the parameter estimates when considering a mixture of elements that can have both a protective and a harmful effect on the outcome; and the advantage of adding a penalization term when estimating the weights.
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Affiliation(s)
- Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Stefano Calza
- Department of Molecular and Translational Medicine, Università degli Studi di Brescia, Brescia, Italy
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Shen J, Lin X, Lin Y, Xiao J, Wu C, Zheng F, Wu X, Lin H, Chen G, Liu H. Supplementation of hyaluronic acid injections with vitamin D improve knee function by attenuating synovial fluid oxidative stress in osteoarthritis patients with vitamin D insufficiency. Front Nutr 2023; 10:1026722. [PMID: 37081922 PMCID: PMC10112517 DOI: 10.3389/fnut.2023.1026722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/22/2023] [Indexed: 04/07/2023] Open
Abstract
ObjectivesThere is still controversy about the effect of vitamin D supplementation on osteoarthritis (OA). The purpose of this study was to investigate the effects of vitamin D supplementation with Hyaluronic acid (HA) injection on OA.MethodsWe investigated serum vitamin D levels and oxidative stress (OS) in synovial fluid from patients with OA who underwent total knee arthroplasty (grade IV, n = 24) and HA injection (grade II and III, n = 40). The effects of HA injection with or without oral vitamin D supplementation on synovial fluid OS and knee pain and function were then further investigated. Finally, patients underwent HA injection were divided into two groups according to vitamin D levels (vitamin D < or > 30 ng/ml), and the efficacy of the two groups were compared.ResultsThe results showed that the levels of glutathione peroxidase (GSH-PX) (P < 0.05) in the synovial fluid were lower in patients with stage IV OA than that in patients with stage II-III OA, while the levels of malondialdehyde (MDA) (P < 0.05) and lactate dehydrogenase (LDH) (P < 0.01) were significantly higher. Moreover, we found that age, BMI and vitamin D levels were significantly associated with the levels of oxidants and/or antioxidants in synovial fluid, and that vitamin D was significantly negatively correlated with BMI (R = −0.3527, p = 0.0043). Supplementation of HA injections with vitamin D significantly reduced the OS status in synovial fluid, attenuated knee pain and improved knee function in OA patients with vitamin D insufficiency.ConclusionWe conclude that maintenance of vitamin D sufficiency may be beneficial for the treatment of OA by improving OS in synovial fluid.
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Liu CC, Huang JP. Potential benefits of vitamin D supplementation on pregnancy. J Formos Med Assoc 2023:S0929-6646(23)00058-X. [PMID: 36925361 DOI: 10.1016/j.jfma.2023.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 03/17/2023] Open
Abstract
BACKGROUND The level of vitamin D in pregnant women and the effect of vitamin D supplementation are lack in Taiwan. OBJECTIVE To investigate the vitamin D serum level and the effect of its supplementation on pregnancy. METHODS We included 1048 pregnant women who underwent prenatal exam with known serum 25-hydroxyvitamin D3 [25(OH)D3] levels and delivery at the Mackay Memorial Hospital, Taipei, Taiwan during 2015-2018. A daily dose 2000 IU of vitamin D was given, starting at 12-16 weeks of pregnancy, to reach the level of 20 ng/mL, and then a maintenance dose of 800 IU/day was given. The other 3654 women without vitamin D supplementation delivered in 2018 served as control group. Pregnancy outcomes were recorded for analysis. RESULTS Over 80% of the 1048 pregnant women were vitamin D deficiency. There was an inverse correlation between serum vitamin D levels and maternal body mass index (p = 0.0366). We compared 375 women with serum vitamin D levels increased above 30 ng/mL after supplementation with control group. The rates of preterm birth, low birth weight, and postpartum hemorrhage between these 2 groups were 6.67% vs. 11.19% (p = 0.007), 6.40% vs. 10.0% (p = 0.025), and 1.33% vs. 3.20% (p = 0.04), respectively. CONCLUSIONS Vitamin D deficiency is very prevalent in pregnant women, especially those with high BMI, in Taiwan. It can be corrected by adequate vitamin D supplementation, which may decrease the risk of pregnancy complications and bring benefits to the fetus.
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Affiliation(s)
- Cheng-Chiang Liu
- Division of General Obstetrics and Gynecology, Department of Obstetrics & Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Jian-Pei Huang
- Division of General Obstetrics and Gynecology, Department of Obstetrics & Gynecology, Mackay Memorial Hospital, Taipei, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.
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20
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Deruyter S, Van Biervliet S, De Guchtenaere A. Response to vitamin D replacement therapy in obese children and adolescents with vitamin D deficiency: a randomized controlled trial. J Pediatr Endocrinol Metab 2023; 36:458-465. [PMID: 36913250 DOI: 10.1515/jpem-2022-0598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/20/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES Vitamin D deficiency is common in the pediatric group with obesity and is a risk factor for metabolic syndrome. Supplementation of vitamin D may require higher dosing than in normal-weight children. The aim of our study was to investigate the response of supplementation on vitamin D levels and the metabolic profile in youths with obesity. METHODS Children and adolescents with obesity (Body mass index >2.3 SDS, age ≤18 years) and hypovitaminosis D (level <20 μg/L) who entered a residential weight-loss program in Belgium, were included during summer. Subjects were randomized: Group 1 received 6,000 IU vitamin D daily for 12 weeks, whereas Group 2 simultaneously participating in the weight-loss program received no supplementation. Differences in vitamin D levels, weight, insulin resistance, lipid patterns, and blood pressure after 12 weeks were assessed. RESULTS A total of 42 subjects (12-18 years) with hypovitaminosis D were included, group 1 (n=22) received supplementation after randomization. After 12 weeks, a median increase in vitamin D levels of 28.2 (24.1-33.0) and 6.7 (4.1-8.4) µg/L was observed in group 1 and group 2, respectively (p-value<0.001), resulting in vitamin D sufficiency in 100 and 60% of subjects. No significant differences in weight loss (p-value 0.695), insulin resistance (p-value 0.078), lipid patterns (p-value 0.438), or blood pressure (p-value 0.511) were observed between both groups after 12 weeks of treatment. CONCLUSIONS Supplementation with 6,000 IU vitamin D daily during 12 weeks in children and adolescents with obesity and hypovitaminosis D is safe and sufficient to reach vitamin D sufficiency. However, no positive effects on weight loss, insulin resistance, lipid patterns, or blood pressure were observed.
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Affiliation(s)
- Sarah Deruyter
- Department of Pediatrics, Ghent University Hospital, Gent, Belgium
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Barzin M, Ebadinejad A, Khalaj A, Mahdavi M, Valizadeh M, Hosseinpanah F. Determinants of Secondary Hyperparathyroidism 1 Year After One-Anastomosis Gastric Bypass or Sleeve Gastrectomy. Obes Surg 2023; 33:156-163. [PMID: 36319824 DOI: 10.1007/s11695-022-06337-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE Bariatric surgery alters the anatomic and physiological structure of the gastrointestinal tract, predisposing patients to the malabsorption of nutrients. The purpose of this study was to determine the prevalence and determinants of secondary hyperparathyroidism (SHPT) in the patients undergoing either one-anastomosis gastric bypass (OAGB) or sleeve gastrectomy (SG). MATERIALS AND METHODS A total of 517 patients (without SHPT at the baseline) who had undergone OAGB or SG were prospectively assessed 1 year after the surgery. Anthropometric parameters, calcium, intact parathyroid hormone (iPTH), and 25(OH)D levels were compared according to the surgery type before and 1 year after surgery. Multiple logistic regression models were used to evaluate possible SHPT predictors after bariatric surgery. RESULTS The overall prevalence of SHPT was 12.6% after surgery, significantly different between the OAGB and SG groups (17.1 vs. 9.9%, respectively). The serum levels of albumin-corrected calcium and 25(OH)D were not significantly different between the two groups. The patients undergoing OAGB had significantly higher serum levels of ALP (198.2 vs. 156.6) compared to the subjects undergoing SG. Higher iPTH levels preoperatively, lower 1-year excess weight loss%, and OAGB surgery seemed to be independent predictors for SHPT 1 year after surgery. CONCLUSION Morbidly-obese patients undergoing OAGB had a higher risk of SHPT than their counterparts undergoing SG, whereas 25(OH)D deficiency and calcium levels did not differ between the two groups. The OAGB procedure, preoperative iPTH levels, and 1-year weight loss were predictors of postoperative SHPT development.
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Affiliation(s)
- Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Ebadinejad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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22
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Gou H, Wang Y, Liu Y, Peng C, He W, Sun X. Efficacy of vitamin D supplementation on child and adolescent overweight/obesity: a systematic review and meta-analysis of randomized controlled trials. Eur J Pediatr 2023; 182:255-264. [PMID: 36305951 DOI: 10.1007/s00431-022-04673-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 01/12/2023]
Abstract
The global prevalence of overweight and obesity in children and adolescents has been increasing. Child and adolescent overweight/obesity has been demonstrated to be partially associated with vitamin D deficiency. This systematic review and meta-analysis aims to assess the efficacy of vitamin D supplementation on child and adolescent overweight/obesity. PubMed, Embase, Cochrane Library, and Web of science were searched from inception to June 20th, 2022. Randomized controlled trials (RCTs) assessing the efficacy of vitamin D on child and adolescent overweight/obesity were included. The Cochrane bias risk assessment tool was used to assess the bias risk of included studies, and subgroup analysis was conducted based on different administration dosages. All data-analyses were performed using R 4.2.1. There were 1502 articles retrieved, and 10 eligible studies were finally included, with a total of 595 participants. Meta-analysis showed no differences in LDL, TC, TG, BMI, ALP, Ca, and PTH between vitamin-D (Vit-D) group and placebo, while Vit-D group resulted in improved HOMA-IR[WMD = - 0.348, 95%CI (- 0.477, - 0.219), p = 0.26]. Subgroup-analysis showed no significant difference in the increase of 25-(OH)-D between subgroups (p = 0.39), whereas the serum 25-(OH)-D level was increased under different Vit-D doses [WMD = 6.973, 95%CI (3.072, 10.873)]. High daily dose (≥ 4000 IU/d) of Vit-D might decrease CRP and increase HDL levels. Conclusion: High dose of Vit-D supplementation (over 4000 IU/d) would reduce several cardiometabolic risk indicators and improve insulin resistance. More high-quality and large-scale RCTs are needed to provide more robust evidence. What is Known: • Vit-D deficiency is common in overweight/obesity (OW/OB) children and adolescents. • Previous randomized studies on the benefit of Vit-D supplementation to OW/OB children and adolescents are inconsistent. What is New: • This is the first meta-analysis conducted to assess the efficacy of Vit-D supplementation on child and adolescent OW/OB. • High dose of Vit-D supplementation is beneficial to cardiovascular metabolism, and improve insulin resistance on child and adolescent OW/OB.
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Affiliation(s)
- Hao Gou
- Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ya Wang
- Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yan Liu
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Cai Peng
- Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Weijia He
- Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiangjuan Sun
- Department of Pediatrics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Barzin M, Ebadinejad A, Vahidi F, Khalaj A, Mahdavi M, Valizadeh M, Hosseinpanah F. The mediating role of bariatric surgery in the metabolic relationship between parathyroid hormone and 25-hydroxyvitamin D. Osteoporos Int 2022; 33:2585-2594. [PMID: 35982319 DOI: 10.1007/s00198-022-06533-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/12/2022] [Indexed: 10/15/2022]
Abstract
UNLABELLED Vitamin D metabolism is altered in obese individuals. Our findings indicated that in patients with severe obesity, a relatively low 25(OH)D concentration was required to suppress PTH. The PTH inflection point increased following surgery-induced weight loss, highlighting 25(OH)D different regulation mechanisms in patients with obesity. INTRODUCTION An optimal and sufficient concentration of 25-hydroxyvitamin D (25(OH)D) has been suggested as the level required to maximally suppress intact parathyroid hormone (iPTH). We evaluated the role of surgery-induced weight loss in determining the threshold(s) of 25(OH)D required to suppress iPTH. METHODS This study was conducted in the framework of the Tehran Obesity Treatment Study (TOTS). We prospectively analyzed 687 patients with severe obesity who participated in the TOTS and underwent bariatric surgery from March 2013 to March 2019. The patients were followed for 1 year after surgery. Anthropometric parameters and serum levels of iPTH, 25OHD, phosphorous, and calcium were measured. Nonlinear and piecewise linear regression was used to evaluate the relationship between 25(OH)D and iPTH and to determine the 25(OH)D-suppression point at which iPTH was maximally suppressed. RESULTS Body mass index was 44.6 kg/m2 at the baseline and decreased to 29.7 kg/m2 1 year after surgery (P < 0.05). Before the surgery, iPTH and 25(OH)D showed an exponential relationship; iPTH began to decrease rapidly at 25(OH)D concentration of 12 ng/mL, reaching maximal suppression at 30 ng/mL. However, the relationship between 25(OH)D and iPTH was non-exponential 1 year after surgery. The piecewise linear regression model revealed the 25(OH)D concentration of 21 ng/mL as the inflection point following surgery-induced weight loss. CONCLUSION In patients with severe obesity, PTH was suppressed at a relatively lower concentration of 25(OH)D; this threshold increased following surgery-induced weight loss. These findings suggest a role for bariatric surgery in regulating 25(OH)D metabolism in patients with obesity.
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Affiliation(s)
- Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amir Ebadinejad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnaz Vahidi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Guevara-Ramírez P, Cadena-Ullauri S, Ruiz-Pozo VA, Tamayo-Trujillo R, Paz-Cruz E, Simancas-Racines D, Zambrano AK. Genetics, genomics, and diet interactions in obesity in the Latin American environment. Front Nutr 2022; 9:1063286. [PMID: 36532520 PMCID: PMC9751379 DOI: 10.3389/fnut.2022.1063286] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 08/25/2023] Open
Abstract
Obesity is a chronic disease characterized by abnormal or excessive fat accumulation that could impact an individual's health; moreover, the World Health Organization (WHO) has declared obesity a global epidemic since 1997. In Latin America, in 2016, reports indicated that 24.2% of the adult population was obese. The environmental factor or specific behaviors like dietary intake or physical activity have a vital role in the development of a condition like obesity, but the interaction of genes could contribute to that predisposition. Hence, it is vital to understand the relationship between genes and disease. Indeed, genetics in nutrition studies the genetic variations and their effect on dietary response; while genomics in nutrition studies the role of nutrients in gene expression. The present review represents a compendium of the dietary behaviors in the Latin American environment and the interactions of genes with their single nucleotide polymorphisms (SNPs) associated with obesity, including the risk allele frequencies in the Latin American population. Additionally, a bibliographical selection of several studies has been included; these studies examined the impact that dietary patterns in Latin American environments have on the expression of numerous genes involved in obesity-associated metabolic pathways.
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Affiliation(s)
- Patricia Guevara-Ramírez
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Santiago Cadena-Ullauri
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Viviana A. Ruiz-Pozo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Rafael Tamayo-Trujillo
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Elius Paz-Cruz
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Daniel Simancas-Racines
- Centro de Investigación en Salud Pública y Epidemiología Clínica (CISPEC), Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
| | - Ana Karina Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
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25
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Song S, Yuan Y, Wu X, Zhang D, Qi Q, Wang H, Feng L. Additive effects of obesity and vitamin D insufficiency on all-cause and cause-specific mortality. Front Nutr 2022; 9:999489. [PMID: 36337642 PMCID: PMC9634746 DOI: 10.3389/fnut.2022.999489] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/06/2022] [Indexed: 12/07/2022] Open
Abstract
Obesity and vitamin D deficiency are both considered risk factors for mortality, but the potential additive effects of vitamin D status and obesity on mortality has not been well-studied. We aimed to examine the possible additive effects of obesity and vitamin D status on all-cause and cause-specific mortality. The data from the NHANES III (1988–1994) and NHANES 2001–2014 surveys were used, and multivariate Cox regression models were performed to assess the additive effects of vitamin D status and overweight/obesity/abdominal obesity on the all-cause, cardiovascular and cancer mortality, by stratifying Cox Hazard Ratios (HRs) across different categories of vitamin D status and body mass index (BMI) and waist circumference (WC) categories. The models were adjusted for age, race/ethnicity, gender, educational level, family income to poverty ratio, leisure-time physical activity, smoking, and drinking. Across all BMI/WC categories, there was an additive effect of the vitamin D both insufficiency and deficiency on all mortality rates, with deficiency having much stronger effect than insufficiency. Interestingly, the effect of vitamin D deficiency overcame the effect of obesity on all mortality rates. The highest HRs for overall and cardiovascular mortality were observed among vitamin D deficient obese/abdominally obese subjects, while for cancer mortality among vitamin D deficient normal weight/non-abdominally obese subjects. In stratified analyses, regarding all-cause mortality, there was an additive effect of the vitamin D both insufficiency and deficiency in all BMI/WC categories. Regarding cardiovascular mortality, there was an additive effect of vitamin D deficiency in all BMI/WC categories, but the additive effect of vitamin D insufficiency reached significance only in normal weight subjects. Regarding cancer mortality, the effect did not reach significance among obese subjects for vitamin D deficiency, while for insufficiency, significance was reached only among non-abdominally obese subjects. Interestingly, vitamin D surplus was associated with increased risk for cancer mortality in obese subjects, but there was an inadequate number of subjects in this category to make proper judgment. In conclusion, vitamin D insufficiency and deficiency gradually increase risk for mortality across all BMI/WC categories. In our analyses, vitamin D deficiency overcame the effect of obesity on mortality rates.
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Affiliation(s)
- Shuaihua Song
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuan Yuan
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xiaolong Wu
- The First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, China
| | - Di Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qianjin Qi
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Haoran Wang
- Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Li Feng
- Department of Clinical Nutrition, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- *Correspondence: Li Feng,
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Hajipoor S, Hekmatdoost A, Pasdar Y, Mohammadi R, Alipour M, Rezaie M, Nachvak SM, Balthazar CF, Sobhiyeh MR, Mortazavian AM, Cruz AG. Consumption of probiotic yogurt and vitamin D-fortified yogurt increases fasting level of GLP-1 in obese adults undergoing low-calorie diet: A double-blind randomized controlled trial. Food Sci Nutr 2022; 10:3259-3271. [PMID: 36249978 PMCID: PMC9548356 DOI: 10.1002/fsn3.2816] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/27/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022] Open
Abstract
Energy restriction and manipulation of macronutrient composition of the diet are the main approaches that are used by people who aim to lose weight. When such strategies are employed, appetite and endocrine regulators of satiety, such as gut peptides, all are deeply affected. The gut microbiota-brain axis controls energy homeostasis in humans by affecting central satiety and gut peptides. The purpose of this study was to evaluate if the synergistic effect of probiotics and vitamin D in yogurt matrix can modulate this effect. In the double-blind, randomized, placebo-controlled trial, 140 obese adults were randomly allocated into four groups: 1) regular yogurt plus low-calorie diet; 2) PY plus low-calorie diet; 3) vitamin D-fortified yogurt plus low-calorie diet, and 4) probiotic and vitamin D co-fortified yogurt plus low-calorie diet. All groups were encouraged to increase their physical activity. Glucagon-like peptide-1 (GLP-1), peptide Tyrosin-Tysrosin (PYY), ghrelin, anthropometric variables, insulin, fasting blood sugar (FBS), insulin resistance/sensitivity, 1,25(OH)2 D3, dietary intake, and physical activity were measured before and after 10 weeks. The difference between groups for GLP-1 after 10 weeks was significant after adjusting for baseline GLP-1 and protein intake as confounders. PY showed the largest effect size (ES) on GLP-1 (p = 14.2) and FBS (p = 14) compared with others. Pairwise comparison of yogurts effect sizes on GLP-1 showed a significant difference in group 1 vs. group 2 (p = .001), group 1 vs. group 3 (p = .003), and group 1 vs. group 4 (p = .048). Vitamin D-fortified yogurt had the largest effect size on the serum level of vitamin D and it showed a significant difference with RY (p = .018) and PY (p = .002). Consumption of vitamin D-fortified yogurt and PY could be regarded as a promising approach during calorie restriction.
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Affiliation(s)
- Shima Hajipoor
- Student Research CommitteeDepartment of Nutritional SciencesSchool of Nutritional Sciences and Food Technology Kermanshah University of Medical SciencesKermanshahIran
| | - Azita Hekmatdoost
- Department of Nutrition and Food ScienceBeheshti University of Medical ScienceTehranIran
| | - Yahya Pasdar
- Department of Nutritional SciencesSchool of Nutritional Sciences and Food Technology Kermanshah University of Medical SciencesKermanshahIran
| | - Reza Mohammadi
- Department of Food Science and Technology, School of Nutrition Sciences and Food TechnologyKermanshah University of Medical SciencesKermanshahIran
| | - Meysam Alipour
- Department of NutritionShoushtar Faculty of Medical SciencesShoushtarIran
| | - Mansour Rezaie
- Research Centre for Environmental Determinacies of HealthHealth InstituteSchool of Public HealthKermanshah University of Medical SciencesKermanshahIran
| | - Seyed Mostafa Nachvak
- Department of Nutritional SciencesSchool of Nutritional Sciences and Food Technology Kermanshah University of Medical SciencesKermanshahIran
| | - Celso Fasura Balthazar
- Department of Food TechnologyVeterinary CollegeFederal Fluminense UniversityRio de JaneiroBrazil
| | - Mohammad Reza Sobhiyeh
- Vascular and Endovascular SurgeonDepartment of SurgeryImam Reza HospitalKermanshah University of Medical ScienceKermanshahIran
| | - Amir Mohammad Mortazavian
- Department of Food Science and TechnologyNational Nutrition and Food Technology Research InstituteFaculty of Nutrition SciencesFood Science and TechnologyShahid Beheshti University of Medical SciencesTehranIran
| | - Adriano G. Cruz
- Instituto Federal de EducaçãoCiência e Tecnologia do Rio de Janeiro (IFRJ)Departamento de AlimentosRio de JaneiroBrazil
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27
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Musazadeh V, Zarezadeh M, Ghalichi F, Kalajahi FH, Ghoreishi Z. Vitamin D supplementation positively affects anthropometric indices: Evidence obtained from an umbrella meta-analysis. Front Nutr 2022; 9:980749. [PMID: 36159504 PMCID: PMC9490226 DOI: 10.3389/fnut.2022.980749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/16/2022] [Indexed: 01/08/2023] Open
Abstract
Despite the growing evidence from meta-analyses on vitamin D's anti-obesity properties, their results are controversial. The current umbrella review was performed to assess the available evidence and provide a conclusive explanation in this regard. The international databases PubMed, Scopus, Embase, Web of Science and Google Scholar were systematically searched till March, 2022. A random-effects model was used to run the meta-analysis. All meta-analyses that examined the effect of vitamin D supplementation on BW, BMI, WC, and fat mass were included. Findings of 14 meta-analyses revealed that vitamin D supplementation reduced body mass index (BMI) (ES: -0.11 kg/m2; 95% CI: -0.18, -0.05, p?0.001; I 2 = 61.0%, p < 0.001), and waist circumference (WC) (ES = -0.79 cm; 95% CI: -1.20, -0.37; p < 0.001; I 2 = 46.5%, p = 0.096) in comparison to control group. However, the effects of vitamin D on body weight (ES = -0.16 kg, 95% CI: -0.36, 0.04; p = 0.125; I 2 = 57.0%, p = 0.017), and fat mass (ES: 0.02, 95% CI: -0.20, 0.24, p = 0.868; I 2 = 0.0%, p = 0.531) were not considerable. Vitamin D supplementation significantly improved levels of obesity indices such as BMI, and WC.
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Affiliation(s)
- Vali Musazadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Ghalichi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fateme Hamedi Kalajahi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Ghoreishi
- Nutrition Research Center, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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The joint association of serum vitamin D status and cardiorespiratory fitness with obesity and metabolic syndrome in Tehranian adults. Br J Nutr 2022; 128:636-645. [PMID: 34420527 DOI: 10.1017/s0007114521003196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
We aimed to assess the individual and joint association of serum vitamin D and cardiorespiratory fitness (CRF) with obesity and metabolic syndrome (MetSyn). In this cross-sectional study 270 adults with an age range of 18 years and older were recruited from health centers from five districts in Tehran, Iran. CRF was assessed with Bruce protocol. MetSyn was defined based on International Diabetes Federation 2009. The odds ratio (OR) and 95 % confidence interval (CI) of obesity and MetSyn across tertiles of serum vitamin D and CRF were estimated with control for confounders. The results indicated that neither 25(OH)D nor 1,25(OH)D was associated with obesity and MetSyn. There was a strong inverse association between CRF and general (P-trend < 0.001) and abdominal adiposity (P-trend: 0.001). The joint association of vitamin D and CRF indicated that the inverse association of CRF with obesity was stronger in those with high serum vitamin D than those with low serum vitamin D and this joint association remained after considering age and diet quality. There was a significant inverse association for those with low serum 25(OH)D and high CRF (OR: 0.12, 95 % CI: 0.04-0.81; P = 0.02) compared to those with low serum 25(OH)D and low CRF in the crude model. Also, the OR of general obesity was 0.17 (95 % CI: 0.02-0.79; P = 0.03) for those with high CRF and low serum 1,25(OH)D compare with the reference group. Our findings indicated a strong inverse association between CRF and obesity, especially in those with high serum vitamin D.
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29
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Chen YC, Li WC, Ke PH, Chen IC, Yu W, Huang HY, Xiong XJ, Chen JY. Association between metabolic body composition status and vitamin D deficiency: A cross-sectional study. Front Nutr 2022; 9:940183. [PMID: 35967768 PMCID: PMC9365955 DOI: 10.3389/fnut.2022.940183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the risk of vitamin D deficiency in a relatively healthy Asian population, with (i) metabolically healthy normal weight (MHNW) (homeostasis model assessment-insulin resistance [HOMA-IR] < 2. 5 without metabolic syndrome [MS], body mass index [BMI] < 25), (ii) metabolically healthy obesity (MHO) (HOMA-IR < 2.5, without MS, BMI ≥ 25), (iii) metabolically unhealthy normal weight (MUNW) (HOMA-IR ≥ 2.5, or with MS, BMI < 25), and (iv) metabolically unhealthy obesity (MUO) (HOMA-IR ≥ 2.5, or with MS, BMI ≥ 25) stratified by age and sex. This cross-sectional study involved 6,655 participants aged ≥ 18 years who underwent health checkups between 2013 and 2016 at the Chang Gung Memorial Hospital. Cardiometabolic and inflammatory markers including anthropometric variables, glycemic indices, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and serum 25-hydroxy vitamin D levels, were retrospectively investigated. Compared to the MHNW group, the MHO group showed a higher odds ratio (OR) [1.35, 95% confidence interval (CI) 1.05-1.73] for vitamin D deficiency in men aged < 50 years. By contrast, in men aged > 50 years, the risk of vitamin D deficiency was higher in the MUO group (OR 1.44, 95% CI 1.05-1.97). Among women aged < and ≥ 50 years, the MUO group demonstrated the highest risk for vitamin D deficiency, OR 2.33 vs. 1.54, respectively. Our study revealed that in women of all ages and men aged > 50 years, MUO is associated with vitamin D deficiency and elevated levels of metabolic biomarkers. Among men aged < 50 years, MHO had the highest OR for vitamin D deficiency.
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Affiliation(s)
- Yi-Chuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan.,Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Pin-Hsuan Ke
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - I-Chun Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Hsiung-Ying Huang
- Department of Pulmonary and Critical Care Medicine, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Xue-Jie Xiong
- Department of Oncology, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
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30
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Ganie MA, Sahar T, Wani I, Rashid A, Robbani I, Nisar S, Charoo BA, Bhat MA, Gania M, Farooq Q, Vishnubhatla S, Lakshmy R, Parvez T. Vitamin D status among Kashmiri tribal population: A cross-sectional community-based study. Indian J Med Res 2022; 156:348-356. [PMID: 36629195 PMCID: PMC10057367 DOI: 10.4103/ijmr.ijmr_544_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background & objectives Vitamin D deficiency (VDD) is prevalent across all age groups in general population of India but studies among tribal populations are scanty. This study aimed to evaluate the prevalence of VDD in the indigenous tribal population of the Kashmir valley and examine associated risk factors. Methods In this cross-sectional investigation, a total of 1732 apparently healthy tribal participants (n=786 males and n=946 females) were sampled from five districts of Kashmir valley by using probability proportional to size method. Serum 25-hydroxy vitamin D (25(OH)D) levels were classified as per the Endocrine Society (ES) recommendations: deficiency (<20 ng/ml), insufficiency (20-30 ng/ml) and sufficiency (>30 ng/ml). The serum 25(OH)D levels were assessed in relation to various demographic characteristics such as age, sex, education, smoking, sun exposure, body mass index and physical activity. Results The mean age of the male participants was 43.79±18.47 yr with a mean body mass index (BMI) of 20.50±7.53 kg/m[2], while the mean age of female participants was 35.47±14.92 yr with mean BMI of 22.24±4.73 kg/m2. As per the ES guidelines 1143 of 1732 (66%) subjects had VDD, 254 (14.71%) had insufficient and 334 (19.3%) had sufficient serum 25(OH)D levels. VDD was equally prevalent in male and female participants. Serum 25(OH)D levels correlated positively with serum calcium, phosphorous and negatively with serum alkaline phosphatase. Gender, sun exposure, altitude, physical activity and BMI did not seem to contribute significantly to VDD risk. Interpretation & conclusions VD deficiency is highly prevalent among Kashmiri tribals, although the magnitude seems to be lower as compared to the general population. These preliminary data are likely to pave way for further studies analyzing the impact of vitamin D supplementation with analysis of functional outcomes.
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Affiliation(s)
- Mohd Ashraf Ganie
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Tajali Sahar
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Ishfaq Wani
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Aafia Rashid
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Irfan Robbani
- Department of Radiodiagnosis, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Sobia Nisar
- Department of Medicine SMHS Hospital, Srinagar, Jammu & Kashmir, India
| | - Bashir A Charoo
- Department of Pediatrics, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Mohd Ashraf Bhat
- Department of Nephrology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Majid Gania
- Department of Psychiatry, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | - Qaiser Farooq
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
| | | | - R Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Tabassum Parvez
- Department of Obstetrics & Gynecology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu & Kashmir, India
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31
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Dominoni LADC, Gabiatti MP, Piazza FRG, Streb AR, Del Duca GF, Hansen F. Vitamin D is associated with body composition and fat intake, but not with cardiometabolic parameters in adults with obesity. Nutr Res 2022; 105:97-104. [PMID: 35908376 DOI: 10.1016/j.nutres.2022.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 11/16/2022]
Abstract
Adults with obesity are at higher risk for developing hypovitaminosis D. Some studies suggest that reduced levels of serum 25-hydroxyvitamin D (25(OH)D) may also be related to disorders in cardiometabolic parameters. However, because of the association between 25(OH)D and obesity, we hypothesized that body composition can be a confounding factor in the association of 25(OH)D with cardiometabolic parameters, and that 25(OH)D is inversely associated with body composition and cardiometabolic parameters and directly associated with fat intake. The aim of this study was to analyze the associations between 25(OH)D with body composition, fat intake, and cardiometabolic parameters in adults with obesity. This cross-sectional study consisted of 52 adults with obesity (61.53% female; 37.50 ± 6.88 years; body mass index [BMI]: 33.60 ± 2.89 kg/m2). Cardiometabolic parameters (fasting blood glucose, insulin resistance index, C-reactive protein, blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and cholesterol), body mass, BMI, waist circumference, body fat percentage, and fat intake were evaluated. Body mass was negatively associated with 25(OH)D (β = -0.108; P = .048; and R² = 0.090) and BMI (β = -0.621; P = .031; and R² = 0.103), both adjusted for fat intake. 25(OH)D was positively associated with fat intake (β = 0.129; P = .045 and R² = 0.078) adjusted for sex, age, and skin color. Cardiometabolic parameters were not associated with 25(OH)D, even after adjusted by body composition variables. However, the high prevalence of hypovitaminosis D (75%) and the negative association between 25(OH)D and body composition reinforce the importance of analyzing and monitoring vitamin D status in this population.
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Affiliation(s)
- Lara A da C Dominoni
- Health Sciences Center - CCS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Mariana P Gabiatti
- Health Sciences Center - CCS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Fernanda R G Piazza
- Health Sciences Center - CCS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Anne R Streb
- Center of Sports - CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Giovani F Del Duca
- Center of Sports - CDS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
| | - Fernanda Hansen
- Health Sciences Center - CCS, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil.
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Keum N, Chen QY, Lee DH, Manson JE, Giovannucci E. Vitamin D supplementation and total cancer incidence and mortality by daily vs. infrequent large-bolus dosing strategies: a meta-analysis of randomised controlled trials. Br J Cancer 2022; 127:872-878. [PMID: 35676320 PMCID: PMC9427835 DOI: 10.1038/s41416-022-01850-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/23/2022] [Accepted: 05/06/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Efficacy of vitamin D supplementation may vary by dosing strategies and adiposity. To address such heterogeneity, we performed a meta-analysis of randomised controlled trials of vitamin D supplementation and total cancer outcomes. METHODS PubMed and Embase were searched through January 2022. Summary relative risk (SRR) and 95% confidence interval (CI) were estimated using the DerSimonian-Laird random-effects model. RESULTS For total cancer incidence (12 trials), the SRR for vitamin D supplementation vs. control group was 0.99 (95% CI, 0.94-1.03; P = 0.54; I2 = 0%). No significant association was observed regardless of whether the supplement was given daily or infrequently in a large-bolus. Yet, among trials testing daily supplementation, a significant inverse association was observed among normal-weight individuals (SRR, 0.76; 95% CI, 0.64-0.90; P = 0.001, I2 = 0%), but not among overweight or obese individuals (Pheterogeneity = 0.02). For total cancer mortality (six trials), the SRR was 0.92 (95% CI, 0.82-1.03; P = 0.17; I2 = 33%). A significant inverse association emerged (SRR, 0.87; 95% CI, 0.78-0.96; P = 0.007; I2 = 0%) among studies testing daily supplementations but not among studies that testing infrequent large-bolus supplementations (Pheterogeneity = 0.09). CONCLUSIONS For vitamin D supplementation, daily dosing, but not infrequent large-bolus dosing, reduced total cancer mortality. For total cancer incidence, bolus dosing did not reduce the risk and the benefits of daily dosing were limited to normal-weight individuals.
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Affiliation(s)
- N Keum
- Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea. .,Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.
| | - Q-Y Chen
- Department of Food Science and Biotechnology, Dongguk University, Goyang, South Korea
| | - D H Lee
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - J E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - E Giovannucci
- Departments of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA.,Departments of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
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Phillips EA, Hendricks N, Bucher M, Maloyan A. Vitamin D Supplementation Improves Mitochondrial Function and Reduces Inflammation in Placentae of Obese Women. Front Endocrinol (Lausanne) 2022; 13:893848. [PMID: 35712242 PMCID: PMC9195071 DOI: 10.3389/fendo.2022.893848] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 04/25/2022] [Indexed: 11/15/2022] Open
Abstract
Background About 30% of women entering pregnancy in the US are obese. We have previously reported mitochondrial dysregulation and increased inflammation in the placentae of obese women. Vitamin D (VitD) is a major player in calcium uptake and was shown to modulate mitochondrial respiration and the immune/inflammation system. Studies show decreased VitD levels in obese individuals; however, the effect of maternal obesity on VitD metabolism and its association with placental function remains understudied. Methods Maternal and cord blood plasma and placental samples were collected upon C-section from normal-weight (NW, body mass index [BMI]<25) and obese (OB, BMI>30) women with uncomplicated pregnancies at term. We measured 25(OH)D3 (calcidiol) levels in maternal and cord blood plasma using ELISA. We assessed the expression of CYP27B1, an activator of calcidiol, and Vitamin D receptor (VDR) in placentae from NW and OB, and women with gestational diabetes and preeclampsia. In addition, we examined the effects of VitD supplementation on mitochondrial function and inflammation in trophoblasts from NW and OB, using the Seahorse Bioanalyzer and Western blot, respectively. Results Vitamin D levels in blood from OB but not NW women and in cord blood from babies born to NW and OB women showed a significant inverse correlation with maternal pre-pregnancy BMI (r=-0.50, p<0.1 and r=-0.55, p=0.004 respectively). Cord plasma VitD levels showed a positive correlation with placental efficiency, i.e., the ratio between fetal and placental weight, as well as with maternal blood VitD levels (r=0.69 and 0.83 respectively, p<0.00). While we found no changes in CYP27B1 in OB vs. NW women, VDR expression were decreased by 50% (p<0.03) independent of fetal sex. No changes in VDR expression relative to BMI-matched controls were observed in the placentae of women with gestational diabetes or preeclampsia. Cytotrophoblasts isolated from placentae of OB women showed a dose-dependent increase in VDR expression after 24-hour treatment with calcitriol (10 nM and 100 nM), an active form of VitD. Trophoblasts isolated from OB women and treated with calcitriol improved mitochondrial respiration (p<0.05). We also found a two-fold increase in expression of the NLRP3 inflammasome and the pro-inflammatory cytokine IL-18 in trophoblasts isolated from placentae of OB women (p<0.05), with IL-18 expression being reversed by calcitriol treatment (100 nM). Conclusions We show that VitD deficiency is at least partially responsible for mitochondrial dysfunction and increased inflammation in the placentae of obese women. Vitamin D supplementation could be beneficial in improving placental dysfunction seen in obese women.
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Affiliation(s)
- Elysse A. Phillips
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
| | - Nora Hendricks
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
| | - Matthew Bucher
- Department of OB/GYN, Oregon Health and Science University, Portland, OR, United States
| | - Alina Maloyan
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, United States
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Morrissey C, Amiot MJ, Goncalves A, Raverdy C, Masson D, Tardivel C, Gayrard S, Carrère M, Landrier JF, Vinet A, Perez-Martin A. Vitamin D Supplementation on Carotid Remodeling and Stiffness in Obese Adolescents. Nutrients 2022; 14:nu14112296. [PMID: 35684098 PMCID: PMC9182680 DOI: 10.3390/nu14112296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/19/2022] [Accepted: 05/25/2022] [Indexed: 02/01/2023] Open
Abstract
Obesity is associated with vitamin D (VD) deficiency and arterial stiffness. This randomized control trial assessed the effects of VD supplementation during a weight-loss program on carotid intima-media thickness (IMT) and carotid compliance in obese adolescents. Participants were randomly assigned to receive either a 12-week lifestyle program with VD supplementation (n = 13), a lifestyle program without VD supplementation (n = 13) or a control group composed of normal-weight adolescents (n = 18). Serum total and free 25-hydroxyvitamin D (25(OH)D), IMT and carotid compliance were measured before and after the trial. Insufficiency in 25(OH)D concentration was found in 73% of obese participants compared to 22% among controls. Obese adolescents had lower free 25(OH)D and displayed higher IMT but lower carotid compliance than controls. Free 25(OH)D and IMT were negatively correlated in adolescents displaying VD insufficiency at baseline. After three months, total and free 25(OH)D increased in both groups. The changes of IMT and carotid compliance were similar between groups. The changes in IMT were correlated with the changes in total 25(OH)D in obese adolescents with VD insufficiency at baseline (r = −0.59, p = 0.03). While the lifestyle program with VD supplementation did not affect carotid compliance, IMT reduction was improved in obese adolescents.
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Affiliation(s)
- Christopher Morrissey
- LAPEC UPR4278—Laboratoire de Pharm-Ecologie Cardiovasculaire, Avignon University, 84029 Avignon, France; (C.M.); (S.G.)
| | - Marie-Josèphe Amiot
- MOISA—Montpellier Interdisciplinary Center on Sustainable Agri-Food Systems, CIRAD—Centre de Coopération Internationale en Recherche Agronomique pour le Développement, Institut Agro-SupAgro, University Montpellier, INRAE—National Research Institute for Agriculture, Food and the Environment, CIHEAM-IAMM—International Centre for Advanced Mediterranean Agronomic Studies-Mediterranean Agronomic Institute of Montpellier, 34090 Montpellier, France; (M.-J.A.); (M.C.)
| | | | - Cecile Raverdy
- SSR—Centre de Soins de Suite et de Réadaptation, Institut Saint Pierre, 34250 Palavas-les-Flots, France; (C.R.); (D.M.)
| | - Delphine Masson
- SSR—Centre de Soins de Suite et de Réadaptation, Institut Saint Pierre, 34250 Palavas-les-Flots, France; (C.R.); (D.M.)
| | - Catherine Tardivel
- UMR C2VN—Center for CardioVascular and Nutrition Research, Aix Marseille University, INSERM—National Institute of Health and Medical Research, INRAE—National Research Institute for Agriculture, Food and the Environment, 13385 Marseille, France; (C.T.); (J.-F.L.)
| | - Sandrine Gayrard
- LAPEC UPR4278—Laboratoire de Pharm-Ecologie Cardiovasculaire, Avignon University, 84029 Avignon, France; (C.M.); (S.G.)
| | - Myriam Carrère
- MOISA—Montpellier Interdisciplinary Center on Sustainable Agri-Food Systems, CIRAD—Centre de Coopération Internationale en Recherche Agronomique pour le Développement, Institut Agro-SupAgro, University Montpellier, INRAE—National Research Institute for Agriculture, Food and the Environment, CIHEAM-IAMM—International Centre for Advanced Mediterranean Agronomic Studies-Mediterranean Agronomic Institute of Montpellier, 34090 Montpellier, France; (M.-J.A.); (M.C.)
| | - Jean-Francois Landrier
- UMR C2VN—Center for CardioVascular and Nutrition Research, Aix Marseille University, INSERM—National Institute of Health and Medical Research, INRAE—National Research Institute for Agriculture, Food and the Environment, 13385 Marseille, France; (C.T.); (J.-F.L.)
| | - Agnes Vinet
- LAPEC UPR4278—Laboratoire de Pharm-Ecologie Cardiovasculaire, Avignon University, 84029 Avignon, France; (C.M.); (S.G.)
- Correspondence:
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Gong T, Di H, Han X, Hu X, Liu C, Chen G. Vitamin D is negatively associated with triglyceride in overweight/obese patients with type 2 diabetes. Endocrine 2022; 76:304-311. [PMID: 35247144 DOI: 10.1007/s12020-022-03009-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 02/03/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE Vitamin D has been identified to have a relation to the development of insulin resistance-related diseases, such as type 2 diabetes (T2D). T2D is often associated with obesity and dyslipidemia. Our study aimed to analyze the relationship between vitamin D and lipid profile in patients with T2D. METHODS A total of 446 T2D patients who were hospitalized from January 2015 to December 2016 were recruited. Baseline characteristics were recorded, including body mass index (BMI), serum level of 25 hydroxy vitamin D (25(OH)D), and other biochemical indicators. T2D patients were divided into normal-weight group and overweight/obese group according to their BMI. Subgroup analysis was conducted after patients were subdivided using the quartet-method according to serum level of 25(OH)D. Differences in glucose and lipid metabolism indicators were analyzed. The correlation between serum 25(OH)D and lipid profiles was assessed by the multiple linear regression. RESULTS The levels of serum 25(OH)D and high-density lipoprotein cholesterol in T2D patients of overweight/obesity group were significantly lower than those in normal-weight group, while the levels of triglyceride (TG) and HOMA-IR were significantly higher (P < 0.05). Subgroup analysis uncovered that total cholesterol (TC) and TG levels were lower with higher 25(OH)D in normal weight T2D patients. In overweight/obese T2D patients, TG level was lower in patients with higher 25(OH)D (P < 0.05). There were no significant differences in low-density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG), fasting insulin (FINS), and hemoglobin Alc (HbAlc) among Q1-Q4 in both normal weight and overweight/obese groups. Pearson test showed that serum 25(OH)D was positively correlated with high density lipoprotein cholesterol (HDL-C), and negatively correlated with TC and TG. Serum 25(OH)D was unrelated to low density lipoprotein cholesterol (LDL-C) in both groups. Multiple linear regression analysis only demonstrated an independent negative correlation between 25(OH)D and TG levels in the overweight/obese group (P < 0.01). CONCLUSIONS In overweight/obese patients with T2D, serum 25(OH)D was independently, negatively correlated with TG. Vitamin D supplementation should be guaranteed in patients with diabetes, especially with obese T2D.
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Affiliation(s)
- Tong Gong
- Department of Endocrinology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210019, China
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Hongjie Di
- Department of Endocrinology, the Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210019, China
| | - Xue Han
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Xin Hu
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Chao Liu
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China
| | - Guofang Chen
- Department of Endocrinology, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210028, China.
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Muhihi A, Fawzi WW, Aboud S, Nagu TJ, Ulenga N, Wang M, Mugusi F, Sudfeld CR. Cholecalciferol Supplementation Does Not Affect the Risk of HIV Progression, Viral Suppression, Comorbidities, Weight Loss, and Depression among Tanzanian Adults Initiating Antiretroviral Therapy: Secondary Outcomes of a Randomized Trial. J Nutr 2022; 152:1983-1990. [PMID: 35460249 PMCID: PMC9361733 DOI: 10.1093/jn/nxac096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/12/2022] [Accepted: 04/21/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Observational studies suggest that blood concentrations of 25-hydroxyvitamin D [25(OH)D] are associated with morbidity, viral suppression, and mortality among adults living with HIV. OBJECTIVES We evaluated the effect of cholecalciferol (vitamin D3) supplementation on the risk of HIV disease progression, HIV-1 viral suppression, comorbidities, weight change, and depression among HIV-infected individuals that were initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania. METHODS We conducted a randomized, double-blind, placebo-controlled trial of vitamin D3 supplementation among 4000 HIV-infected adult men and nonpregnant women initiating ART with insufficient serum 25(OH)D concentrations (<30 ng/mL). Participants were randomly assigned to receive either weekly 50,000-IU doses for 4 wk followed by daily 2000 IU vitamin D3 until 1 y or a matching placebo regimen given in weekly followed by daily doses until 1 y. Participants were followed up at weekly visits for the first month followed by monthly visits thereafter. We conducted intent-to-treat analyses to assess the effect of vitamin D3 supplementation on the secondary trial outcomes of HIV progression or death, viral suppression, comorbidities, change in BMI, >10% weight loss, incident wasting, and depression. RESULTS During follow-up, 345 participants (17.2%) in the vitamin D3 group and 371 participants (18.6%) in the placebo group experienced HIV disease progression or death and there was no difference in risk between groups (RR: 0.91; 95% CI: 0.79, 1.06). Vitamin D3 supplementation did not affect the risk of an unsuppressed HIV-1 viral load (>1000 copies/mL) after 6 mo (RR: 1.10; 95% CI: 0.87, 1.41) and there was also no effect on change in BMI, risk of >10% weight loss, wasting, comorbidities, and depression (P values >0.05). CONCLUSIONS Vitamin D supplementation did not affect the risk of HIV progression, viral suppression, common morbidities, weight-related indicators, or depression among adults initiating ART in Tanzania.This trial was registered at clinicaltrials.gov as NCT01798680.
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Affiliation(s)
- Alfa Muhihi
- Management and Development for Health, Dar es Salaam, Tanzania,Department of Community Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wafaie W Fawzi
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tumaini J Nagu
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Nzovu Ulenga
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Molin Wang
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ferdinand Mugusi
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Doğan Y, Kara M, Culha MA, Özçakar L, Kaymak B. The relationship between vitamin D deficiency, body composition, and physical/cognitive functions. Arch Osteoporos 2022; 17:66. [PMID: 35420317 PMCID: PMC9008297 DOI: 10.1007/s11657-022-01109-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/06/2022] [Indexed: 02/03/2023]
Abstract
Vitamin D deficiency is still an important subject due to its significant effects on various tissues and functions. We found a relationship between vitamin D deficiency and increase in adipose tissue thicknesses. This situation reveals the importance of vitamin D supplementation, the harms of weight gain and obesity, and the importance of a balanced diet. PURPOSE Although the relationship between vitamin D (VitD) levels with body composition and physical/cognitive functions have been investigated in various studies, however, there is no study evaluating all these parameters together. In accordance with, we aimed to evaluate the relationship between VitD deficiency with body composition (i.e., skin, subcutaneous fat, and muscle thicknesses) and physical/cognitive functions. METHODS A total of 203 adults (78 M, 125 F, aged 19-91 years) who had recent 25-OH-vitamin D measurements were included. Ultrasonographic (US) measurements (skin, subcutaneous fat, and muscle thicknesses) were made from the dorsum of the hand, and anterior sides of forearm, arm, and thigh. Handgrip strength, gait speed, Timed Up and Go Test, and Chair Stand Test were evaluated. Additionally, cognitive status was also evaluated with Mini-Mental State Exam. RESULTS Subjects were classified as VitD deficient group (< 20 ng/ml, N = 125) and control group (≥ 20 ng/ml, N = 78). The groups were not significantly different as regards age, gender, and anthropometric measurements (all p > 0.05). Subcutaneous fat tissues were thicker in the VitD deficient group (all p < 0.05). All the other US measurements and functional/cognitive tests were not significantly different between the groups (all p > 0.05). According to linear regression analyses, body mass index (BMI) was independently related with all subcutaneous fat thicknesses in both genders, and VitD deficiency was related with all subcutaneous fat thicknesses in females and anterior forearm subcutaneous fat thickness in males (all p < 0.05). CONCLUSION We imply that together with BMI, VitD deficiency is independently related with increased regional subcutaneous fat tissue. We also underscore the role of US measurements for evaluation of body composition in related clinical scenarios.
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Affiliation(s)
- Yahya Doğan
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey.
| | - Murat Kara
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Mehmet Ali Culha
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
| | - Bayram Kaymak
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Zemin Kat FTR AD, Sıhhiye, Ankara, Turkey
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The role of serum 25 (OH) vitamin D level in the correlation between lipid profile, body mass index (BMI), and blood pressure. Clin Nutr ESPEN 2022; 48:421-426. [PMID: 35331523 DOI: 10.1016/j.clnesp.2022.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 12/23/2021] [Accepted: 01/08/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Since the prevalence of vitamin D deficiency is high in some countries, such as Iran, and the trend of hypertension and obesity is increasing, this study aimed to investigate the serum level of vitamin D and explore its correlation and association with obesity, blood pressure, fasting blood sugar (FBS), and lipid profile. Our hypothesis is that serum vitamin D levels are associated with risk factors for cardiometabolic disease such as hypertension. METHODS The results of this article were extracted from a cross-sectional study with a sample size of 720 people in the winter of 2020. The serum level of 25 OH vit D was measured using the ELISA method. In addition, lipid profiles were measured using the Auto Analyzer photometry method. RESULTS Serum levels of vitamin D (25 (OH) vitamin D) were significantly higher in the control group compared to the case group (29.5 ± 16.3 vs. 26.7 ± 14.5; P-value = 0.016). The significant association between body mass index (BMI) and FBS (Beta unadjusted:0.024, 95%CI 0.009:0.038; Beta adjusted:0.020,95%CI 0.005:0.034), and triglyceride (Beta unadjusted:0.009, 95%CI 0.006:0.012; Beta adjusted:0.008,95%CI 0.005:0.011), and an inverse association HDL-C (Beta unadjusted:-0.079,95%CI -0.123:-0.036; Beta adjusted:-0.065,95%CI -0.111:-0.019) were seen in both unadjusted and adjusted models. CONCLUSION In conclusion, we report that obese people had significantly lower serum vitamin D levels than normal-weight people. There is also a significant correlation between BMI and blood pressure.
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Wu SE, Chen WL. Moderate Sun Exposure Is the Complementor in Insufficient Vitamin D Consumers. Front Nutr 2022; 9:832659. [PMID: 35350415 PMCID: PMC8957913 DOI: 10.3389/fnut.2022.832659] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/10/2022] [Indexed: 11/14/2022] Open
Abstract
Background and Aims Vitamin (Vit) D plays a vital role in human health, and the prevalence of Vit D deficiency worldwide has been a rising concern. This study investigates the serum 25-hydroxy-Vit D [25(OH)D] status in healthy US civilians and identifies how the two main sources, sun exposure and dietary Vit D intake, determine the final 25(OH)D levels in individuals. Methods A total of 2,360 of participants from The National Health and Nutrition Examination Survey (NHANES) 2009–2014 were analyzed. We divided the levels of sun exposure and dietary Vit D intake of all subjects into 10 strata and gave a score ranging from 1 to 10 points, respectively. Scores 1–5 in sun exposure and dietary intake were considered as relatively low exposure groups, whereas scores 6–10 were considered as relatively high exposure groups. Serum Vit D inadequacy was defined as <50 nmol/L. Linear and logistic regression analyses were used to examine the associations between sources of Vit D and serum 25(OH)D levels. Results In relatively low Vit D intake groups (Vit D intake score 1–5), relatively high sun exposure (sun exposure score >5) resulted in higher serum 25(OH)D levels (average 57 nmol/L) compared with relatively low sun exposure (sun exposure score <5) (average 50 nmol/L), whereas this difference became negligible in high intake groups (Vit D intake score 6–10). Moreover, the greatest slope occurred in the low Vit D intake curve (decile 3 of Vit D intake), which shows increased sun exposure time causing the greatest degree of change in serum 25(OH)D level in this group. Conclusion Sun exposure can significantly make up for deficiencies in subjects who consume insufficient dietary Vit D. Compared with the extra cost and time for building habits of Vit D supplementation, moderate sun exposure appears to be a simple and costless means for the public to start in daily practice.
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Affiliation(s)
- Shou-En Wu
- Department of Dermatology, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei City, Taiwan
- Department of Biochemistry, National Defense Medical Center, Taipei City, Taiwan
- *Correspondence: Wei-Liang Chen,
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Hohoff E, Perrar I, Jankovic N, Alexy U. Dairy intake and long-term body weight status in German children and adolescents: results from the DONALD study. Eur J Nutr 2022; 61:1087-1096. [PMID: 34718860 PMCID: PMC8854286 DOI: 10.1007/s00394-021-02715-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To analyse the association between intake of total dairy (TD) and types of dairy [liquid dairy (LD), solid dairy (SD), low-fat dairy (LFD), high-fat dairy (HFD), high sugar dairy (HSD), low-sugar dairy (LSD), not fermented dairy (NFD), as well as fermented dairy (FD)] and long-term changes in body weight status and composition among children and adolescents in Germany. METHODS In total, 9999 3-day dietary records collected between 1985 and 2019 by 1126 participants (3.5-18.5 years; boys: 50.8%) of the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study were analysed. Polynomial mixed-effects regression models were used to examine whether changes (median follow-up: 9 years) in the intake of TD and dairy types (in 100 g/1000 kcal total energy intake) were associated with changes in body-mass-index-standard-deviation-score (BMI-SDS); fat mass index (FMI); fat-free mass index (FFMI) over time. RESULTS An individual increase in TD intake was slightly but significantly associated with an increase in BMI-SDS (β = 0.0092; p = 0.0371), FMI (β = 0.022; p = 0.0162), and FFMI (β = 0.0156; p = 0.0417) after adjustment for potential confounder. Analyses for LD (BMI-SDS: β = 0.0139; p = 0.0052; FMI: β = 0.0258; p = 0.0125; FFMI: β = 0.0239; p = 0.0052) and LSD intake (BMI-SDS: β = 0.0132; p = 0.0041, FMI: β = 0.02; p = 0.0316, FFMI: β = 0.0183; p = 0.0189) showed similar results to TD. Both processing method and fat content showed no association with body composition in our analyses. CONCLUSION Increases in TD, LD, and LSD intake showed small but significant increases in BMI and concomitant increases in fat mass and lean mass. However, the observed changes were too small to expect biological or physiological meaningful effects. Overall, our results showed that policies to promote dairy intake in childhood are to be welcomed, as no negative effects on body composition are expected, while the intake of important nutrients for growth is ensured. The type of dairy does not seem to matter.
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Affiliation(s)
- Eva Hohoff
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Ines Perrar
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Nicole Jankovic
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
| | - Ute Alexy
- Institute of Nutritional and Food Sciences-Nutritional Epidemiology, University of Bonn, DONALD Study, Heinstück 11, 44225 Dortmund, Germany
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Relationship between the double burden of malnutrition and mental health in overweight and obese adult women. J Nutr Sci 2022; 11:e12. [PMID: 35291277 PMCID: PMC8889085 DOI: 10.1017/jns.2022.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 12/22/2021] [Accepted: 01/17/2022] [Indexed: 11/23/2022] Open
Abstract
The co-existence of overweight or obesity with concurrent deficiency of one or more nutrients is referred to as double burden of malnutrition (DBM), and numerous mental health impairments have been associated with a variety of nutrient deficiencies. Although DBM is relevant for several health outcomes, the ubiquitous involvement of vitamin D across multiple systems and tissues suggests D insufficiency as a viable target for nutritional modification. The present study aimed to evaluate the contribution of DBM and mental health among adult women. Study participants included 300 women, aged 18–59 years, who presented to one of the 25 health centres in Tehran. Participants with a body mass index (BMI) of greater than 25 kg/m2 and a plasma concentration of 25-hydroxy vitamin D [25(OH)D] of >20 ng/ml were considered to have DBM. The 147-item food frequency questionnaire was used to estimate their dietary intake. Mental health status was assessed using the depression, anxiety and stress scales-21 (DASS-21). The mean ± standard deviation age, weight and BMI of the participants were 36⋅49 ± 8⋅38, 80⋅89 ± 12⋅45 kg and 31⋅04 ± 4⋅31 kg/m2, respectively. DBM was significantly associated with stress, after adjusting for potential confounders, including age, energy and marital status in model 1 (OR = 1⋅28, 95 % confidence interval (CI) 1⋅00, 1⋅65, P < 0⋅04) v. the crude model (OR = 1⋅22; 95 % CI 0⋅96, 1⋅55, P = 0⋅09). No significant association was seen among DBM and DASS-21 outcomes. In this cross-sectional study, stress and DBM were significantly associated. While vitamin D insufficiency was associated with mental health and obesity in opposing directions. Elucidation of whether vitamin D supplementation can improve mental health impairments requires further evaluation.
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Razaghi M, Gharibeh N, Vanstone CA, Sotunde OF, Wei SQ, McNally D, Rauch F, Jones G, Weiler HA. Maternal excess adiposity and serum 25-hydroxyvitamin D < 50 nmol/L are associated with elevated whole body fat mass in healthy breastfed neonates. BMC Pregnancy Childbirth 2022; 22:83. [PMID: 35093026 PMCID: PMC8801116 DOI: 10.1186/s12884-022-04403-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 01/11/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin D status of pregnant women is associated with body composition of the offspring. The objective of this study was to assess whether the association between maternal vitamin D status and neonatal adiposity is modified by maternal adiposity preconception. METHODS Healthy mothers and their term appropriate weight for gestational age (AGA) infants (n = 142; 59% male, Greater Montreal, March 2016-2019) were studied at birth and 1 month postpartum (2-6 weeks). Newborn (24-36 h) serum was collected to measure total 25-hydroxyvitamin D [25(OH)D] (immunoassay); maternal pre-pregnancy BMI was obtained from the medical record. Anthropometry, body composition (dual-energy X-ray absorptiometry) and serum 25(OH)D were measured at 2-6 weeks postpartum in mothers and infants. Mothers were grouped into 4 categories based on their vitamin D status (sufficient 25(OH)D ≥ 50 nmol/L vs. at risk of being insufficient < 50 nmol/L) and pre-pregnancy BMI (< 25 vs. ≥25 kg/m2): insufficient-recommended weight (I-RW, n = 24); insufficient-overweight/obese (I-OW/O, n = 21); sufficient-recommended weight (S-RW, n = 69); and sufficient-overweight/obese (S-OW/O, n = 28). Partial correlation and linear fixed effects model were used while adjusting for covariates. RESULTS At birth, infant serum 25(OH)D mean concentrations were below 50 nmol/L, the cut-point for sufficiency, for both maternal pre-pregnancy BMI categories; 47.8 [95%CI: 43.8, 51.9] nmol/L if BMI < 25 kg/m2 and 38.1 [95%CI: 33.5, 42.7] nmol/L if BMI ≥25 kg/m2. Infant serum 25(OH)D concentrations at birth (r = 0.77; P < 0.0001) and 1 month (r = 0.59, P < 0.0001) were positively correlated with maternal postpartum serum 25(OH)D concentrations. Maternal serum 25(OH)D concentration was weakly correlated with maternal percent whole body fat mass (r = - 0.26, P = 0.002). Infants of mothers in I-OW/O had higher fat mass versus those of mothers in S-OW/O (914.0 [95%CI: 766.4, 1061.6] vs. 780.7 [95%CI: 659.3, 902.0] g; effect size [Hedges' g: 0.42]; P = 0.04 adjusting for covariates) with magnitude of difference of 220.4 g or ~ 28% difference. CONCLUSIONS Maternal and neonatal vitamin D status are positively correlated. In this study, maternal adiposity and serum 25(OH)D < 50 nmol/L are dual exposures for neonatal adiposity. These findings reinforce the importance of vitamin D supplementation early in infancy irrespective of vitamin D stores acquired in utero and maternal weight status.
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Affiliation(s)
- Maryam Razaghi
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Nathalie Gharibeh
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Catherine A Vanstone
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Olusola F Sotunde
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - Shu Qin Wei
- Institut national de santé publique du Québec, Montréal, Québec, Canada
| | - Dayre McNally
- Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada
| | - Frank Rauch
- Shriners Hospital for Children, Montréal, Québec, Canada
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada
| | - Hope A Weiler
- School of Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Québec, Canada.
- Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, 251 Sir Frederick Banting Driveway, Room E338, Ottawa, Ontario, K1A 0K9, Canada.
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Isgin-Atici K, Alathari BE, Turan-Demirci B, Sendur SN, Lay I, Ellahi B, Alikasifoglu M, Erbas T, Buyuktuncer Z, Vimaleswaran KS. Interaction between Dietary Fat Intake and Metabolic Genetic Risk Score on 25-Hydroxyvitamin D Concentrations in a Turkish Adult Population. Nutrients 2022; 14:382. [PMID: 35057563 PMCID: PMC8778439 DOI: 10.3390/nu14020382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 12/19/2022] Open
Abstract
Previous studies have pointed out a link between vitamin D status and metabolic traits, however, consistent evidence has not been provided yet. This cross-sectional study has used a nutrigenetic approach to investigate the interaction between metabolic-genetic risk score (GRS) and dietary intake on serum 25-hydroxyvitamin D [25(OH)D] concentrations in 396 unrelated Turkish adults, aged 24-50 years. Serum 25(OH)D concentration was significantly lower in those with a metabolic-GRS ≥ 1 risk allele than those with a metabolic-GRS < 1 risk allele (p = 0.020). A significant interaction between metabolic-GRS and dietary fat intake (energy%) on serum 25(OH)D levels was identified (Pinteraction = 0.040). Participants carrying a metabolic-GRS ≥ 1 risk allele and consuming a high fat diet (≥38% of energy = 122.3 ± 52.51 g/day) had significantly lower serum 25(OH)D concentration (p = 0.006) in comparison to those consuming a low-fat diet (<38% of energy = 82.5 ± 37.36 g/d). In conclusion, our study suggests a novel interaction between metabolic-GRS and dietary fat intake on serum 25(OH)D level, which emphasises that following the current dietary fat intake recommendation (<35% total fat) could be important in reducing the prevalence of vitamin D deficiency in this Turkish population. Nevertheless, further larger studies are needed to verify this interaction, before implementing personalized dietary recommendations for the maintenance of optimal vitamin D status.
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Affiliation(s)
- Kubra Isgin-Atici
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara 06230, Turkey; (K.I.-A.); (B.T.-D.)
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Amasya University, Amasya 05000, Turkey
| | - Buthaina E. Alathari
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK;
- Department of Food Science and Nutrition, Faculty of Health Sciences, The Public Authority for Applied Education and Training, AlFaiha 72853, Kuwait
| | - Busra Turan-Demirci
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara 06230, Turkey; (K.I.-A.); (B.T.-D.)
| | - Suleyman Nahit Sendur
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara 06230, Turkey; (S.N.S.); (T.E.)
| | - Incilay Lay
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, Ankara 06230, Turkey;
- Clinical Pathology Laboratory, Hacettepe University Hospitals, Ankara 06230, Turkey
| | - Basma Ellahi
- Faculty of Health and Social Care, University of Chester, Chester CH1 4DS, UK;
| | - Mehmet Alikasifoglu
- Department of Medical Genetics, School of Medicine, Hacettepe University, Ankara 06230, Turkey;
- Genetics Diagnostic Centre, DAMAGEN, Ankara 06230, Turkey
| | - Tomris Erbas
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara 06230, Turkey; (S.N.S.); (T.E.)
| | - Zehra Buyuktuncer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara 06230, Turkey; (K.I.-A.); (B.T.-D.)
| | - Karani Santhanakrishnan Vimaleswaran
- Hugh Sinclair Unit of Human Nutrition, Department of Food and Nutritional Sciences, University of Reading, Reading RG6 6DZ, UK;
- Institute for Food, Nutrition, and Health, University of Reading, Reading RG6 6AH, UK
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Zhao T, Zhang D, Liu Y, Feng M, Xu Z, Huang H, Zhang L, Li W, Li X. The Association Between GC Gene Polymorphisms and Metabolic Syndrome in Chinese Rural Population: A Case-Control Study. Diabetes Metab Syndr Obes 2022; 15:165-174. [PMID: 35058699 PMCID: PMC8765441 DOI: 10.2147/dmso.s346528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/21/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND GC (group-specific component globulin) encoding VDBP (Vitamin D binding protein) polymorphisms have been associated with susceptibility to some diseases such as diabetes, obesity, osteoporosis, and polycystic ovary syndrome, but the evidence for metabolic syndrome (MetS) in the Chinese rural population is inconclusive. Therefore, we investigated the relationship between GC variants (rs7041, rs4588, rs2282679, and rs705117) and MetS risk as well as VDBP levels in the Chinese rural population. PATIENTS AND METHODS The participants (range of age: 20-90 years) of this case-control study were recruited from the northern Chinese Han rural population. We matched 445 MetS cases with non-MetS controls in a 1:1 ratio by sex, age (within 5 years). Real-time PCR technology was carried out by TaqMan assays to examine the four variants of rs7041, rs4588, rs2282679, and rs705117 within the GC gene. To identify the association of GC gene polymorphisms with MetS, we calculated ORs using a conditional logistic regression model adjusted for potential confounding factors. RESULTS We observed inverse associations of CA and AA genotypes of rs4588 with risk of MetS (OR = 0.678, 95% CI 0.505-0.910, P = 0.010; 0.603, 95% CI 0.373-0.973, P = 0.039, respectively) compared with carriers of CC genotype. A similar relationship was also found between rs2282679 and MetS, showing that carrying AC genotype of rs2282679 can decrease the risk of MetS (OR = 0.683, 95% CI 0.509-0.917, P = 0.011) compared with carriers of AA genotype. The results of correlation analysis between MetS components and GC polymorphisms showed that the ORs of AA genotype of rs4588 with high level of TG (triglycerides) and low level of HDL-C (high-density lipoprotein cholesterol) were 0.473 (95% CI 0.245-0.911, P = 0.025) and 0.268 (95% CI 0.117-0.615, P = 0.002), respectively; the ORs of CC genotype of rs2282679 with high level of TG and low level of HDL-C were 0.428 (95% CI 0.217-0.842, P = 0.014) and 0.263 (95% CI 0.110-0.628, P = 0.003), respectively. However, there was no significant association between the concentration of VDBP and MetS risk. CONCLUSION Among the Chinese rural population, GC polymorphism was associated with lower metabolic syndrome susceptibility, which might be through affecting blood lipid levels (TG and HDL-C).
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Affiliation(s)
- Tong Zhao
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Dongdong Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Yiming Liu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Mingming Feng
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Ze Xu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Haoyue Huang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Luoya Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, People’s Republic of China
- Correspondence: Xing Li Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People’s Republic of ChinaTel +86 371 6778 1305 Email
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Huang J, Wu Y, Wang M, Zhu Y, Lin S. Lower Vitamin D Levels are Associated with Higher Seroprevalence of Toxoplasma gondii—a US National Survey Study. ZOONOSES 2022; 2. [DOI: 10.15212/zoonoses-2022-0019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2025]
Abstract
Objective:
Vitamin D deficiency is associated with high susceptibility to infections. The present study aimed at exploring the relationship between vitamin D levels and Toxoplasma gondii (T. gondii) infection, on the basis of a nationally representative database.
Methods:
The study data came from the National Health and Nutrition Examination Surveys (NHANES) 2001–2004. Participants underwent both Toxoplasma IgG antibody testing and serum vitamin D testing. Vitamin D deficiency was defined by a serum 25-hydroxyvitamin D level <20 ng/mL. Multivariate logistic regression and propensity score matching were used to adjust for potential confounders. All analyses were conducted in R software.
Results:
A total of 10613 participants were included. Among these, 3973 (37.4%) were vitamin D deficient, and 2070 (19.5%) were seropositive for T. gondii IgG antibody. Vitamin D deficiency was found in 42.3% of the seropositive population, compared with 36.3% of the seronegative population (P<0.001). After adjustment for sex, age, body mass index, smoking history, drinking history and testing season, vitamin D deficiency was associated with an elevated risk of T. gondii infection (OR=1.303, 95% CI=1.136–1.495, P<0.001). This effect persisted in the propensity matching cohort.
Conclusions:
Low vitamin D levels are associated with high seroprevalence of T. gondii.
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Damas-Fuentes M, Boughanem H, Molina-Vega M, Tinahones FJ, Fernández-García JC, Macías-González M. 25-hydroxyvitamin D and testosterone levels association through body mass index: A cross-sectional study of young men with obesity. Front Endocrinol (Lausanne) 2022; 13:960222. [PMID: 36120442 PMCID: PMC9478588 DOI: 10.3389/fendo.2022.960222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUNDS Vitamin D and testosterone deficiency have been widely related to obesity. However, only a few studies have investigated the effect of vitamin D on testosterone in the context of obesity, in which controversial results have been raised. OBJECTIVES The purpose of this study was to determine the relationship between serum 25-hydroxyvitamin D (25(OH)D) and testosterone levels in young men with different grade of obesity. DESIGN AND METHODS This cross-sectional study included 269 healthy young men with obesity (body mass index (BMI) ≥ 30 kg/m2). Participants were divided into two groups based on their serum 25(OH)D levels (134 subjects with vitamin D sufficiency and 135 participants with vitamin D deficiency, according to the 50th percentile of 25(OH)D). Serum 25(OH)D and sex hormones have been measured. The relationships between 25(OH)D, sex hormones, and obesity grades were investigated with linear and binary logistic regression analyses, as well as mediation analysis. RESULTS Compared to the 25(OH)D sufficiency group, total and free testosterone levels were found to be decreased, whereas serum androstenedione levels were increased in the 25(OH)D deficiency group (p<0.05). Using multivariable lineal regression analyses, 25(OH)D was correlated with the majority of sex hormones (p<0.05). When mediation with BMI was performed, the direct effect between 25(OH)D and sex hormones disappeared, and only the indirect effect via BMI remained (demonstrating the importance of BMI). Furthermore, after controlling for age and smoking status, we discovered that total testosterone and SHBG were both significantly associated with 25(OH)D (p<0.05) in subjects with obesity type III. Using a mediation analysis, we discovered that BMI had a partial effect on the association between 25(OH)D and total testosterone levels in morbidly obese participants, indicating that a direct association between 25(OH)D and total testosterone levels, and that BMI partially mediated this association. CONCLUSIONS Serum 25(OH)D is associated with total testosterone levels in only those subjects with morbid obesity, suggesting a specific benefit in severe cases of obesity. Additional research is needed to elucidate possible common mechanisms.
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Affiliation(s)
- Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
| | - Hatim Boughanem
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
- *Correspondence: Francisco J. Tinahones, ; José C. Fernández-García,
| | - José C. Fernández-García
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
- *Correspondence: Francisco J. Tinahones, ; José C. Fernández-García,
| | - Manuel Macías-González
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Institute of Biomedical Research in Malaga (IBIMA), University of Malaga, Malaga, Spain
- Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III , Madrid, Spain
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Bennouar S, Cherif AB, Kessira A, Bennouar DE, Abdi S. Association and interaction between vitamin D level and metabolic syndrome for non-alcoholic fatty liver disease. J Diabetes Metab Disord 2021; 20:1309-1317. [PMID: 34900782 PMCID: PMC8630213 DOI: 10.1007/s40200-021-00857-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 07/10/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION/OBJECTIVES Previous studies have shown conflicting results regarding the association between hypovitaminosis D and non-alcoholic fatty liver disease (NAFLD). The aim of this study is to explore the individual and combined effect of hypovitaminosis D and metabolic syndrome (MS) on NAFLD. MATERIALS AND METHODS In this cross-sectional study, 874 subjects were enrolled. 25(OH)D was assessed by a sequential competitive immuno-fluoro-assay method. The Fatty Liver Index (FLI) was used for NAFLD screening. Binary logistic regression and additive interaction were performed to investigate the association between vitamin D status, MS and NAFLD. RESULTS Severe vitamin D deficiency was found to be positively related to NAFLD, with a higher risk in women than in men (OR = 6.4, 95% CI [2.8-15], p < 0.0001 vs. OR = 5.8, 95% CI [1.9-17.7], p = 0.002). In men, this association was partially masked by obesity. The additive interaction with MS was significant in women but not in men, the relative excess risk due to interaction was of 7.2, 95% CI [1.3-12.9], p = 0.02), the attributable proportion due to the combined effect was of 0.6, 95% CI [0.4-0.8], p < 0.0001. The interaction mechanism is synergistic; the synergy index: was of 2.9, 95% CI [1.6-5.3], p = 0.0006. CONCLUSION A positive association has been found between severe vitamin D deficiency and NAFLD. Moreover, an excess risk in women combining both MS and severe vitamin D deficiency was quantified.
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Affiliation(s)
- Salam Bennouar
- Central Laboratory of Clinical Biology, Frantz Fanon Hospital, University Hospital center of Blida, 9000 Blida, Algeria
| | - Abdelghani Bachir Cherif
- Department of Internal Medicine and Cardiology, University Hospital Center of Blida, 9000 Blida, Algeria
| | - Amel Kessira
- Department of hemobiology and Blood Transfusion, University Hospital Center of Annaba, 23000 Annaba, Algeria
| | - Djamel Eddine Bennouar
- Department of hemobiology and Blood Transfusion, University Hospital Center of Annaba, 23000 Annaba, Algeria
| | - Samia Abdi
- Central Laboratory of Clinical Biology, Frantz Fanon Hospital, University Hospital center of Blida, 9000 Blida, Algeria
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Kleftaki SA, Simati S, Amerikanou C, Gioxari A, Tzavara C, Zervakis GI, Kalogeropoulos N, Kokkinos A, Kaliora AC. Pleurotus eryngii improves postprandial glycaemia, hunger and fullness perception, and enhances ghrelin suppression in people with metabolically unhealthy obesity. Pharmacol Res 2021; 175:105979. [PMID: 34798266 DOI: 10.1016/j.phrs.2021.105979] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 11/19/2022]
Abstract
The aim of this study was to examine potential postprandial benefits of Pleurotus eryngii in nineteen volunteers with metabolically unhealthy obesity. An acute, randomized, crossover-designed trial comparing a meal with Pleurotus eryngii and a control meal was performed. The two meals matched in macronutrient and caloric content. Participants consumed both meals in random order after an overnight fast. Blood samples were drawn before and 30, 60, 90, 120, 150 and 180 min after meal consumption (in total 266 samples) to determine glucose, insulin, ghrelin, peptide YY, glucagon-like peptide-1 and glicentin. Visual analog scales measuring the subjective perception of hunger and fullness were completed at the same time points. The test meal resulted in lower glucose incremental area under the curve (iAUC). Additionally, the iAUC of the ghrelin response over time was substantially lower after the test meal (p = 0.033). Lower desire to eat and higher fullness was reflected by significantly lower hunger iAUC (p = 0.046) and higher fullness iAUC (p = 0.042) after the test meal. No differences in insulin, PYY, GLP-1 and glicentin were observed. Pleurotus eryngii can ameliorate postprandial glycaemia, appetite and regulate ghrelin levels at the postprandial state. This effect is attributed to the bioactive polysaccharides that inhibit the activity of enzymes catalysing carbohydrate hydrolysis, cause a delayed gastric emptying and glucose absorption.
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Affiliation(s)
- Stamatia-Angeliki Kleftaki
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Stamatia Simati
- First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Charalampia Amerikanou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Aristea Gioxari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Chara Tzavara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Georgios I Zervakis
- Laboratory of General and Agricultural Microbiology, Department of Crop Science, Agricultural University of Athens, 11855 Athens, Greece
| | - Nick Kalogeropoulos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Alexander Kokkinos
- First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Andriana C Kaliora
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece.
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Shen Q, Xu Q, Li G, Ren L, Zhang Z, Zhang Y, Zhong Z, Li X, Wang Q. Joint effect of 25-hydroxyvitamin D and secondhand smoke exposure on hypertension in non-smoking women of childbearing age: NHANES 2007-2014. Environ Health 2021; 20:117. [PMID: 34781965 PMCID: PMC8591921 DOI: 10.1186/s12940-021-00803-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/01/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Vitamin D deficiency (VDD) may increase the risk of hypertension in women of childbearing age, who may be exposed to secondhand smoke (SHS) simultaneously. Till now, few studies have investigated the joint effects of VDD and SHS on hypertension in this population. We evaluated whether exposure to SHS modified the association between VDD and hypertension. METHODS Data from National Health and Nutrition Examination Surveys (NHANES) 2007-2014 were analyzed. Our research subjects were 2826 nonsmoking and nonpregnant women of childbearing age (20-44 years old). Hypertension was defined based either on systolic blood pressure (SBP) ≥ 130 mmHg and/or diastolic blood pressure (DBP) ≥ 80 mmHg or on now taking prescribed medicine for hypertension. The directed acyclic graphs (DAG) and the back-door criterion were used to select a minimal sufficient adjustment set of variables (MSAs) that would identify the unconfounded effect of 25(OH)D and hypertension. The interactive effect of VDD and SHS on hypertension was evaluated by using logistic regression models, followed by strata-specific analyses. RESULTS The prevalence of VDD in the hypertension group was significantly higher than that in the non-hypertension group (48.2% vs 41.0%, P = 0.008), as well as the exposure rate of SHS (39.1% vs 33.8%, P = 0.017). VDD was independently associated with nearly 50% increased risk of hypertension [adjusted odds ratio (aOR) = 1.43, 95% confidence interval (CI): 1.01, 2.04], while no significant association was observed between SHS and hypertension. However, SHS showed a significant synergistic effect on VDD with a higher aOR of 1.79 (95% CI: 1.14, 2.80) (Pinteraction = 0.011). This synergistic effect was more obvious when stratified by BMI (in overweight women, aOR, 95% CI =4.74, 1.65-13.60 for interaction vs 2.33, 1.01-5.38 for VDD only) and race (in Non-Hispanic Black women, aOR, 95% CI =5.11, 1.58-16.54 for interaction vs 2.69, 1.10-6.62 for VDD only). CONCLUSION There exist synergistic effects of SHS and VDD on the prevalence of hypertension in American women of childbearing age, with more significant effects in women who were overweight or Non-Hispanic Black. Further studies are warranted to verify this finding in other populations, and the molecular mechanisms underlying the joint effect of SHS and VDD need to be elucidated.
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Affiliation(s)
- Qianqian Shen
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Qian Xu
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Guoju Li
- Qingdao Women and Children's Hospital, Qingdao University, Qingdao, China
| | - Lisheng Ren
- The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhenhong Zhang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Yangting Zhang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Zhaoyi Zhong
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Xiaona Li
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China
| | - Qiuzhen Wang
- Public Health School, Institute of Human Nutrition, Medical College of Qingdao University, Gate 2, Haoyuan, Ningde Road, Qingdao, China.
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He Y, Yang X, Li M, Zhang A, Sun N. Vitamin D supplementation and energy and metabolic homoeostasis in obese and overweight subjects: a protocol for a systematic review. BMJ Open 2021; 11:e051230. [PMID: 34593501 PMCID: PMC8487182 DOI: 10.1136/bmjopen-2021-051230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Obesity and vitamin D deficiency are major public health problems. According to the pathophysiological mechanism of obesity as well as the bidirectional relationship between obesity and vitamin D metabolism and storage, vitamin D supplementation in obese and overweight subjects could have beneficial effects on the energy and metabolic homoeostasis. This review will assess the efficacy of vitamin D supplementation on the energy and metabolic homoeostasis in overweight and obese subjects. METHODS AND ANALYSIS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols, we retrieved the relevant literature from the following electronic bibliographic databases: MEDLINE/PubMed, EMBASE and the Cochrane Central Register of Controlled Trials, from inception to June 2021. A manual search of the reference lists of all the relevant research articles will be performed to identify additional studies. We will include randomised controlled trials (RCTs) published in English that examine the effects of vitamin D supplementation on energy and metabolic homoeostasis in overweight and obese subjects. RCTs with multiple vitamin D groups will also be included. Two reviewers will independently complete the article selection, data extraction and rating. The bias tool from the Cochrane Handbook for Systematic Reviews of Interventions was used to assess the methodological quality of the included studies. A narrative or quantitative synthesis will be performed based on the available data. The planned start and end dates for the study were 1 February 2021 and 1 March 2022. ETHICS AND DISSEMINATION Ethical approval will not be required for this review. The results of this review will be disseminated in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42021228981.
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Affiliation(s)
- Yu He
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiao Yang
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Min Li
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Anren Zhang
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Nianyi Sun
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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