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1.
Anticancer Res ; 40(1): 491-499, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892604

RESUMEN

This article is a narrative review of recent epidemiological findings regarding ultraviolet-B (UVB) dose or exposure, serum 25-hydroxyvitamin D [25(OH)D] concentrations, vitamin D supplementation, and genetic variations in 25(OH)D concentration for incidence, survival, and mortality rates of overall and breast, colorectal, and prostate cancer. According to ecological studies, solar UVB doses are inversely correlated with incidence/mortality rates for about 20 cancer types. Observational studies support a role of higher 25(OH)D concentrations in reducing risk of breast and colorectal cancer incidence and mortality rates but, for prostate cancer, in increasing incidence rates while reducing mortality rates. Mendelian randomization studies offer little support for vitamin D in reducing cancer risk. Their primary limitation is that they only investigate small variations in genetically predicted 25(OH)D concentration near the population mean value. The secondary analyses from the VITAL clinical trial indicated significant reductions from 2000 IU/d of vitamin D3 supplementation in all-cancer incidence and mortality rates for selected subgroups. Thus, Hill's criteria for causality in a biological system are now largely satisfied for supporting the claim that vitamin D reduces the risk of cancer incidence and death.


Asunto(s)
Neoplasias/epidemiología , Vitamina D/metabolismo , Suplementos Dietéticos , Humanos , Neoplasias/sangre , Neoplasias/mortalidad , Estudios Observacionales como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo , Vitamina D/sangre
2.
Anticancer Res ; 40(1): 535-543, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892609

RESUMEN

BACKGROUND/AIM: To assess the impact of vitamin D supplementation on genomic and metabolomic profiles and relate them to the individual's responsiveness to varying doses of vitamin D3 Patients and Methods: Healthy adults were given either 600, 4000 or 10,000 IUs vitamin D3/day for 6 months. Circulating parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], calcium, peripheral white blood cells broad gene expression and urine and serum metabolomic profiles were evaluated. RESULTS: There was a dose-dependent effect of vitamin D supplementation on serum 25(OH)D, PTH and broad gene expression. Serum calcium levels remained normal for all study subjects and no untoward toxicity was observed. The metabolomic profiles were related to the genomic expression analysis. There were significant inter-individual effects on gene expression and metabolomic profile in response to the same dose of vitamin D3 supplementation, despite similar changes in 25(OH)D and PTH concentrations. CONCLUSION: These results may help explain the variability observed in clinical trials regarding vitamin D's non-calcemic health benefits.


Asunto(s)
Suplementos Dietéticos , Genómica , Metabolómica , Vitamina D/farmacología , Adulto , Relación Dosis-Respuesta a Droga , Femenino , Regulación de la Expresión Génica/efectos de los fármacos , Humanos , Masculino , Hormona Paratiroidea/sangre , Análisis de Componente Principal , Mapas de Interacción de Proteínas/efectos de los fármacos , Vitamina D/análogos & derivados , Vitamina D/sangre
3.
Anticancer Res ; 40(1): 545-550, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892610

RESUMEN

BACKGROUND/AIM: Many studies have shown an antiproliferative, anti-inflammatory, anti-angiogenetic, and apoptosis-inducing effect of Vitamin D. A vitamin D deficiency has been associated with an increased risk for different types of cancer. This study examined vitamin D 25(OH)D levels in gynaecological cancers in comparison with benign gynaecological diseases. PATIENTS AND METHODS: Serum 25(OH)D levels in 688 gynaecological patients (488 with malignant, 200 with a benign gynaecological disease) were assayed between 2009 and 2015 using an electrochemiluminescence immunoassay. RESULTS: In total, the 25(OH)D levels in cancer patients were lower, but not significantly lower than those in cancer-free patients. Significant results were shown regarding seasonal effects for patients with breast-, endometrial and ovarian cancer. No significant effects occurred with regard to menopause status, nicotine, or grade in relation to 25(OH)D levels. CONCLUSION: 25(OH)D levels seem to influence gynaecological cancers.


Asunto(s)
Enfermedades de los Genitales Femeninos/sangre , Vitamina D/análogos & derivados , Factores de Edad , Femenino , Humanos , Menopausia/sangre , Estaciones del Año , Vitamina D/sangre
4.
J Zoo Wildl Med ; 50(4): 751-757, 2020 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-31926504

RESUMEN

Although biochemical analytes have typically been measured using serum or whole blood samples, an increasing number of assays are validated for measurement of analytes from dried blood spots (DBS) on filter paper. DBS techniques are minimally invasive, require only a small sample volume, and simplify processing, storage, and shipment of samples. These qualities make DBS-based assays ideal for sampling of wildlife species in both captive and field settings. In this study, a liquid chromatography-tandem mass spectrometry assay was evaluated for measurement of 25-hydroxyvitamin D in sloths. Paired serum and DBS samples were collected from nine healthy captive Hoffmann's two-toed sloths (Choloepus hoffmanni). Statistical analysis using Passing-Bablok regression analysis, Bland-Altman plots, and the Wilcoxon signed-rank tests found good agreement between 25-hydroxyvitamin D3 measurements in serum and DBS samples. Constant and proportional bias were absent. Results from this study support the use of DBS samples for the evaluation of vitamin D status in Hoffmann's two-toed sloths and provide a foundation for further studies to validate this technique.


Asunto(s)
Cromatografía Liquida/veterinaria , Pruebas con Sangre Seca/veterinaria , Perezosos/sangre , Espectrometría de Masas en Tándem/veterinaria , Vitamina D/análogos & derivados , Animales , Animales de Zoológico , Pruebas con Sangre Seca/métodos , Femenino , Vitamina D/sangre
5.
Ann Otol Rhinol Laryngol ; 129(1): 70-77, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31510765

RESUMEN

OBJECTIVE: Prediction and early intervention for hypocalcemia following parathyroidectomy and total thyroidectomy can decrease hospital cost and prevent severe hypocalcemia-related complications. This study aims to predict the severity of hypocalcemia after parathyroidectomy or thyroidectomy and to stratify patients into groups with different levels of risk for developing severe hypocalcemia, so that higher risk patients may be monitored more closely and receive earlier interventions. METHODS: This was a retrospective cohort study of 100 patients with primary hyperparathyroidism who underwent parathyroidectomy as the primary treatment modality at a tertiary care hospital. Clinical information, including demographic information, perioperative PTH and calcium levels, vitamin D levels, weight of the pathologic glands removed, gland pathology, and re-admission rates, were retrieved. Statistical analysis was performed to analyze the association between collected variables and percentage of calcium drop following parathyroidectomy with statistical significant set at P-values <0.05. RESULTS: Age, sex, and vitamin D level provided very minimal information to quantify risks of postoperative hypocalcemia. The percentage of decrease from preoperative PTH level to the lowest PTH level after the removal of the abnormal gland(s) is the most significant predicting factor for the severity of postoperative hypocalcemia. There is a mathematic regressional correlation between them. A formula was generated to quantify this linear relationship between them, and the nadir calcium can be calculated as Canadir=Capreop*[1-0.35*(PTHpreop-PTHintraop)2PTHpreop2], where Canadir = the lowest postoperative calcium level, and PTHintraop = PTH level 15 minutes after removal of the abnormal gland, with the value of R2 > 0.7. The formula has been tested primarily in our patient population with good reliability. CONCLUSIONS: The highest preoperative, lowest postoperative, and change in PTH level can help us reliably calculate the trend of postoperative calcium level. Decision to pursue early interventions can be made based on the calculated result from the formula we obtained.


Asunto(s)
Hiperparatiroidismo Primario/cirugía , Hipocalcemia/epidemiología , Paratiroidectomía , Complicaciones Posoperatorias/epidemiología , Adenoma/sangre , Adenoma/patología , Adenoma/cirugía , Adulto , Factores de Edad , Femenino , Humanos , Hiperparatiroidismo Primario/sangre , Hipocalcemia/sangre , Hipocalcemia/terapia , Periodo Intraoperatorio , Magnesio/sangre , Masculino , Persona de Mediana Edad , Modelos Teóricos , Hormona Paratiroidea/sangre , Neoplasias de las Paratiroides/sangre , Neoplasias de las Paratiroides/patología , Neoplasias de las Paratiroides/cirugía , Complicaciones Posoperatorias/sangre , Periodo Posoperatorio , Periodo Preoperatorio , Estudios Retrospectivos , Medición de Riesgo , Índice de Severidad de la Enfermedad , Factores Sexuales , Tiroidectomía , Carga Tumoral , Vitamina D/sangre
6.
Gut ; 69(1): 103-111, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31023832

RESUMEN

OBJECTIVE: We assessed the effect of surgical resection of colorectal cancer (CRC) on perioperative plasma vitamin D (25OHD) and C-reactive protein (CRP) level. We investigated the relationship between circulating vitamin D level and CRC survival. DESIGN: We sequentially sampled 92 patients undergoing CRC resection, and measured plasma 25OHD and CRP. For survival analyses, we assayed 25OHD and CRP in two temporally distinct CRC patient cohorts (n=2006, n=2100) and investigated the association between survival outcome, circulating vitamin D and systemic inflammatory response. RESULTS: Serial sampling revealed a postoperative fall (mean 17.3 nmol/L; p=3.6e-9) in plasma 25OHD (nadir days 1-2). CRP peaked 3-5 days postoperatively (143.1 mg/L; p=1.4e-12), yet the postoperative fall in 25OHD was independent of CRP. In cohort analyses, 25OHD was lower in the 12 months following operation (mean=48.8 nmol/L) than preoperatively (54.8 nmol/L; p=1.2e-5) recovering after 24 months (52.2 nmol/L; p=0.002). Survival analysis in American Joint Committee on Cancer stages I-III demonstrated associations between 25OHD tertile and CRC mortality (HR=0.69; 95% CI 0.46 to 0.91) and all-cause mortality (HR=0.68; 95% CI 0.50 to 0.85), and was independent of CRP. We observed interaction effects between plasma 25OHD and rs11568820 genotype (functional VDR polymorphism) with a strong protective effect of higher 25OHD only in patients with GG genotype (HR=0.51; 95% CI 0.21 to 0.81). We developed an online tool for predicted survival (https://apps.igmm.ed.ac.uk/mortalityCalculator/) that incorporates 25OHD with clinically useful predictive performance (area under the curve 0.77). CONCLUSIONS: CRC surgery induces a fall in circulating 25OHD. Plasma 25OHD level is a prognostic biomarker with low 25OHD associated with poorer survival, particularly in those with rs11568820 GG genotype. A randomised trial of vitamin D supplementation after CRC surgery has compelling rationale.


Asunto(s)
Biomarcadores de Tumor/sangre , Neoplasias Colorrectales/cirugía , Vitamina D/análogos & derivados , Anciano , Proteína C-Reactiva/metabolismo , Estudios de Casos y Controles , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/genética , Femenino , Estudios de Seguimiento , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Pronóstico , Receptores de Calcitriol/genética , Análisis de Supervivencia , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Vitamina D/sangre
7.
N Engl J Med ; 381(26): 2529-2540, 2019 12 26.
Artículo en Inglés | MEDLINE | ID: mdl-31826336

RESUMEN

BACKGROUND: Vitamin D deficiency is a common, potentially reversible contributor to morbidity and mortality among critically ill patients. The potential benefits of vitamin D supplementation in acute critical illness require further study. METHODS: We conducted a randomized, double-blind, placebo-controlled, phase 3 trial of early vitamin D3 supplementation in critically ill, vitamin D-deficient patients who were at high risk for death. Randomization occurred within 12 hours after the decision to admit the patient to an intensive care unit. Eligible patients received a single enteral dose of 540,000 IU of vitamin D3 or matched placebo. The primary end point was 90-day all-cause, all-location mortality. RESULTS: A total of 1360 patients were found to be vitamin D-deficient during point-of-care screening and underwent randomization. Of these patients, 1078 had baseline vitamin D deficiency (25-hydroxyvitamin D level, <20 ng per milliliter [50 nmol per liter]) confirmed by subsequent testing and were included in the primary analysis population. The mean day 3 level of 25-hydroxyvitamin D was 46.9±23.2 ng per milliliter (117±58 nmol per liter) in the vitamin D group and 11.4±5.6 ng per milliliter (28±14 nmol per liter) in the placebo group (difference, 35.5 ng per milliliter; 95% confidence interval [CI], 31.5 to 39.6). The 90-day mortality was 23.5% in the vitamin D group (125 of 531 patients) and 20.6% in the placebo group (109 of 528 patients) (difference, 2.9 percentage points; 95% CI, -2.1 to 7.9; P = 0.26). There were no clinically important differences between the groups with respect to secondary clinical, physiological, or safety end points. The severity of vitamin D deficiency at baseline did not affect the association between the treatment assignment and mortality. CONCLUSIONS: Early administration of high-dose enteral vitamin D3 did not provide an advantage over placebo with respect to 90-day mortality or other, nonfatal outcomes among critically ill, vitamin D-deficient patients. (Funded by the National Heart, Lung, and Blood Institute; VIOLET ClinicalTrials.gov number, NCT03096314.).


Asunto(s)
Colecalciferol/administración & dosificación , Enfermedad Crítica/terapia , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas/administración & dosificación , Adulto , Colecalciferol/efectos adversos , Enfermedad Crítica/mortalidad , Método Doble Ciego , Femenino , Humanos , Estimación de Kaplan-Meier , Tiempo de Internación , Masculino , Persona de Mediana Edad , Puntuaciones en la Disfunción de Órganos , Insuficiencia del Tratamiento , Vitamina D/análogos & derivados , Vitamina D/sangre , Vitaminas/efectos adversos
8.
BMC Infect Dis ; 19(1): 1020, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31791247

RESUMEN

BACKGROUND: Vitamin D deficiency, determined by blood levels of 25-hydroxyvitamin D [25(OH) D, i.e. the major vitamin D form in blood], has been shown to associate with all-cause mortalities. We recently demonstrated that blood levels of 1,25-dihydroxyvitamin D [1,25(OH)2D, i.e. the active vitamin D] were significantly lower in non-survivors compared to survivors among sepsis patients. Unexpectedly, despite the well documented roles of 1,25(OH)2D in multiple biological functions such as regulation of immune responses, stimulation of antimicrobials, and maintenance of barrier function, 1,25(OH)2D supplementation failed to improve disease outcomes. These previous findings suggest that, in addition to 1,25(OH)2D deficiency, disorders leading to the 1,25(OH)2D deficiency also contribute to mortality among sepsis patients. Therefore, this study investigated the mechanisms leading to sepsis-associated 1,25(OH)2D deficiency. METHODS: We studied mechanisms known to regulate kidney 25-hydroxylvitamin D 1α-hydroxylase which physiologically catalyzes the conversion of 25(OH) D into 1,25(OH)2D. Such mechanisms included parathyroid hormone (PTH), insulin-like growth factor 1 (IGF-1), fibroblast growth factor 23 (FGF-23), and kidney function. RESULTS: We demonstrated in both human subjects and mice that sepsis-associated 1,25(OH)2D deficiency could not be overcome by increased production of PTH which stimulates 1α-hydroxylase. Further studies showed that this failure of PTH to maintain blood 1,25(OH)2D levels was associated with decreased blood levels of IGF-1, increased blood levels of FGF-23, and kidney failure. Since the increase in blood levels of FGF-23 is known to associate with kidney failure, we further investigated the mechanisms leading to sepsis-induced decrease in blood levels of IGF-1. Our data showed that blood levels of growth hormone, which stimulates IGF-1 production in liver, were increased but could not overcome the IGF-1 deficiency. Additionally, we found that the inability of growth hormone to restore the IGF-1 deficiency was associated with suppressed expression and signaling of growth hormone receptor in liver. CONCLUSIONS: Because FGF-23 and IGF-1 have multiple biological functions besides their role in regulating kidney 1α-hydroxylase, our data suggest that FGF-23 and IGF-1 are warranted for further investigation as potential agents for the correction of 1,25(OH)2D deficiency and for the improvement of survival among sepsis patients.


Asunto(s)
Sepsis/sangre , Sepsis/complicaciones , Deficiencia de Vitamina D/etiología , Vitamina D/análogos & derivados , Animales , Estudios de Casos y Controles , Modelos Animales de Enfermedad , Regulación hacia Abajo , Femenino , Factores de Crecimiento de Fibroblastos/sangre , Humanos , Factor I del Crecimiento Similar a la Insulina , Riñón/efectos de los fármacos , Pruebas de Función Renal , Masculino , Ratones , Ratones Endogámicos C57BL , Hormona Paratiroidea/sangre , Sepsis/fisiopatología , Transducción de Señal , Vitamina D/sangre , Vitamina D/metabolismo , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/fisiopatología
9.
J Int Soc Sports Nutr ; 16(1): 55, 2019 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-31771586

RESUMEN

BACKGROUND: The purpose of this systematic review and meta-analysis is to investigate the effects of vitamin D3 supplementation on skeletal muscle strength in athletes. Vitamin D3 supplements or vitamin D3 fortified foods always have claims for bringing people health benefits including bone and muscle health. An up-to-date rigorous systematic review and meta-analysis is important to better understand the effect of vitamin D3 supplementation on muscle strength. METHODS: English written randomized controlled trials (RCTs) that looked at effects of vitamin D3 supplementation on muscle strength in healthy athletes were searched using three databases (PubMed, Embase and Cochrane Library). Serum 25(OH)D above 30 ng/mL is considered to be sufficient in this systematic review and meta-analysis. RESULTS: Five RCTs with 163 athletes (vitamin D3 n = 86, placebo n = 77) met inclusion criteria. Fourteen athletes were lost to follow-up and 149 athletes (vitamin D3 n = 80, placebo n = 69) were documented with complete result. Among athletes with baseline serum 25(OH)D values suggesting insufficiency, vitamin D3 daily dosage at 5000 IU for over 4 weeks led to a serum 25(OH)D concentration of 31.7 ng/mL. Athletes with sufficient serum 25(OH)D level at baseline were recruited in only one study, and the participants of which were assigned to either vitamin D3 at a daily dosage of 3570 IU or placebo for 12 weeks, their serum 25(OH)D sufficiency (VD: 37.2 ± 7.6 vs. 45.6 ± 7.6; PL: 38 ± 6.8 vs. 32 ± 8.4) was well maintained above the cut-off boundary. One repetition maximum Bench Press (1-RM BP) was not improved significantly (SMD 0.07, 95% CI: - 0.32 to 0.47, P = 0.72) and there was no significant increase in maximal quadriceps contraction (SMD -2.14, 95% CI: - 4.87 to 0.59, P = 0.12). Furthermore, there was no significant overall effect of vitamin D3 intervention on muscle strength in this meta-analysis (SMD -0.75, 95% CI: - 1.82 to 0.32, P = 0.17). CONCLUSION: Although, serum 25(OH)D concentrations after supplementation reached sufficiency was observed, muscle strength did not significantly improve at this point of current meta-analysis. Additional well-designed RCTs with large number of participants examined for the effect of vitamin D3 supplementation on serum 25(OH)D concentrations, muscle strength in a variety of sports, latitudes and diverse multicultural populations are needed.


Asunto(s)
Colecalciferol/administración & dosificación , Suplementos Dietéticos , Fuerza Muscular , Fenómenos Fisiológicos en la Nutrición Deportiva , Vitamina D/análogos & derivados , Humanos , Músculo Esquelético/efectos de los fármacos , Ensayos Clínicos Controlados Aleatorios como Asunto , Vitamina D/sangre , Vitaminas/administración & dosificación
10.
Methodist Debakey Cardiovasc J ; 15(3): 207-213, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31687100

RESUMEN

Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.


Asunto(s)
Calcio/uso terapéutico , Enfermedades Cardiovasculares/prevención & control , Suplementos Dietéticos , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/uso terapéutico , Animales , Biomarcadores/sangre , Calcio/efectos adversos , Calcio/deficiencia , Calcio en la Dieta/sangre , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Suplementos Dietéticos/efectos adversos , Humanos , Factores Protectores , Ingesta Diaria Recomendada , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento , Vitamina D/efectos adversos , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/epidemiología
11.
Georgian Med News ; (294): 88-91, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687956

RESUMEN

Plenty of studies demonstrated an association between a Vitamin D deficiency and several autoimmune disorders, such as diabetes mellitus, systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) in adult patients. This study was aimed to assess probable association between the 25-hydroxyvitamin D [25(OH)D] level and juvenile idiopathic arthritis (JIA) features and the possible relationship between serum vitamin D level and disease activity. 69 patients with JIA were examined and 15 healthy children were chosen as the control group. The mean age of patients was 10 years 8 months ±4 years 6 months (45 female, 24 male). 25 patients with oligoarthicular subtype of disease, 34 with poliarthicular sybtype and 10 patient with undifferentiated arthritis . The total duration of the disease was 4 years 1 month ± 1 year 1 month. Patients got methotrexate therapy (15mg/m2). Any of the patients were not treated by corticosteroids. The serum level of vitamin D was measured through blood test by chemiluminescence method. The relationship between the level of vitamin D and disease activity was analyzed based on juvenile arthritis disease activity score (JADAS27). The average level of vitamin D in serum was 22,69±7,8 ng/ml at the control group the vitamin D status was 28,67±5,06 ng/ml. In spite of the fact that a decrease in vitamin D status was observed in both groups, however in the group of healthy children it was significantly higher (p>0.05). Using the regression method, a significant relationship was established between the number of active joints and the age of patients, duration of disease, the level of vitamin D in serum, the number of injured joints, and disease activity (accordant to JADAS27 score) (number of active joints = - 1,144 + 0,005 x age of patients - 0,007x duration of disease + 0,292 x the number of injured joints + 0,033 x level of vitamin D + 0,077 x the number of points accordant to JADAS27). The monitoring of vitamin D level is advisable to carry out during observing the children with JIA. It can be useful for timely correction of vitamin D deficiency and preventions both skeleton and non-skeleton complications. That may improve the quality of life of patients and their families.


Asunto(s)
Artritis Juvenil , Deficiencia de Vitamina D/sangre , Adulto , Artritis Juvenil/sangre , Artritis Juvenil/complicaciones , Artritis Juvenil/epidemiología , Artritis Reumatoide , Estudios de Casos y Controles , Niño , Femenino , Humanos , Masculino , Calidad de Vida , Ucrania/epidemiología , Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología
12.
BMC Neurol ; 19(1): 284, 2019 Nov 13.
Artículo en Inglés | MEDLINE | ID: mdl-31722673

RESUMEN

BACKGROUND: We aimed to comprehensively explore the associations between serum 25(OH)D deficiency and risk of dementia and Alzheimer's disease(AD). METHODS: We systematically searched Pubmed, the Cochrane Library, Embase and the reference lists of pertinent review articles for relevant articles published from database inception up until January 2019. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with random effects models using the Stata 12.0 statistical software package. RESULTS: Twelve prospective cohort studies and four cross-sectional studies were included in this meta-analysis. The pooled HRs of dementia and AD, respectively, were 1.32 (95%CI: 1.16, 1.52) and 1.34 (95%CI: 1.13, 1.60) for vitamin D deficiency (< 20 ng/ml). In the subgroup analyses, the pooled HRs of dementia and AD, respectively, were 1.48 (95%CI: 1.19, 1.85) and 1.51 (95%CI: 1.04, 2.18) for moderate vitamin D deficiency (10-20 ng/ml) and 1.20 (95%CI: 0.99, 1.44) and 1.36 (95%CI: 1.01, 1.84) for severe vitamin D deficiency (< 10 ng/ml). CONCLUSION: There are significant associations between vitamin D deficiency and both dementia and AD. There are stronger associations between severe vitamin D deficiency (< 10 ng/ml) and both dementia and AD compared to moderate vitamin D deficiency (10-20 ng/ml).


Asunto(s)
Enfermedad de Alzheimer/sangre , Demencia/sangre , Deficiencia de Vitamina D/complicaciones , Algoritmos , Estudios Transversales , Bases de Datos Factuales , Humanos , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Factores de Riesgo , Vitamina D/sangre
13.
Klin Lab Diagn ; 64(11): 673-676, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31747496

RESUMEN

The aim was to study the level of some cytokines (IL-2, IL-6, IL-8 TNFα) and calcium regulating hormones (calcitonin, parathyroid hormone, 25 (OH) D) in the blood of patients with rheumatoid arthritis (RA) depending on rheumatoid factor (RF) and the assessment of the role of the revealed violations in the pathogenesis of bone loss in this pathology. For this purpose, 74 patients with RA (59 women, 15 men) aged from 27 to 71 were examined. On the basis of RF in the blood serum, the patients were divided into 2 groups: seronegative and seropositive RA. The control group included 16 healthy individuals (13 women, 3 men). The results obtained that the serological variant of RA affects the serum levels of proinflammatory cytokines and calcium-regulating hormones: more pronounced changes were found in seropositive RA. The high production of IL-2, IL-6, IL-8, TNF-α and parathyroid hormone detected in both groups of patients undoubtedly contributes to the mechanisms of bone loss in RA. In both groups we detected hypovitaminosis D. This results recommended to use this vitamin in the complex treatment of RA.


Asunto(s)
Artritis Reumatoide/sangre , Calcitonina/sangre , Citocinas/sangre , Hormona Paratiroidea/sangre , Vitamina D/análogos & derivados , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factor Reumatoide , Vitamina D/sangre
14.
Medicine (Baltimore) ; 98(48): e18113, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770235

RESUMEN

The impact of vitamin D deficiency on the recovery of patients with malnutrition remains undefined. Our aim was to study the prevalence of vitamin D deficiency in a well-characterized cohort of patients with malnutrition and its association with outcomes.Within this secondary analysis of a randomized controlled trial, we examined the association of vitamin D deficiency and adverse clinical outcomes over a follow-up of 180 days in hospitalized patients at risk for malnutrition. We measured 25-hydroxyvitamin D levels upon admission and defined Vitamin D deficiency when levels were <50nmol/l. The primary endpoint was 180-day mortality.The prevalence of vitamin D deficiency in our cohort of 828 patients was 58.2% (n = 482). Patients with vitamin D deficiency had increased 180-day mortality rates from 23.1% to 29.9% (odds ratio 1.42, 95% confidence interval [CI] 1.03-1.94, P = .03). When adjusting the analysis for demographics, comorbidities, and randomization, this association remained significant for the subgroup of patients not receiving vitamin D treatment (adjusted odds ratio 1.63, 95% CI 1.01-2.62, P = .04). There was no significantly lower risk for mortality in the subgroup of vitamin D deficient patients receiving vitamin D treatment compared to not receiving treatment (adjusted odds ratio 0.74, 95% CI 0.48-1.13, P = .15).Vitamin D deficiency is highly prevalent in the population of malnourished inpatients and is negatively associated with long-term mortality particularly when patients are not receiving vitamin D treatment. Our findings suggest that malnourished patients might benefit from vitamin D screening and treatment in case of deficiency.


Asunto(s)
Anciano Frágil/estadística & datos numéricos , Fragilidad/mortalidad , Desnutrición/mortalidad , Deficiencia de Vitamina D/mortalidad , Deficiencia de Vitamina D/terapia , Anciano , Anciano de 80 o más Años , Suplementos Dietéticos , Femenino , Fragilidad/sangre , Fragilidad/complicaciones , Humanos , Pacientes Internos/estadística & datos numéricos , Masculino , Desnutrición/sangre , Desnutrición/complicaciones , Prevalencia , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento , Vitamina D/análogos & derivados , Vitamina D/sangre , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/complicaciones , Vitaminas/uso terapéutico
15.
Medicine (Baltimore) ; 98(48): e18118, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770239

RESUMEN

BACKGROUND: Vitamin D is a fat-soluble vitamin that is related to the health of the human body and is an indispensable nutrient for human beings. Some studies indicated that type 2 diabetes mellitus (T2DM) with diabetic peripheral neuropathy (DPN) may be associated with vitamin D deficiency, but the current understanding of this point of view remains controversial. This study aimed to evaluate the correlation between serum 25-hydroxyl vitamin D (25 [OH] D) concentration and DPN in patients with T2DM by a meta-analysis, and to provide a reference for doctors. METHODS: Relevant studies were selected from the PubMed, Cochrane Library, China National Knowledge Infrastructure, VIP databases, and Wanfang Data Knowledge Service Platform databases dating from 2000 to December 2017. A total of 75 articles related to serum 25 (OH) D and DPN were selected from 2000 to December 2017. Based on the inclusion and exclusion criteria of the literature, a quality assessment was conducted using the Newcastle-Ottawa scale, and a meta-analysis was performed by RevMan5.3 statistical software. RESULTS: Thirteen studies that involved a total of 2814 type 2 diabetic patients were finally included into the meta-analysis. Meta-analysis results, heterogeneity test showed that, P < .000 01, I = 92%, calculation by random effect model revealed that, the serum concentration of 25 (OH) D in T2DM combined with DPN group was lower than that in the group without DPN (weighted mean difference = -0.74, 95% confidence interval: -1.03 to -0.46) CONCLUSIONS:: Vitamin D is associated with type 2 DPN (DPN), and vitamin D deficiency can lead to an increased risk of type 2 DPN. However, more high-quality research is needed.


Asunto(s)
Diabetes Mellitus Tipo 2/sangre , Neuropatías Diabéticas/sangre , Enfermedades del Sistema Nervioso Periférico/sangre , Deficiencia de Vitamina D/etiología , Vitamina D/análogos & derivados , Adulto , Anciano , Diabetes Mellitus Tipo 2/complicaciones , Neuropatías Diabéticas/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/etiología , Factores de Riesgo , Vitamina D/sangre , Deficiencia de Vitamina D/sangre
16.
BMC Neurol ; 19(1): 244, 2019 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-31640594

RESUMEN

BACKGROUND: Activated Vitamin D has anti-inflammatory properties and adequate 25-hydroxyvitamin D [25(OH)D] concentrations may be important for neurocognitive function and protection against neurologic injury. We examined whether mid-life 25(OH) D concentrations were associated with later-life performance on neuropsychological testing, functional ability, depressive symptoms, and incident dementia. METHODS: We studied 13,039 white and black ARIC participants who had serum 25(OH) D measured mid-life at visit 2 (1990-1992). Over the next ~ 20 years through visit 5 (2011-2013), participants underwent 3 additional in-person visits, annual telephone calls, and hospitalization surveillance. An extensive battery of neuropsychological outcomes were assessed at visit 5 using standardized protocols. Incident dementia was ascertained through a formal algorithm that included data from in-person cognitive testing, telephone interviews, hospital discharge codes, and death certificate codes. Diagnoses of dementia were adjudicated by expert clinician committee. For the primary cognitive analyses, we imputed for missing covariates and outcomes and used linear regression to evaluate non-concurrent cross-sectional associations of mid-life 25(OH) D (visit 2) with late-life neuropsychological outcomes (visit 5). We also used Cox regression models to examine associations of mid-life 25(OH) D and incident dementia. RESULTS: In mid-life, the mean (SD) age of participants was 57 (6) years, 57% were women, and 24% black. Mean (SD) 25(OH) D was 24.3 (8.6) ng/mL; 33% had deficient (< 20 ng/mL), 44% intermediate (20- < 30 ng/mL), and 23% sufficient (≥30 ng/mL) 25(OH) D concentrations. Association between mid-life 25(OH) D and late-life performance on neuropsychological testing were mostly null. There was no significant association with functional ability or depressive symptoms. Results were similar in a sensitivity analysis using complete-case data (no imputation). However, after a median follow-up of 20 years, low 25(OH) D concentrations were associated with increased risk for incident dementia (p = 0.01 for trend across categories), with HR of 1.26 (95% CI 1.06, 1.49) for participants with deficient 25(OH) D, compared to sufficient concentrations. CONCLUSION: In this community cohort, mid-life serum 25(OH) D concentrations were associated with incident dementia but not with performance on neuropsychological testing, functional ability, or depressive symptoms, 20 years later. Whether serum 25(OH) D concentrations are causally related to dementia or confounded by poorer health status remains uncertain. TRIAL REGISTRATION: Registered on clinicaltrials.gov NCT00005131 .


Asunto(s)
Demencia/epidemiología , Vitamina D/análogos & derivados , Afroamericanos , Anciano , Estudios de Cohortes , Estudios Transversales , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Vitamina D/sangre
17.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(9): 1118-1121, 2019 Sep 30.
Artículo en Chino | MEDLINE | ID: mdl-31640966

RESUMEN

OBJECTIVE: To investigate the relationship between serum 25(OH) vitamin D and liver fat content in nonalcoholic fatty liver disease (NAFLD). METHODS: A total of 120 patients with NAFLD admitted in our hospital between June and August, 2017 were enrolled and divided into 4 groups with different serum 25 (OH) vitamin D levels: >75 nmol/L (group A, n=25), 50-75 nmol/L (group B, n=35), 25-50 nmol/L (group C, n=32), and < 25 nmol/L (group D, n=28). For all the patients, serum 25 (OH) vitamin D level was measured by ELISA, and liver fat content was determined using in-phase opposed-phase T1WI sequences. The measurement data were compared among the 4 groups to assess the association between serum 25(OH) vitamin D level and liver fat content. RESULTS: The liver fat content appeared to be higher in group B (28.66±6.45%) and group C (38.74±11.47%) than in group A (22.79 ± 6.10%), but the difference was not statistically significant (P>0.05); the liver fat content in group D (54.79 ± 5.28%) was significantly higher than that in the other 3 groups (P>0.05). Liver fat content increased significantly as serum 25(OH) vitamin D level decreased, showing an inverse correlation between them in these patients (P < 0.05, r=-0.125). CONCLUSIONS: In patients with NAFLD, a decreased serum 25(OH) vitamin D level is associated with an increased liver fat content, suggesting the value of serum 25(OH) vitamin D as a predictor of NAFLD.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico/patología , Vitamina D/sangre , Humanos , Hígado/patología , Enfermedad del Hígado Graso no Alcohólico/sangre
18.
Wei Sheng Yan Jiu ; 48(4): 633-637, 2019 Jul.
Artículo en Chino | MEDLINE | ID: mdl-31601348

RESUMEN

OBJECTIVE: To test the performance of direct chemiluminescence immunoassay(CLIA) in the determination of serum 25-hydroxyvitamin D [25(OH)D] concentration. METHODS: The CLIA analyzer of Italy DiaSorin was used to measure the 25(OH)D concentrations in the Standard Reference Material 972 a of National Institute of Standards and Technology, DiaSorin control materials, blind samples of Vitamin D External Quality Assessment Scheme(DEAQS), and outpatient serum samples. The functional sensitivity, precision, accuracy, recovery, and linearity were evaluated, and the samples of mild hemolysis, 5 days' storage at 4 ₿ and >1 year's storage at-80 ₿were tested for 25(OH)D. RESULTS: The functional sensitivity was<4 ng/mL. The coefficient of variations of intra-and inter batch were<8. 1%. The relative deviation was-3. 1%-5. 7%. The recovery rates were 82. 8%-112. 9% and it had good linearity in the range of 7. 6-128. 1 ng/mL. Compared with fresh serum, the serum 25(OH)D concentration was not affected by mild hemolysis or being stored at 4 ₿for 5 days, but averagely decreased at 7. 6% by being stored at-80 ₿for more than 1 year. Compared with others, the deviation was-2. 9%-3. 6%. The differences in precision, accuracy and recovery of this method among the three different hospitals is slightly. CONCLUSION: The performance of direct CLIA for 25(OH)D assay meet the basic technical requirements for laboratory medicine, and is laborsaving and timesaving.


Asunto(s)
Luminiscencia , Vitamina D/análogos & derivados , 25-Hidroxivitamina D 2 , Calcifediol , Inmunoensayo , Vitamina D/sangre
19.
Prague Med Rep ; 120(2-3): 84-94, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31586507

RESUMEN

Ageing is associated with the accumulation of damage to all the macromolecules within and outside cells leading to progressively more cellular and tissue defects and resulting in age-related frailty, disability and disease. As a result of the aging process the bone deteriorates in composition, structure and function. Age-related musculoskeletal losses are a major public health burden because they can cause physical disability and increased mortality. We tried to find out on a small set of old women, without risk factors for osteoporosis, what caused them the loss of bone minerals. All 492 women had just only one risk factor - the old age. Laboratory findings have shown a decreased serum C telopeptide and low serum alkaline phosphatase circulating markers, used to quantify bone resorption and formation, and very low level of vitamin D. Very low level of vitamin D that disrupted calcium absorption through the intestine, and decreased calcemia increased parathyroid hormone levels with resulting bone effect. The manifestation of physiological aging is worsening eyesight, peripheral neuropathy, depression, worsening of physical condition, skin aging, sarcopenia and bone mineral loss. Senile osteoporosis, which is not caused by known risk factors for osteoporosis, does not appear to be a separate disease, but is part of the physiological process of aging. Treatment of senile osteoporosis should be focused on the control of secondary hyperparathyroidism by administration of vitamin D and calcium. The risk of fractures in the advanced age is determined by a large number of factors ranging from hazards in the home environment to frailty and poor balance.


Asunto(s)
Envejecimiento/sangre , Envejecimiento/patología , Fosfatasa Alcalina/sangre , Densidad Ósea , Calcio/metabolismo , Colágeno Tipo I/sangre , Femenino , Humanos , Osteogénesis , Osteoporosis/sangre , Hormona Paratiroidea/sangre , Péptidos/sangre , Vitamina D/sangre
20.
Bratisl Lek Listy ; 120(10): 723-729, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31663345

RESUMEN

OBJECTIVES: Multiple sclerosis is a chronic inflammatory and autoimmune demyelinating disease of the brain and spinal cord. Vitamin D has anti-inflammatory and anti-Th1, Th17 activities, activates the function of regulatory T cells, shifts the immune response towards Th2, so it might be favorable for downregulation of the disease pathogenesis, and if inflammation and Th1 and Th17 immunity are hyperactivated. The aim of our study was to highlight the role of vitamin D in multiple sclerosis pathogenesis. METHODS: We investigated 178 patients with multiple sclerosis. Plasma levels of 25(OH)D and HMGB1 were investigated. RESULTS: Despite a regular use of VD by patients, the plasma levels of 25(0H)D were significantly decreased in 57% of them, 14.1% had VD deficiency (level of 25(OH)D < 20 ng/mL) and more than 6 % of patients had VD severe deficiency with the plasma level of 25(OH)D < 12 ng/mL. The level of 25(OH)D negatively correlated with the severity of the disease (EDSS, index of progression, duration of the disease) and negative association was found also with Herbert´s six severity grades. HMGB1 levels were higher in patients (p < 0.0001). CONCLUSION: Our result showed that vitamin D deficiency plays a role in multiple sclerosis pathogenesis. We believe that administration of vitamin D to patients at a sufficient dose providing a physiological level of vitamin D could have a positive effect on the course of the disease. However, regular monitoring of vitamin D levels is required, which should be at least within 30-75 ng/mL, and even more, but below the toxicity limit (Tab. 6, Ref. 66).


Asunto(s)
Esclerosis Múltiple/sangre , Esclerosis Múltiple/diagnóstico , Deficiencia de Vitamina D/complicaciones , Vitamina D/análogos & derivados , Progresión de la Enfermedad , Proteína HMGB1/sangre , Humanos , Vitamina D/sangre
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