High-dose vitamin D supplementation is related to an improvement in serum alkaline phosphatase in COVID-19 patients; a randomized double-blinded clinical trial.

BACKGROUND: The benefits and harms of vitamin D supplementation in the treatment of COVID-19 have not yet been fully documented. In this study, we aimed to evaluate the effects of high-dose vitamin D supplementation on liver function tests in COVID-19. METHOD: This double-blinded randomized clinical trial was conducted on 140 hospitalized patients aged > 30 years. Patients were randomly allocated to receive either intervention group (n = 70 receiving 50,000 IU of vitamin D capsules orally as a single dose and then 10,000 IU syrup daily from the second day of admission for 30 days) and the control group (n = 70 receiving 1000 IU vitamin D syrup orally per day). Liver function tests (LFT), including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and Lactate Dehydrogenase (LDH) were evaluated at baseline and at the end of the intervention. Decision tree analysis was performed to identify the predictors for change in liver enzymes. RESULTS: Among COVID-19 patients, a significant decrease was observed in serum level of ALP between intervention and placebo groups (p = 0.04). In addition, decision tree analysis revealed that GGT, temperature, serum magnesium level at baseline and gender were the most important predictors of ALT changes in COVID-19 patients. CONCLUSION: High-dose vitamin D supplementation improved ALP markers among COVID-19 patients. More randomized controlled trials with longer follow-up times will be required.

Dietary Intake and Its Relationship to Different Body Mass Index Categories: A Population-Based Study.

BACKGROUND: Obesity is a major public health problem because of its associated diabetes mellitus and cardiovascular disease. We aimed to explore the relationship between dietary macronutrients and adiposity in a cohort study, representative of the city of Mashhad in northeastern Iran. STUDY DESIGN: A cross-sectional study. METHODS: The population sample (9847) derived from Mashhad stroke and heart atherosclerotic disorders (MASHAD: 2010-2020) and was obtained using a stratified-cluster method. The subjects were separated into 4 groups by body mass index status: normal weight, underweight, overweight and obese individuals. Individuals with mean age of 48.33 ±8.26 yr were recruited and anthropometric and biochemical factors were measured in all the subjects. Individual dietary intakes were assessed using 24-h dietary recall Dietplan6. Univariate and multivariate analyses were conducted before and after adjustment for age, gender and energy intake. RESULTS: Obese individuals were significantly less physically active. They had higher levels of serum fasted lipid profile, hs-CRP, uric acid, and glucose, and blood pressures compared to normal weight individuals (P=0.001). There was a significant difference in the dietary intakes of the groups categorized by obese before adjustment for energy intake in the obese compared to the normal weight group. These differences remained statistically significant for Trans fatty acid (P=0.033), lactose (P=0.009), fructose (P=0.025), glucose (P=0.017), sucrose (P=0.021) and maltose (P=0.015) after adjustment for energy intake. CONCLUSION: Our findings demonstrate a significant association between dietary Trans fatty acid and total sugar intake with adiposity in a representative population sample from northeastern Iran.

The 9p21 Locus and its Potential Role in Atherosclerosis Susceptibility; Molecular Mechanisms and Clinical Implications.

Cardiovascular disease (CVD) is the leading cause of global mortality. Although extensive efforts have been made to identify valid biomarkers for CVD risk, relatively few are of proven clinical utility. It is recognized that genetic factors play a major role in determining the susceptibility to CVD. Recent genome-wide-association-studies have demonstrated common genetic variants in a region on chromosome 9p21 associated with an increased risk of CVD. Several genetic-polymorphisms have been identified in this region that are highly associated with CVD, and these are clustered around the gene loci for CDKN2B (coding for p15ink4b), CDKN2A (coding for p16ink4a and p14ARF) and the 3' end of CDKN2BAS, which has been termed antisense noncoding RNA in the INK4 locus (ANRIL). Targeted deletion of the 9p21 locus reduces the cardiac expression of CDKN2A/B and is the most frequent mechanism for methylthioadenosine phosphorylase inactivation, leading to a less stable plaque phenotype in the artery. Further investigations will be essential to explore the clinical utility of emerging-markers in larger and multicenter setting in order to establish their values for risk stratification or prediction a chance of future CVD events. The aim of the current review was to provide an overview of the possible molecular mechanisms by which the chromosome 9p21 locus may confer CVD risk, and the consequential clinical implications with particular emphasis on preclinical/clinical trials on genetic changes of this locus and CVD risk.

Association between serum cytokine concentrations and the presence of hypertriglyceridemia.

OBJECTIVE: Hypertriglyceridemia is an established risk factor for coronary-heart-disease. Inflammatory cytokines are known to be important mediators of atherogenesis; however, the relationship between the concentrations of specific inflammatory cytokines and the presence of hypertriglyceridemia has not been well established. The purpose of this study was to investigate the relationship between the serum levels of several pro- and anti-inflammatory cytokines and the presence of hypertriglyceridemia. DESIGN AND METHODS: Four hundred and eighty-four subjects with/without established hypertriglyceridemia were recruited. Anthropometric parameters and biochemical analysis (including a full fasting lipid profile) were determined. The serum levels of several cytokines and growth factors including IL-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, MCP-1, IFN-γ, EGF, and VEGF were measured followed by univariate and multivariate analyses. RESULTS: Individuals with hypertriglyceridemia had a significantly higher body mass index, total-cholesterol and triglyceride, compared to the group without hypertriglyceridemia. Serum levels of MCP-1, TNF-α and IL-8 were significantly higher in subjects with hypertriglyceridemia [e.g., IL-8 from 7.8ng/L (95% CI: 4.6-18.9) versus 5.7ng/L (95% CI: 3.6-11.9), P<0.05]. The multivariate analysis showed that the increased serum concentration of TNF-α was independently associated with high-density lipoprotein cholesterol (HDL-C), while the serum levels of IL-8 and MCP-1 were associated with hypertriglyceridemia. CONCLUSION: Subjects with serum triglycerides of ≥2.25mmol/L had an altered cytokine-profile, particularly with respect to serum IL-8, MCP-1 and TNF-α, which might partially account for its adverse clinical-consequences. Further-investigations in a large multi-center setting are warranted to unravel the potential functional-importance of these cytokines in individuals with hypertriglyceridemia.