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1.
N Engl J Med ; 382(6): 525-533, 2020 02 06.
Artigo em Inglês | MEDLINE | ID: mdl-32023372

RESUMO

BACKGROUND: We previously reported the results of a trial of prenatal vitamin D supplementation to prevent asthma and recurrent wheeze in young children, which suggested that supplementation provided a protective effect at the age of 3 years. We followed the children through the age of 6 years to determine the course of asthma and recurrent wheeze. METHODS: In this follow-up study, investigators and participants remained unaware of the treatment assignments through the children's sixth birthday. We aimed to determine whether, when maternal levels of 25-hydroxyvitamin D were taken into account, children born to mothers who had received 4400 IU of vitamin D3 per day during pregnancy (vitamin D group) would have a lower incidence of asthma and recurrent wheeze at the age of 6 years than would those born to mothers who had received 400 IU of vitamin D3 per day (control group). Time-to-event methods were used to compare the treatment groups with respect to time to the onset of asthma or recurrent wheeze. Multivariate methods were used to compare longitudinal measures of lung function between the treatment groups. RESULTS: There was no effect of maternal vitamin D supplementation on asthma and recurrent wheeze in either an intention-to-treat analysis or an analysis with stratification according to the maternal 25-hydroxyvitamin D level during pregnancy. There was no effect of prenatal vitamin D supplementation on most of the prespecified secondary outcomes. We found no effects of prenatal supplementation on spirometric indexes. Although there was a very small effect on airway resistance as measured by impulse oscillometry, this finding was of uncertain significance. CONCLUSIONS: Vitamin D supplementation during the prenatal period alone did not influence the 6-year incidence of asthma and recurrent wheeze among children who were at risk for asthma. (Funded by the National Heart, Lung, and Blood Institute; VDAART ClinicalTrials.gov number, NCT00920621.).


Assuntos
Resistência das Vias Respiratórias/efeitos dos fármacos , Asma/prevenção & controle , Suplementos Nutricionais , Cuidado Pré-Natal , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Asma/epidemiologia , Criança , Feminino , Seguimentos , Humanos , Incidência , Análise de Intenção de Tratamento , Pulmão/efeitos dos fármacos , Pulmão/embriologia , Gravidez , Sons Respiratórios/efeitos dos fármacos , Espirometria , Vitamina D/análogos & derivados , Vitamina D/sangue
2.
Life Sci ; 244: 117305, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31953161

RESUMO

Diabetes mellitus (DM) is a complex metabolic disorder involving multiple deleterious molecular pathways and cellular defects leading to disturbance in the biologic milieu. It is currently a global health concern with growing incidence, especially among younger adults. There is an unmet need to find new therapeutic targets for the management of diabetes. Vitamin D is a promising target in the pathophysiology of DM, especially since vitamin D deficiency is common in patients with diabetes compared to people without diabetes. Evidence suggests that it can play significant roles in improving peripheral insulin sensitivity and glucose metabolism, however, the exact pathophysiological mechanism is not clarified yet. In this current study, we have reviewed the evidence on the effect of vitamin D in improving insulin resistance via distinct molecular pathways.


Assuntos
Intolerância à Glucose/prevenção & controle , Homeostase , Deficiência de Vitamina D/complicações , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Animais , Intolerância à Glucose/etiologia , Humanos
3.
Life Sci ; 244: 117331, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31972209

RESUMO

AIM: Drug-induced liver and kidney injuries are worldwide problems that cause restrictions in the use of drugs. The injury is highly mediated by oxidative stress and inflammation pathways. So, demonstrating the role of the natural compound (Vit.D) on the prevention of acetaminophen (APAP) overdose toxicity and the molecular mechanism through NrF2/BACH1/HO-1 pathway is promising. EXPERIMENTAL: Male Sprague Dawley rats (40 rats) were divided randomly into 4 groups: Normal, APAP, APAP+Vit.D (500 IU/kg) and APAP+Vit.D (1000 IU/kg). The APAP toxicity caused by 2 g/kg (orally) on day 7. KEY FINDINGS: Vit D decreased significantly liver and kidney functions: serum ALT and AST activities (P < 0.0005); creatinine and urea (P < 0.0005) concentrations; liver and kidney histopathological scores. Furthermore, Vit.D ameliorated APAP-caused oxidative stress through the liver malondialdehyde concentration's decrease and the total antioxidant capacity's increase (P < 0.0005). The molecular mechanism of Vit.D may include the prevention of high deteriorating increase of oxidative stress mediators: hepatic and renal NrF2 and BACH1 tissue expression in addition to serum HO-1 (P < 0.0005); the increase of inflammatory mediators; hepatic and renal NF-κB tissue expression, serum interleukin-10 (P < 0.0005) and TNF-α (P < 0.05). The 500 IU/kg Vit.D administration caused better protection results especially on the histopathological and immunohistochemical results than the 1000 IU/kg Vit.D administration. SIGNIFICANCE: Vit.D ameliorates APAP-induced liver and kidney injury that may be attributed to its ability to moderately increase antioxidant status to counteract the toxicity without the massive destructive increase in the anti-oxidant pathway (NrF2/HO-1/BACH1). So, this work represents a great prophylactic role of Vit.D against drug-induced liver and kidney injury.


Assuntos
Acetaminofen/toxicidade , Fatores de Transcrição de Zíper de Leucina Básica/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/prevenção & controle , Heme Oxigenase (Desciclizante)/metabolismo , Rim/efeitos dos fármacos , Fator 2 Relacionado a NF-E2/metabolismo , Proteínas Repressoras/metabolismo , Vitamina D/administração & dosagem , Doença Aguda , Analgésicos não Entorpecentes/toxicidade , Animais , Fatores de Transcrição de Zíper de Leucina Básica/genética , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Doença Hepática Induzida por Substâncias e Drogas/patologia , Regulação da Expressão Gênica/efeitos dos fármacos , Heme Oxigenase (Desciclizante)/genética , Rim/metabolismo , Rim/patologia , Masculino , Fator 2 Relacionado a NF-E2/genética , Ratos , Ratos Sprague-Dawley , Proteínas Repressoras/genética , Vitaminas/administração & dosagem
4.
Maturitas ; 132: 57-64, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31883664

RESUMO

Progressive age-related reductions in muscle mass and strength (sarcopenia) can cause substantial morbidity. This narrative review summarizes evidence of nutritional interventions for maintaining muscle mass and strength from midlife through old age. PubMed and Cochrane databases were searched to identify studies of dietary intake and nutritional interventions for sustaining muscle mass and strength. The benefits of progressive resistance training with and without dietary interventions are well documented. Protein and amino acid (particularly leucine) intake should be considered, and supplementation may be warranted for those not meeting recommended intakes. Vitamin D receptors are expressed in muscle tissue; meta-analyses have shown that vitamin D benefits muscle strength. Data suggest that milk and other dairy products containing different bioactive compounds (i.e. protein, leucine) can enhance muscle protein synthesis, particularly when combined with resistance exercise. Omega-3 s can improve muscle mass and strength by mediating cell signaling and inflammation-related oxidative damage; no studies were specifically conducted in sarcopenia. Low-dose antioxidants (e.g. vitamins C and E) can protect muscle tissue from oxidative damage, but relevant studies are limited. Magnesium is involved with muscle contraction processes, and data have shown benefits to muscle strength. Acidogenic diets increase muscle protein breakdown, which is exacerbated by aging. Alkalizing compounds (e.g. bicarbonates) can promote muscle strength. Small studies of probiotics and plant extracts have generated interest, but few large studies have been conducted. Based on available data, dietary and supplemental interventions may add to the benefits of exercise on muscle mass and strength; effects independent of exercise have not been consistently shown.


Assuntos
Dieta , Proteínas na Dieta/administração & dosagem , Força Muscular , Músculo Esquelético/fisiologia , Sarcopenia/prevenção & controle , Idoso , Aminoácidos/administração & dosagem , Antioxidantes/administração & dosagem , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Pessoa de Meia-Idade , Proteínas Musculares/biossíntese , Compostos Fitoquímicos/administração & dosagem , Probióticos/administração & dosagem , Vitamina D/administração & dosagem
5.
J Pediatr Orthop ; 40(1): e58-e62, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30998583

RESUMO

BACKGROUND: Within the last decade, multiple studies have demonstrated the potential health benefits of vitamin D supplementation including improved bone health, reduced fracture risk, protection from autoimmune disease, and decreased cancer risk. Because of the prevalence of vitamin D deficiency in pediatric populations and despite recent evidence of increased vitamin D supplementation in the United States, our goal is to assess the knowledge of current vitamin D recommendations among pediatric orthopaedists and fellows within the Pediatric Society of North America (POSNA). It is our purpose to use the data to increase awareness and understanding of vitamin D among all pediatric providers. METHODS: Our survey was distributed to 1316 POSNA members via a series of 2 email requests to participate in the survey on the SurveyMonkey website. They agreed to participate by responding positively on the first page of the survey. The data was depersonalized and analyzed via χ and the Fisher exact testing. RESULTS: A total of 395 responses were recorded. Overall, 69% of participants rated their vitamin D knowledge as fair to good. In total, 68% of participants have been in practice over 10 years and represented most US geographic regions fairly equally. Most estimate that over 25% of their practice is vitamin D deficient with about a 50% compliance rate of supplementation. Over 30% of participants feel vitamin D management is mostly the role of the pediatrician; however, 64% of participants discuss or check vitamin D levels in their practice for patients with repeat fractures, medical comorbidities, or nonunions most commonly. CONCLUSIONS: Survey participants demonstrated a wide variety of responses indicating their understanding of vitamin D testing and supplementation. Although providers estimate a high deficiency rate, many do not routinely check vitamin D. When they do check, there is no standard indication for testing or supplementation and many believe this to be the role of the pediatrician or endocrinologist. More studies are needed to provide a standardized protocol for vitamin D testing and supplementation in the pediatric orthopaedic literature. CLINICAL RELEVANCE: POSNA survey.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Ortopedia , Pediatria , Papel do Médico , Deficiência de Vitamina D , Vitamina D/administração & dosagem , Suplementos Nutricionais , Humanos , Padrões de Prática Médica , Prevalência , Inquéritos e Questionários , Estados Unidos , Deficiência de Vitamina D/diagnóstico , Deficiência de Vitamina D/tratamento farmacológico , Vitaminas/administração & dosagem
6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 628-638, dic. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184790

RESUMO

Background: Studies trying to find the association between vitamin D status and metabolic syndrome (MetS) have led to inconsistent results, and community-based data for individuals living in the Middle East are limited. Objectives: To find out if MetS and its components are associated with vitamin D status among female teachers residing in Yazd city during winter 2015. Materials and methods: A total of 276 female teachers (case group, n = 124 and control group, n = 152) aged 20-60 years were included. Weight, height, waist circumference, blood pressure, daily energy intake, physical activity, serum 25 hydroxy vitamin D (25(OH)D3), fasting blood glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C) levels were assessed. Logistic regression was used to examine the odds ratio of MetS according to vitamin D status. Results: Mean serum 25(OH)D3 was 32.79 ± 18.62 ng/ml and 33.73 ± 20.20, in females with and without MetS, respectively (P > 0.142). Compared to those with 25(OH)D3of < 20 ng/ml, the odds ratio for MetS was 1.01 (95% CI: 0.48-2.13) and 0.95 (95% CI: 0.56-1.60) for those with serum 25(OH)D3 levels of 20-29 ng/ml and ≥ 30 ng/ml, respectively (P trend = 0.84). The association remained insignificant after adjusting for potential confounders. Furthermore, vitamin D status was not associated with MetS components (P > 0.05). Conclusion: Although several studies have claimed the association between vitamin D status and MetS, we could not find a similar connection in a sample of Iranian female teachers. Prospective studies are needed to determine the possible effect of vitamin D in the development of MetS, particularly in the Yazd province


Antecedentes: Los estudios en busca de una asociación entre el estado de vitamina D y el síndrome metabólico (SM) han dado resultados no concluyentes, y los datos sobre comunidades de personas residentes en Oriente Próximo son limitados. Objetivos: Averiguar si existe asociación entre el SM y sus componentes y el estado de vitamina D en profesoras residentes en la ciudad de Yazd durante el invierno de 2015. Materiales y métodos: Se incluyó a un total de 276 profesoras (grupos de casos, n = 124 y grupo de control, n = 152) de 20-60 años de edad. Se determinaron el peso, la talla, el perímetro de la cintura, la presión arterial, la ingesta diaria de energía, la actividad física y los niveles de 25-hidroxivitamina D (25(OH)D3), glucosa en ayunas, triglicéridos y colesterol de las proteínas de alta densidad (C-HDL). Se utilizó regresión logística para determinar la razón de probabilidades de SM en función del estado de vitamina D. Resultados: La concentración sérica media de 25(OH)D3 era de 32,79 ± 18,62 ng/ml y 33,73 ± 20,20 en las mujeres con y sin SM, respectivamente (P > 0,142). En comparación con las que tenían < 20 ng/ml de 25(OH)D3, la razón de probabilidades de SM era 1,01 (IC al 95%, 0,48-2,13) y 0,95 (IC al 95%, 0,56-1,60) en las que tenían valores de 20-29 ng/ml y ≥ 30 ng/ml, respectivamente (tendencia de P = 0,84). La asociación seguía siendo no significativa después del ajuste por posibles factores de confusión. Además, el estado de vitamina D no se asociaba con los componentes del SM (P > 0,05). Conclusión: Aunque varios estudios han informado de una asociación entre el estado de la vitamina D y el SM, no pudimos hallar una relación similar en una muestra de profesoras iraníes. Se necesitan estudios prospectivos para determinar el posible efecto de la vitamina D en el desarrollo del SM, especialmente en la provincia de Yazd


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Vitamina D/administração & dosagem , Síndrome Metabólica/tratamento farmacológico , Deficiência de Vitamina D/dietoterapia , Irã (Geográfico) , Modelos Logísticos , Peso-Estatura , Relação Cintura-Quadril , Pressão Arterial , Pressão Sanguínea , Exercício/fisiologia
7.
PLoS Genet ; 15(12): e1008530, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31841498

RESUMO

Vitamin D is important for normal skeletal homeostasis, especially in growing children. There are no previous genome-wide association (GWA) studies exploring genetic factors that influence vitamin D metabolism in early childhood. We performed a GWA study on serum 25-hydroxyvitamin D (25(OH)D) and response to supplementation in 761 healthy term-born Finnish 24-month-old children, who participated in a randomized clinical trial comparing effects of 10 µg and 30 µg of daily vitamin D supplementation from age 2 weeks to 24 months. Using the Illumina Infinium Global Screening Array, which has been optimized for imputation, a total of 686085 markers were genotyped across the genome. Serum 25(OH)D was measured at the end of the intervention at 24 months of age. Skeletal parameters reflecting bone strength were determined at the distal tibia at 24 months using peripheral quantitative computed tomography (pQCT) (data available for 648 children). For 25(OH)D, two strong GWA signals were identified, localizing to GC (Vitamin D binding protein) and CYP2R1 (Vitamin D 25-hydroxylase) genes. The GWA locus comprising the GC gene also associated with response to supplementation. Further evidence for the importance of these two genes was obtained by comparing association signals to gene expression data from the Genotype-Tissue Expression project and performing colocalization analyses. Through the identification of haplotypes associated with low or high 25(OH)D concentrations we used a Mendelian randomization approach to show that haplotypes associating with low 25(OH)D were also associated with low pQCT parameters in the 24-month-old children. In this first GWA study on 25(OH)D in this age group we show that already at the age of 24 months genetic variation influences 25(OH)D concentrations and determines response to supplementation, with genome-wide significant associations with GC and CYP2R1. Also, the dual association between haplotypes, 25(OH)D and pQCT parameters gives support for vertical pleiotropy mediated by 25(OH)D.


Assuntos
Colestanotriol 26-Mono-Oxigenase/genética , Família 2 do Citocromo P450/genética , Tíbia/diagnóstico por imagem , Proteína de Ligação a Vitamina D/genética , Vitamina D/análogos & derivados , Vitamina D/administração & dosagem , Desenvolvimento Infantil , Pré-Escolar , Feminino , Finlândia , Estudo de Associação Genômica Ampla , Haplótipos , Humanos , Masculino , Análise da Randomização Mendeliana , Variantes Farmacogenômicos , Polimorfismo de Nucleotídeo Único , Ensaios Clínicos Controlados Aleatórios como Assunto , Tíbia/efeitos dos fármacos , Tíbia/crescimento & desenvolvimento , Tomografia Computadorizada por Raios X , Vitamina D/sangue , Vitamina D/farmacocinética
8.
Med J Aust ; 211(10): 468-473, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31680267

RESUMO

Vitamin D is made in the skin when exposed to sunlight, so deficiency is usually the result of low sunlight exposure (eg, in frail older people and in individuals who are veiled). Calcium and/or vitamin D supplements have been used for the prevention and treatment of osteoporosis. The major trials in community-dwelling individuals have not demonstrated fracture prevention with either calcium, vitamin D, or their combination, but the results of a large study in vitamin D-deficient nursing home residents indicated a reduced fracture incidence. Trials show that vitamin D increases bone density when winter 25-hydroxyvitamin D levels are below 25-30 nmol/L. However, assay expense and variability suggest that supplements are better targeted based on clinical status to frail older people and possibly to people with dark skin living at higher latitudes. A daily dose of 400-800 units (10-20 µg) is usually adequate. Parenteral antiresorptive drugs can cause hypocalcaemia in severe vitamin D deficiency (< 25 nmol/L), which should therefore be corrected before treatment. Clinical trials have not demonstrated benefits of vitamin D on non-skeletal endpoints. Calcium supplements in healthy individuals are not needed, nor are they required in most people receiving treatment for osteoporosis, where they have not been shown to affect treatment efficacy. Calcium supplements cause constipation, bloating and kidney stones, and some evidence suggests they may cause a small increase in the risk of myocardial infarction. Low dose vitamin D is safe, but high doses result in more falls and fractures. Current evidence does not support the use of these supplements in healthy community-dwelling adults.


Assuntos
Cálcio , Vitamina D , Idoso , Densidade Óssea , Cálcio/administração & dosagem , Cálcio/efeitos adversos , Cálcio/deficiência , Cálcio/uso terapêutico , Fraturas Ósseas , Humanos , Vitamina D/administração & dosagem , Vitamina D/efeitos adversos , Vitamina D/uso terapêutico , Deficiência de Vitamina D
10.
Int Urol Nephrol ; 51(11): 2027-2036, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31531805

RESUMO

BACKGROUND: Secondary hyperparathyroidism (SHPT) is a common and serious complication of chronic kidney disease, particularly in end-stage renal disease. Currently, both cinacalcet and vitamin D are used to treat SHPT via two different mechanisms, but it is still unclear whether the combination use of these two drugs can be a safe and effective alternative to vitamin D alone. Therefore, the aim of this meta-analysis was to assess the efficacy and safety of cinacalcet plus vitamin D in the treatment of SHPT. METHODS: Four electronic databases, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, were searched for eligible publications. All randomized-controlled trials comparing cinacalcet plus vitamin D with vitamin D alone in SHPT patients undergoing dialysis were included. Mean difference (MD) with 95% confidence intervals (CIs) and risk ratios (RRs) with 95% CIs were calculated using a random-effects model or fixed-effects model. Sensitivity analysis was conducted by removing any one study successively to estimate the stability of the pooled results, and subgroup analysis was carried out to explore potential sources of heterogeneity, and funnel plots were used to test publication bias. RESULTS: A total of 8 randomized-controlled trials involving 1480 patients were included in the study. Compared with vitamin D treatment, the combination use of cinacalcet and vitamin D significantly lowered serum calcium (MD - 0.82, 95% CI - 1.02 to - 0.61, P < 0.001), phosphorus (MD - 0.57, 95% CI - 0.97 to - 0.18, P = 0.005), and calcium × phosphorus product (MD - 9.41, 95% CI - 10.00 to - 8.82, P < 0.001). However, there was no difference in serum parathyroid hormone (PTH, MD 43.99, 95% CI - 49.22 to 137.20, P = 0.35), ≥ 30% reduction in PTH (RR 1.02, 95% CI 0.69-1.52, P = 0.91), and PTH achieve 150-300 pg/ml (RR 0.88, 95% CI 0.68-1.15, P = 0.35). Moreover, the combination therapy did not increase the risk of all adverse events, all-cause mortality, diarrhea, muscle spasms, and headache (all P > 0.05), but had a higher risk of hypocalcemia (RR 17.98, 95% CI 5.68-56.99, P < 0.001), and nausea or vomiting (RR 3.47, 95% CI 2.25-5.35, P < 0.001). CONCLUSIONS: In comparison with vitamin D alone, the combination use of cinacalcet and vitamin D significantly lowered serum calcium, phosphorus, and the calcium × phosphorus product, and did not increase the risk of all adverse events, all-cause mortality, diarrhea, muscle spasms, and headache, whereas had no effect on serum PTH and increased the risk of hypocalcemia and nausea or vomiting. Future studies are needed to assess the effects of cinacalcet plus vitamin D on PTH level, cardiovascular events, and other clinical outcomes in larger samples with longer durations.


Assuntos
Calcimiméticos/administração & dosagem , Cinacalcete/administração & dosagem , Hiperparatireoidismo Secundário/tratamento farmacológico , Diálise Renal , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Combinação de Medicamentos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Pak J Pharm Sci ; 32(3 Special): 1343-1348, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31551213

RESUMO

There are still no FDA approved drugs for NAFLD so far. Vitamin D may be a good therapeutic option for NAFLD patients due to its insulin sensitizing and anti-inflammatory properties. The purpose is to investigate the effect of oral vitamin D supplementation on various parameters in NAFLD patients. In this double blind randomized placebo controlled trial, 109 patients of NAFLD diagnosed by abdominal ultrasound and liver enzymes were divided into two groups for treatment with oral capsule of vitamin D3 50,000 IU and capsule placebo weekly for a period of 12 weeks. Anthropometric, chemical, metabolic and inflammatory parameters were assessed pre and post treatment by using SPSS 16. After 12 weeks oral treatment with vitamin D , its level increased significantly in vitamin D group from 12.5±4.2 to 24.5±3.8 ng/ml p =0.003 vs placebo group. This rise was further accompanied by decrease in HOMA-IR (4.56±1.6 to 3.26± 1.8 p=0.003) liver enzymes (i.e. ALT: 72.±17.6 to 54.5±14.5 IU/L p=0.04; AST: 68±14.5 to 46.± 10.5 p =0.002) serum CRP 3.25±0.68 to 2.28±0.44 mg/L p =0.06 and increase in serum adiponectin 8.56 ±1.12 to 10.44±2.35 mg/L p =0.03 as compared to placebo group. However non significant changes were observed in both groups in terms of body weight, BMI, and serum lipid profiles. Vitamin D supplementation not only improved its own status but also caused a significant amelioration in metabolic, chemical and inflammatory parameters in NAFLD patients. So it should be consider as an adjunctive therapy in NAFLD patients.


Assuntos
Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Vitamina D/uso terapêutico , Adiponectina/sangue , Administração Oral , Adulto , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Proteína C-Reativa/análise , Método Duplo-Cego , Feminino , Humanos , Resistência à Insulina , Lipídeos/sangue , Fígado/efeitos dos fármacos , Fígado/enzimologia , Masculino , Hepatopatia Gordurosa não Alcoólica/metabolismo , Placebos , Resultado do Tratamento , Vitamina D/administração & dosagem
12.
Iran J Allergy Asthma Immunol ; 18(4): 402-411, 2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31522448

RESUMO

The current study aimed to investigate the effects of vitamin D administration on the markers of inflammation and metabolic damages in the liver of high-fat diet-induced obese rats. Forty male Wistar rats were divided into two groups of control receiving a normal diet (ND) and intervention receiving a high-fat diet (HFD). After 16 weeks, each group was divided into two groups including ND, ND + vitamin D, HFD, and HFD + vitamin D. Vitamin D was administered by oral gavage for five weeks at the dose of 500 IU/kg. Hepatic MCP-1, TGF-ß, and NF-κB levels, serum liver enzymes, and serum lipids, and histological and structural changes in the liver were determined. Vitamin D administration significantly reduced the monocyte chemoattractant protein (MCP)-1 concentrations in the HFD + vitamin D group compared with the HFD group and reduced liver Transforming growth factor beta (TGF-ß) levels in both vitamin D-treated groups (p<0.05). Moreover, a significant reduction in the serum levels of aspartate amino transferase (AST) and alanine amino transferase (ALT) in vitamin D treated groups was identified (p<0.05). A significant improvement in lipids and a pronounced improvement in the markers of liver histology damage including fat accumulation, aggregation of inflammatory cells, pre-apoptotic changes, hepatic sinusoidal dilatation, and necrotic pyknosis in the Kupffer cells were also identified. Our results demonstrated that vitamin D has potential effects in ameliorating the inflammatory, metabolic, and histologic changes in the liver of these animals.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Metabolismo Energético , Fígado/metabolismo , Fígado/patologia , Obesidade/etiologia , Obesidade/metabolismo , Vitamina D/metabolismo , Animais , Biomarcadores , Biópsia , Modelos Animais de Doenças , Metabolismo Energético/efeitos dos fármacos , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Fígado/efeitos dos fármacos , Testes de Função Hepática , Masculino , Obesidade/tratamento farmacológico , Obesidade/patologia , Ratos , Vitamina D/administração & dosagem
13.
Asian Pac J Cancer Prev ; 20(9): 2825-2830, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31554383

RESUMO

Background: Vitamin D and Calcium have a possible protective impact versus rectal neoplasm. Vitamin D, an important nutrient, is vital to regulate the absorption of calcium and bone mineralization; nevertheless, in a case-control study in Iran, we investigated the relationship among the dietary intake of vitamin D and calcium with the hazard of rectal neoplasm. Methods: 363 subjects (162 cases and 201 controls) participated in the case- control Study from March 2017 to November 2018. Dietary intake of Calcium and Vitamin D was calculated using a 148-items food-frequency questionnaire. Results: Since altering the strong confounding agents, the multivariate risk proportion within the dietary vitamin D intake was OR=0.2, 95%CI 0.1-0.5, P-value <0.001 among cases. There was no association in case of calcium and rectal cancer. Conclusions: Taken together, a possible reduction in the hazard of rectal neoplasm with dietary intake of Vitamin D within Iranian patients was observed.


Assuntos
Cálcio na Dieta/administração & dosagem , Neoplasias Colorretais/prevenção & controle , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Feminino , Seguimentos , Humanos , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Prognóstico , Fatores de Risco
14.
J Nutr Sci Vitaminol (Tokyo) ; 65(4): 303-308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474679

RESUMO

The relationship between vitamin D levels and non-alcoholic fatty liver disease (NAFLD) remains unestablished. In this study, we aimed to explore the relationship between vitamin D levels and NAFLD based on population survey data. This cross-sectional study was conducted based on data from the National Health and Nutrition Examination Survey. Liver steatosis was diagnosed by ultrasonography. Binary logistic regression analyses were performed to determine the relationship between vitamin D status and NAFLD. A total of 9,782 participants were identified in this analysis, with 46.8% male and an average age of 44.41±0.16 y old. Among them, 6,047 (61.8%) cases were without NAFLD, 1,357 (13.9%) had mild NAFLD, 1,594 (16.3%) had moderate and 784 (8.0%) had severe NAFLD. Compared to those with non-NAFLD or mild NAFLD, patients in the moderate to severe NAFLD group had higher vitamin D deficiency or insufficiency rates (12.4% vs 11.5% and 36.8% vs 33.2%, respectively). After adjustment for male gender, older age, race, BMI, history of diabetes and vitamin D intake, vitamin D levels were independently associated with the severity of NAFLD (vitamin D deficiency group OR: 1.314, 95% CI: 1.129 to 1.529, vitamin D insufficiency group OR: 1.203, 95% CI: 1.090 to 1.328). Besides that, cold season was also found to be an independent factor for NAFLD (OR: 0.896, 95% CI: 0.820 to 0.979). Lower vitamin D level is an independent risk factor for NAFLD. Vitamin D levels are inversely associated with the severity of NAFLD. Cold season increases the risk of NAFLD independently.


Assuntos
Hepatopatia Gordurosa não Alcoólica/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adulto , Índice de Massa Corporal , Temperatura Baixa , Estudos Transversais , Diabetes Mellitus , Dieta , Grupos Étnicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Inquéritos Nutricionais , Fatores de Risco , Estações do Ano , Ultrassonografia , Vitamina D/administração & dosagem , Vitamina D/sangue , Deficiência de Vitamina D/complicações
15.
Best Pract Res Clin Rheumatol ; 33(2): 290-300, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31547984

RESUMO

In view of the high imminent risk for subsequent fractures, evaluation as early as possible after the fracture will result in early decisions about drug treatment, fall prevention and nutritional supplements. Drug treatment includes anti-resorptive and bone forming agents. Anti-resorptive therapy with broad spectrum fracture prevention and early anti-fracture effects are the first choice. In patients with multiple or severe VFs, the bone forming agent teriparatide should be considered. Adequate calcium and vitamin D are needed in all patients, together with appropriate nutrition, including adequate protein intake.


Assuntos
Acidentes por Quedas/prevenção & controle , Fraturas Ósseas/prevenção & controle , Necessidades Nutricionais , Prevenção Secundária/métodos , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Suplementos Nutricionais , Feminino , Humanos , Masculino , Vitamina D/administração & dosagem
16.
Anticancer Res ; 39(9): 4627-4635, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519560

RESUMO

In the clinical setting, administration of high daily or bolus doses of vitamin D is often solely based on 25-hydroxyvitamin D [25(OH)D] testing. This review summarizes the evidence of the effect of vitamin D on cardiovascular disease (CVD). Meta-analyses of randomized controlled trials (RCTs) have demonstrated that CVD risk markers, such as lipid parameters, inflammation markers, blood pressure, and arterial stiffness, are largely unaffected by vitamin D supplementation. Similar results have been obtained regarding CVD events and mortality from (meta)-analyses of RCTs, even in subgroups with 25(OH)D concentrations <50 nmol/l. Likewise, Mendelian randomization studies have indicated that the genetic reduction of the 25(OH)D concentration does not increase CVD risk. Some studies do not exclude the possibility of adverse vitamin D effects, such as elevated plasma calcium concentration and an increased CVD risk at a 25(OH)D concentration >125 nmol/l. Based on a conservative benefit-risk management approach, vitamin D doses beyond the nutritionally recommended amounts of 600 to 800 IE daily currently cannot be advised for the prevention of CVD events.


Assuntos
Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/metabolismo , Vitamina D/metabolismo , Animais , Biomarcadores , Doenças Cardiovasculares/epidemiologia , Suplementos Nutricionais/efeitos adversos , Overdose de Drogas/complicações , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Fatores de Risco , Vitamina D/administração & dosagem , Vitamina D/efeitos adversos , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/diagnóstico
17.
Breast Cancer Res Treat ; 178(2): 347-356, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31399931

RESUMO

PURPOSE: Epidemiologic and preclinical data suggest a potential role for vitamin D in breast cancer treatment and prevention. However, results of prospective randomized trials are inconsistent. The objective of this study was to assess the effects of high-dose cholecalciferol (vitamin D3) on breast tumour proliferation and apoptosis. METHODS: We conducted a prospective, randomized, phase 2, double-blinded pre-surgical window of opportunity trial. Newly diagnosed breast cancer patients were randomized to receive 40,000 IU of vitamin D3 per day or placebo for 2 to 6 weeks prior to breast surgery. The primary outcome was the relative change in proliferation (Ki67) and apoptosis (cleaved caspase 3 apoptotic assay [CC3]) in primary breast cancer cells pre and post treatment. RESULTS: Of 83 patients randomized, 80 completed the study (43 (53.8%) vitamin D and 37 (46.3%) placebo). Mean duration of drug intake was 19 days (range 9-28 days). There were no significant differences between the control arm and the vitamin D arm in percent changes of either Ki67 index (1.6% vs. 16.7%, p = 0.25) or CC3 (- 55.9% vs. - 45.9%, p = 0.28). Serum 25-hydroxyvitamin D (25-OHD) levels were 3 times higher in the vitamin D arm (62 nmol/L vs. 246 nmol/L, p < 0.001). Adverse effects were minimal and all classified as grade 1. CONCLUSIONS: Despite significantly higher levels of serum 25-OHD in the vitamin D-treated group, this was not associated with any significant effects on tumour proliferation or apoptosis. These findings are consistent with the lack of benefit observed in prospective prevention trials. TRIAL REGISTRY: Trial registration clinicaltrials.gov NCT01948128.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , Vitamina D/administração & dosagem , Apoptose , Biomarcadores , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/cirurgia , Caspase 3/metabolismo , Feminino , Humanos , Antígeno Ki-67/metabolismo , Masculino , Gradação de Tumores , Estadiamento de Neoplasias , Cuidados Pré-Operatórios , Resultado do Tratamento
18.
Dtsch Med Wochenschr ; 144(16): 1120-1124, 2019 08.
Artigo em Alemão | MEDLINE | ID: mdl-31416103

RESUMO

Adequate intake of vitamin D and calcium are fundamental for the treatment of osteoporosis. A normal vitamin D status is required for optimal intestinal calcium absorption. However, general calcium and vitamin D supplementation is not sufficient for prevention of osteoporotic fractures in persons older than 50 years. Nevertheless, vitamin D deficiency should be avoided and corrected. In particular, parts of the population with increased risk for vitamin D deficiency (immobilized or older individuals, swarthy, migrants) should be tested. Secondary causes of vitamin D deficiency should be identified and treated.


Assuntos
Conservadores da Densidade Óssea , Osteoporose , Vitamina D , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Cálcio/uso terapêutico , Suplementos Nutricionais , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/fisiopatologia , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , Deficiência de Vitamina D
19.
Diabetes Metab Syndr ; 13(4): 2375-2380, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405646

RESUMO

AIM: Diabetes increases the odds of depression and depression is often associated with poor glycemic control and complications of diabetes. Vitamin D is also believed to improve glycemic control and ameliorate depressive symptoms. Therefore, we examined effects of vitamin D monotherapy (without antidepressant drugs) on depressive symptoms in Type 2 diabetic patients with mild to moderate depressive symptoms. METHODS: We conducted 12 weeks, placebo-controlled, double-blind, randomized trial on 68 subjects with T2DM and mild to moderate depressive symptoms. Subjects received 100 µg (4000 IU) vitamin D (n = 32) or placebo (n = 34) daily. Beck Depression Inventory-II (BDI-II-PERSIAN) was applied for assessment of the severity of depression. Depression scores and metabolic profiles were measured at the beginning and end of trail. RESULTS: after 3 months of vitamin D supplementation, mean values of 25(OH) D increased from 15.5 ±â€¯8.8 to 32.2 ±â€¯8.9 ng/ml (p-value <0.001) in the vitamin D group. Moreover, BDI-II scores decreased from 15.2 ±â€¯9.6 to 9.8 ±â€¯7.2 (p-value <0.001) in the vitamin D group and 15.5 ±â€¯11.2 to 13.7 ±â€¯11.5 (p-value = 0.03) in placebo group. This decrease in BDI-II scores were significant (27.6% vs 10.8%) compared with placebo (p-value = 0.02). In term of metabolic profiles, mean change in level of Hemoglobin A1c (HbA1c), insulin and triglycerides (TG) were significantly higher in response to the treatment with vitamin D compared to placebo (p-value <0.02). CONCLUSIONS: In conclusion, supplementation of vitamin D in T2DM patients may protect these patients against the onset of major depressive disorder (MDD), with noticeable favorable effects on measures of metabolic profiles. TRIAL REGISTRATION: NCT03008057.


Assuntos
Transtorno Depressivo Maior/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Suplementos Nutricionais , Deficiência de Vitamina D/fisiopatologia , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem , Biomarcadores/análise , Glicemia/análise , Transtorno Depressivo Maior/etiologia , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
20.
BMJ ; 366: l4673, 2019 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-31405892

RESUMO

OBJECTIVE: To investigate whether vitamin D supplementation is associated with lower mortality in adults. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase, and the Cochrane Central Register from their inception to 26 December 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials comparing vitamin D supplementation with a placebo or no treatment for mortality were included. Independent data extraction was conducted and study quality assessed. A meta-analysis was carried out by using fixed effects and random effects models to calculate risk ratio of death in the group receiving vitamin D supplementation and the control group. MAIN OUTCOME MEASURES: All cause mortality. RESULTS: 52 trials with a total of 75 454 participants were identified. Vitamin D supplementation was not associated with all cause mortality (risk ratio 0.98, 95% confidence interval 0.95 to 1.02, I2=0%), cardiovascular mortality (0.98, 0.88 to 1.08, 0%), or non-cancer, non-cardiovascular mortality (1.05, 0.93 to 1.18, 0%). Vitamin D supplementation statistically significantly reduced the risk of cancer death (0.84, 0.74 to 0.95, 0%). In subgroup analyses, all cause mortality was significantly lower in trials with vitamin D3 supplementation than in trials with vitamin D2 supplementation (P for interaction=0.04); neither vitamin D3 nor vitamin D2 was associated with a statistically significant reduction in all cause mortality. CONCLUSIONS: Vitamin D supplementation alone was not associated with all cause mortality in adults compared with placebo or no treatment. Vitamin D supplementation reduced the risk of cancer death by 16%. Additional large clinical studies are needed to determine whether vitamin D3 supplementation is associated with lower all cause mortality. STUDY REGISTRATION: PROSPERO registration number CRD42018117823.


Assuntos
Suplementos Nutricionais , Mortalidade , Vitamina D/administração & dosagem , Colecalciferol/administração & dosagem , Ergocalciferóis/administração & dosagem , Humanos , Neoplasias/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto
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