Bilateral inferior petrosal sinus sampling in the differential diagnosis of ACTH-dependent Cushing's syndrome: A reappraisal.

Cushing's syndrome (CS) is a rare disorder, once exogenous causes have been excluded. However, when diagnosed, the majority of cases are adrenocorticotropic hormone (ACTH)-dependent, of which a substantial minority are due to a source outside of the pituitary, ectopic ACTH syndrome (EAS). Differentiating among pituitary-dependent CS, Cushing's disease (CD) and an ectopic source can be problematic. Because non-invasive tests in the evaluation of CS patients often lack adequate sensitivity and specificity, bilateral inferior petrosal sinus sampling (BIPSS), a minimally invasive procedure performed during the investigation of ACTH-dependent CS, can be extremely helpful. BIPSS is considered to be the gold standard for differentiating CD from the EAS. Furthermore, although such differentiation may indeed be challenging, BIPSS is itself a complex investigation, especially in recent times due to the widespread withdrawal of corticotrophin-releasing hormone and its replacement by desmopressin. We review current published data on this investigation and, in the light of this and our own experience, discuss its appropriate use in diagnostic algorithms.

Vitamin D, testosterone and depression in middle-aged and elderly men: a systematic review.

Depression is one of the common psychiatric disorders during elderly. This systematic review aims to present the relationship between vitamin D deficiency, depression and testosterone serum concentration in the middle-aged and elderly men. We performed a comprehensive search in the Google Scholar, PubMed, ProQuest, Web of Science, Cochrane, Science Direct, and Scopus databases to collect any relevant published studies. The data of the articles that had been investigated the relationship between depression and 25-hydroxy vitamin D (25[OH]D) serum concentration (nine studies), or testosterone and 25[OH]D (six studies), as the primary outcomes, were included in our review. The results of the cohort and cross-sectional studies have shown that vitamin-D deficiency is associated with the incidence of depression in older men. In addition, documents have reported the positive association between vitamin D and testosterone, and previous studies have shown that testosterone can involve in the mood. We have proposed scientific mechanisms that have shown vitamin D may also play a protective role in depression through its effect on the testosterone. Therefore, it is a low risk and safe recommendation for the middle-aged and elderly men to use the vitamin D supplement or exposure to the sunlight to prevent depression.

Dietary determinants of healthy/unhealthy metabolic phenotype in individuals with normal weight or overweight/obesity: a systematic review.

Objectives: Nutritional factors are amongst the major determinants in the onset and development of obesity and metabolic complications. Nevertheless, the dietary determinants of metabolic health are not completely elucidated. The aim of this systematic review is to investigate nutritional and dietary factors that may contribute to metabolic heterogeneity in individuals with obesity or normal weight. Methods: A literature search was performed in PubMed, Scopus, EMBASE, and google scholar databases until August 2021, to locate studies that examined metabolic health and its association with intakes of specific foods or food groups, nutrient intakes or status, as well as adherence to certain dietary patterns. Two researchers had independently screened titles and abstracts, examined full-text studies, conducted data extraction, and evaluated their quality using the Newcastle-Ottawa Scale. Results: Twenty-seven studies, with a total of 39518 subjects, were included. Of these studies, 11 articles evaluated the association between different dietary patterns and metabolic phenotypes, while 15 had investigated the association of single food/nutrients intakes or nutrient status with metabolic phenotype, and one paper evaluated the association of dietary inflammatory index with metabolic health. The findings of these studies propose that healthy dietary patterns such as the Mediterranean pattern, Dietary Approaches to Stop Hypertension, and population-derived patterns (such as the "Healthy" and "Fruit and vegetable" patterns) were associated with higher odds of the metabolically healthy phenotype. Higher intakes of fruits, vegetables, dairy products, coffee/tea, vitamin D, magnesium, and flavonoids, were suggested to lower the risk of developing metabolically unhealthy phenotype, while, higher consumption of saturated fat, carbohydrate and sugar-sweetened beverages, fast foods, organ meats, and a pro-inflammatory diet increased the risk. Conclusion: Results from published studies, which were mostly cross-sectional, suggest that higher adherence to unhealthier dietary patterns, characterized by the consumption of refined and processed foods, was associated with a lower likelihood of having a healthy metabolic phenotype, while the opposite was observed for healthier dietary patterns. Findings may be used in developing nutritional strategies aimed at improving metabolic health in the population.

Effect of time restricted feeding on anthropometric measures, eating behavior, stress, serum levels of BDNF and LBP in overweight/obese women with food addiction: a randomized clinical trial.

BACKGROUND & AIM: Food addiction (FA) as a specific food-related behavior may play an essential role in the pathogenesis of obesity. Brain-derived neurotrophic factor (BDNF) and gut microbiota (GM) alterations probably through fasting are closely related to brain function, affecting eating behaviors and body weight management. This study aimed to evaluate the effect of time-restricted feeding (TRF) on serum BDNF levels and eating behaviors in overweight and obese women with FA. METHODS AND DESIGN: This clinical trial was performed with a 2-month follow-up on 56 obese and overweight women with FA. Participants were randomly divided into two groups receiving a low-calorie diet (n = 27) and a group receiving a low-calorie diet with TRF (n = 29). Anthropometric measurements, biochemical markers, eating behavior, and stress were assessed during the study period. RESULTS: The reductions in weight, body mass index (BMI), waist circumference, and body fat mass were significantly higher in the TRF group compared to the control group at week 8 (P = 0.018, P = 0.015. P = 0.03, and P = 0.036, respectively). The cognitive restriction score was higher in the TRF as compared with the control group (P = 0.002). The food addiction criteria score was significantly reduced in both groups (P < 0.001). Serum levels of BDNF were significantly increased in the TRF group (P < 0.001). In addition, BDNF levels had a positive and significant correlation with the cognitive restriction score (r = 0.468 and P < 0.001), While the correlation with FA was not significant (ß = 0.588 and P = 0.618). Lipopolysaccharide binding protein decreased significantly in both groups, but this decrease was significantly higher in the TRF group than in the control group (P < 0.001). CONCLUSION: The results of this study showed that a low-calorie diet with TRF is more effective in weight management than a low-calorie diet alone, probably through further modulating the GM and improving BDNF levels. More effective weight loss in the TRF is probably related to better management of eating behavior than FA. TRIAL REGISTRATION: Iranian Registry of Clinical Trials identifier: IRCT20131228015968N7.

Diagnostic accuracy of bilateral inferior petrosal sinus sampling using desmopressin or corticotropic- releasing hormone in ACTH-dependent Cushing's syndrome: A systematic review and meta-analysis.

The current gold standard diagnostic method for Cushing disease (CD) is bilateral inferior petrosal sinus sampling (BIPSS) after corticotropin-releasing hormone (CRH) stimulation. Due to shortages of CRH, BIPSS has been performed with desmopressin (DDAVP) instead. The objective of this systematic review and meta-analysis was to estimate the diagnostic accuracy of BIPSS using DDAVP or CRH for the differential diagnosis of Cushing's syndrome (CS). A literature review was done in PubMed, Scopus, EMBASE, and google scholar databases to derive summary estimates of the overall diagnostic sensitivity and accuracy of BIPSS using DDAVP or CRH in Cushing's syndrome. Pooled sensitivity, specificity, diagnostic odds ratio and summary receiver operating characteristic curves (SROC) for differential diagnosis of Cushing's syndrome in the random-effects models, were computed. Overall, 11 different studies with a total of 612 participants, were eligible for the analysis. Five articles with data on BIPSS using DDAVP, 5 papers on BIPSS using CRH, and another one evaluated the results of stimulation using DDAVP, with or without CRH, for differential diagnosis of Cushing's syndrome. The pooled (95% CI) sensitivity and specificity of BIPSS using DDAVP, were 96% (91-98%) and 1.00 (0.00-1.00), respectively. The area under the SROC curve was 0.95. The pooled (95% CI) sensitivity and specificity of BIPSS using CRH, were 98% (92-99%) and 1.00 (0.00-1.00), respectively, and the area under the SROC curve was 0.98. The I2 index (95% CI) was 0% (0-100%) for both BIPSS using DDAVP and using CRH. As a result, DDAVP stimulation is a safe, effective, less expensive, valuable and available alternative to CRH in the setting of BIPSS for all age groups of patients with CS. Registration code in PROSPERO: CRD42021292531.

Mental health and quality of life in different obesity phenotypes: a systematic review.

OBJECTIVES: It has been suggested that obesity phenotypes are related to mental health problems and health-related quality of life (HRQoL). However, there is no certain consensus. This systematic review aimed to evaluate the association between different obesity phenotypes with common psychiatric symptoms and HRQoL. METHODS: Electronic databases i.e. PubMed, Scopus, EMBASE, and google scholar were searched until September 2021, to identify studies that investigated associations between the obesity phenotypes with psychiatric symptoms and/or mental and physical HRQoL. Two researchers independently checked titles and abstracts, evaluated full-text studies, extracted data, and appraised their quality using the Newcastle-Ottawa Scale. RESULTS: Eighteen studies, with a total of 3,929,203 participants, were included. Of the studies included in this systematic review, 10 articles evaluated the association between obesity phenotypes and psychiatric symptoms, while six papers investigated the association between HRQoL and obesity phenotypes, and two studies assessed both. As a whole, the findings of these studies suggest that obese individuals with a favorable metabolic profile have a slightly higher risk of mental health problems and poor quality of life, however, the risk becomes larger when obesity is combined with an adverse metabolic profile. So, metabolically healthy obesity may not be a completely benign condition in relation to mental disorders and poor quality of life. CONCLUSION: According to published research, obesity is likely to increase the risk of mental health problems and poor quality of life when metabolic disturbances are present.

Randomized study of the effects of vitamin D and/or magnesium supplementation on mood, serum levels of BDNF, inflammation, and SIRT1 in obese women with mild to moderate depressive symptoms.

OBJECTIVES: This study aimed to evaluate the effects of vitamin D and/or magnesium supplementation on mood, serum levels of BDNF, inflammation, and SIRT1 in obese women with mild to moderate depressive symptoms. METHODS: In this trial, the 108 obese women with mild to moderate depressive symptoms were randomly allocated into 4 groups: (1) co- supplementation group (n = 27): receiving a 50000 IU vitamin D soft gel weekly + a 250- mg magnesium tablet daily; (2) vitamin D group (n = 27): receiving a 50000 IU vitamin D soft gel weekly + a magnesium placebo daily; (3) magnesium group (n = 27): receiving a vitamin D placebo weekly + a 250- mg magnesium tablet daily; (4) control group (n = 27): receiving a vitamin D placebo weekly + a magnesium placebo daily, for 8 weeks. Before and after the intervention, anthropometric indices, depressive symptoms, serum levels of BDNF, 25(OH)-D, inflammation, and SIRT1, were measured. RESULTS: At the end of the study, ANCOVA demonstrated significant differences between the 4 groups in 25(OH)-D, magnesium, TNF-α, IL-6, and BDNF levels. But, we found no significant differences in terms of hs-CRP and SIRT1 levels. A significant reduction in depression score was observed in 3 intervention groups and also in control group. No significant differences in BDI-II score were shown among the 4 groups at the end of the intervention. CONCLUSION: Vitamin D plus magnesium supplementation in obese women with mild to moderate depressive symptoms has beneficial influences on mood, serum levels of BDNF, inflammation, and SIRT1.

Transition from metabolically healthy to unhealthy overweight/obesity and risk of cardiovascular disease incidence: A systematic review and meta-analysis.

AIMS: Discrepant results have been demonstrated regarding the cardiovascular (CV) risk of populations with metabolically healthy overweight/obesity (MHO) who were transitioned into metabolically unhealthy states. So, the objective of this systematic review and meta-analysis was to estimate the risk of cardiovascular diseases (CVD) incidence in individuals with transitional MHO phenotype. DATA SYNTHESIS: A literature review was done in PubMed, Scopus, EMBASE, and google scholar databases. Pooled HRs for all fatal and nonfatal CV events were computed using random-effect models for transitional MHOs in general as well as for each sex subgroup separately. This systematic review and meta-analysis included a total of 7 prospective observational studies with a total of 7,720,165 participants, published between 2018 and 2020. The mean follow-up duration of participants was 11.7 (5.5) years. Overall, the transitional MHO individuals had a significant risk of CVD incidence [HR = 1.42, 95% CI (1.24-1.60)]. In addition, in both male and female subgroups, unstable MHO phenotype demonstrated a significant CVD risk and HRs for incident CVD in males and females were 1.51 (1.07-1.96) and 1.71 (1.08-2.34), respectively. CONCLUSION: Transition from MHO to unhealthy state throughout follow-up elevated the risk of CVD in both male and female groups. This can explain the association between MHO and incidence of CV events especially with longer follow up period. REGISTRATION CODE IN PROSPERO: CRD42021270225.

The effect of bariatric surgery in comparison with the control group on the prevention of comorbidities in people with severe obesity: a prospective cohort study.

BACKGROUND: Obesity is a global health priority, particularly in developing countries. The preventive effect of bariatric surgery against obesity-related diseases in the developing countries of the Middle East and North Africa region, where type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia prevail, has not been examined. METHOD: Severely obese participants who underwent bariatric surgery were compared with their counterparts who underwent no intervention. These patients had been followed up in two prospective cohort studies for three years. We here determined the incidence of new-onset T2DM, HTN, and dyslipidemia and reported absolute and relative risks for the incidence of these comorbidities in the two groups. RESULTS: In this study, 612 participants in the bariatric surgery group were compared with 593 participants in the control group. During the follow-up period, T2DM developed in eight (2.9%) people in the surgery group and 66 (15.0%) people in the control group (P < 0.001). New-onset HTN and dyslipidemia showed significantly lower frequencies in the surgery group compared to the control group (4 (1.8%) vs. 70 (20.4%) and 33 (14.3%) vs. 93 (31.5%), respectively). Regarding a less favorable metabolic profile in the surgery group at the baseline, the relative risk reductions associated with bariatric surgery were 94, 93, and 55% for the development of T2DM, HTN, and dyslipidemia, respectively. CONCLUSION: The risk reduction of obesity-related comorbidities after bariatric surgery should be considered in the decision-making process for public health in the region, which bariatric surgery could result in the prevention of comorbidities.

Vitamin C and Cancer: The Role of Vitamin C in Disease Progression and Quality of Life in Cancer Patients.

Much attention has been put on antioxidants as potential preventive and therapeutic agents against cancer. Vitamin C, an important antioxidant with anti-inflammatory and immune system enhancement features, could provide protection against cancer. However, experimental and epidemiologic evidence on vitamin C and cancer risk are still indefinite. Substantial literature reports that cancer patients experience vitamin C deficiency associated with decreased oral intake, infection, inflammation, disease processes, and treatments such as radiation, chemotherapy, and surgery. Studies demonstrate associations between IVC and inflammation biomarkers and propose some amelioration in symptoms, with a possible advantage in quality of life (QoL) when intravenous vitamin C (IVC) alone or in combination with oral vitamin C is administered in oncologic care. While, the anticancer impact of high doses of IVC remains debatable in spite of growing evidence that high dose vitamin C shows anti-tumorigenic activity by elevating the amount of reactive oxygen species (ROS) in cancer cells without meaningful toxicities. Hence, there is an urgent requirement for rigorous and well-controlled assessments of IVC as an adjuvant therapy for cancer before clear conclusions can be drawn. Thus, more clinical trials are required to determine the additive impact of high dose vitamin C in cancer patients.

How Do We Manage Breastfeeding During the COVID-19 Pandemic?

The COVID-19 pandemic is causing global disturbances and creating many questions in every aspect of life. Since it influences health in multiple ways, including sexual and reproductive health, publishing in all of these areas has increased lately. One aspect that requires basing on scientific evidence is breastfeeding. There are some controversies in the literature on the breastfeeding management in confirmed COVID-19 mothers. Breast milk is excellent for the infant's nutritional needs and growth, because it includes all of the nutrients an infant requires. It promotes the immature immune system of the infant and reinforces defense mechanisms against infectious and other agents during the breastfeeding period. While limited clinical research is available, we can build on what we know about breastfeeding and previous similar outbreaks to plan and manage this crisis. The aim of this chapter is to provide pediatricians with further guidance on breastfeeding and associated safety measures during the COVID-19 crisis, particularly in instances where a mother has or may have COVID-19. This will also be a benefit to future epidemics and pandemics.

Experience in Nutrition Management of Diabetes-Affected COVID-19 Patients.

When diabetic patients are ill, their bodies react by releasing hormones to combat the illness. These hormones can be triggered by some states, such as infections. Some illnesses that most likely have an influence on blood glucose levels include common cold or flu, COVID-19, bronchitis, or chest infections. So, it is important for diabetic patients affected by COVID-19 to eat a healthy balanced diet to maintain stable blood glucose levels and enhance their immune functions. The immune response has often been demonstrated to be attenuated by insufficient nutrition in many model systems as well as in human studies. We summarize and propose potential nutritional therapeutic options available for the treatment of this novel coronavirus in diabetic patients.

Obesity and Risk of COVID-19 Infection and Severity: Available Evidence and Mechanisms.

The coronavirus disease 2019 (COVID-19) pandemic has resulted in worldwide research efforts to recognize people at greatest risk of developing critical illness and dying. Growing numbers of reports have connected obesity to more severe COVID-19 illness and death. Although the exact mechanism by which obesity may lead to severe COVID-19 outcomes has not yet been determined, the mechanisms appear to be multifactorial. These include mechanical changes of the airways and lung parenchyma, systemic and airway inflammation, and general metabolic dysfunction that adversely affect pulmonary function and/or response to treatment. As COVID-19 continues to spread worldwide, clinicians should carefully monitor and manage obese patients for prompt and targeted treatment.

Iron Deficiency and Anemia in Cancer Patients: The Role of Iron Treatment in Anemic Cancer Patients.

Anemia is a prevalent complication in patients with cancer, both at diagnosis and during treatment, with notable negative effects on quality of life and overall prognosis. Iron deficiency is the most common cause of anemia in the patients and can affect almost half of patients with solid and hematologic malignancies. The pathogenesis is complex and multifactorial, including bleeding, malnutrition, medications, and inflammation resulted from cancer and cancer treatment. In fact, either absolute or functional iron deficiency can occur. Most iron deficient cancer patients present with functional iron deficiency, a condition with adequate iron storage but insufficient iron supply for erythroblasts and other iron dependent tissues. Functional iron deficiency is the result of the cancer related cytokine release, but in absolute iron deficiency iron reserves are depleted leading to similar but often more severe symptoms of inadequate iron store. Current therapeutic options in cancer anemia consist of iron administration, erythropoietic stimulating agents, and blood transfusion. The latter should be administered to a minimum, because of problems regarding risks. Here, we present a review on the epidemiology, pathophysiology, clinical outcomes, and therapeutic options of iron deficiency as well as the effect of iron therapy on tumor progression in anemic cancer patients.

Effects of Vitamin D and Omega-3 Fatty Acids Co-Supplementation on Inflammatory Factors and Tumor Marker CEA in Colorectal Cancer Patients Undergoing Chemotherapy: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Objectives: This study aimed to investigate the effects of vitamin D and omega-3 fatty acids co-supplementation on inflammatory factors and tumor marker CEA in colorectal cancer patients undergoing chemotherapy.Methods: In this study, 81 patients with stage ӀӀ or ӀӀӀ colorectal cancer were randomly assigned into four groups: (1) control: receiving a vitamin D placebo, weekly + two omega-3 fatty acid placebo capsules, daily; (2) omega-3 fatty acid, receiving two omega-3 fatty acid capsules (each capsule containing 330 mg of omega-3 fatty acids), daily + a vitamin D placebo, weekly; (3) vitamin D, receiving a 50,000 IU vitamin D soft gel, weekly + two omega-3 fatty acid placebo capsules, daily; (4) co-supplementation, receiving a 50,000 IU vitamin D soft gel, weekly + two omega-3 fatty acids capsules, for 8 weeks. Before and after the intervention, serum levels of 25(OH)D, TNF-α, IL-1ß, IL-6, IL-8, NF-kB activity, and tumor marker CEA, were measured.Results: After 8 weeks of intervention, patients who received combined vitamin D and omega-3 fatty acids supplements compared with omega-3, vitamin D, and placebo had significantly decreased TNF-α, and IL-1ß (P < .05). In addition, serum levels of TNF-α, IL-1ß, IL-6, IL-8, and tumor marker CEA were decreased significantly in omega-3, vitamin D, and co-supplementation of them, compared with baseline. NF-kB activity was decreased significantly in vitamin D and co-supplementation groups, compared with baseline. Regarding CEA, there was no significant difference between the four groups at the end of intervention (P > .05).Conclusion: Results show that co-supplementation of vitamin D and omega-3 fatty acids co-supplementation, in colorectal cancer patients have beneficial impacts on inflammation and tumor marker CEA.

A hypocaloric high-protein diet supplemented with ß-cryptoxanthin improves non-alcoholic fatty liver disease: a randomized controlled trial.

BACKGROUND: Despite promising animal data, there is no randomized controlled trial (RCT) on the effects of high protein (HP)-diet and/or ß-cryptoxanthin in non-alcoholic fatty liver disease (NAFLD). AIMS: Safety and efficacy assessment of a hypocaloric HP-diet supplemented with ß-cryptoxanthin in NAFLD. METHODS: Ninety-two Iranian NAFLD outpatients were recruited for this 12-week, single-center, parallel-group, double-blind RCT and randomized into 4 arms (n = 23): HP-diet and ß-cryptoxanthin (hypocaloric HP-diet + ß-cryptoxanthin), HP-diet (hypocaloric HP-diet + placebo), ß-cryptoxanthin (standard hypocaloric diet + ß-cryptoxanthin), and control (standard hypocaloric diet + placebo). Serum levels of liver enzymes and grade of hepatic steatosis were assessed at baseline and study endpoint as outcome measures. RESULTS: In the intention-to-treat population (N = 92), HP-diet and ß-cryptoxanthin group experienced greater 12-week reductions in serum levels of liver enzymes than control group (mean difference for alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and gamma-glutamyl transferase: - 27.2, - 7.2, - 39.2, and - 16.3 IU/L, respectively; all p < 0.010). Clinical remission rate (achieving grade 0 hepatic steatosis) in HP-diet and ß-cryptoxanthin group (82.6%) was also higher than other groups (13.0%, 17.4%, and 0.0% in HP-diet, ß-cryptoxanthin, and control groups, respectively; p < 0.001). Sixteen patients reported minor adverse events. CONCLUSION: A hypocaloric HP-diet supplemented with ß-cryptoxanthin safely and efficaciously improves NAFLD. TRIAL REGISTRATION NUMBER: This trial was registered at https://www.irct.ir as IRCT2017060210181N10.

Micronutrients that Affect Immunosenescence.

The immune system undergoes some adverse changes throughout aging, many of which have been implicated in the increased morbidity and mortality related to infection in the elderly. In addition to intrinsic alterations in the immune system with aging, the elderly are more likely to have poor nutritional status, which further affects the already impaired immune function. Micronutrient deficiencies are a recognized global public health problem, and poor nutritional status predisposes to certain infections. Immune function may be ameliorated by restoring deficient micronutrients to recommended levels, thereby increasing resistance to infection and supporting faster recovery when infected. This review looks at the effects of micronutrient supplementation on immune function during aging.

The Role of Nutrition in Attenuating Age-Related Skeletal Muscle Atrophy.

The elderly population is increasing rapidly worldwide, and we are faced with the significant challenge for maintaining or improving physical activity, independence, and quality of life. Sarcopenia, the age-related decline of skeletal muscle mass, is characterized by loss of muscle quantity and quality resulting to a gradual slowing of movement, a decrease in strength and power, elevated risk of fall-related injury, and often frailty. Supplemental, hormonal, and pharmacological approaches have been attempted to attenuate sarcopenia but these have not achieved outstanding results. In this review, we summarize the current knowledge of nutrition-based therapies for counteracting sarcopenia.

Effect of Vitamin D Therapy on Sexual Function in Women with Sexual Dysfunction and Vitamin D Deficiency: A Randomized, Double-Blind, Placebo Controlled Clinical Trial.

PURPOSE: We investigated the effect of vitamin D therapy on sexual function in women with low vitamin D levels and sexual dysfunction. MATERIALS AND METHODS: We performed this randomized, double-blind, placebo controlled trial in women 18 to 45 years old with sexual dysfunction, defined as a FSFI (Female Sexual Functioning Index) score less than 26.55, and serum 25[OH]D less than 30 ng/ml. Participants received an intramuscular injection of 300,000 IU cholecalciferol or a placebo at baseline and then after 4 weeks. Sexual function was evaluated with the FSFI at baseline, and 4 and 8 weeks. The serum level of 25[OH]D was measured and depression symptoms were evaluated by the BDI (Beck Depression Inventory) at baseline and 8 weeks. RESULTS: A total of 38 women in each group completed the study. Serum 25[OH]D levels increased only in the cholecalciferol group by a mean ± SD of 14.4 ± 3.2 ng/ml (p <0.001). The FSFI score was higher in the intervention group at study week 4 (19.6 vs 16.3, p = 0.002) and week 8 (25.0 vs 17.1, p <0.001). The BDI score was significantly decreased only in the cholecalciferol group by a mean of -21.0 ± 12.3 (p <0.001). The effect of treatment on sexual function was independent of its effect on depression symptoms. CONCLUSIONS: Vitamin D therapy in women with sexual dysfunction and vitamin D deficiency can improve sexual function. This effect does not seem to be mediated by an improvement in depression symptoms.

The Effects of UVB and Vitamin D on Decreasing Risk of Colorectal Cancer Incidence and Mortality: A Review of the Epidemiology, Clinical Trials, and Mechanisms.

The solar ultraviolet B-vitamin D-cancer hypothesis was first suggested in 1980 based on a geographical ecological study. Since then, several ecological and observational studies, as well as researches of mechanisms have supported the hypothesis. Also, the association between vitamin D condition and cancer risk has been assessed in a number of epidemiologic studies, while data from interventional studies remain scant. In regard of cancer locations, the body of evidence is most substantial for colorectal cancer, for which support comes from studies of 25(OH)D, vitamin D intake, and region of residence in a sunny weather. Collectively evidence demonstrates that vitamin D has a potent and beneficial effect at antagonizing and blocking several mitogenic mechanisms related to tumorigenesis. Taken together with the epidemiological studies and limited clinical trials, individuals may need to consider elevating 25(OH)D levels via sun exposure and/or vitamin D supplementation to decrease risk of colorectal cancer, in addition to standard care, treat cancer.