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1.
Front Immunol ; 12: 648546, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33763085

RESUMEN

Multisystem Inflammatory Syndrome in children (MIS-C) is a rare but devastating complication of coronavirus disease 19 (COVID-19). The development of prognostic biomarkers and more importantly the implementation of new treatment modalities would have a significant impact in clinical practice regarding the outcome of MIS-C. Vitamin D could be a potential candidate. In this mini review we analyze the immunomodulatory role of vitamin D in viral infections and specifically in COVID-19. We also examine the current literature regarding the association of vitamin D with MIS-C and Kawasaki disease. The vitamin D was evaluated not only as a biomarker but also as a nutritional supplement. We concluded that vitamin D levels could be valuable in predicting severe forms of MIS-C and correction of abnormal levels in severe MIS-C may influences its evolution. 25-hydroxyvitamin D3 [25(OH)D3] supplementation raising serum [25(OH)D] concentrations potentially have a favorable effect in reducing the severity of MIS-C in certain circumstances. Further studies are needed to confirm these results.


Asunto(s)
/complicaciones , Síndrome de Respuesta Inflamatoria Sistémica/tratamiento farmacológico , Síndrome de Respuesta Inflamatoria Sistémica/etiología , Vitamina D/administración & dosificación , Animales , /tratamiento farmacológico , /virología , Niño , Humanos , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Vitamina D/sangre
2.
Eur Rev Med Pharmacol Sci ; 25(4): 2131-2145, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33660833

RESUMEN

The world is currently facing the COVID-19 pandemic, caused by the novel Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to a lack of specific treatment and prophylaxis, protective health measures that can reduce infection severity and COVID-19 mortality are urgently required. Clinical and epidemiological studies have shown that vitamin D deficiency can be linked to an increased risk of viral infection, including COVID-19. Therefore, in this review, we looked at various possible roles of vitamin D in reducing the risk of COVID-19 infection and severity. We describe in this article that individuals at high risk of vitamin D deficiency should consider taking vitamin D supplements to keep optimal concentrations. Moreover, we discuss different possible mechanisms by which vitamin D can efficiently reduce the risk of infections through modulation of innate and adaptive immunity against various types of infections. It is advisable to perform further studies addressing the observed influence of vitamin D levels to reduce the risk of COVID-19 infection and mortality.


Asunto(s)
/tratamiento farmacológico , Sustancias Protectoras/uso terapéutico , Deficiencia de Vitamina D/prevención & control , Vitamina D/uso terapéutico , Inmunidad Adaptativa/efectos de los fármacos , Efecto Espectador , /mortalidad , Suplementos Dietéticos , Humanos , Inmunidad Innata/efectos de los fármacos , Sustancias Protectoras/administración & dosificación , Índice de Severidad de la Enfermedad , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/epidemiología , Deficiencia de Vitamina D/inmunología
3.
Québec; INESSS; 9 mars 2021.
No convencional en Francés | BRISA/RedTESA | ID: biblio-1150887

RESUMEN

CONTEXTE: Le présent document ainsi que les constats qu'il énonce ont été rédigés dans le contexte de la crise sanitaire liée à la maladie à coronavirus (COVID-19) au Québec. L'objectif est de réaliser une recension des données publiées et de mobiliser les savoirs clés afin d'informer les décideurs publics et les professionnels de la santé et des services sociaux. Bien que les constats reposent sur un repérage exhaustif des données scientifiques publiées, l'évaluation de la qualité méthodologique des études et une appréciation du niveau de preuve scientifique par paramètre clinique d'intérêt, le processus ne repose pas sur une méthode systématique ni une validation externe selon les normes habituelles à l'INESSS. Par ailleurs, les positions ne découlent pas d'un processus de consultation élaboré. Dans les circonstances d'une telle crise de santé publique, l'INESSS reste à l'affût de toutes nouvelles données, qu'elles soient de nature scientifique ou contextuelle, susceptibles de lui faire modifier cette réponse. MÉTHODOLOGIE: Questions d'évaluation Comparativement aux standards de soins, est-ce qu'un supplément de vitamine D, chez les personnes ayant ou non une déficience ou une insuffisance, est efficace et sécuritaire pour, prévenir l'infection et les manifestations cliniques de la COVID-19? Traiter les patients (adulte, enfant, femme enceinte) COVID-19 confirmés dont l'état à l'amorce n'exige pas une hospitalisation? Traiter les patients (adulte, enfant, femme enceinte) COVID-19 confirmés dont l'état à l'amorce exige o une hospitalisation sans le recours à une oxygénothérapie; o une hospitalisation avec le recours à une oxygénothérapie non invasive (oxygène à faible débit, à haut débit, ventilation mécanique non invasive); o une hospitalisation avec le recours à une oxygénothérapie invasive (ventilation mécanique invasive, ECMO)? Quelle est la position des sociétés savantes, des agences règlementaires, des agences de santé publique et des agences d'évaluation des technologies en santé sur l'usage d'un supplément de vitamine D dans la prévention et le traitement de la COVID-19? Type de revue de littérature: Revue rapide. RÉSULTATS: ÉTAT ACTUEL DES CONNAISSANCES SCIENTIFIQUES. Données cliniques sur l'efficacité de la supplémentation en vitamine D dans le contexte de la COVID-19. Depuis l'instauration en mars 2020 de la recherche systématique en continu de la littérature scientifique sur les médicaments à visée thérapeutique, 42 027 notices ont été recensées dont 113 études cliniques où l'intervention étudiée portait sur la vitamine D. De ce nombre, 3 ECRA [Murai et al., 2021; Castillo et al., 2020; Rastogi et al., 2020] ont été retenus. Ces études sont décrites ci-dessous en fonction du type de prise en charge, soit la prophylaxie pré/post-exposition, ou le traitement de patient dont l'état de santé requiert ou non une hospitalisation. Seuls les paramètres d'intérêts sur l'évolution de la charge virale, l'amélioration ou la résolution des symptômes ou d'évolution clinique, le pronostic, l'innocuité ou la mortalité sont présentés. Supplémentation en vitamine D en prophylaxie: En date du 24 février 2021, aucun ECRA ni aucune étude observationnelle publiés n'ont été retracés par la recherche de la littérature scientifique sur les bénéfices cliniques associés à l'usage de vitamine D en prophylaxie pré- ou post- exposition au SARS-CoV-2. Par contre, il y a quelques essais cliniques actuellement enregistrés sur le site de ClinicalTrials, dont un essai comparatif à répartition aléatoire multicentrique à triple insu (PROTECT6 ) en cours de réalisation au sein de deux hôpitaux du Québec. Le principal objectif de cet essai est d'étudier les effets prophylactiques d'une supplémentation à hautes doses de vitamine D3 per os (bolus 100 000 UI suivi de 10 000 UI par semaine pendant 16 semaines) chez les travailleurs de la santé exposés à la COVID-19. Il est prévu que l'essai se termine en juin 2021. DISCUSSION: Au terme des travaux, il ressort qu'aucun ECRA ni aucune étude observationnelle publiés dans la littérature ne permettent d'évaluer l'effet d'une supplémentation en vitamine D utilisée en prophylaxie pré- ou post- exposition au SRAS-CoV-2 ni dans le traitement des sujets COVID-19 confirmés dont l'état n'exige pas une hospitalisation. Toutefois, en ce qui concerne les personnes atteintes de la COVID-19 dont l'état de santé requiert une hospitalisation, l'état actuel des connaissances scientifiques suggère qu'une supplémentation en vitamine D3 ne permet pas de réduire la durée d'hospitalisation et le nombre de nouveaux sujets ayant besoin de ventilation mécanique invasive et ne permet pas d'établir un lien en une supplémentation en vitamine D et les admissions aux soins intensifs ou la mortalité. Un supplément en vitamine D3 à raison de 60 000 UI par jour pendant 8 ou 14 jours, chez des personnes ayant une déficience en vitamine D, pourrait cependant permettre d'augmenter la proportion de sujets avec une négativation de la RTPCR sans toutefois avoir d'impact sur la durée moyenne avant la négativation de celle-ci. Il est toutefois important de souligner que les trois ECRA ont été réalisés sur des populations distinctes, hospitalisées pour une COVID-19 de sévérité variable, et avec différentes posologies et formes de vitamine D3 (calcifédiol ou cholécalciférol). Les profils d'innocuité et d'interactions médicamenteuses de la vitamine D sont aujourd'hui bien connus dans plusieurs contextes extérieurs à la COVID-19 [Euro-Pharm International Canada, 2018; Vifor Pharma, 2018]. Fondé sur 2 ECRA à double insu conduits au Brésil et en Inde dans le contexte de la COVID-19, la supplémentation de vitamine D3 à haute dose semble sécuritaire lorsque cette dernière est administrée en prise unique ou de manière quotidienne pendant une durée maximale de 14 jours chez des sujets adultes atteints de la COVID-19 et hospitalisés. Dans tous les documents consultés présentant des positions ou des recommandations cliniques, aucune organisation ne se prononce en faveur de l'usage de la vitamine D en prévention d'une infection par le SARS-CoV-2 ou comme traitement d'une telle infection en dehors d'un essai clinique, en raison d'une insuffisance de preuves. Compte tenu des risques potentiels d'effets indésirables, un suivi régulier des personnes recevant des doses de vitamine D supérieures à 4 000 UI par jour est également recommandé. Cette réponse rapide de l'INESSS comporte certaines limites qui méritent d'être soulignées. D'abord, l'analyse du niveau de preuve scientifique est basée sur 3 études primaires de type ECRA, elles aussi, empreintes de biais et de limites méthodologiques (y compris des déséquilibres dans les caractéristiques des sujets, dans la puissance statistique et dans les posologies et formes de vitamine D3 utilisées) affectant la confiance envers les résultats actuellement disponibles. Par ailleurs, le manque de résultats ne permet pas de conclure quant à d'éventuelles différences d'efficacité entre des sujets à différents stades de la maladie ou avec des niveaux de vitamine D différents au début des études (taux normal, insuffisance, déficience). Enfin, les constats ne découlent pas d'un processus de consultation élaboré. À la suite de l'analyse effectuée, la tendance pointe vers une absence de bénéfice de la supplémentation en vitamine D ayant 2021-03-08 15:16 22 un réel impact sur l'évolution clinique ou la mortalité liée à la COVID-19. Il faudra toutefois attendre les résultats d'ECRA supplémentaires dont la qualité méthodologique sera jugée acceptable avant d'infirmer ou confirmer une absence de bénéfices. L'efficacité et l'innocuité d'une supplémentation en vitamine D sont présentement évaluées dans plusieurs études cliniques en cours, soit en prophylaxie, chez des patients non hospitalisés ou chez des patients hospitalisés9 . En demeurant à l'affût de nouvelles données scientifiques, cette réponse rapide permet d'informer les professionnels de la santé et de les soutenir dans leur prise de décision clinique dans le contexte de la pandémie actuelle.


Asunto(s)
Humanos , Neumonía Viral/prevención & control , Neumonía Viral/tratamiento farmacológico , Vitamina D/administración & dosificación , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/tratamiento farmacológico , Evaluación de la Tecnología Biomédica , Análisis Costo-Eficiencia
4.
Nutr. hosp ; 38(1): 186-193, ene.-feb. 2021. tab, graf
Artículo en Inglés | IBECS | ID: ibc-198856

RESUMEN

INTRODUCTION: research shows the potential effect of vitamin D supplementation with an improvement in the glycemic profile of pre-diabetic patients. OBJECTIVE: this study evaluates the effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals. METHODS: we analyzed studies published over the last ten years, and indexed in the Science Direct, PubMed, and LILACS databases. We searched studies using health descriptors related to vitamin D, pre-diabetes, and glycemic control markers. We considered randomized controlled trials eligible for inclusion. All phases of selection, data extraction, and risk of bias assessment were carried out by two independent evaluators. RESULTS: we identified 309 articles, of which 4 met the inclusion criteria. Of these, 3 studies have shown that vitamin D supplementation does not alter glycemic control markers in pre-diabetic individuals. Only one study showed a positive effect after supplementation with 60,000 IU/month of vitamin D3 for 12 months, with a significant reduction in the concentrations of glycated hemoglobin, fasting glucose, and two-hour postprandial glucose. CONCLUSION: there is insufficient scientific evidence to confirm the beneficial effects of vitamin D supplementation on glycemic control markers in pre-diabetic individuals


INTRODUCCIÓN: las investigaciones muestran el efecto potencial de la suplementación con vitamina D con una mejora del perfil glucémico de los pacientes prediabéticos. OBJETIVO: este estudio evalúa los efectos de la suplementación con vitamina D sobre los marcadores de control glucémico en personas prediabéticas. MÉTODOS: analizamos los estudios publicados en los últimos diez años e indexados en las bases de datos Science Direct, PubMed y LILACS. Se realizaron búsquedas de estudios mediante descriptores de salud relacionados con la vitamina D, la prediabetes y los marcadores de control glucémico. Los ensayos controlados y aleatorizados se consideraron elegibles para su inclusión. Todas las fases de selección, extracción de datos y evaluación del riesgo de sesgos fueron realizadas por dos evaluadores independientes. RESULTADOS: identificamos 309 artículos, de los que 4 cumplieron los criterios de inclusión. De estos, 3 estudios demostraron que la suplementación con vitamina D no altera los marcadores de control glucémico en las personas prediabéticas. Solo un estudio mostró un efecto positivo después de la suplementación de 60.000 UI/mes de vitamina D3 durante 12 meses, con una reducción significativa de las concentraciones de hemoglobina glucosilada, glucosa en ayunas y glucosa posprandial a las dos horas. CONCLUSIÓN: no hay evidencia científica suficiente para confirmar los efectos beneficiosos de la suplementación de vitamina D sobre los marcadores de control glucémico en las personas prediabéticas


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Estado Prediabético/dietoterapia , Estado Prediabético/prevención & control , Vitamina D/administración & dosificación , Índice Glucémico , Insulina/administración & dosificación , Vitamina D/metabolismo , Ensayos Clínicos Controlados Aleatorios como Asunto
5.
Mo Med ; 118(1): 68-73, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33551489

RESUMEN

Magnesium and vitamin D each have the possibility of affecting the immune system and consequently the cytokine storm and coagulation cascade in COVID-19 infections. Vitamin D is important for reducing the risk of upper respiratory tract infections and plays a role in pulmonary epithelial health. While the importance of vitamin D for a healthy immune system has been known for decades, the benefits of magnesium has only recently been elucidated. Indeed, magnesium is important for activating vitamin D and has a protective role against oxidative stress. Magnesium deficiency increases endothelial cell susceptibility to oxidative stress, promotes endothelial dysfunction, reduces fibrinolysis and increases coagulation. Furthermore, magnesium deficient animals and humans have depressed immune responses, which, when supplemented with magnesium, a partial or near full reversal of the immunodeficiency occurs. Moreover, intracellular free magnesium levels in natural killer cells and CD8 killer T cells regulates their cytotoxicity. Considering that magnesium and vitamin D are important for immune function and cellular resilience, a deficiency in either may contribute to cytokine storm in the novel coronavirus 2019 (COVID-19) infection.


Asunto(s)
/complicaciones , Síndrome de Liberación de Citoquinas/etiología , Coagulación Intravascular Diseminada/etiología , Enfermedades del Sistema Inmune/etiología , Deficiencia de Magnesio/complicaciones , Deficiencia de Vitamina D/complicaciones , Animales , Linfocitos T CD8-positivos/efectos de los fármacos , /tratamiento farmacológico , Humanos , Células Asesinas Naturales/efectos de los fármacos , Magnesio/administración & dosificación , Magnesio/farmacología , Magnesio/uso terapéutico , Estrés Oxidativo/efectos de los fármacos , /genética , Vitamina D/administración & dosificación , Vitamina D/farmacología , Vitamina D/uso terapéutico , Vitaminas/administración & dosificación , Vitaminas/farmacología , Vitaminas/uso terapéutico
6.
Nutr Metab Cardiovasc Dis ; 31(3): 756-761, 2021 03 10.
Artículo en Inglés | MEDLINE | ID: mdl-33549427

RESUMEN

AIMS: In the course of the COVID-19 pandemic, multiple suggestions have been delivered through websites and social media referring to natural substances and various kinds of supplements with thaumaturgical properties in preventing and/or fighting the coronavirus infection. Indeed, there is no clinical trial evidence that a dietary or pharmacological supplementation of any particular substance will increase the effectiveness of the immune defences. There are however three nutritional issues that deserve special attention under the present circumstances, namely vitamin D deficiency, excess salt intake and inappropriate alcohol consumption. Here is a short review of the current knowledge about the possible role of these factors in the immunity defence system and their potential impact on the modulation of the immune response to SARS-COV2 infection. DATA SYNTHESIS: For all of these factors there is convincing evidence of an impact on the immune defence structure and function. In the absence of RCT demonstration that increased ingestion of any given substance may confer protection against the new enemy, special attention to correction of these three nutritional criticisms is certainly warranted at the time of COVID pandemic. CONCLUSIONS: We propose that the inappropriate intake of salt and alcohol and the risk of inadequate vitamin D status should be object of screening, in particular in subjects at high mortality risk from SARS-COV 2 infection, such as institutionalised elderly subjects and all those affected by predisposing conditions.


Asunto(s)
Consumo de Bebidas Alcohólicas/epidemiología , Estado Nutricional , Sodio en la Dieta/efectos adversos , Deficiencia de Vitamina D/epidemiología , Consumo de Bebidas Alcohólicas/inmunología , Dieta/métodos , Suplementos Dietéticos , Humanos , Inmunidad , Pandemias , Salud Pública , Factores de Riesgo , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/inmunología , Deficiencia de Vitamina D/terapia , Vitaminas/administración & dosificación
7.
Orv Hetil ; 162(1): 3-12, 2021 01 03.
Artículo en Húngaro | MEDLINE | ID: mdl-33388736

RESUMEN

Összefoglaló. A sarcopenia progresszív, generalizált vázizombetegség az izomtömeg fogyásával és az izomfunkció romlásával, számos szövodménnyel, rossz prognózissal. A sarcopeniát eredetileg életkorfüggo, idosekben jelentkezo kórképnek írták le (primaer sarcopenia). Késobb derült ki, hogy fiatal- és középkorú személyeknél is elofordul, különbözo betegségekhez társulva (secundaer sarcopenia). A közlemény áttekintést ad a betegség patofiziológiájáról, a fizikai inaktivitás, az inzulinrezisztencia, a krónikus gyulladás, a citokinek, hepatokinek és miokinek szerepérol az izomkárosodásban, valamint az izom, a zsírszövet és a máj funkcionális kapcsolatairól nem alkoholos zsírmájban és cirrhosisban. A diagnózis felállítását számos funkcionális próba, illetve vizsgálóeljárás teszi lehetové. Az izomero-csökkenés igazolása a legfontosabb paraméter (kézszorító ero). Az izomtömegvesztést kettos energiájú röntgenabszorpciometria, bioelektromosimpedancia-analízis, komputertomográfia vagy mágneses rezonanciás képalkotó vizsgálat mutathatja ki, megerosítve a kórismét, a fizikai teljesítmény csökkenése pedig a sarcopenia súlyosságát jelzi. A sarcopenia kezelése és a progresszió prevenciója a fiatalkorban elkezdett és élethosszig tartó rendszeres fizikai aktivitáson, a protein-kalória túltápláláson és a gyógyszeres terápián alapul, beleértve a D-vitamin és a tesztoszteron pótlását, az elágazó láncú aminosavak és az L-karnitin adását. Másodlagos sarcopeniában az alapbetegség kezelése is szükséges. Orv Hetil. 2021; 162(1): 3-12. Summary. Sarcopenia is a progressive, generalized skeletal muscle disease with the loss of muscle mass and function, associated with adverse outcomes and poor prognosis. Sarcopenia first was regarded as an age-related disorder of older people (primary sarcopenia). Later it turned out that it can also occur in young age due to a range of chronic disorders such as cancer, anorexia or malnutrition (secondary sarcopenia). This paper overviews the pathophysiology of sarcopenia and the factors involved in the muscle mass loss, i.e., physical inactivity, insulin resistance, low-grade chronic inflammation, hepatokines and myokines. The basic feature is the imbalance between proteolysis and protein synthesis that leads to muscle atrophy. We discuss the relationship between liver, muscle and adipose tissue in non-alcoholic fatty liver disease and cirrhosis. To diagnose sarcopenia, there are a range of tests and tools that measure muscle strength and muscle mass as well as physical performance. The low muscle strength (hand grip strength) is the primary parameter of the diagnosis, the best measure of muscle function. The loss of skeletal muscle mass assessed by dual-energy X-ray absorptiometry, bioelectric impedance analysis, computer tomography, or magnetic resonance imaging confirms diagnosis, while the decrease in physical performance reflects severe sarcopenia. For the treatment and prevention of progression, the most important is the regular physical activity started from early adulthood, and healthy diet containing protein-calorie hyperalimentation. In addition, a pharmacotherapy with the supplementation of vitamin D and testosterone, furthermore, the administration of L-carnitine and branched-chain amino acids can be recommended. In the case of secondary sarcopenia, the underlying disease also requires treatment. Orv Hetil. 2021; 162(1): 3-12.


Asunto(s)
Imagen por Resonancia Magnética/métodos , Músculo Esquelético/diagnóstico por imagen , Sarcopenia , Vitamina D/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Fuerza de la Mano , Humanos , Sarcopenia/diagnóstico , Sarcopenia/fisiopatología , Sarcopenia/terapia
8.
Rev Med Suisse ; 17(720-1): 42-49, 2021 Jan 13.
Artículo en Francés | MEDLINE | ID: mdl-33443830

RESUMEN

What's new in infectious diseases in 2020 ? This year has been marked by the COVID-19 pandemic, prompting a review of the current knowledge on SARS-CoV-2 and its management in this article. The results of the Swiss project «â€…PIRATE ¼ indicate non-inferiority between CRP-guided antibiotic durations or fixed 7-day durations and 14-day durations for Gram-negative bacteremia. A Mongolian study did not show any benefit of vitamin D substitution in protecting children from tuberculosis. Baloxavir, a new antiviral against the flu, has been approved by Swissmedic. Finally, new American recommendations for therapeutic monitoring of vancomycin and universal screening for hepatitis C virus have been published.


Asunto(s)
Infectología/tendencias , Antibacterianos/administración & dosificación , Antivirales/uso terapéutico , Proteína C-Reactiva/análisis , Niño , Enfermedades Transmisibles/tratamiento farmacológico , Humanos , Gripe Humana/tratamiento farmacológico , Pandemias , Tuberculosis/prevención & control , Vitamina D/administración & dosificación
9.
Int J Infect Dis ; 104: 58-64, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33401034

RESUMEN

BACKGROUND: Observational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, the data are inconsistent. OBJECTIVES: We conducted a systematic review and meta-analysis to assess the association between low vitamin D status and COVID-19. METHODS: A systematic search was conducted with PubMed, Embase, and the Cochrane Library from database inception to September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) and corresponding 95% confidence interval (CI) was applied to estimate pooled results. Random - or fixed-effect models based on heterogeneity were used for the meta-analysis. Funnel plots and Egger regression tests were used to assess publication bias. RESULTS: A total of ten articles with 361,934 participants were selected for meta-analysis. Overall, the pooled OR in the fixed-effect model showed that vitamin D deficiency or insufficiency was associated with an increased risk of COVID-19 (OR = 1.43, 95% CI 1.00-2.05). In addition, COVID-19-positive individuals had lower vitamin D levels than COVID-19-negative individuals (SMD = -0.37, 95% CI = -0.52 to -0.21). Significant heterogeneity existed in both endpoints. Funnel plots and Egger regression tests revealed significant publication bias. CONCLUSIONS: This systematic review and meta-analysis indicated that low vitamin D status might be associated with an increased risk of COVID-19 infection. Further studies are needed to evaluate the impact of vitamin D supplementation on the clinical severity and prognosis in patients with COVID-19. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no: CRD42020216740.


Asunto(s)
/etiología , Deficiencia de Vitamina D/complicaciones , Suplementos Dietéticos , Humanos , Vitamina D/administración & dosificación
10.
Public Health ; 190: 123-131, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33453688

RESUMEN

OBJECTIVES: Epidemiological studies indicate an association between vitamin D deficiency and obesity. However, there is no consistent evidence of the direction or causal relationship between these conditions. Thus, we analysed the longitudinal relationship between vitamin D deficiency and obesity/adiposity in different age groups. STUDY DESIGN: This study was a systematic review with PROSPERO registry (CRD42016047523). METHODS: Electronic searches were undertaken in Lilacs, Medline, Science Direct, Scopus and Web of Science databases until April 2020. For each study, we collected the frequency of vitamin D deficiency and obesity. RESULTS: In total, 5071 articles were identified and 8 were ultimately included in this systematic review. Five cohort studies involved adults, two of which recorded a positive association between vitamin D deficiency and obesity. The other three studies found a borderline or null association between vitamin D deficiency and obesity. Three studies investigated the elderly population; two of these recorded an association between vitamin D and greater adiposity, and one study recorded that 25-hydroxyvitamin D levels ≥30 ng/ml were associated with less weight gain in the follow-up. CONCLUSIONS: This review reports that the majority of studies included show that vitamin D deficiency can contribute to the occurrence of obesity in adults and the elderly. It is recommended that prospective studies are conducted, with varying age groups and weather conditions, designed to test the longitudinal relationship between vitamin D deficiency and obesity outcomes.


Asunto(s)
Obesidad/etiología , Deficiencia de Vitamina D/complicaciones , Vitamina D/análogos & derivados , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Adiposidad , Adulto , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Vitamina D/efectos adversos
11.
Chem Biol Interact ; 337: 109399, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33503443

RESUMEN

Diabetes mellitus (DM), a non-communicable endocrine disease that is marked by a differing degree of tolerance to insulin and dysfunction. The connection between diabetes and liver failure important to doctors in general practice diabetologists and hepatologists. DM is linked with an elevated risk of hepatic consequences and mortality of liver cirrhosis patients. DM may facilitate to insult the liver by inducing inflammation and fibrosis by elevating mitochondrial oxidative stress. The conventional liver function indices are bilirubin including Indirect Bilirubin (IBil), Direct Bilirubin (DBil), and Total Bilirubin (TBil). DBil, IBil, and TBil, have diverse clinical implications as the standard index of liver disorder. An elevated level of DBil may suggest damage to the hepatic cell whereas TBil is within the normal range. Thus, increased liver enzymes are correlated with hepatic insulin resistance in healthy subjects. Notably, a significant correlation between DBil levels and Insulin resistance risk could indicate a connection between liver dysfunction and diabetes mellitus risk. Thus, our primary goal via the current review to examine the impact of dietary vitamin D (VitD) in serum mediated risk reduction of insulin resistance and further incidence of DM through inflammatory liver associated high DBil. Therefore, modifying these inflammatory pathways may be a therapeutic alternative approach for diabetes treatment.


Asunto(s)
Bilirrubina/metabolismo , Diabetes Mellitus/patología , Vitamina D/sangre , Diabetes Mellitus/sangre , Suplementos Dietéticos , Hemo-Oxigenasa 1/metabolismo , Humanos , Resistencia a la Insulina , Hígado/metabolismo , Hígado/patología , Especies Reactivas de Oxígeno/metabolismo , Vitamina D/administración & dosificación
12.
Cell Immunol ; 360: 104259, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33359760

RESUMEN

Vitamin D regulates homeostasis, anti-microbial response, and inflammation. The vitamin D receptors are expressed in the macrophages and other immune cells, regulating the transcription of many different genes, including those coding the anti-microbial peptides. One of the most severe complications of the SARS-CoV-2 infection is the acute respiratory distress syndrome (ARDS) caused by the hyperinflammatory response (commonly called cytokine storm) of the lung macrophages. Studies showed that Vitamin D deficiency increases the severity of the ARDS in COVID-19 infection. We discuss here how the vitamin D supplementation may influence macrophage and myeloid-derived suppressor cells (MDSCs) inflammatory response, subdue the hyperinflammatory response, and lessen the ARDS in COVID-19 patients.


Asunto(s)
/tratamiento farmacológico , Pulmón/patología , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Animales , /inmunología , Niño , Humanos , Inflamación/tratamiento farmacológico , Inflamación/inmunología , Inflamación/patología , Inflamación/prevención & control , Pulmón/inmunología , Macrófagos/inmunología , Macrófagos/metabolismo , Células Supresoras de Origen Mieloide/inmunología , Células Supresoras de Origen Mieloide/metabolismo , Receptores de Calcitriol/metabolismo , /inmunología , /prevención & control
14.
PLoS One ; 15(12): e0241459, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33378408

RESUMEN

OBJECTIVE: The association between vitamin D deficiency and multiple sclerosis (MS) is well described. We set out to use remote sampling to ascertain vitamin D status and vitamin D supplementation in a cross-sectional study of people with MS across the UK. METHODS: People with MS and matched controls were recruited from across the UK. 1768 people with MS enrolled in the study; remote sampling kits were distributed to a subgroup. Dried blood spots (DBS) were used to assess serum 25(OH)D in people with MS and controls. RESULTS: 1768 MS participants completed the questionnaire; 388 MS participants and 309 controls provided biological samples. Serum 25(OH)D was higher in MS than controls (median 71nmol/L vs 49nmol/L). A higher proportion of MS participants than controls supplemented (72% vs 26%, p<0.001); people with MS supplemented at higher vD doses than controls (median 1600 vs 600 IU/day, p<0.001). People with MS who did not supplement had lower serum 25(OH)D levels than non-supplementing controls (median 38 nmol/L vs 44 nmol/L). Participants engaged well with remote sampling. CONCLUSIONS: The UK MS population have higher serum 25(OH)D than controls, mainly as a result of vitamin D supplementation. Remote sampling is a feasible way of carrying out large studies.


Asunto(s)
Suplementos Dietéticos , Esclerosis Múltiple/sangre , Deficiencia de Vitamina D/sangre , Vitamina D/sangre , Adulto , Anciano , Estudios de Casos y Controles , Estudios Transversales , Pruebas con Sangre Seca , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/complicaciones , Esclerosis Múltiple/diagnóstico , Esclerosis Múltiple/dietoterapia , Encuestas y Cuestionarios , Reino Unido , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/dietoterapia
15.
Trials ; 21(1): 1031, 2020 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-33371905

RESUMEN

BACKGROUND: With the lack of effective therapy, chemoprevention, and vaccination against SARS-CoV-2, focusing on the immediate repurposing of existing drugs gives hope of curbing the COVID-19 pandemic. A recent unbiased genomics-guided tracing of the SARS-CoV-2 targets in human cells identified vitamin D among the three top-scoring molecules manifesting potential infection mitigation patterns. Growing pre-clinical and epidemiological observational data support this assumption. We hypothesized that vitamin D supplementation may improve the prognosis of COVID-19. The aim of this trial is to compare the effect of a single oral high dose of cholecalciferol versus a single oral standard dose on all-cause 14-day mortality rate in COVID-19 older adults at higher risk of worsening. METHODS: The COVIT-TRIAL study is an open-label, multicenter, randomized controlled superiority trial. Patients aged ≥ 65 years with COVID-19 (diagnosed within the preceding 3 days with RT-PCR and/or chest CT scan) and at least one worsening risk factor at the time of inclusion (i.e., age ≥ 75 years, or SpO2 ≤ 94% in room air, or PaO2/FiO2 ≤ 300 mmHg), having no contraindications to vitamin D supplementation, and having received no vitamin D supplementation > 800 IU/day during the preceding month are recruited. Participants are randomized either to high-dose cholecalciferol (two 200,000 IU drinking vials at once on the day of inclusion) or to standard-dose cholecalciferol (one 50,000 IU drinking vial on the day of inclusion). Two hundred sixty participants are recruited and followed up for 28 days. The primary outcome measure is all-cause mortality within 14 days of inclusion. Secondary outcomes are the score changes on the World Health Organization Ordinal Scale for Clinical Improvement (OSCI) scale for COVID-19, and the between-group comparison of safety. These outcomes are assessed at baseline, day 14, and day 28, together with the serum concentrations of 25(OH)D, creatinine, calcium, and albumin at baseline and day 7. DISCUSSION: COVIT-TRIAL is to our knowledge the first randomized controlled trial testing the effect of vitamin D supplementation on the prognosis of COVID-19 in high-risk older patients. High-dose vitamin D supplementation may be an effective, well-tolerated, and easily and immediately accessible treatment for COVID-19, the incidence of which increases dramatically and for which there are currently no scientifically validated treatments. TRIAL REGISTRATION: ClinicalTrials.gov NCT04344041 . Registered on 14 April 2020 TRIAL STATUS: Recruiting. Recruitment is expected to be completed in April 2021.


Asunto(s)
/terapia , Suplementos Dietéticos , Terapia Nutricional/métodos , Pandemias , Vitamina D/administración & dosificación , Anciano , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Vitaminas/administración & dosificación
16.
Clín. investig. arterioscler. (Ed. impr.) ; 32(6): 267-277, nov.-dic. 2020. graf
Artículo en Español | IBECS | ID: ibc-197448

RESUMEN

Si bien carecemos de suficiente evidencia que justifique suplementar con vitaminaD en la prevención y/o tratamiento de la infección por COVID-19, a la fecha resulta cada vez más factible que esta hipótesis sea válida. Dos mecanismos básicos generales deberían ser considerados. Uno sería la acción antiinfecciosa e inmunomoduladora que ejerce mejorando las barreras intercelulares por estímulo de la inmunidad innata, así también por modulación de la inmunidad adaptativa. También, la vitaminaD reduce la producción de citoquinas inflamatorias como IL-2 e interferón gamma (INF-γ). Más recientemente se han demostrado múltiples efectos pleiotrópicos sobre las acciones de la vitaminaD a nivel antiinflamatorio e inmunomodulador. Esto explica resultados positivos en estudios con influenza, coronavirus y otras infecciones respiratorias. Se ha descrito relación inversa entre niveles séricos de vitaminaD y prevalencia de patología infecciosa respiratoria. De interés, otro abordaje mecanístico responde a considerar la inhibición del sistema renina-angiotensina-aldosterona, que se exacerba en la infección por COVID-19 debido a que el virus se une a la enzima ECA2, quedando disponible más angiotensinaII para causar daño. La vitaminaD inhibe mediadores del SRAA -presente en todas las células del organismo-, y al inhibir la actividad ECA y aumentar la ECA2, disminuye los niveles de angiotensinaII. Presentamos estudios con propuestas de dosis recomendadas de vitaminaD, y aunque no quede concretada una única guía, los posibles beneficios son promisorios. Finalmente, el propósito de la presente revisión es compartir esta idea con profesionales de la salud para encender el debate y llamar a la reflexión crítica, de modo tal que se pueda contribuir con el emprendimiento de diseños clínicos adecuados para validar los beneficios de utilizar altas dosis de vitaminaD en beneficio de la salud pública, sobre todo en tiempos de esta emergencia por COVID-19


Although we lack enough evidence to justify supplementing with vitaminD in the prevention and treatment of COVID-19 infection, it is increasingly feasible that this hypothesis is valid. Two general underlying mechanisms should be considered. One would be the anti-infectious and immunomodulatory action that it exerts by improving intercellular barriers by stimulating innate immunity, as well as by modulating adaptive immunity. Also, vitaminD reduces the production of inflammatory cytokines, such as IL-2 and interferon-gamma (INF-γ). More recently, multiple pleiotropic effects have been demonstrated on the actions of vitaminD at the anti-inflammatory and immunomodulatory level with positive results in studies with influenza, coronavirus, and other respiratory infections. An inverse relationship between serum vitaminD levels and the prevalence of the respiratory infectious disease has been described. Of interest, another mechanistic approach responds to considering the inhibition of the renin-angiotensin-aldosterone system (RAAS), which is exacerbated in COVID-19 infection because the virus binds to the enzyme ACE2, making more angiotensinII available to cause damage. VitaminD inhibits mediators of RAAS - present in all cells of the body - and by inhibiting ACE activity and increasing ACE2, it lowers angiotensinII levels. We present studies with proposals for recommended doses of vitaminD, and although a single guideline is not specified, the possible benefits are promising. Finally, the purpose of this review is to share this idea with health professionals to ignite the debate and call for critical reflection, so that it can contribute to the undertaking of more and better clinical designs to validate the benefits of using high doses of vitaminD for the benefit of public health and especially in times of crisis for COVID-19


Asunto(s)
Humanos , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Suplementos Dietéticos , Síndrome Respiratorio Agudo Grave , Vitamina D/administración & dosificación , Vitaminas/administración & dosificación , Inhibidores de la Enzima Convertidora de Angiotensina , Receptor de Angiotensina Tipo 2/metabolismo , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Calcitriol/administración & dosificación , Gripe Humana/tratamiento farmacológico , Gripe Humana/prevención & control , Pandemias , Vitamina D/farmacología , Vitaminas/farmacología
17.
Nutr. hosp ; 37(6): 1238-1245, nov.-dic. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-198316

RESUMEN

INTRODUCTION: vitamin D deficiency (VDD) has been associated with depressive symptoms in pregnancy and postpartum, which can result in increased adverse outcomes in the maternal-infant segment. A possible explanation in the literature is VDD relationship with genetic and neurological mechanisms. OBJECTIVE: to evaluate VDD relationship with gestational and postpartum depression. METHODS: this review followed the recommendations proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Research was conducted in electronic databases, PubMed and LILACS, including studies of the analytical type (cross-sectional and longitudinal), systematic reviews, meta-analyses, and controlled clinical trials carried out in humans; inclusion and exclusion criteria were applied. RESULTS AND CONCLUSIONS: in this systematic review, eight articles were analyzed comprising 8,583 women from seven different countries. Among the selected articles, six found an association between VDD and gestational and postpartum depression. Considering the data collection, it was possible to conclude that there is a probable relationship between VDD and a higher predisposition to gestational and postpartum depression. Also, we concluded that vitamin D supplementation has proven to be a promising strategy for reducing the risk of depressive symptoms


INTRODUCCIÓN: la deficiencia de vitamina D (VDD) se ha asociado a síntomas depresivos en el embarazo y el posparto, lo que puede resultar en un aumento de los resultados adversos en el segmento materno-infantil. Una posible explicación en la literatura es la relación de la VDD con mecanismos genéticos y neurológicos. OBJETIVO: evaluar la relación de la VDD con la depresión gestacional y posparto. MÉTODOS: esta revisión siguió las recomendaciones propuestas por los Elementos de Informes Preferidos para revisiones sistemáticas y metaanálisis. La investigación se llevó a cabo en bases de datos electrónicas, PubMed y LILACS, incluyendo estudios de tipo analítico (sección transversal y longitudinal), revisiones sistemáticas, metaanálisis y ensayos clínicos controlados realizados en seres humanos; se aplicaron criterios de inclusión y exclusión. RESULTADOS Y CONCLUSIONES: en esta revisión sistemática se analizaron ocho artículos que comprenden a 8716 mujeres de siete países diferentes. Entre los artículos seleccionados, seis encontraron asociación entre la VDD y la depresión gestacional y posparto. Teniendo en cuenta la recopilación de datos, fue posible concluir que existe una relación probable entre la VDD y una mayor predisposición a la depresión gestacional y posparto. También llegamos a la conclusión de que la suplementación con vitamina D ha demostrado ser una estrategia prometedora para reducir el riesgo de síntomas depresivos


Asunto(s)
Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Vitamina D/administración & dosificación , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/diagnóstico , Depresión Posparto/diagnóstico , Depresión Posparto/dietoterapia
18.
Aging (Albany NY) ; 12(24): 24522-24534, 2020 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-33353888

RESUMEN

INTRODUCTION: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality. RESULTS: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse "activities of daily living (ADL)" scores, such as Barthel index, Tinetti scale and S.OS.I.A. CONCLUSION: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation. DESIGN: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.


Asunto(s)
/mortalidad , Casas de Salud , Actividades Cotidianas , Factores de Edad , Anciano , Anciano de 80 o más Años , /terapia , Suplementos Dietéticos , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad , Pandemias , Sensibilidad y Especificidad , Factores Sexuales , Vitamina D/administración & dosificación
19.
PLoS One ; 15(12): e0243768, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33315950

RESUMEN

BACKGROUND: Observational studies suggest that low 25-hydroxyvitamin D status is common and has been associated with higher mortality in critically ill patients. This study aim to investigate whether vitamin D supplementation is associated with lower mortality in critically ill patients. METHOD: We searched Medline, Embase, and Cochrane databases from inception to January 12, 2020, without language restrictions, for randomized controlled trials comparing the effect of vitamin D supplementation with placebo in critically ill patients. Two authors independently performed data extraction and assessed study quality. The primary outcome was all-cause mortality at the longest follow-up. RESULT: We identified nine trials with a total of 2066 patients. Vitamin D supplementation was not associated with reduced all-cause mortality at the longest follow-up (RR 0.90, 95% CI 0.74 to 1.09, I2 = 20%), at 30 days (RR 0.81, 95% CI 0.56 to 1.15), at 90 days (RR 1.15, 95% CI 0.92 to 1.44), and at 180 days (RR 0.82, 95% CI 0.65 to 1.03). Results were similar in the sensitivity analysis. The sample size met the optimum size in trial sequential analysis. Similarly, supplemental vitamin D was not associated with length of ICU stay, hospital stay, or mechanical ventilation. CONCLUSION: Vitamin D supplement was not associated with reduced all-cause mortality in critically ill patients. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework https://osf.io/bgsjq.


Asunto(s)
Enfermedad Crítica/mortalidad , Vitamina D/administración & dosificación , Bases de Datos Factuales , Suplementos Dietéticos , Humanos , Unidades de Cuidados Intensivos , Tiempo de Internación , Ensayos Clínicos Controlados Aleatorios como Asunto , Respiración Artificial
20.
Maturitas ; 141: 63-70, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33036705

RESUMEN

During the last decade, a cascade of evidence has questioned the anti-fracture efficacy of vitamin D supplementation. In general, vitamin D status, reflected by serum 25-hydroxy-vitamin D [25(OH)D] concentrations, seems to predict fracture risk and bone mineral density (BMD). Despite the well-documented detrimental effect of vitamin D deficiency on bones, vitamin D monotherapy does not seem to reduce the risk of fractures. On the other hand, high vitamin D doses, either at monthly (60,000-100,000 IU) or daily intervals (>4000 IU), appear to be harmful with regard to falls, fracture risk and BMD, especially for people without vitamin D deficiency and at low fracture risk. Therefore, a U-shaped effect of vitamin D on the musculoskeletal system may be supported by the current evidence. Vitamin D supplementation could be of value, at daily doses of at least 800 IU, co-supplemented with calcium (1000-1200  mg/day), in elderly populations, especially those with severe vitamin D deficiency [25(OH)D <25-30  nmol/L (<10-12  ng/mL)], although its anti-fracture and anti-fall efficacy is modest. Good compliance and at least 3-5 years of therapy are required.


Asunto(s)
Densidad Ósea/efectos de los fármacos , Fracturas Óseas/prevención & control , Vitamina D/administración & dosificación , Accidentes por Caídas , Anciano , Huesos/efectos de los fármacos , Calcio en la Dieta/administración & dosificación , Suplementos Dietéticos , Fracturas Óseas/etiología , Humanos , Vitamina D/efectos adversos , Vitamina D/análogos & derivados , Deficiencia de Vitamina D/complicaciones , Vitaminas/uso terapéutico
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