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Yu K, Song W, Tu X, Zhou K, Prabahar K. The effect of vitamin D on the lipid profile in individuals with overweight or obesity: A meta-analysis and systematic review of randomized controlled trials. Prostaglandins Other Lipid Mediat 2025; 176:106938. [PMID: 39667430 DOI: 10.1016/j.prostaglandins.2024.106938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 11/28/2024] [Accepted: 12/09/2024] [Indexed: 12/14/2024]
Abstract
BACKGROUND AND AIM Previous studies have reported on the relationship between vitamin D and the lipid profile in individuals with obesity or overweight, but results have been inconsistent. Hence, we conducted this meta-analysis and systematic review of randomized controlled trials to assess the effect of vitamin D on the lipid profile in individuals with overweight or obesity. METHODS A meticulous search strategy was used in various databases, and article published up to November 2023 were included. The DerSimonian and Laird random effects model was applied to compute the weighted mean difference (WMD) and 95 % confidence intervals (CI) of the intervention on each variable. RESULTS Vitamin D supplementation did not yield significant alterations in LDL-C (WMD: 2.10 mg/dL, CI: -5.20-9.41, p = 0.572), HDL-C (WMD: 1.49 mg/dL, 95 % CI: -1.55-4.55, P = 0.337), and TC concentrations (WMD: -1.99 mg/dL, CI: -8.21-4.22, P = 0.530). Conversely, a significant decrease in TG levels was observed studies conducted in individuals with comorbidities (WMD: -6.03 mg/dL, 95 % CI: -11.92 to -0.15, p = 0.044), vitamin D doses of ≥ 50000 IU/week (WMD: -20.87 mg/dL, 95 % CI: -39.63 to -2.11, P = 0.029), and subjects with baseline TG concentrations ≥ 150 mg/dl (WMD: -25.95 mg/dL, 95 % CI: -51.51 to -0.40, p = 0.046). CONCLUSION According to our study findings, vitamin D has significant effect on the hypertriglyceridemia in individuals with obesity or overweight. However, vitamin D has no significant effect on the LDL-C, HDL-C, and TC concentrations in individuals with obesity or overweight.
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Affiliation(s)
- Kehao Yu
- Medical College of PanZhiHua University, PanZhiHua University, NO.10, Jichang Road, East District, Panzhihua, Sichuan 617000, China.
| | - Wentao Song
- Medical College of Southwest Medical University, No.319, Section 3, Zhongshan Road, Jiangyang District, Luzhou, Sichuan 646000, China
| | - Xinyu Tu
- Medical College of PanZhiHua University, PanZhiHua University, NO.10, Jichang Road, East District, Panzhihua, Sichuan 617000, China
| | - Ke Zhou
- The Second College of Clinical Medicine of Chong Qing Medical University, Chong Qing Medical University, No.61, Middle Road, Shapingba District, Chongqing 400016, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
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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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Alqahtani RM, Alsulami EF. The Association Between Glycated Hemoglobin (HbA1c) Level and Vitamin D Level in Diabetes Mellitus Patients: A Cross-Sectional Study. Cureus 2023; 15:e47166. [PMID: 38022364 PMCID: PMC10652031 DOI: 10.7759/cureus.47166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Prior research has established noteworthy correlations between inadequate glycemic management and a multitude of problems in individuals diagnosed with diabetes mellitus (DM). METHODS This is a cross-sectional retrospective study that was conducted at the Jeddah Center for the Care of Diabetes and Blood Pressure Patients, Jeddah, Kingdom of Saudi Arabia. The medical records of patients diagnosed with DM between 2015 and 2022 were identified and reviewed for the purpose of this study. Pearson correlation coefficient was used to examine the correlation between glycated haemoglobin (HbA1c) and vitamin D levels. Multiple linear regression analysis was applied to identify the association between HbA1c and vitamin D levels. RESULTS A total of 152 patients were included in this study. The mean HbA1c level for the patients in this study was 8.2% (SD: 1.7). The median vitamin D level for the patients was 20.9 ng/ml (interquartile range (IQR): 13-30.4). More than half of the patients (n= 92; 60.5%) were found to have vitamin D insufficiency. Pearson correlation coefficient identified that there is an inverse correlation between the level of HbA1c and vitamin D level (r= -0.21 (95%CI -0.36 to -0.06; p-value= 0.007). Multiple linear regression analysis (adjusting for age and type of DM) identified that poor glycaemic control has a negative association with vitamin D level (regression coefficient (B) = -0.027; 95%CI -0.053 to - 0.001; p-value= 0.039). CONCLUSION Poor glycaemic control is associated with vitamin D deficiency in DM patients. It is recommended that patients with DM adhere to their medications and maintain a healthy lifestyle in order to manage their condition. This will improve their overall health, specifically their vitamin D status.
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Qiu S, Divine G, Rao SD. Effect of vitamin D metabolites on bone histomorphometry in healthy black and white women: An attempt to unravel the so-called vitamin D paradox in blacks. Bone Rep 2022; 18:101650. [PMID: 36588780 PMCID: PMC9801084 DOI: 10.1016/j.bonr.2022.101650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/29/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
An apparent vitamin D paradox, characterized by lower serum 25-hydroxyvitamin D (25(OH)D) levels and higher bone mineral density, is present in black population. In contrast, blacks have higher serum 1,25-dihydroxyvitamin D (1,25(OH)2D) levels. The effect of 1,25(OH)2D on the skeleton is not fully understood. We examined serum 25(OH)D, 1,25(OH)2D and bone histomorphometry in 50 black and white women (25 each) matched for age, menstrual status, and BMI. Histomorphometric indices related to bone structure, remodeling and mineralization were measured in cancellous bone in iliac bone biopsies. Data analyses led to the following results: 1) serum 25(OH)D was significantly lower and 1,25(OH)2D was significantly higher in black than in white women, but neither blacks nor whites revealed significant correlation between these two vitamin D metabolites. 2) there was no significant difference in PTH levels between blacks and whites. 3) except for greater trabecular thickness (Tb.Th) in blacks, there were no significant differences in other histomorphometric variables between the two ethnic groups. 4) osteoid surface (OS/BS), unlabeled osteoid surface (ulOS/BS), and osteoblast surface (ObS/BS) significantly correlated with serum 1,25(OH)2D levels. We conclude that lower serum 25(OH)D levels in blacks do not impair bone structure and remodeling, nor decrease bone mineralization. Higher serum 1,25(OH)2D levels in blacks may help preserve bone mass by stimulating bone formation via increasing osteoblast number and function, but moderately inhibit terminal bone mineralization as shown by higher ulOS/BS.
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Affiliation(s)
- Shijing Qiu
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
- Corresponding author at: Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI 48202, USA.
| | - George Divine
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Sudhaker D. Rao
- Bone and Mineral Research Laboratory, Henry Ford Hospital, Detroit, MI, USA
- Division of Endocrinology, Diabetes, and Bone & Mineral Disorders, Henry Ford Hospital, Detroit, MI, USA
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Khan EA, Cheddani L, Saint-Jacques C, Vargas-Poussou R, Frochot V, Chieze R, Letavernier E, Avellino V, Lionnet F, Haymann JP. Primary Hyperparathyroidism in Homozygous Sickle Cell Patients: A Hemolysis-Mediated Hypocalciuric Hypercalcemia Phenotype? J Clin Med 2021; 10:jcm10215179. [PMID: 34768698 PMCID: PMC8584729 DOI: 10.3390/jcm10215179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/21/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022] Open
Abstract
Primary hyperparathyroidism (pHPT) has been reported to have a higher prevalence in sickle cell disease (SCD) patients, including a high rate of recurrence following surgery. However, most patients are asymptomatic at the time of diagnosis, with surprisingly infrequent hypercalciuria, raising the issue of renal calcium handling in SCD patients. We conducted a retrospective study including (1) 64 hypercalcemic pHPT non-SCD patients; (2) 177 SCD patients, divided into two groups of 12 hypercalcemic pHPT and 165 non-pHPT; (3) eight patients with a diagnosis of familial hypocalciuric hypercalcemia (FHH). Demographic and biological parameters at the time of diagnosis were collected and compared between the different groups. Determinants of fasting fractional excretion of calcium (FeCa2+) were also analyzed in non-pHPT SCD patients. Compared to non-SCD pHPT patients, our data show a similar ionized calcium and PTH concentration, with a lower plasmatic calcitriol concentration and a lower daily urinary calcium excretion in pHPT SCD patients (p < 0.0001 in both cases). Fasting FeCa2+ is also surprisingly low in pHPT SCD patients, and thus inadequate to be considered hypercalcemia, recalling the FHH phenotype. FeCa2+ is also low in the non-pHPT SCD control group, and negatively associated with PTH and hemolytic biomarkers such as LDH and low hemoglobin. Our data suggest that the pHPT biochemical phenotype in SCD patients resembles the FHH phenotype, and the fasting FeCa2+ association with chronic hemolysis biomarkers strengthens the view of a potential pharmacological link between hemolytic by-products and calcium reabsorption, potentially through a decreased calcium-sensing receptor (CaSR) activity.
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Affiliation(s)
- Edmat Akhtar Khan
- Service de Néphrologie, Université de Lorraine, CHRU-Nancy, 54500 Vandœuvre-lès-Nancy, France;
| | - Lynda Cheddani
- Unité HTA, Prévention et Thérapeutique Cardiovasculaires, Assistance Publique—Hôpitaux de Paris, Hôpital Hôtel Dieu, 75004 Paris, France;
- Centre de Diagnostic et de Thérapeutique, Hôtel-Dieu, Université de Paris, 75006 Paris, France
| | - Camille Saint-Jacques
- Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (C.S.-J.); (V.F.); (R.C.); (E.L.)
- Unité Mixte de Recherche (UMR) S 1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Hôpital Tenon, 75020 Paris, France
| | - Rosa Vargas-Poussou
- Centre d’Investigation Clinique, Centre de Référence des Maladies Rénales Héréditaires de l’Enfant et de l’Adulte, Assistance Publique—Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 75015 Paris, France;
| | - Vincent Frochot
- Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (C.S.-J.); (V.F.); (R.C.); (E.L.)
- Unité Mixte de Recherche (UMR) S 1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Hôpital Tenon, 75020 Paris, France
| | - Remi Chieze
- Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (C.S.-J.); (V.F.); (R.C.); (E.L.)
- Unité Mixte de Recherche (UMR) S 1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Hôpital Tenon, 75020 Paris, France
| | - Emmanuel Letavernier
- Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (C.S.-J.); (V.F.); (R.C.); (E.L.)
- Unité Mixte de Recherche (UMR) S 1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Hôpital Tenon, 75020 Paris, France
| | - Virginie Avellino
- Service de Médecine Interne, Centre de Référence de la Drépanocytose, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (V.A.); (F.L.)
| | - Francois Lionnet
- Service de Médecine Interne, Centre de Référence de la Drépanocytose, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (V.A.); (F.L.)
| | - Jean-Philippe Haymann
- Service des Explorations Fonctionnelles Multidisciplinaires, Assistance Publique—Hôpitaux de Paris, Hôpital Tenon, 75020 Paris, France; (C.S.-J.); (V.F.); (R.C.); (E.L.)
- Unité Mixte de Recherche (UMR) S 1155, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Hôpital Tenon, 75020 Paris, France
- Correspondence: ; Tel.: +33-1-5601-6771; Fax: +33-1-5601-7003
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Hsu S, Zelnick LR, Lin YS, Best CM, Kestenbaum B, Thummel KE, Rose LM, Hoofnagle AN, de Boer IH. Differences in 25-Hydroxyvitamin D Clearance by eGFR and Race: A Pharmacokinetic Study. J Am Soc Nephrol 2021; 32:188-198. [PMID: 33115916 PMCID: PMC7894669 DOI: 10.1681/asn.2020050625] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/08/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Conversion of 25-hydroxyvitamin D (25[OH]D) to the active form of vitamin D occurs primarily in the kidney. Observational studies suggest 25(OH)D clearance from the circulation differs by kidney function and race. However, these potential variations have not been tested using gold-standard methods. METHODS We administered intravenous, deuterated 25(OH)D3 (d-25[OH]D3) in a pharmacokinetic study of 87 adults, including 43 with normal eGFR (≥60 ml/min per 1.73 m2), 24 with nondialysis CKD (eGFR <60 ml/min per 1.73 m2), and 20 with ESKD treated with hemodialysis. We measured concentrations of d-25(OH)D3 and deuterated 24,25-dihydroxyvitamin D3 at 5 minutes and 4 hours after administration, and at 1, 4, 7, 14, 21, 28, 42, and 56 days postadministration. We calculated 25(OH)D clearance using noncompartmental analysis of d-25(OH)D3 concentrations over time. We remeasured 25(OH)D clearance in a subset of 18 participants after extended oral vitamin-D3 supplementation. RESULTS The mean age of the study cohort was 64 years; 41% were female, and 30% were Black. Mean 25(OH)D clearances were 360 ml/d, 313 ml/d, and 263 ml/d in participants with normal eGFR, CKD, and kidney failure, respectively (P=0.02). After adjustment for age, sex, race, and estimated blood volume, lower eGFR was associated with reduced 25(OH)D clearance (β=-17 ml/d per 10 ml/min per 1.73 m2 lower eGFR; 95% CI, -21 to -12). Black race was associated with higher 25(OH)D clearance in participants with normal eGFR, but not in those with CKD or kidney failure (P for interaction=0.05). Clearance of 25(OH)D before versus after vitamin-D3 supplementation did not differ. CONCLUSIONS Using direct pharmacokinetic measurements, we show that 25(OH)D clearance is reduced in CKD and may differ by race. CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER Clearance of 25-hydroxyvitamin D in Chronic Kidney Disease (CLEAR), NCT02937350; Clearance of 25-hydroxyvitamin D3 During Vitamin D3 Supplementation (CLEAR-PLUS), NCT03576716.
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Affiliation(s)
- Simon Hsu
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
| | - Leila R. Zelnick
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
| | - Yvonne S. Lin
- Department of Pharmaceutics, University of Washington, Seattle, Washington
| | - Cora M. Best
- Kidney Research Institute, University of Washington, Seattle, Washington
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Bryan Kestenbaum
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Kenneth E. Thummel
- Department of Pharmaceutics, University of Washington, Seattle, Washington
| | - Lynn M. Rose
- Department of Pharmacy, University of Washington, Seattle, Washington
| | - Andrew N. Hoofnagle
- Kidney Research Institute, University of Washington, Seattle, Washington
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Ian H. de Boer
- Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
- Kidney Research Institute, University of Washington, Seattle, Washington
- Veterans Affairs Puget Sound Health Care System, Seattle, Washington
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Winder MB, Mason DL, Rangaswami J, Asif A, Vachharajani TJ, Mathew RO. Racial differences in the relationship between high-normal 25-hydroxy vitamin d and parathyroid hormone levels in early stage chronic kidney disease. J Bras Nefrol 2021; 43:34-40. [PMID: 33022030 PMCID: PMC8061959 DOI: 10.1590/2175-8239-jbn-2020-0138] [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] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/23/2020] [Indexed: 12/03/2022] Open
Abstract
AIM Current guidelines do not address between-person variability in markers of bone and mineral metabolism across subgroups of patients, nor delineate treatment strategies based upon such factors. METHODS A cross sectional study was carried out to analyze data from 20,494 United States Veterans and verify the variability of Vitamin D (25(OH)D) and parathyroid hormone (PTH) levels across race and stage of chronic kidney disease. RESULTS PTH levels were higher in Black Americans (BA) than White Americans (WA) at all levels of 25(OH)D and across eGFR strata. There was a progressive decline in PTH levels from the lowest (25(OH)D < 20) to highest quartile (25(OH)D >=40) in both BA (134.4 v 90 pg/mL, respectively) and WA (112.5 v 71.62 pg/mL) (p<0.001 for all comparisons). CONCLUSION In this analysis, higher than normal 25(OH)D levels were well tolerated and associated with lower parathyroid hormone values in both blacks and whites. Black Americans had higher PTH values at every level of eGFR and 25(OH)D levels suggesting a single PTH target is not appropriate.
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Affiliation(s)
- Marquita B. Winder
- Columbia Veterans Affairs Health Care System, Columbia, SC, United States
| | | | | | - Arif Asif
- Jersey Shore University Medical Center, Hackensack-Meridian School of Medicine, Neptune, NJ, United States
| | - Tushar J. Vachharajani
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Glickman Urological & Kidney Institute, Department of Nephrology & Hypertension, Cleveland, OH, United States
| | - Roy O. Mathew
- Columbia Veterans Affairs Health Care System, Columbia, SC, United States
- University of South Carolina, School of Medicine, Columbia, SC, United States
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Hsu S, Hoofnagle AN, Gupta DK, Gutierrez OM, Peralta CA, Shea S, Allen NB, Burke G, Michos ED, Ix JH, Siscovick D, Psaty BM, Watson KE, Kestenbaum B, de Boer IH, Robinson-Cohen C. Race, Ancestry, and Vitamin D Metabolism: The Multi-Ethnic Study of Atherosclerosis. J Clin Endocrinol Metab 2020; 105:dgaa612. [PMID: 32869845 PMCID: PMC7526733 DOI: 10.1210/clinem/dgaa612] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/27/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT A comprehensive characterization of racial/ethnic variations in vitamin D metabolism markers may improve our understanding of differences in bone and mineral homeostasis and the risk of vitamin D-related diseases. OBJECTIVE Describe racial/ethnic differences in vitamin D metabolism markers and their associations with genetic ancestry. DESIGN, SETTING, PARTICIPANTS In a cross-sectional study within the Multi-Ethnic Study of Atherosclerosis (MESA), we compared a comprehensive panel of vitamin D metabolism markers across self-reported racial/ethnic groups of Black (N = 1759), White (N = 2507), Chinese (N = 788), and Hispanic (N = 1411). We evaluated associations of proportion African and European ancestry with this panel of markers in Black and Hispanic participants using ancestry informative markers. Latent class analysis evaluated associations between patterns of vitamin D measurements with race/ethnicity. RESULTS Compared with Black participants, White participants had significantly higher serum concentrations of 25-hydroxyvitamin D and fibroblast growth factor-23; lower concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D; circulating vitamin D metabolite ratios suggesting lower CYP27B1 and higher CYP24A1 activity; higher urinary concentrations of calcium and phosphorus with higher urinary fractional excretion of phosphorus; and differences in vitamin D binding globulin haplotypes. Higher percent European ancestry was associated with higher 25-hydroxyvitamin D and lower parathyroid hormone concentrations among Black and Hispanic participants. Latent classes defined by vitamin D measurements reflected these patterns and differed significantly by race/ethnicity and ancestry. CONCLUSIONS Markers of vitamin D metabolism vary significantly by race/ethnicity, may serve to maintain bone and mineral homeostasis across ranges of 25-hydroxyvitamin D production, and be attributable, at least partly, to genetic ancestry.
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Affiliation(s)
- Simon Hsu
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | - Andrew N Hoofnagle
- Department of Laboratory Medicine, University of Washington, Seattle, Washington
| | - Deepak K Gupta
- Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Orlando M Gutierrez
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Carmen A Peralta
- Cricket Health, Inc., San Francisco, California
- The Kidney Health Research Collaborative, San Francisco, California
- University of California, San Francisco, San Francisco, California
| | - Steven Shea
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Norrina B Allen
- Department of Internal Medicine, Northwestern University, Chicago, Illinois
| | - Gregory Burke
- Division of Public Health Sciences Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Joachim H Ix
- Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California
- Division of Nephrology-Hypertension, University of California, San Diego, San Diego, California
| | | | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology and Health Services, University of Washington, Seattle, Washington
- Kaiser Permanente Washington Health Research Institute, Seattle, Washington
| | - Karol E Watson
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Bryan Kestenbaum
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | - Ian H de Boer
- Kidney Research Institute, Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington
| | - Cassianne Robinson-Cohen
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
- Vanderbilt Center for Kidney Disease, Vanderbilt University Medical Center, Nashville, Tennessee
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Garrido C, Bardón-Cancho EJ, Fajardo-Sánchez VDLÁ, Cascón-Pérez-Teijón ME, García-Morín M, Cela E. Evaluation of the effectiveness of prophylactic oral vitamin D (cholecalciferol) in children with sickle cell disease. Bone 2020; 133:115228. [PMID: 31972313 DOI: 10.1016/j.bone.2020.115228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/23/2019] [Accepted: 01/08/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND Vitamin D (25(OH)D) deficiency has become an emerging public health problem due to its influence on skeletal and extraskeletal diseases. Bone health in patients with sickle cell disease (SCD) is especially compromised and they are more likely to have 25(OH)D deficiency than the general population. Despite this, there is little information on the efficacy of vitamin D3 (vitD3) prophylaxis and its role in improving bone mineral density (BMD) in this population. PROCEDURES A prospective, longitudinal, single-center study was conducted with 136 children with SCD monitored at a tertiary referral hospital for SCD. Demographic, clinical and management data, 25(OH)D levels and bone densitometries (DXA) were collected. RESULTS Eighty patients were included. There are significant differences between the means of each of 25(OH)D levels as a function of whether the patient started prophylactic treatment as an infant or not (35.71 vs. 27.89 ng/ml, respectively [p = .014]). In multivariate analysis, 800 IU daily dose was shown as a protective factor (p = .044) to reach optimal blood levels (≥30 ng/ml). According to Kaplan-Meier curves, patients younger than 10 years reached optimal levels earlier than older (p = .002), as well as those who were not being treated with hydroxyurea (p = .039). CONCLUSIONS VitD3 prophylaxis is a safe practice in SCD. It is important to start this prophylactic treatment when the child is an infant. The daily regimen with 800 IU could be more effective for reaching levels ≥30 ng/ml, and, especially in preadolescent and adolescent patients, we should raise awareness about the importance of good bone health.
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Affiliation(s)
- Carmen Garrido
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Instituto Nacional de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
| | - Eduardo J Bardón-Cancho
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | | | - María Elena Cascón-Pérez-Teijón
- Musculoskeletal Section, Radiodiagnosis Department, "Hospital General Universitario Gregorio Marañón", Profesora asociada Facultad de Medicina, Universidad Complutense de Madrid, Spain.
| | - Marina García-Morín
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Elena Cela
- Pediatric Hematology Unit, "Hospital General Universitario Gregorio Marañón", Facultad de Medicina, Universidad Complutense de Madrid, Spain; Instituto Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Instituto Nacional de Investigación Biomédica en Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.
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10
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Cho DH, Chung JO, Chung MY, Cho JR, Chung DJ. Reference Intervals for Bone Turnover Markers in Korean Healthy Women. J Bone Metab 2020; 27:43-52. [PMID: 32190608 PMCID: PMC7064366 DOI: 10.11005/jbm.2020.27.1.43] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/03/2020] [Accepted: 02/05/2020] [Indexed: 11/11/2022] Open
Abstract
Background Adequate suppression of bone turnover rate is important to decrease fracture risk without mineralization defect due to oversuppression. This study was performed to determine reference intervals (RIs) for 2 bone turnover markers, serum C-terminal telopeptide of type I collagen (CTX) and osteocalcin, in Korean women. Methods A total of 461 Korean women (287 premenopausal and 174 postmenopausal) without any disease or drug history affecting bone metabolism was included. Serum CTX and osteocalcin were measured after overnight fasting. Bone mineral density (BMD) was measured at the 1st to 4th lumbar vertebra using dual energy X-ray absorptiometry. Subjects with normal spinal BMD (T-score ≥-1.0) were included in this study. Results After stable concentrations were maintained, both CTX and osteocalcin were abruptly increased in 50 to 59 years, and then decreased with increasing age. Median levels and interquartile range of serum CTX and osteocalcin in all subjects were 0.322 (0.212-0.461) ng/mL and 15.68 (11.38-19.91) ng/mL. RIs for serum CTX and osteocalcin in all subjects were 0.115 to 0.861 ng/mL and 6.46 to 36.76 ng/mL. Those were higher in postmenopausal women (CTX, 0.124-1.020 ng/mL, osteocalcin, 5.42-41.57 ng/mL) than in premenopausal women (CTX, 0.101-0.632 ng/mL, osteocalcin, 6.73-24.27 ng/mL). If we use target reference levels as lower half of premenopausal 30 to 45 years in patients with antiresorptive drugs, those were 0.101 to 0.251 ng/mL and 6.40 to 13.36 ng/mL. Conclusions We established RIs for serum CTX and osteocalcin in healthy Korean women with normal lumbar spine BMD. Premenopausal RIs for serum CTX and osteocalcin would be useful to monitor patients with low bone mass using osteoporosis drugs.
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Affiliation(s)
- Dong Hyeok Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jin Ook Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Min Young Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Jeong-Ran Cho
- Department of Health Administration, Kwangju Women's University, Gwangju, Korea
| | - Dong Jin Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
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11
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Nicolo M, Boullata JI. Serum 25OHD concentration as a predictor of haemoglobin A1c among adults living in the USA: NHANES 2003 to 2010. BMJ Nutr Prev Health 2019; 2:35-38. [PMID: 33235955 PMCID: PMC7664494 DOI: 10.1136/bmjnph-2019-000029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/25/2019] [Accepted: 05/10/2019] [Indexed: 01/21/2023] Open
Abstract
Background Vitamin D status influences glucose metabolism. Serum 25-hydroxyvitamin D (25OHD) concentrations have been inversely associated with type 2 diabetes risk. The optimal serum 25OHD level needed for adequate glycaemic control is unknown. Objective To determine the relationship among serum 25OHD concentrations and degree of glucose regulation using percentage of haemoglobin A1c (HbA1c%). Methods Data for adults ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) (2003-2010) were included. A binary logistic regression was used for serum 25OHD (nmol/L) as a continuous variable to determine the OR and 95% CI for HbA1c >6.5%, adjusting for sex, race and body mass index (BMI). Measures of serum 25OHD were grouped into quartiles and entered into a binary logistic regression model to determine the OR and 95% CI for HbA1c >6.5% in an adjusted model. Results Across all NHANES cycles, lower serum 25OHD was associated with greater odds of HbA1c ≥ 6.5% when adjusting for sex, race, age and BMI (NHANES 2003-2004 (N=4402): OR 0.985, 95% CI 0.979 to 0.990; NHANES 2005-2006 (N=4409): OR 0.976, 95% CI 0.969 to 0.982; NHANES 2007-2008 (N=4525): OR 0.989, 95% CI 0.984 to 0.993; and NHANES 2009-2010 (N=5660): OR 0.988, 95% CI 0.984 to 0.991). In an adjusted model, the lowest quartile of serum 25OHD (0-41 nmol/L, N=4879) was associated with greater odds of HbA1c ≥ 6.5% compared with the highest quartile (73-260 nmol/L, N=4472), OR 2.37, 95% CI 2.03 to 2.77. The odds of HbA1c ≥ 6.5% were also greater for adults with serum 25OHD considered to be sufficient compared with the highest quartile, OR 1.68, 95% CI 1.56 to 1.61). Conclusion Lower serum 25OHD concentrations are associated with poor glycaemic control (HbA1c ≥ 6.5%). Sufficient serum 25OHD levels were also associated with poorer blood glucose control. Further research is needed to investigate an optimal serum concentration or threshold to support adequate blood glucose control.
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Affiliation(s)
- Michele Nicolo
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Joseph I Boullata
- Nutrition Sciences, Drexel University, Philadelphia, Pennsylvania, USA
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12
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Migliaccio S, Di Nisio A, Mele C, Scappaticcio L, Savastano S, Colao A. Obesity and hypovitaminosis D: causality or casualty? INTERNATIONAL JOURNAL OF OBESITY SUPPLEMENTS 2019; 9:20-31. [PMID: 31391922 DOI: 10.1038/s41367-019-0010-8] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Epidemiological studies reported that vitamin D deficiency represents an increasingly widespread phenomenon in various populations. Vitamin D deficiency is considered a clinical syndrome determined by low circulating levels of 25-hydroxyvitamin D (25(OH)D), which is the biologically-inactive intermediate and represents the predominant circulating form. Different mechanisms have been hypothesized to explain the association between hypovitaminosis D and obesity, including lower dietary intake of vitamin D, lesser skin exposure to sunlight, due to less outdoor physical activity, decreased intestinal absorption, impaired hydroxylation in adipose tissue and 25(OH)D accumulation in fat. However, several studies speculated that vitamin D deficiency itself could cause obesity or prevent weight loss. The fat-solubility of vitamin D leads to the hypothesis that a sequestration process occurs in body fat depots, resulting in a lower bioavailability in the obese state. After investigating the clinical aspects of vitamin D deficiency and the proposed mechanisms for low 25(OH)D in obesity, in this manuscript we discuss the possible role of vitamin D replacement treatment, with different formulations, to restore normal levels in individuals affected by obesity, and evaluate potential positive effects on obesity itself and its metabolic consequences. Food-based prevention strategies for enhancement of vitamin D status and, therefore, lowering skeletal and extra-skeletal diseases risk have been widely proposed in the past decades; however pharmacological supplementation, namely cholecalciferol and calcifediol, is required in the treatment of vitamin D insufficiency and its comorbidities. In individuals affected by obesity, high doses of vitamin D are required to normalize serum vitamin D levels, but the different liposolubility of different supplements should be taken into account. Although the results are inconsistent, some studies reported that vitamin D supplementation may have some beneficial effects in people with obesity.
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Affiliation(s)
- Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Unit Endocrinology, University Foro Italico, Roma, Italy
| | - Andrea Di Nisio
- 2Department of Medicine, Operative Unit of Andrology and Medicine of Human Reproduction, University of Padova, Padova, Italy
| | - Chiara Mele
- 3Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.,4Division of General Medicine, S. Giuseppe Hospital, Istituto Auxologico Italiano, Piancavallo, Verbania, Italy
| | - Lorenzo Scappaticcio
- Division of Endocrinology and Metabolic Diseases, Dept of Medical, Surgical, Neurological, Metabolic Sciences and Aging, University of Campania L. Vanvitelli, Naples, Italy
| | - Silvia Savastano
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
| | - Annamaria Colao
- 6Department of Medicine and Surgery, Unit of Endocrinology, Federico II University Medical School of Naples, Roma, Italy
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13
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Cavalier E, Sagou Yayo E, Attoungbre-Hauhouot ML, Konan JL, Yao-Yapo C, Monnet D, Gnionsahé A, Souberbielle JC, Delanaye P. Vitamin D, bone alkaline phosphatase and parathyroid hormone in healthy subjects and haemodialysed patients from West Africa: impact of reference ranges and parathyroid hormone generation assays on the KDIGO guidelines. Clin Kidney J 2019; 12:288-293. [PMID: 30976410 PMCID: PMC6452202 DOI: 10.1093/ckj/sfy074] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend targets based on multiples of the upper limit of normal (ULN) of parathyroid hormone (PTH) concentration. However, the ULN has not always been correctly established by manufacturers. While it is known that the ULN is supposed to be higher in African Americans than in Caucasians, it is largely unknown in Africans. METHODS We established the ULN of PTH concentration in a population of 240 healthy Ivorians using second- and third-generation PTH assays before and after supplementation with 100 000 IU of cholecalferol. We measured the levels of PTH, bone alkaline phosphatase, 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D in 100 haemodialysed Ivorian patients. RESULTS The prevalence of vitamin D deficiency in Ivory Coast is low. The ULN obtained using the third-generation PTH assay was similar to that obtained in Caucasians but was higher when PTH was measured using the second-generation PTH assay. According to the KDIGO guidelines, ∼20% of the haemodialysed patients were below twice the ULN and 30% were above nine times the ULN. Approximately 25% of the patients were even >12 times the ULN. We observed a discrepancy in the results between the two PTH assays (14%) that was relatively more important than what we observed from previous studies in Caucasians using the same strategy. CONCLUSIONS We found a low prevalence of vitamin D deficiency in a tropical country like Ivory Coast. We also established the PTH reference range, which could prove useful for the follow-up of haemodialysed patients, particularly for the large number of patients suffering from secondary hyperparathyroidism who are at high risk of adverse bone events.
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Affiliation(s)
- Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, Liège, Belgium
| | - Eric Sagou Yayo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Marie-Laure Attoungbre-Hauhouot
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Jean-Louis Konan
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
| | - Carine Yao-Yapo
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
| | - Dagui Monnet
- Département de Biochimie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | - Appolinaire Gnionsahé
- Service d’Hémodialyse Publique de Côte d’Ivoire, Abidjan, Côte d’Ivoire
- Institut de Cardiologie d’Abidjan, Abidjan, Côte d’Ivoire
- Département de Néphrologie, UFR Sciences Pharmaceutiques et Biologiques, University Felix Houphouet Boigny, Abidjan, Côte d’Ivoire
| | | | - Pierre Delanaye
- Department of Nephrology, Dialysis and Transplantation, University of Liège, CHU de Liège, Liège, Belgium
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14
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Mandese V, Bigi E, Bruzzi P, Palazzi G, Predieri B, Lucaccioni L, Cellini M, Iughetti L. Endocrine and metabolic complications in children and adolescents with Sickle Cell Disease: an Italian cohort study. BMC Pediatr 2019; 19:56. [PMID: 30744584 PMCID: PMC6371531 DOI: 10.1186/s12887-019-1423-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 01/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with Sickle Cell Disease (SCD) show endocrine complications and metabolic alterations. The physiopathology of these conditions is not completely understood: iron overload due to chronic transfusions, ischemic damage, and inflammatory state related to vaso-occlusive crises may be involved. Aims of this study were to evaluate the growth pattern, endocrine complications, and metabolic alterations and to detect the relationship between these conditions and the SCD severity in affected children and adolescents. METHODS Fifty-two children and adolescents with SCD [38 homozygous sickle hemoglobin (HbSS) and 14 heterozygous sickle hemoglobin (HbSC); age range 3-18 years] were recruited. Anthropometric [height, body mass index (BMI), arm span, sitting height, target height (TH), and pubertal status] and laboratory [blood cell counts, hemolysis indices, metabolic and nutritional status indices and hormonal blood levels] data were evaluated. The SCD severity was defined according to hematological and clinical parameters. RESULTS Height-SDS adjusted for TH and BMI-SDS were significantly higher in HbSC children than in HbSS ones. Forty-eight out of 52 patients (92%) had at least one metabolic and/or endocrine alteration: insufficiency/deficiency of vitamin D (84.7%), insulin resistance (11.5%), growth hormone deficiency (3.8%), subclinical hypothyroidism (3.8%), and hypogonadism (1.9%). Levels of vitamin D were significantly and negatively correlated with clinical indicators of the SCD severity. Subjects with HbSS genotype show significant lower levels of both insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein 3 than children with HbSC. In the study population IGF-1 values were significantly and positively correlated with Hb and negatively with lactate dehydrogenase. CONCLUSIONS Metabolic alterations and endocrine complications are very common in children and adolescents with SCD. A regular follow-up is necessary to identify subjects at risk for complications to precociously start an appropriate treatment and to improve the quality of life of SCD patients.
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Affiliation(s)
- V Mandese
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - E Bigi
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - P Bruzzi
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - G Palazzi
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - B Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - L Lucaccioni
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy
| | - M Cellini
- Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy
| | - L Iughetti
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy. .,Oncology and Hematology Pediatric Unit Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy. .,Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124, Modena, Italy.
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15
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Medrano M, Carrillo-Cruz E, Montero I, Perez-Simon JA. Vitamin D: Effect on Haematopoiesis and Immune System and Clinical Applications. Int J Mol Sci 2018; 19:ijms19092663. [PMID: 30205552 PMCID: PMC6164750 DOI: 10.3390/ijms19092663] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/31/2018] [Accepted: 09/04/2018] [Indexed: 12/19/2022] Open
Abstract
Vitamin D is a steroid-like hormone which acts by binding to vitamin D receptor (VDR). It plays a main role in the calcium homeostasis and metabolism. In addition, vitamin D display other important effects called “non-classical actions.” Among them, vitamin D regulates immune cells function and hematopoietic cells differentiation and proliferation. Based on these effects, it is currently being evaluated for the treatment of hematologic malignancies. In addition, vitamin D levels have been correlated with patients’ outcome after allogeneic stem cell transplantation, where it might regulate immune response and, accordingly, might influence the risk of graft-versus-host disease. Here, we present recent advances regarding its clinical applications both in the treatment of hematologic malignancies and in the transplant setting.
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Affiliation(s)
- Mayte Medrano
- Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, 41013 Sevilla, Spain.
| | - Estrella Carrillo-Cruz
- Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, 41013 Sevilla, Spain.
| | - Isabel Montero
- Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, 41013 Sevilla, Spain.
| | - Jose A Perez-Simon
- Department of Hematology, University Hospital Virgen del Rocio, Instituto de Biomedicina de Sevilla (IBIS/CSIC/CIBERONC), Universidad de Sevilla, 41013 Sevilla, Spain.
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16
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Jovanovich A, Kendrick J. Personalized Management of Bone and Mineral Disorders and Precision Medicine in End-Stage Kidney Disease. Semin Nephrol 2018; 38:397-409. [PMID: 30082059 PMCID: PMC6615060 DOI: 10.1016/j.semnephrol.2018.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Chronic kidney disease mineral bone disorder (CKD-MBD) is common in end-stage renal disease and is associated with an increased risk of cardiovascular morbidity and mortality. Mainstays of treatment include decreasing serum phosphorus level toward the normal range with dietary interventions and phosphate binders and treating increased parathyroid hormone levels with activated vitamin D and/or calcimimetics. There is significant variation in serum levels of mineral metabolism markers, intestinal absorption of phosphorus, and therapeutic response among individual patients and subgroups of patients with end-stage renal disease. This variation may be partly explained by polymorphisms in genes associated with calcium and phosphorus homeostasis such as the calcium-sensing receptor gene, the vitamin D-binding receptor gene, and genes associated with vascular calcification. In this review, we discuss how personalized medicine may be used for the management of CKD-MBD and how it ultimately may lead to improved clinical outcomes. Although genetic variants may seem attractive targets to tailor CKD-MBD therapy, complete understanding of how these polymorphisms function and their clinical utility and applicability to personalized medicine need to be determined.
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MESH Headings
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/genetics
- Bone Diseases, Metabolic/metabolism
- Bone Diseases, Metabolic/therapy
- Calcium/metabolism
- Cardiovascular Diseases
- Humans
- Hyperparathyroidism, Secondary/etiology
- Hyperparathyroidism, Secondary/metabolism
- Hyperparathyroidism, Secondary/therapy
- Intestinal Absorption
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/metabolism
- Kidney Failure, Chronic/therapy
- Parathyroid Hormone/metabolism
- Phosphorus/metabolism
- Polymorphism, Genetic
- Precision Medicine
- Receptors, Calcium-Sensing/genetics
- Vascular Calcification/etiology
- Vascular Calcification/metabolism
- Vitamin D/metabolism
- Vitamin D-Binding Protein/genetics
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Affiliation(s)
- Anna Jovanovich
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO.; VA Eastern Colorado Healthcare System, Denver, CO
| | - Jessica Kendrick
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, CO..
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17
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Okereke OI, Reynolds CF, Mischoulon D, Chang G, Cook NR, Copeland T, Friedenberg G, Buring JE, Manson JE. The VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention (VITAL-DEP): Rationale and design of a large-scale ancillary study evaluating vitamin D and marine omega-3 fatty acid supplements for prevention of late-life depression. Contemp Clin Trials 2018; 68:133-145. [PMID: 29526608 PMCID: PMC5899680 DOI: 10.1016/j.cct.2018.02.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/19/2018] [Accepted: 02/27/2018] [Indexed: 02/07/2023]
Abstract
RATIONALE Depression is a leading cause of disease burden and disability for older adults; thus, prevention is a priority. Biologic and observational data support potential mental health benefits of vitamin D and omega-3 fatty acids; however, it is unclear whether these supplements can prevent late-life depression. DESIGN We describe the novel methodology of a large-scale study: VITAL-DEP (VITamin D and OmegA-3 TriaL-Depression Endpoint Prevention), an ancillary to the VITAL trial. Primary Aims of VITAL-DEP are to determine effects on prevention of depression and on trajectory of mood symptoms of long-term (mean=5years) supplementation with vitamin D (vitamin D3 [cholecalciferol], 2000IU/day) and marine omega-3 fatty-acids (eicosapentaenoic acid + docosahexaenoic acid, 1g/day), in a 2×2 factorial design, among 25,874 older adults. Secondary Aims will evaluate: vitamin D's effects among African-Americans (an at-risk group for vitamin D deficiency); both agents' effects among those with high-risk factors or sub-syndromal depression in a sub-set of ~1000 participants with detailed examinations at baseline and 2-year follow-up; whether baseline nutrient levels influence depression risk and/or modify agents' effects. Additional planned analyses will use pre-randomization blood samples available in ~17,000 participants to address whether key biomarkers and factors influence long-term mood and depression risk and/or the agents' effects. CONCLUSION VITAL-DEP applies all modalities of state-of-the-art prevention research - universal, selective and indicated. VITAL-DEP will clarify effects of supplemental vitamin D and/or omega-3 on mood, and inform clinical care and public health guidelines on the use of these agents for prevention of depression in mid-life and older adults.
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Affiliation(s)
- Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
| | - Charles F Reynolds
- Department of Psychiatry, UPMC and University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - David Mischoulon
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Grace Chang
- VA Boston Healthcare System, Brockton, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Nancy R Cook
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Georgina Friedenberg
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Julie E Buring
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Budhathoki S, Hidaka A, Yamaji T, Sawada N, Tanaka-Mizuno S, Kuchiba A, Charvat H, Goto A, Kojima S, Sudo N, Shimazu T, Sasazuki S, Inoue M, Tsugane S, Iwasaki M. Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort. BMJ 2018; 360:k671. [PMID: 29514781 PMCID: PMC5838719 DOI: 10.1136/bmj.k671] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. DESIGN Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. SETTING Nine public health centre areas across Japan. PARTICIPANTS 3301 incident cases of cancer and 4044 randomly selected subcohort participants. EXPOSURE Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. MAIN OUTCOME MEASURE Incidence of overall or site specific cancer. RESULTS Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. CONCLUSIONS In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites.
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Affiliation(s)
- Sanjeev Budhathoki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Taiki Yamaji
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Medical Statistics, Shiga University of Medical Science, Ohtsu, Shiga, 520-2192, Japan
| | - Aya Kuchiba
- Division of Biostatistical Research, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
- Biostatistics Division, Center for Research Administration and Support, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hadrien Charvat
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Satoshi Kojima
- CL New Product Development Department, Fujirebio Inc., Hachioji-shi, Tokyo, 192-0031, Japan
| | - Natsuki Sudo
- CL New Product Development Department, Fujirebio Inc., Hachioji-shi, Tokyo, 192-0031, Japan
| | - Taichi Shimazu
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shizuka Sasazuki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Manami Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
| | - Motoki Iwasaki
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Tokyo, 104-0045, Japan
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Suh‐Chiou C, Moysés RM, Bittencourt MS, Bensenor IM, Lotufo PA. Chronic kidney disease and coronary artery calcification in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Clin Cardiol 2017; 40:1309-1315. [PMID: 29243272 PMCID: PMC6490421 DOI: 10.1002/clc.22829] [Citation(s) in RCA: 10] [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: 05/22/2017] [Revised: 09/12/2017] [Accepted: 09/22/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic kidney disease is a worldwide public health concern due to the increased prevalence the high fatalities related to heart disease in this population. Among novel cardiovascular risk markers, the coronary artery calcification score (CAC) emerged as an independent predictor of cardiovascular events. HYPOTHESIS We aimed to test if glomerular filtration rate or albuminuria are independently associated with coronary calcification. METHODS The Brazilian Longitudinal Study of Adult Health is a cohort of men and women aged 35 to 74 years old addressing cardiovascular diseases. We analyzed the association of CAC, estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR) according to stages of eGFR (1 = ≥90; 2 = 60-89; 3 = <60 mL/min/1.73 m2 ), and ACR (<30; 30 to 300; >300 mg/g). These associations were estimated by logistic regression with a model including age, sex, race, income, and cardiovascular risk factors. RESULTS Among 4189 persons (median age = 51 years, 54% women), 1183 had CAC. The odds ratio (OR) and the 95% confidence interval (95% CI) in the multivariate model was 0.86 (0.58-1.29) for the category of eGFR <60 mL/min/1.73 m2 compared to people with eGFR >90 mL/min/1.73m2 . On the other hand, the OR (95% CI) for individuals with ACR >300 mg/g was 4.31 (1.27-14.64) compared to people with ACR <30 mg/g. A discrete interaction factor for the association with CAC between eGFR and ACR were analyzed as continuous variable. CONCLUSIONS Albuminuria was independently associated with coronary calcification, but the reduction of the glomerular filtration rate was not associated with CAC score in this sample of apparently healthy adults.
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Affiliation(s)
- Cheng Suh‐Chiou
- Internal Medicine Division, Center for Clinical and Epidemiological Research, University HospitalUniversity of Sao PauloSão PauloBrazil
| | - Rosa M. Moysés
- Internal Medicine Division, Center for Clinical and Epidemiological Research, University HospitalUniversity of Sao PauloSão PauloBrazil
| | - Marcio S. Bittencourt
- Internal Medicine Division, Center for Clinical and Epidemiological Research, University HospitalUniversity of Sao PauloSão PauloBrazil
| | - Isabela M. Bensenor
- Internal Medicine Division, Center for Clinical and Epidemiological Research, University HospitalUniversity of Sao PauloSão PauloBrazil
| | - Paulo A. Lotufo
- Internal Medicine Division, Center for Clinical and Epidemiological Research, University HospitalUniversity of Sao PauloSão PauloBrazil
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20
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Souberbielle JC, Brazier F, Piketty ML, Cormier C, Minisola S, Cavalier E. How the reference values for serum parathyroid hormone concentration are (or should be) established? J Endocrinol Invest 2017; 40:241-256. [PMID: 27696297 DOI: 10.1007/s40618-016-0553-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/09/2016] [Indexed: 10/20/2022]
Abstract
Well-validated reference values are necessary for a correct interpretation of a serum PTH concentration. Establishing PTH reference values needs recruiting a large reference population. Exclusion criteria for this population can be defined as any situation possibly inducing an increase or a decrease in PTH concentration. As recommended in the recent guidelines on the diagnosis and management of asymptomatic primary hyperparathyroidism, PTH reference values should be established in vitamin D-replete subjects with a normal renal function with possible stratification according to various factors such as age, gender, menopausal status, body mass index, and race. A consensus about analytical/pre-analytical aspects of PTH measurement is also needed with special emphasis on the nature of the sample (plasma or serum), the time and the fasting/non-fasting status of the blood sample. Our opinion is that blood sample for PTH measurement should be obtained in the morning after an overnight fast. Furthermore, despite longer stability of the PTH molecule in EDTA plasma, we prefer serum as it allows to measure calcium, a prerequisite for a correct interpretation of a PTH concentration, on the same sample. Once a consensus is reached, we believe an important international multicentre work should be performed to recruit a very extensive reference population of apparently healthy vitamin D-replete subjects with a normal renal function in order to establish the PTH normative data. Due to the huge inter-method variability in PTH measurement, a sufficient quantity of blood sample should be obtained to allow measurement with as many PTH kits as possible.
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Affiliation(s)
- J-C Souberbielle
- Service des Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France.
- Université René Descartes, 75015, Paris, France.
| | - F Brazier
- Service des Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
- Université René Descartes, 75015, Paris, France
| | - M-L Piketty
- Service des Explorations Fonctionnelles, Hôpital Necker-Enfants Malades, 149 rue de Sèvres, 75015, Paris, France
- Université René Descartes, 75015, Paris, France
| | - C Cormier
- Rheumatology Department, Cochin University Hospital, 75014, Paris, France
| | - S Minisola
- Ordinario di Medicina Interna, Responsabile UOC Medicina Interna e Malattie Metaboliche dell'Osso (TMC 04), « Sapienza » Università di Roma, Rome, Italy
| | - E Cavalier
- Clinical Chemistry Department, Sart Tilman University Hospital, Liège, Belgium
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21
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Haimi M, Kremer R. Vitamin D deficiency/insufficiency from childhood to adulthood: Insights from a sunny country. World J Clin Pediatr 2017; 6:1-9. [PMID: 28224090 PMCID: PMC5296623 DOI: 10.5409/wjcp.v6.i1.1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Revised: 07/15/2016] [Accepted: 10/09/2016] [Indexed: 02/06/2023] Open
Abstract
Vitamin D is known to be a key regulator of bone metabolism and is associated with muscle strength. Vitamin D deficiency is widely prevalent worldwide. In adults, vitamin D deficiency has been implicated in numerous health conditions including osteoporosis, cancer, diabetes, and autoimmune diseases. Considerable changes have occurred in lifestyles and childhood activities in the past years. Studies have shown that the children population is at high risks of vitamin D deficiency. The objective of this study was to learn about the extent of vitamin D deficiency in children worldwide and especially in sunny country like Israel. In this article we reviewed the extent and severity of vitamin D deficiency worldwide and especially in Israel, through a very comprehensive review of previous reports and research studies done during the last years. We found reports on vitamin D deficiency in children, which was associated with metabolic syndromes and obesity. It was more prevalent in children who spend less time on outdoor activities, in obese children, and in cases when there was imbalance between nutritional intakes and requirements. Vitamin D deficiency is common even in children living in sunny places like Israel. Health professionals should be aware of the fact that although vitamin D deficiency is prevalent in the elderly population, it is also common in children, and can be associated with different illnesses. We encourage supplementation of vitamin D to special populations (pregnant and lactating women, infants, and high risk groups). We also encourage implementation of international food fortification programs.
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22
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Lukaszuk JM, Luebbers PE. 25(OH)D status: Effect of D 3 supplement. Obes Sci Pract 2017; 3:99-105. [PMID: 28392936 PMCID: PMC5358080 DOI: 10.1002/osp4.85] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/31/2016] [Accepted: 11/06/2016] [Indexed: 12/21/2022] Open
Abstract
Background Excess adipose tissue may lead to sequestrating of vitamin D, making it less available for use in the body. Objective This study determined if overweight or obese individuals (BMI > 25 kg m−2) had insufficient (<30 ng mL−1) levels of 25‐hydroxyvitamin D [25(OH)D] and, if so, would serum levels respond to exogenous supplementation. Methods Sixty‐three women who were overweight/obese (BMI = 31.07 ± 5.00 kg m−2) were randomly assigned in a double‐blind manner to receive 5,000 IU of vitamin D3 (D3) (n = 31) or a placebo (PL) (n = 32) daily. Serum 25(OH)D concentrations were measured by finger‐stick analyses at baseline and after 8 weeks of supplementation. Data were analyzed by using a 2 × 2 (group × time) repeated measure multivariate analysis of variance to determine group differences for pre‐values and post‐values (p < 0.05). Results On day one of the study, both D3 and PL groups had insufficient levels of vitamin D (mean ± SD) 24.03 ± 9.78 ng mL−1 and 23.62 ± 9.77 ng mL−1, respectively. After 8 weeks of supplementation, the D3 group 25(OH)D level rose to a mean of 43.57 ± 10.87 ng mL−1 (p < 0.001) versus the PL group whose 25(OH)D level remained statistically unchanged 24.31 ± 8.84 ng mL−1. Women who were overweight/obese had insufficient vitamin D levels prior to supplementation. Conclusions Following supplementation with 5,000 IU of vitamin D3, all subjects' 25(OH)D levels rose to a sufficient level (≥30 ng mL−1). The findings of this study concur with the Institute of Medicine and Endocrine Society recommendations in that two to three times the daily requirement of vitamin D is required to improve serum vitamin D levels in individuals who are overweight or obese.
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Affiliation(s)
- J M Lukaszuk
- College of Health and Human Sciences Northern Illinois University DeKalb IL USA
| | - P E Luebbers
- Department of Health, Physical Education, and Recreation Emporia State University Emporia KS USA
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23
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Christensen MHE, Scragg RK. Consistent ethnic specific differences in diabetes risk and vitamin D status in the National Health and Nutrition Examination Surveys. J Steroid Biochem Mol Biol 2016; 164:4-10. [PMID: 26386461 DOI: 10.1016/j.jsbmb.2015.09.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Revised: 08/29/2015] [Accepted: 09/14/2015] [Indexed: 11/28/2022]
Abstract
Previous findings from the Third National Health and Nutrition Examination Survey (NHANES III), a representative sample of the US population carried out in 1988-1994, showed an inverse association between diabetes risk and serum concentrations of 25-hydroxyvitamin D (25(OH)D) in non-Hispanic whites and Mexican-Americans but not in non-Hispanic blacks. The study aim was to determine if this same pattern in ethnic variation occurred in more recent NHANES surveys. Cross-sectional data came from the NHANES carried out from 1988 to 1994 (NHANES III) and from 2001 to 2006 (NHANES 01-06). The analysis included 11,331 people (5641 non-Hispanic white, 2714 non-Hispanic black and 2976 Mexican American) without known diabetes mellitus, fasting for ≥8h and aged ≥20 years, with available measurements of 25(OH)D, fasting glucose, fasting insulin and body mass index (BMI). Adjusting for age, gender, BMI, leisure time physical activity and season, higher levels of 25(OH)D were associated with decreased fasting glucose, decreased fasting insulin, and decreased diabetes risk in both non-Hispanic whites and Mexican Americans for both surveys and when combined. When combining NHANES III and NHANES 01-06 the odds ratio (95% confidence interval) for having diabetes was 0.28 (0.19, 0.41) in the highest 25(OH)D quartile compared to the lowest quartile in non-Hispanic whites, and 0.13 (0.06, 0.28) in Mexican Americans (both p<0.0001); but 1.54 (0.62, 3.82) in non-Hispanic blacks, among whom 25(OH)D was not associated with fasting glucose, fasting insulin, or diabetes risk (p>0.05). There was a significant interaction between non-Hispanic whites and Mexican Americans combined, compared with non-Hispanic blacks, when 25(OH)D was regressed against fasting glucose (p=0.016) but not against fasting insulin (p>0.05). The major finding in both NHANES surveys of consistent inverse associations between serum 25(OH)D concentrations and diabetes risk in non-Hispanic whites and Mexican Americans, but not in non-Hispanic blacks, suggests this finding is unlikely due to chance.
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Affiliation(s)
- Monika H E Christensen
- Department of Clinical Science, University of Bergen, Bergen, Norway; School of Population Health, University of Auckland, Auckland, New Zealand
| | - Robert K Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand.
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Pilic L, Pedlar CR, Mavrommatis Y. Salt-sensitive hypertension: mechanisms and effects of dietary and other lifestyle factors. Nutr Rev 2016; 74:645-58. [PMID: 27566757 DOI: 10.1093/nutrit/nuw028] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Salt sensitivity, which is an increase in blood pressure in response to high dietary salt intake, is an independent risk factor for cardiovascular disease and mortality. It is associated with physiological, environmental, demographic, and genetic factors. This review focuses on the physiological mechanisms of salt sensitivity in populations at particular risk, along with the associated dietary factors. The interplay of mechanisms such as the renin-angiotensin aldosterone system, endothelial dysfunction, ion transport, and estrogen decrease in women contributes to development of salt sensitivity. Because of their effects on these mechanisms, higher dietary intakes of potassium, calcium, vitamin D, antioxidant vitamins, and proteins rich in L-arginine, as well as adherence to dietary patterns similar to the DASH (Dietary Approaches to Stop Hypertension) diet, can be beneficial to salt-sensitive populations. In contrast, diets similar to the typical Western diet, which is rich in saturated fats, sucrose, and fructose, together with excessive alcohol consumption, may exacerbate salt-sensitive changes in blood pressure. Identifying potential mechanisms of salt sensitivity in susceptible populations and linking them to protective or harmful dietary and lifestyle factors can lead to more specific guidelines for the prevention of hypertension and cardiovascular disease.
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Affiliation(s)
- Leta Pilic
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA.
| | - Charles R Pedlar
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Yiannis Mavrommatis
- L. Pilic, C.R. Pedlar, and Y. Mavrommatis are with the School of Sport, Health and Applied Science, St Mary's University, Twickenham, London, United Kingdom. CR Pedlar is with the Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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Redmond J, Fulford AJ, Jarjou L, Zhou B, Prentice A, Schoenmakers I. Diurnal Rhythms of Bone Turnover Markers in Three Ethnic Groups. J Clin Endocrinol Metab 2016; 101:3222-30. [PMID: 27294326 PMCID: PMC4971334 DOI: 10.1210/jc.2016-1183] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Ethnic groups differ in fragility fracture risk and bone metabolism. Differences in diurnal rhythms (DRs) of bone turnover and PTH may play a role. OBJECTIVE We investigated the DRs of plasma bone turnover markers (BTMs), PTH, and 1,25(OH)2D in three groups with pronounced differences in bone metabolism and plasma PTH. PARTICIPANTS Healthy Gambian, Chinese, and white British adults (ages 60-75 years; 30 per country). INTERVENTIONS Observational study with sample collection every 4 hours for 24 hours. MAIN OUTCOMES Levels of plasma C-terminal telopeptide of type I collagen, procollagen type-1 N-propeptide, N-mid osteocalcin, bone alkaline phosphatase, PTH, and 1,25-dihydroxyvitamin D were measured. DRs were analyzed with random-effects Fourier regression and cross-correlation and regression analyses to assess associations between DRs and fasting and 24-hour means of BTMs and PTH. RESULTS Concentrations of BTMs, PTH, and 1,25-dihydroxyvitamin D were higher in Gambians compared to other groups (P < .05). The DRs were significant for all variables and groups (P < .03) and were unimodal, with a nocturnal peak and a daytime nadir for BTMs, whereas PTH had two peaks. The DRs of BTMs and PTH were significantly cross-correlated for all groups (P < .05). There was a significant positive association between C-terminal telopeptide of type I collagen and PTH in the British and Gambian groups (P = .03), but not the Chinese group. CONCLUSIONS Despite ethnic differences in plasma BTMs and PTH, DRs were similar. This indicates that alteration of rhythmicity and loss of coupling of bone resorption and formation associated with an elevated PTH in other studies may not uniformly occur across different populations and needs to be considered in the interpretation of PTH as a risk factor of increased bone loss.
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Affiliation(s)
- Jean Redmond
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Anthony J Fulford
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Landing Jarjou
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Bo Zhou
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Ann Prentice
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Inez Schoenmakers
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
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Souberbielle JC, Massart C, Brailly-Tabard S, Cormier C, Cavalier E, Delanaye P, Chanson P. Serum PTH reference values established by an automated third-generation assay in vitamin D-replete subjects with normal renal function: consequences of diagnosing primary hyperparathyroidism and the classification of dialysis patients. Eur J Endocrinol 2016; 174:315-23. [PMID: 26628583 DOI: 10.1530/eje-15-0595] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/01/2015] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To determine parathyroid hormone (PTH) reference values in French healthy adults, taking into account serum 25-hydroxyvitamin D (25OHD), renal function, age, gender, and BMI. PARTICIPANTS AND MAIN BIOLOGICAL MEASUREMENTS We studied 898 healthy subjects (432 women) aged 18-89 years with a normal BMI and estimated glomerular filtration rate (eGFR), 81 patients with surgically proven primary hyperparathyroidism (PHPT), and 264 dialysis patients. 25OHD and third-generation PTH assays were implemented on the LIAISON XL platform. RESULTS Median PTH and 25OHD values in the 898 healthy subjects were 18.8 ng/l and 23.6 ng/ml respectively. PTH was lower in subjects with 25OHD ≥30 ng/ml than in those with lower values. Among the 183 subjects with 25OHD ≥30 ng/ml, those aged ≥60 years (n=31) had higher PTH values than younger subjects, independent of 25OHD, BMI, and eGFR (P<0.001). Given the small number of subjects aged ≥60 years, we adopted the 95% CI of PTH values for the entire group of 183 vitamin D-replete subjects (9.4-28.9 ng/l) as our reference values. With 28.9 ng/l as the upper limit of normal (ULN) rather than the manufacturer's ULN of 38.4 ng/l, the percentage of PHPT patients with 'high' PTH values rose to 90.1% from 66.6% (P<0.001), and 18.6% of the dialysis patients were classified differently in view of the KDIGO target range (two to nine times the ULN). CONCLUSION When only subjects with 25OHD ≥30 ng/ml were included in the reference population, the PTH ULN fell by 22.4%, diagnostic sensitivity for PHPT improved, and the classification of dialysis patients was modified.
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Affiliation(s)
| | - Catherine Massart
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Sylvie Brailly-Tabard
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpita
| | - Catherine Cormier
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Etienne Cavalier
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Pierre Delanaye
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France
| | - Philippe Chanson
- Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpitaux de ParisHôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, F94275 Le Kremlin-Bicêtre, FranceUMR S1185Faculté de Médecine Paris-Sud, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceINSERM U1185F-94276 Le Kremlin-Bicêtre, France Service des Explorations FonctionnellesNecker-Enfants Malades University Hospital, 149 Rue de Sèvres, Paris F75015, FranceHormonology LaboratoryPontchaillou University Hospital, Rennes F29000, FranceService de Génétique MoléculairePharmacogénétique et Hormonologie, F-94275 Le Kremlin-Bicêtre, FranceFaculté de Médecine Paris-SudUnité Mixte de Recherche-S1185, Univ Paris-Sud, Université Paris-Saclay, F-94276 Le Kremlin-Bicêtre, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) U1185F-94276 Le Kremlin-Bicêtre, FranceRheumatology DepartmentCochin University Hospital, Paris F75014, FranceClinical Chemistry DepartmentSart Tilman University Hospital, Liège, BelgiumNephrology and Dialysis DepartmentSart Tilman University Hospital, Liège, BelgiumAssistance Publique-Hôpita
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Gutiérrez OM, Parsa A, Isakova T, Scialla JJ, Chen J, Flack JM, Nessel LC, Gupta J, Bellovich KA, Steigerwalt S, Sondheimer JH, Wright JT, Feldman HI, Kusek JW, Lash JP, Wolf M. Genetic African Ancestry and Markers of Mineral Metabolism in CKD. Clin J Am Soc Nephrol 2016; 11:653-62. [PMID: 26912553 DOI: 10.2215/cjn.08020715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 01/05/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND OBJECTIVES Disorders of mineral metabolism are more common in African Americans with CKD than in European Americans with CKD. Previous studies have focused on the differences in mineral metabolism by self-reported race, making it difficult to delineate the importance of environmental compared with biologic factors. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In a cross-sectional analysis of 3013 participants of the Chronic Renal Insufficiency Cohort study with complete data, we compared markers of mineral metabolism (phosphorus, calcium, alkaline phosphatase, parathyroid hormone, fibroblast growth factor 23, and urine calcium and phosphorus excretion) in European Americans versus African Americans and separately, across quartiles of genetic African ancestry in African Americans (n=1490). RESULTS Compared with European Americans, African Americans had higher blood concentrations of phosphorus, alkaline phosphatase, fibroblast growth factor 23, and parathyroid hormone, lower 24-hour urinary excretion of calcium and phosphorus, and lower urinary fractional excretion of calcium and phosphorus at baseline (P<0.001 for all). Among African Americans, a higher percentage of African ancestry was associated with lower 24-hour urinary excretion of phosphorus (Ptrend<0.01) in unadjusted analyses. In linear regression models adjusted for socio-demographic characteristics, kidney function, serum phosphorus, and dietary phosphorus intake, higher percentage of African ancestry was significantly associated with lower 24-hour urinary phosphorus excretion (each 10% higher African ancestry was associated with 39.6 mg lower 24-hour urinary phosphorus, P<0.001) and fractional excretion of phosphorus (each 10% higher African ancestry was associated with an absolute 1.1% lower fractional excretion of phosphorus, P=0.01). CONCLUSIONS A higher percentage of African ancestry was independently associated with lower 24-hour urinary phosphorus excretion and lower fractional excretion of phosphorus among African Americans with CKD. These findings suggest that genetic variability might contribute to racial differences in urinary phosphorus excretion in CKD.
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Affiliation(s)
- Orlando M Gutiérrez
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
| | - Afshin Parsa
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Tamara Isakova
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Julia J Scialla
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jing Chen
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - John M Flack
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Lisa C Nessel
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jayanta Gupta
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Keith A Bellovich
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Susan Steigerwalt
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - James H Sondheimer
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jackson T Wright
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Harold I Feldman
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - John W Kusek
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - James P Lash
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Myles Wolf
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
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28
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Lemacks JL, Ilich JZ, Liu PY, Shin H, Ralston PA, Cui M, Wickrama KAS. Dietary Influence on Calcitropic Hormones and Adiposity in Caucasian and African American Postmenopausal Women Assessed by Structural Equation Modeling (SEM). J Nutr Health Aging 2016; 20:602-10. [PMID: 27273349 DOI: 10.1007/s12603-015-0637-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine differences in hydroxycholecalciferol (25(OH)D) and parathyroid hormone (PTH) concentrations between Caucasian and African American (AA) postmenopausal women, as well as the effects of dietary calcium, protein and vitamin D intakes on 25(OH)D, PTH, and body adiposity using structural equation modeling (SEM). DESIGN Population-based prospective cohort study. SETTING Academic research using the baseline data from two longitudinal studies. Participants Included n=113 Caucasian and n=40 African American, postmenopausal women who completed the baseline data collection and met inclusion criteria (dietary calcium intake <900 mg/day and being generally healthy) between 2006 and 2010. MAIN OUTCOME Dietary intake of calcium and vitamin D, assessed by dietary records, were examined in relation to calcitropic hormones concentrations and adiposity markers. Independent t-tests, confirmatory factor analysis, SEM and multi-group analyses were conducted to examine the aforementioned relationships as well as group differences among hormones, dietary intake, anthropometrics, age and other factors. RESULTS Dietary calcium and protein intakes were significantly lower in AA women. Years since menopause were significantly higher in AA compared to Caucasian women. PTH and 25(OH)D levels were significantly lower in AA compared to Caucasian women. Dietary calcium and protein intakes did not influence body adiposity in either group of women. Dietary vitamin D had minimal indirect (via 25(OH)D levels) influence on adiposity. CONCLUSION The study confirmed the positive relationship of 25(OH)D with adiposity markers and both AA and Caucasian women. The study provides a unique example of the use of SEM in nutrition research within a clinical context. This model should be further tested in other populations.
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Affiliation(s)
- J L Lemacks
- Jennifer L. Lemacks, Nutrition and Food Systems Department, The University of Southern Mississippi, 118 College Drive #5172, Hattiesburg, Mississippi, United States; ; Tel.: +1-601-266-6825; Fax: +1-601-266-6343
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29
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Zagami RM, Di Pino A, Urbano F, Piro S, Purrello F, Rabuazzo AM. Low circulating vitamin D levels are associated with increased arterial stiffness in prediabetic subjects identified according to HbA1c. Atherosclerosis 2015; 243:395-401. [DOI: 10.1016/j.atherosclerosis.2015.09.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/25/2015] [Accepted: 09/29/2015] [Indexed: 02/07/2023]
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Esposito S, Lelii M. Vitamin D and respiratory tract infections in childhood. BMC Infect Dis 2015; 15:487. [PMID: 26521023 PMCID: PMC4628332 DOI: 10.1186/s12879-015-1196-1] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Accepted: 10/08/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Respiratory tract infections (RTIs) remain among of the most important causes of morbidity and mortality among children. Several studies have associated vitamin D deficiency with an increased risk of RTIs, and vitamin D supplementation has been proposed as a possible preventive measure against RTIs in children. The main aim of this review is to summarize the current evidence from the literature about the link between vitamin D and RTIs in children. DISCUSSION Several recent studies have shown that vitamin D has different immunomodulatory properties associated with the risk of RTIs in childhood. In this regard, it is very important to understand the definition of deficiency and insufficiency of vitamin D and when and how to treat this condition. Unfortunately, there is no consensus, although a level of at least 10 ng/mL 25-hydroxycholecalciferol (25[OH]D) is thought to be necessary to promote bone mineralization and calcium homeostasis, and a concentration between 20 ng/mL and 50 ng/mL is considered adequate to provide an immunomodulatory effect. Available data support a role for vitamin D deficiency in the risk of pediatric tuberculosis, recurrent acute otitis media, and severe bronchiolitis, whereas further studies are needed to confirm an association in children with recurrent pharyngotonsillitis, acute rhinosinusitis and community-acquired pneumonia. CONCLUSIONS Maintenance of adequate vitamin D status may be an effective and inexpensive prophylactic method against some RTIs, but the supplementation regimen has not been clearly defined. Further clinical trials are needed to determine the 25(OH)D concentrations associated with an increased risk of RTIs and optimal vitamin D supplementation regimen according to the type of RTI while also taking into consideration vitamin D receptor polymorphisms.
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Affiliation(s)
- Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
| | - Mara Lelii
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 9, 20122, Milan, Italy.
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31
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Sablok A, Batra A, Thariani K, Batra A, Bharti R, Aggarwal AR, Kabi BC, Chellani H. Supplementation of vitamin D in pregnancy and its correlation with feto-maternal outcome. Clin Endocrinol (Oxf) 2015; 83:536-41. [PMID: 25683660 DOI: 10.1111/cen.12751] [Citation(s) in RCA: 132] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 01/19/2015] [Accepted: 02/09/2015] [Indexed: 11/28/2022]
Abstract
CONTEXT Vitamin D deficiency is widely prevalent throughout the world. Pregnant women, neonates and infants form most vulnerable groups for vitamin D deficiency. OBJECTIVE (1) To find prevalence of vitamin D deficiency in pregnant women. (2) To evaluate the effect of supplementation with cholecalciferol in improving vitamin D levels in pregnant women and evaluate its correlation with feto-maternal outcome. DESIGN Randomized control trial from years 2010 to 2012. SETTING Tertiary care centre, Delhi, India. PARTICIPANTS One-hundred and eighty pregnant women. Study population divided randomly into two groups: group A: nonintervention (60 women) and group B: intervention (120 women). INTERVENTION The intervention group received supplementation of vitamin D in dosages depending upon 25(OH)-D levels. MAIN OUTCOME MEASURES Risk of maternal complications such as preterm labour, pre-eclampsia and gestational diabetes associated with vitamin D deficiency and risk of low birthweight and poor Apgar score in infants of mothers with vitamin D deficiency. RESULTS Adjusted serum 25(OH)-D concentration was lower in group A as compared to group B (mean 46·11 ± 74·21 nmol/l vs 80 ± 51·53 nmol/l). Forty-four percent patients in group A and 20·3% patients in group B developed preterm labour/pre-eclampsia/gestational diabetes. Newborns of mothers in group A had lower cord blood levels of 25(OH)-D levels as compared to group B (mean 43·11 ± 81·32 nmol/l vs 56·8 ± 47·52 nmol/l). They also had lower birthweight of mean 2·4 ± 0·38 kg as compared to group B 2·6 ± 0·33 kg. CONCLUSIONS Vitamin D supplementation reduces risk of maternal comorbidities and helps improve neonatal outcomes.
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Affiliation(s)
- Aanchal Sablok
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Aruna Batra
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Karishma Thariani
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Achla Batra
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Rekha Bharti
- Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Abha Rani Aggarwal
- National Institute of Medical Statistics, All India Institute of Medical Sciences, New Delhi, India
| | - B C Kabi
- Department of Biochemistry, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Harish Chellani
- Department of Paediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Scialla JJ, Parekh RS, Eustace JA, Astor BC, Plantinga L, Jaar BG, Shafi T, Coresh J, Powe NR, Melamed ML. Race, Mineral Homeostasis and Mortality in Patients with End-Stage Renal Disease on Dialysis. Am J Nephrol 2015; 42:25-34. [PMID: 26287973 DOI: 10.1159/000438999] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 06/08/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Abnormalities in mineral homeostasis are ubiquitous in patients on dialysis, and influenced by race. In this study, we determine the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. METHODS We measured the levels of fibroblast growth factor 23 (FGF23) and 25-hydroxyvitamin D (25 D) in 184 African American and 327 non-African American hemodialysis patients who enrolled between 1995 and 1998 in the Choices for Healthy Outcomes in Caring for ESRD Study. Serum calcium, phosphorus, parathyroid hormone (PTH) and total alkaline phosphatase levels were averaged from clinical measurements during the first 4.5 months of dialysis. We evaluated the associated prospective risk of mortality using multivariable Cox proportional hazards models stratified by race. RESULTS PTH and total alkaline phosphatase levels were higher, whereas calcium, phosphorus, FGF23 and 25 D levels were lower in African Americans compared to those of non-African Americans. Higher serum phosphorus and FGF23 levels were associated with greater mortality risk overall; however, phosphorus was only associated with risk among African Americans (HR 5.38, 95% CI 2.14-13.55 for quartile 4 vs. 1), but not among non-African Americans (p-interaction = 0.04). FGF23 was associated with mortality in both groups, but more strongly in African Americans (HR 3.91, 95% CI 1.74-8.82 for quartiles 4 vs. 1; p-interaction = 0.09). Serum calcium, PTH, and 25 D levels were not consistently associated with mortality. The lowest and highest quartiles of total alkaline phosphatase were associated with higher mortality risk, but this did not differ by race (p-interaction = 0.97). CONCLUSIONS Aberrant phosphorus homeostasis, reflected by higher phosphorus and FGF23, may be a risk factor for mortality in patients initiating hemodialysis, particularly among African Americans.
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Affiliation(s)
- Julia J Scialla
- University of Miami Miller School of Medicine, Miami, Fla., USA
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33
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Souberbielle JC, Cavalier E, Cormier C. How to manage an isolated elevated PTH? ANNALES D'ENDOCRINOLOGIE 2015; 76:134-41. [DOI: 10.1016/j.ando.2015.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 03/04/2015] [Indexed: 02/01/2023]
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Nolan VG, Nottage KA, Cole EW, Hankins JS, Gurney JG. Prevalence of vitamin D deficiency in sickle cell disease: a systematic review. PLoS One 2015; 10:e0119908. [PMID: 25734582 PMCID: PMC4347975 DOI: 10.1371/journal.pone.0119908] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 02/03/2015] [Indexed: 11/19/2022] Open
Abstract
Vitamin D deficiency has emerged as a public health focus in recent years and patients with sickle cell disease (SCD) reportedly have a high prevalence of the condition. Our objectives were to summarize definitions of vitamin D deficiency and insufficiency used in the literature, and to determine the prevalence and magnitude of each in patients with SCD through a systematic review conducted according to PRISMA guidelines. From a PubMed search, 34 potential articles were identified and 15 met eligibility criteria for inclusion. Definitions of deficiency and insufficiency varied greatly across studies making direct comparisons difficult. This review provides evidence to suggest that suboptimal vitamin D levels are highly prevalent among those with SCD, far more so than in comparable non-SCD patients or matched control populations. Defining deficiency as vitamin D < 20 ng/mL, prevalence estimates in SCD populations range from 56.4% to 96.4%. When compared with results from the population-based National Health and Nutrition Examination Survey, however, the general African American population appeared to have a similarly high prevalence of vitamin D deficiency. African American patients with and without SCD were both substantially higher than that of Caucasians. What remains to be determined is whether there are adverse health effects for patients with SCD because of concurrent vitamin D deficiency.
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Affiliation(s)
- Vikki G. Nolan
- Departments of Hematology, Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, School of Public Health, Memphis, TN, United States of America
| | - Kerri A. Nottage
- Epidemiology and Cancer Control, Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, School of Public Health, Memphis, TN, United States of America
| | - Elliott W. Cole
- Departments of Hematology, Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, School of Public Health, Memphis, TN, United States of America
| | - Jane S. Hankins
- Epidemiology and Cancer Control, Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, School of Public Health, Memphis, TN, United States of America
| | - James G. Gurney
- Departments of Hematology, Division of Epidemiology, Biostatistics and Environmental Health, University of Memphis, School of Public Health, Memphis, TN, United States of America
- St. Jude Children’s Research Hospital, Memphis, TN, United States of America
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35
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Yu R, Sun J, Zheng Z, Chen J, Fan R, Liang X, Zhu Y, Liu Y, Shen S, Hou J. Association between vitamin D level and viral load or fibrosis stage in chronic hepatitis B patients from Southern China. J Gastroenterol Hepatol 2015; 30:566-74. [PMID: 25238258 DOI: 10.1111/jgh.12783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/30/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM The role of vitamin D playing in patients with chronic hepatitis C has been intensively studied. However, studies on the potential interaction between vitamin D level and chronic hepatitis B are still limited. This study aimed to explore whether any association existed between serum vitamin D level and liver histology or virological parameters in patients with chronic hepatitis B infection in Southern China. METHODS 25-Hydroxyvitamin D serum levels were determined in a cohort of 242 treatment-naïve chronic hepatitis B patients. Histologic assessment was based on Knodell histologic activity index and Ishak fibrosis staging. Predictors of vitamin D insufficiency were identified using multivariate analysis. RESULTS Mean 25-hydroxyvitamin D value was 33.90 ng/mL. The percentage of patients with different concentration of 25-hydroxyvitamin D (≥ 30 ng/mL, 20-30 ng/mL, < 20 ng/mL) were 59.9%, 31.4%, and 8.7%, respectively. Gender, season, age, and viral genotype were independent predictors of vitamin D insufficiency (< 30 ng/mL). Patients with genotype B virus infection had a lower mean 25-hydroxyvitamin D level (P = 0.023) and higher prevalence of vitamin D insufficiency than those with genotype C (P = 0.021), while no association was found between vitamin D status and viral load. In addition, 25-hydroxyvitamin D level did not significantly vary according to activity grade or fibrosis stage. CONCLUSIONS The prevalence of vitamin D insufficiency is relatively low in our cohort. Patients infected with genotype B had a higher prevalence of vitamin D insufficiency than genotype C. 25-Hydroxyvitamin D serum level is not associated with viral load or fibrosis stage in chronic hepatitis B patients.
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Affiliation(s)
- Rui Yu
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Redmond J, Palla L, Yan L, Jarjou LMA, Prentice A, Schoenmakers I. Ethnic differences in urinary calcium and phosphate excretion between Gambian and British older adults. Osteoporos Int 2015; 26:1125-35. [PMID: 25311107 PMCID: PMC4331615 DOI: 10.1007/s00198-014-2926-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 10/01/2014] [Indexed: 12/04/2022]
Abstract
UNLABELLED Ethnic differences in renal calcium and phosphate excretion exist, which may depend on differences in their dietary intakes and regulatory factors. We report highly significant differences in urinary calcium and phosphate excretion between white British and Gambian adults after statistical adjustment for mineral intakes, indicating an independent effect of ethnicity. INTRODUCTION Populations vary in their risk of age-related osteoporosis. There are racial or ethnic differences in the metabolism of the bone-forming minerals calcium (Ca) and phosphate (P), with a lower renal Ca and P excretion in African-Americans compared to white counterparts, even at similar intakes and rates of absorption. Also, Africans in The Gambia have a lower Ca excretion compared to white British subjects, groups known to differ in their dietary Ca intake. Here, we report on differences in urinary Ca and P excretion between Gambian and white British adults while allowing for known predictors, including dietary intakes. METHODS Participants were healthy white British (n = 60) and Gambian (n = 61) men and women aged 60-75 years. Fasting blood and 2-h urine samples were collected. Markers of Ca and P metabolism were analysed. Dietary intake was assessed with country-specific methods. RESULTS White British older adults had higher creatinine-corrected urinary Ca and P excretion (uCa/uCr, uP/uCr) and lower tubular maximum of Ca and P compared to Gambian counterparts. The predictors of urinary Ca and P differed between groups. Multiple regression analysis showed that dietary Ca and Ca/P were predictors of uCa/uCr and uP/uCr, respectively. Ethnicity remained a significant predictor of uCa/uCr and uP/uCr after adjustment for diet and other factors. CONCLUSIONS Gambian older adults have higher renal Ca conservation than British counterparts. Dietary mineral intakes were predictors of the differences in urinary Ca and P excretion, but ethnicity remained a highly significant predictor after statistical adjustment. This suggests that ethnicity has an independent effect on renal Ca and P handling.
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Affiliation(s)
- J. Redmond
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
| | - L. Palla
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
- Present Address: Department of Non-communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - L. Yan
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
| | | | - A. Prentice
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
- Medical Research Council Keneba, Keneba, The Gambia
| | - I. Schoenmakers
- Medical Research Council Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, CB1 9NL UK
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Abstract
BACKGROUND AND OBJECTIVE Psoriasis is a common, chronic autoimmune inflammatory skin disorder, which has potential systemic complications and is clinically defined by sharply demarcated, erythematous patches and plaques covered by a characteristic silvery white scale. Topical corticosteroids have widely been regarded as the mainstay first line of treatment. Recently, topical vitamin D analogs have been added to the first-line treatment repertoire as well, either as monotherapy or in combination with topical steroids due to synergistic, complementary effectiveness. In this paper, we review the role of vitamin D in the pathophysiology and treatment of psoriasis. METHODS A comprehensive search of the Cochrane Library, MEDLINE, and PUBMED databases were performed to identify relevant basic science and clinical trial literature investigating the role of vitamin D in psoriasis. Primary endpoints in clinical trials were largely based on clinical improvement as assessed by the psoriasis area severity index score or physician's global assessment. RESULTS AND CONCLUSION The role of vitamin D in psoriasis is complex and extensive. Oral and topical vitamin D therapies provide comparable efficacies to corticosteroids when used as monotherapy and may be superior when used in combination with a potent topical steroid. Additionally topical vitamin D analogs demonstrate a favorable safety profile with "steroid-sparing" effects. Thus, topical vitamin D derivatives should be considered an indispensable component of the current physician's arsenal in the treatment of psoriasis.
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Affiliation(s)
- Teo Soleymani
- Department of Dermatology, University of California, Irvine School of Medicine, Irvine, CA, USA
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Hsu JW, Wingard JR, Logan BR, Chitphakdithai P, Akpek G, Anderlini P, Artz AS, Bredeson C, Goldstein S, Hale G, Hematti P, Joshi S, Kamble RT, Lazarus HM, O'Donnell PV, Pulsipher MA, Savani BN, Schears RM, Shaw BE, Confer DL. Race and ethnicity influences collection of granulocyte colony-stimulating factor-mobilized peripheral blood progenitor cells from unrelated donors, a Center for International Blood and Marrow Transplant Research analysis. Biol Blood Marrow Transplant 2015; 21:165-71. [PMID: 25316111 PMCID: PMC4272878 DOI: 10.1016/j.bbmt.2014.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/07/2014] [Indexed: 11/27/2022]
Abstract
Little information exists on the effect of race and ethnicity on collection of peripheral blood stem cells (PBSC) for allogeneic transplantation. We studied 10,776 donors from the National Marrow Donor Program who underwent PBSC collection from 2006 to 2012. Self-reported donor race/ethnic information included Caucasian, Hispanic, Black/African American (AA), Asian/Pacific Islander (API), and Native American (NA). All donors were mobilized with subcutaneous filgrastim at an approximate dose of 10 μg/kg/day for 5 days. Overall, AA donors had the highest median yields of mononuclear cells per liter and CD34(+) cells per liter of blood processed (3.1 × 10(9) and 44 × 10(6), respectively), whereas Caucasians had the lowest median yields at 2.8 × 10(9) and 33.7 × 10(6), respectively. Multivariate analysis of CD34(+) per liter mobilization yields using Caucasians as the comparator and controlling for age, gender, body mass index, and year of apheresis revealed increased yields in overweight and obese AA and API donors. In Hispanic donors, only male obese donors had higher CD34(+) per liter mobilization yields compared with Caucasian donors. No differences in CD34(+) per liter yields were seen between Caucasian and NA donors. Characterization of these differences may allow optimization of mobilization regimens to allow enhancement of mobilization yields without compromising donor safety.
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Affiliation(s)
- Jack W Hsu
- University of Florida Shands Cancer Center, Gainesville, Florida.
| | - John R Wingard
- University of Florida Shands Cancer Center, Gainesville, Florida
| | - Brent R Logan
- Center for International Blood and Marrow Transplant Research, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Pintip Chitphakdithai
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota
| | - Gorgun Akpek
- Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Paolo Anderlini
- University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | - Chris Bredeson
- Ottawa Hospital Blood and Marrow Transplant Program, Ottawa, Ontario, Canada
| | | | - Gregory Hale
- All Children's Hospital, St. Petersburg, Florida
| | - Peiman Hematti
- University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | | | - Rammurti T Kamble
- Baylor College of Medicine Center for Cell and Gene Therapy, Houston, Texas
| | - Hillard M Lazarus
- University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, Ohio
| | | | - Michael A Pulsipher
- University of Utah School of Medicine, Primary Children's Hospital, Salt Lake City, Utah
| | - Bipin N Savani
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Bronwen E Shaw
- Anthony Nolan Research Institute, London, United Kingdom
| | - Dennis L Confer
- Center for International Blood and Marrow Transplant Research, Minneapolis, Minnesota; National Marrow Donor Program, Minneapolis, Minnesota
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Vitamin D deficiency in pregnant women of ethnic minority: a potential contributor to preeclampsia. J Perinatol 2014; 34:767-73. [PMID: 24854625 DOI: 10.1038/jp.2014.91] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 04/02/2014] [Accepted: 04/04/2014] [Indexed: 01/01/2023]
Abstract
OBJECTIVE We investigated risk for comorbidities and preeclampsia at low vitamin D levels in ethnic minorities. STUDY DESIGN Umbilical cord vitamin D (25(OH)D) concentration was determined in urban minorities: 80.9% African American and 17% Hispanic mothers-baby pairs. To identify the correlation between vitamin D levels and high-risk comorbidities which result in preeclampsia, multivariate logistic regression analyses were performed. RESULT Below the Institute of Medicine threshold of 25(OH)D for pregnant women (25 ng ml⁻¹), obesity (P=0.055) and pregestational diabetes (odds ratio (OR)=2.056) were observed. The study median was 16 ng ml⁻¹ (<25th percentile), at which gestational hypertension (P=0.042), chronic hypertension (OR=4.842) and pregestational diabetes (OR=3.45) became relevant. The risk for preeclampsia increased 12-fold with gestational hypertension (P=0.003) and 14-fold with combined chronic and gestational hypertension (P=0.001). CONCLUSION Pregnant women of ethnic minority had lower median vitamin D levels which may contribute to a potential risk for preeclampsia.
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Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Hunter K. Correction of Low Vitamin D Improves Fatigue: Effect of Correction of Low Vitamin D in Fatigue Study (EViDiF Study). NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2014; 6:396-402. [PMID: 25210673 PMCID: PMC4158648 DOI: 10.4103/1947-2714.139291] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background: Fatigue is a common presenting complaint of patients in the primary care offices. Low levels of vitamin D have been associated with fatigue in cancer patients. Normalization of vitamin D level improves their fatigue. Whether low vitamin D plays a role in fatigue in medically stable patients is not known. Aims: This prospective non-randomized therapeutic study observed the prevalence of low vitamin D in fatigue and the effect of normalization of vitamin D on fatigue. Material and Methods: One hundred and seventy four adult patients, who presented in our primary care office with fatigue and stable chronic medical conditions,completed fatigue assessment questionnaires. Patients with low vitamin D levels received ergocalciferol therapy for 5 weeks. Scores of pre- and post-treatment fatigue assessment questionnaires were compared. Results: Prevalence of low vitamin D was 77.2% in patients who presented with fatigue. After normalization of vitamin D levels fatigue symptom scores improved significantly (P < 0.001) in all five subscale categories of fatigue assessment questionnaires. Conclusion: The prevalence of low vitamin D is high in patients who present with fatigue and stable chronic medical conditions, if any. Normalization of vitamin D levels with ergocalciferol therapy significantly improves the severity of their fatigue symptoms.
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Affiliation(s)
- Satyajeet Roy
- Department of Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Anthony Sherman
- Department of Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Mary Joan Monari-Sparks
- Department of Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Olga Schweiker
- Department of Medicine, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Krystal Hunter
- Cooper Research Institute, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey, USA
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Fibroblast growth factor 23, vitamin D, and health disparities among African Americans with chronic kidney disease. Semin Nephrol 2014; 33:448-56. [PMID: 24119850 DOI: 10.1016/j.semnephrol.2013.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Compared with Caucasians, African Americans have lower circulating concentrations of 25-hydroxyvitamin D (25(OH)D), the major storage form of vitamin D, leading to the widespread assumption that African Americans are at higher risk of vitamin D deficiency. However, the finding that African Americans maintain better indices of musculoskeletal health than Caucasians throughout their lifespan despite having lower circulating 25(OH)D concentrations suggests that the relationship between vitamin D deficiency and racial health disparities may not be so straightforward. The fairly recent emergence of fibroblast growth factor 23 (FGF23) may help resolve some of this uncertainty. FGF23 strongly modulates both systemic and local activation of 25(OH)D, playing a potentially important role in the degree to which lower 25(OH)D concentrations impact health outcomes, including differences in the incidence and rate of progression of chronic kidney disease by race. This review critically assesses ongoing controversies surrounding the relationship between vitamin D and racial disparities in chronic kidney disease outcomes, and how FGF23 may help to clarify the picture.
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Chung IH, Kim HJ, Chung S, Yoo EG. Vitamin D deficiency in Korean children: prevalence, risk factors, and the relationship with parathyroid hormone levels. Ann Pediatr Endocrinol Metab 2014; 19:86-90. [PMID: 25077091 PMCID: PMC4114049 DOI: 10.6065/apem.2014.19.2.86] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 06/20/2014] [Accepted: 06/25/2014] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study was performed to investigate the relationship between serum vitamin D and parathyroid hormone (PTH) levels as well as to describe the prevalence and the risk factors of vitamin D deficiency (VDD) in Korean children. METHODS Participants were 1,212 children aged 4 to 15 years, who visited Bundang CHA Medical Center (located at 37°N) between March 2012 and February 2013. Overweight was defined as body mass index≥85th percentile. Participants were divided into 4 age groups and 2 seasonal groups. VDD was defined by serum 25-hydroxyvitamin D (25OHD) <20 ng/mL. RESULTS The level of 25OHD was significantly lower in overweight group than in normal weight group (17.1±5.1 ng/mL vs. 19.1±6.1 ng/mL, P<0.001). Winter-spring season (odds ratio [OR], 4.46; 95% confidence interval [CI], 3.45-5.77), older age group (OR, 1.60; 95% CI, 1.36-1.88), and overweight (OR, 2.21; 95% CI, 1.62-3.01) were independently related with VDD. The PTH levels were significantly higher in VDD group compared to vitamin D insufficiency and sufficiency group (P<0.001). In normal weight children, 25OHD (β=-0.007, P<0.001) and ionized calcium (β=-0.594, P=0.007) were independently related with PTH, however, these associations were not significant in overweight children. CONCLUSION VDD is very common in Korean children and its prevalence increases in winter-spring season, in overweight children and in older age groups. Further investigation on the vitamin D and PTH metabolism according to adiposity is required.
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Affiliation(s)
- In Hyuk Chung
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Hae Jung Kim
- Department of Pediatrics, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Eun-Gyong Yoo
- Department of Pediatrics, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Korea
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Abstract
The prevalence of osteoporosis and the incidence of age-related fragility fracture vary by ethnicity. There is greater than 10-fold variation in fracture probabilities between countries across the world. Mineral and bone metabolism are intimately interlinked, and both are known to exhibit patterns of daily variation, known as the diurnal rhythm (DR). Ethnic differences are described for Ca and P metabolism. The importance of these differences is described in detail between select ethnic groups, within the USA between African-Americans and White-Americans, between the Gambia and the UK and between China and the UK. Dietary Ca intake is higher in White-Americans compared with African-Americans, and is higher in White-British compared with Gambian and Chinese adults. Differences are observed also for plasma 25-hydroxy vitamin D, related to lifestyle differences, skin pigmentation and skin exposure to UVB-containing sunshine. Higher plasma 1,25-dihydroxy vitamin D and parathyroid hormone are observed in African-American compared with White-American adults. Plasma parathyroid hormone is also higher in Gambian adults and, in winter, in Chinese compared with White-British adults. There may be ethnic differences in the bone resorptive effects of parathyroid hormone, with a relative skeletal resistance to parathyroid hormone observed in some, but not all ethnic groups. Renal mineral excretion is also influenced by ethnicity; urinary Ca (uCa) and urinary P (uP) excretions are lower in African-Americans compared with White-Americans, and in Gambians compared with their White-British counterparts. Little is known about ethnic differences in the DR of Ca and P metabolism, but differences may be expected due to known differences in lifestyle factors, such as dietary intake and sleep/wake pattern. The ethnic-specific DR of Ca and P metabolism may influence the net balance of Ca and P conservation and bone remodelling. These ethnic differences in Ca, P and the bone metabolism may be important factors in the variation in skeletal health.
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Affiliation(s)
- J. Redmond
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
| | | | - B. Zhou
- Department of Public health, Shenyang Medical College, 146 Huanghe North Street, Shenyang 110034, People's Republic of China
| | - A. Prentice
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
- Medical Research Council Keneba, The Gambia
| | - I. Schoenmakers
- Elsie Widdowson Laboratory, Medical Research Council Human Nutrition Research, Cambridge CB1 9NL, UK
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Thayer ZM. The vitamin D hypothesis revisited: race-based disparities in birth outcomes in the United States and ultraviolet light availability. Am J Epidemiol 2014; 179:947-55. [PMID: 24618066 DOI: 10.1093/aje/kwu023] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Skin color has been proposed to contribute to race-based health disparities in the United States because of differences in ultraviolet (UV) light-induced vitamin D synthesis. The prediction of this hypothesis, herein named the UVD hypothesis, is that racial disparities in health outcomes are correlated with UV light availability. This paper investigates whether UV light availability is associated with disparities in the rates of low birth weight (LBW) and preterm birth (PTB) between whites and blacks, because these outcomes are thought to be influenced by vitamin D status and to shape disease risk in later life. Data on LBW and PTB from 2007 (n = 2,825,620 births) were compared with data on UV light exposure across the United States. Contrary to the predictions of the UVD hypothesis, LBW and PTB rate disparities were greatest in states with the highest UV light exposure. Notably, income inequality was positively and significantly related to LBW and PTB disparities, even after controlling for UV light availability. The results of this analysis demonstrate that there is a significant environmental gradient in racial disparities in birth outcomes in the United States, but other social or environmental factors associated with living in the southern United States are likely stronger contributors to disparities in birth outcomes than UV light-induced vitamin D status.
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Mitri J, Nelson J, Ruthazer R, Garganta C, Nathan DM, Hu FB, Dawson-Hughes B, Pittas AG. Plasma 25-hydroxyvitamin D and risk of metabolic syndrome: an ancillary analysis in the Diabetes Prevention Program. Eur J Clin Nutr 2014; 68:376-83. [PMID: 24448494 PMCID: PMC4091839 DOI: 10.1038/ejcn.2013.293] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 06/12/2013] [Accepted: 08/23/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES Low blood levels of 25-hydroxyvitamin D (25OHD) have been associated with cardiometabolic disease but results are inconsistent. The objective of the study was to investigate the association of 25OHD with metabolic syndrome in a population at increased risk for diabetes. SUBJECTS/METHODS Using baseline data from the placebo and lifestyle intervention arms of the Diabetes Prevention Program (N=2000), multivariable logistic regression models were used to estimate the odds of prevalent metabolic syndrome and each of its individual components across 25OHD tertiles. Multivariable linear regression was used to estimate the adjusted mean difference of insulin secretion and sensitivity across the same 25OHD tertiles. In participants free of metabolic syndrome at baseline (N=546), incident metabolic syndrome in the first 2 years of follow-up was assessed using discrete-time proportional hazards regression to test its association with 25OHD concentration. RESULTS After multivariate adjustment, participants in the highest tertile of 25OHD had lower odds of prevalent metabolic syndrome (odds ratio=0.62; 95% confidence interval (CI)=0.45-0.84), smaller waist circumference, higher high-density lipoprotein and lower fasting plasma glucose compared with participants in the lowest tertile of 25OHD. Higher plasma 25OHD concentration was associated with greater insulin sensitivity and lower insulin secretion. After multivariate adjustment, there was a nonsignificant lower risk of metabolic syndrome in the highest tertile of 25OHD (hazard ratio=0.79; 95% CI=0.48-1.32) compared with the lowest tertile. CONCLUSIONS In a population at increased risk for diabetes, higher plasma 25OHD concentration was inversely associated with prevalent metabolic syndrome and nonsignificantly with incident metabolic syndrome.
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Affiliation(s)
- J Mitri
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
| | - J Nelson
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - R Ruthazer
- Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - C Garganta
- Department of Clinical Genetics, Floating Hospital for Children at Tufts Medical Center, Boston, MA, USA
| | - D M Nathan
- Diabetes Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - F B Hu
- 1] Department of Nutrition and Epidemiology, Harvard School of Public Health, Boston, MA, USA [2] Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - B Dawson-Hughes
- 1] Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA [2] Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - A G Pittas
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
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Das S, Singh GK, Das P. Vitamin D concentration and disease risk: the concerns. Am J Clin Nutr 2014; 99:648-9. [PMID: 24557533 DOI: 10.3945/ajcn.113.075945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Sushmita Das
- Department of Microbiology All-India Institute of Medical Sciences (AIIMS) Phulwarisharif, Patna India E-mail:
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Maeda SS, Saraiva GL, Hayashi LF, Cendoroglo MS, Ramos LR, Corrêa MDP, Henrique de Mesquita C, Lazaretti-Castro M. Seasonal variation in the serum 25-hydroxyvitamin D levels of young and elderly active and inactive adults in São Paulo, Brazil: The São PAulo Vitamin D Evaluation Study (SPADES). DERMATO-ENDOCRINOLOGY 2014; 5:211-7. [PMID: 24494057 PMCID: PMC3897593 DOI: 10.4161/derm.24476] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 03/17/2013] [Accepted: 03/27/2013] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the 25-hydroxyvitamin D [25(OH)D] concentrations in individuals in the city of São Paulo belonging to different age groups and exhibiting specific behavioral characteristics and to correlate the 25(OH)D concentration with the level of UV radiation (UVR). PATIENTS AND METHODS A total of 591 individuals were included, distributed as follows: 177 were living in institutions (NURSING, 76.2 ± 9.0 y old), 243 were part of the community elderly (COMMUNITY, 79.6 ± 5.3 y old), 99 were enrolled in a physical activity program targeting the elderly (ACTIVE, 67.6 ± 5.4 y old) and 72 were young (YOUNG, 23.9 ± 2.8 y old). Blood samples from all individuals were collected throughout the year. UVR measurements were taken by an official meteorology institution. RESULTS The UVR values varied throughout the year, following a sinusoidal-like pattern. Because of the Earth's orbit, we hypothesized that there would be cyclic patterns for the 25(OH)D and UVR values that repeat every 12 mo. The general formula is represented by the equation P1+P2⋅sin(-2⋅π12⋅(t-P3)) The mean 25(OH)D concentration and the amplitude of the variation were significantly higher for the YOUNG and ACTIVE groups than for the COMMUNITY and NURSING groups. The nadir for UVR was in June, whereas the nadir for the 25(OH)D concentration was in the spring, corresponding to a delay of one season. CONCLUSIONS There was seasonal variation in the 25(OH)D concentration for all the groups studied; however, the amplitude of the variation was higher for the groups of young and physically active people, possibly due to the higher level of sunlight exposure for these groups. The lowest 25(OH)D concentration was detected in the spring.
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Affiliation(s)
- Sergio Setsuo Maeda
- Department of Medicine; Endocrinology; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
| | - Gabriela Luporini Saraiva
- Department of Medicine; Endocrinology; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
| | - Lilian Fukusima Hayashi
- Department of Medicine; Endocrinology; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
| | - Maysa Seabra Cendoroglo
- Department of Medicine; Geriatrics; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
| | - Luiz Roberto Ramos
- Department of Preventive Medicine; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
| | | | | | - Marise Lazaretti-Castro
- Department of Medicine; Endocrinology; UNIFESP (Universidade Federal de São Paulo); São Paulo, Brazil
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Bodnar LM, Klebanoff MA, Gernand AD, Platt RW, Parks WT, Catov JM, Simhan HN. Maternal vitamin D status and spontaneous preterm birth by placental histology in the US Collaborative Perinatal Project. Am J Epidemiol 2014; 179:168-76. [PMID: 24124195 DOI: 10.1093/aje/kwt237] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to determine the association between maternal 25-hydroxyvitamin D (25(OH)D) and the risk of spontaneous preterm birth (sPTB) before 35 weeks' gestation. A random subcohort from the US Collaborative Perinatal Project (1959-1965) was sampled (n = 2,629) and augmented with all remaining cases of sPTB before 35 weeks' gestation for a total of 767 cases. Banked serum samples collected at 26 weeks' gestation or earlier were assayed for 25(OH)D. Constructs for vascular histology and inflammatory histology were developed from placental pathology examinations. There was no relationship between 25(OH)D and sPTB among white women. Among nonwhite mothers, serum 25(OH)D levels of 30-<50, 50-<75, and ≥75 nmol/L were associated with reductions of 1.0-1.6 cases of sPTB per 100 live births and 20%-30% reductions in risk of sPTB compared with 25(OH)D levels less than 30 nmol/L after adjustment for prepregnancy body mass index (weight (kg)/height (m)(2)), season, and other confounders. This association was driven by inflammation-mediated cases of sPTB and sPTB cases without placental lesions. A sensitivity analysis for unmeasured confounding by exercise, fish intake, and skin color suggested some bias away from the null in the conventional results, but conclusions were generally supported. The vitamin D-sPTB relationship should be examined in modern cohorts with detailed data on skin pigmentation and other covariates.
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Gallagher JC, Jindal PS, Smith LM. Vitamin D supplementation in young White and African American women. J Bone Miner Res 2014; 29:173-81. [PMID: 23761326 DOI: 10.1002/jbmr.2010] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/22/2013] [Accepted: 06/03/2013] [Indexed: 11/09/2022]
Abstract
There is limited information on the effects of vitamin D on serum 25 hydroxyvitamin D (25OHD) in young people and none on African Americans. The main objective of this trial was to measure the effect of different doses of vitamin D3 on serum 25OHD and serum parathyroid hormone (PTH) in young women with vitamin D insufficiency (serum 25OHD ≤ 20 ng/mL (50 nmol/L). A randomized double-blind placebo-controlled trial of vitamin D3 was conducted in young white and African American women, age 25 to 45 years. A total of 198 healthy white (60%) and African American (40%) women were randomly assigned to placebo, or to 400, 800, 1600, or 2400 IU of vitamin D3 daily. Calcium supplements were added to maintain a total calcium intake of 1000 to 1200 mg daily. The primary outcomes of the study were the final serum 25OHD and PTH levels at 12 months. The absolute increase in serum 25OHD with 400, 800, 1600, and 2400 IU of vitamin D daily was slightly greater in African American women than in white women. On the highest dose of 2400 IU/d, the mixed model predicted that mean 25OHD increased from baseline 12.4 ng/mL (95% confidence interval [CI], 9.2-15.7) to 43.2 ng/mL (95% CI, 38.2-48.1) in African American women and from 15.0 ng/mL (95% CI, 12.3-17.6) to 39.1 ng/mL (95% CI, 36.2-42.0) in white women. There was no significant effect of vitamin D dose on serum PTH in either race but there was a significant inverse relationship between final serum PTH and serum 25OHD. Serum 25OHD exceeded 20 ng/mL in 97.5% of whites on the 400 IU/d dose and between 800 and 1600 IU/d for African Americans. The recommended dietary allowance (RDA) suggested by the Institute of Medicine for young people is 600 IU daily. The increase in serum 25OHD after vitamin D supplementation was similar in young and old, and in white and African American women.
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Kato A. Racial differences in secondary hyperparathyroidism. Nephrourol Mon 2013; 5:932. [PMID: 24350098 PMCID: PMC3842570 DOI: 10.5812/numonthly.9449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 12/16/2012] [Indexed: 11/16/2022] Open
Affiliation(s)
- Akihiko Kato
- Blood Purification Unit, Hamamatsu University Hospital, Hamamatsu, Japan
- Corresponding author: Akihiko Kato, Blood Purification Unit, Hamamatsu University Hospital, 1-20-1 Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan. Tel/Fax: +81-534352756, E-mail:
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