1
|
John H, Gondalia S, Sharma J, Shankar G. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review. Cureus 2025; 17:e81150. [PMID: 40276439 PMCID: PMC12020444 DOI: 10.7759/cureus.81150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2025] [Indexed: 04/26/2025] Open
Abstract
Hypertension is a major risk factor for cardiovascular disease and mortality. Emerging evidence suggests a potential role of vitamin D in blood pressure regulation through its influence on the renin-angiotensin-aldosterone system, endothelial function, and inflammation. However, findings from interventional studies remain inconsistent. This systematic review aims to evaluate the effect of vitamin D supplementation on systolic and diastolic blood pressure across various populations. A comprehensive literature search was conducted in PubMed, Cochrane Central, and ScienceDirect to identify randomized controlled trials and cohort studies investigating the impact of vitamin D on hypertension. Data extraction and risk of bias assessments were performed independently by two reviewers. The primary outcome was the change in systolic and diastolic blood pressure before and after vitamin D supplementation. In total, 12 studies met the inclusion criteria, with sample sizes ranging from 35 to 3,788 participants. The highest reduction in systolic blood pressure (-28.44 mmHg) and diastolic blood pressure (-7.38 mmHg) was observed in one study with 50,000 IU/week supplementation. Other studies reported reductions ranging from -0.5 to -4.5 mmHg for systolic blood pressure and -1 to -5 mmHg for diastolic blood pressure, with variability influenced by dosage and duration. Vitamin D supplementation demonstrates potential benefits in reducing blood pressure, particularly with higher doses over shorter durations. However, heterogeneity across studies warrants further research to establish optimal dosing strategies for hypertensive patients.
Collapse
Affiliation(s)
- Hannah John
- Medical Writing, Index Research International, Vadodara, IND
| | | | | | - Gauri Shankar
- Medical Writing, Index Research International, Vadodara, IND
| |
Collapse
|
2
|
Hu L, Velu P, Prabahar K, Hernández-Wolters B, Kord-Varkaneh H, Xu Y. Effect of Vitamin D Supplementation on Lipid Profile in Overweight or Obese Women: A Meta-analysis and Systematic Review of Randomized Controlled Trials. Nutr Rev 2025:nuae226. [PMID: 39873663 DOI: 10.1093/nutrit/nuae226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2025] Open
Abstract
CONTEXT Previous studies have explored the relationship between vitamin D and lipid profile in individuals with obesity or overweight women, but the results have been inconsistent. OBJECTIVE This meta-analysis and systematic review of randomized controlled trials (RCTs) was conducted to assess the effect of vitamin D on lipid profile in women who are overweight or obese. DATA SOURCES A meticulous search strategy was used across the Scopus, PubMed/Medline, Web of Science, and Embase databases up to June 2024. DATA EXTRACTION RCT studies administering vitamin D to overweight or obese women were extracted. A random-effects model was applied to compute the weighted mean difference (WMD) and 95% CIs of the intervention on each variable. DATA ANALYSES Thirteen eligible publications with 16 arms focused on low-density-lipoprotein cholesterol (LDL-C), 16 arms on high-density-lipoprotein cholesterol (HDL-C), 18 arms on total cholesterol (TC), and 18 arms on triglycerides (TG) were included in the final quantitative analysis. Vitamin D supplementation resulted in significant reductions in TG (WMD: -6.13 mg/dL; 95% CI: -8.99 to -3.28; P = .000) and TC (WMD: -4.45 mg/dL; 95% CI: -7.06 to -1.83; P = .001), as well as a significant increase in HDL-C concentrations (WMD: 1.54 mg/dL; 95% CI: 0.57 to 2.52; P = .002). Stratified analysis indicated a greater reduction in TG levels in studies with a mean baseline TG concentration ≥150 mg/dL (WMD: -23.58 mg/dL) and when vitamin D was administered for ≤26 weeks (WMD: -11.44 mg/dL). CONCLUSION According to our findings, vitamin D has a significant effect on hypertriglyceridemia in individuals who are overweight or obese. However, vitamin D has no significant effect on LDL-C concentrations in this population.
Collapse
Affiliation(s)
- Li Hu
- Department of Emergency Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan 64600, China
| | - Periyannan Velu
- Department of Biochemistry and Biotechnology, Annamalai University, Chidambaram, Tamil Nadu 608002, India
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | | | - Hamed Kord-Varkaneh
- Department of Nutrition and Food Hygiene, School of Medicine, Nutrition Health Research Center, Hamadan University of Medical Sciences, Hamadan 65156, Iran
| | - Yan Xu
- Department of Emergency Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan 64600, China
| |
Collapse
|
3
|
Yu K, Song W, Tu X, Zhou K, Prabahar K. The effect of vitamin D on the lipid profile in individuals with overweight or obesity: A meta-analysis and systematic review of randomized controlled trials. Prostaglandins Other Lipid Mediat 2025; 176:106938. [PMID: 39667430 DOI: 10.1016/j.prostaglandins.2024.106938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 11/28/2024] [Accepted: 12/09/2024] [Indexed: 12/14/2024]
Abstract
BACKGROUND AND AIM Previous studies have reported on the relationship between vitamin D and the lipid profile in individuals with obesity or overweight, but results have been inconsistent. Hence, we conducted this meta-analysis and systematic review of randomized controlled trials to assess the effect of vitamin D on the lipid profile in individuals with overweight or obesity. METHODS A meticulous search strategy was used in various databases, and article published up to November 2023 were included. The DerSimonian and Laird random effects model was applied to compute the weighted mean difference (WMD) and 95 % confidence intervals (CI) of the intervention on each variable. RESULTS Vitamin D supplementation did not yield significant alterations in LDL-C (WMD: 2.10 mg/dL, CI: -5.20-9.41, p = 0.572), HDL-C (WMD: 1.49 mg/dL, 95 % CI: -1.55-4.55, P = 0.337), and TC concentrations (WMD: -1.99 mg/dL, CI: -8.21-4.22, P = 0.530). Conversely, a significant decrease in TG levels was observed studies conducted in individuals with comorbidities (WMD: -6.03 mg/dL, 95 % CI: -11.92 to -0.15, p = 0.044), vitamin D doses of ≥ 50000 IU/week (WMD: -20.87 mg/dL, 95 % CI: -39.63 to -2.11, P = 0.029), and subjects with baseline TG concentrations ≥ 150 mg/dl (WMD: -25.95 mg/dL, 95 % CI: -51.51 to -0.40, p = 0.046). CONCLUSION According to our study findings, vitamin D has significant effect on the hypertriglyceridemia in individuals with obesity or overweight. However, vitamin D has no significant effect on the LDL-C, HDL-C, and TC concentrations in individuals with obesity or overweight.
Collapse
Affiliation(s)
- Kehao Yu
- Medical College of PanZhiHua University, PanZhiHua University, NO.10, Jichang Road, East District, Panzhihua, Sichuan 617000, China.
| | - Wentao Song
- Medical College of Southwest Medical University, No.319, Section 3, Zhongshan Road, Jiangyang District, Luzhou, Sichuan 646000, China
| | - Xinyu Tu
- Medical College of PanZhiHua University, PanZhiHua University, NO.10, Jichang Road, East District, Panzhihua, Sichuan 617000, China
| | - Ke Zhou
- The Second College of Clinical Medicine of Chong Qing Medical University, Chong Qing Medical University, No.61, Middle Road, Shapingba District, Chongqing 400016, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| |
Collapse
|
4
|
Aghasizadeh M, Ghanei M, Ghoflchi S, Asadian-Sohan P, Haghani M, Kazemi T, Esmaily H, Avan A, Ferns GA, Miri-Moghaddam E, Ghayour-Mobarhan M. Association of Genotypes of ANGPTL3 with Vitamin D and Calcium Concentration in Cardiovascular Disease. Biochem Genet 2024; 62:2482-2494. [PMID: 37955843 DOI: 10.1007/s10528-023-10533-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/18/2023] [Indexed: 11/14/2023]
Abstract
One of the leading causes of mortality worldwide is cardiovascular disease, which is influenced by some variables, including calcium and vitamin D. This study aimed to assess the relationship between Angiopoietin-Like 3 (ANGPTL3) gene polymorphisms with vitamin D and calcium levels in cardiovascular disease (CVD) patients. In this research, 1002 people participated. Participants' anthropometric parameters, and FBG, calcium, and vitamin D were assessed. Blood samples were used to extract DNA. Taqman®-based polymerase chain reaction (PCR) was used to conduct genetic analysis for the rs10789117 and rs17458195. Statistical analysis was applied to determine differences across subgroups and the relationship between polymorphisms and disease. Age, body mass index (BMI), fasting Blood Sugar (FBG), phenylalanine ammonia-lyase (PAL), and smoking history were significantly correlated with CVD. Vitamin D was statistically associated with rs10789117 and rs17458195 in non-CVD individuals. In the moderate group, individuals with the C allele in rs10789117 showed a tenfold increase in vitamin D deficiency compared to those with the A allele. However, in rs11207997, individuals with the T allele had 5 to 6 times higher vitamin D deficiency than those with the C allele in all groups. This research demonstrates the relationship between some ANGPTL3 gene polymorphisms and complement levels in CVD patients. It may be concluded that individuals carrying these variants would likely benefit from using vitamin D and calcium supplements to avoid CVD.
Collapse
Affiliation(s)
- Malihe Aghasizadeh
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Ghanei
- Medical Genetics and Molecular Medicine Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sahar Ghoflchi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parisa Asadian-Sohan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Haghani
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Razi Clinical Research Development Unit, Faculty of Medicine Birjand University of Medical Sciences, Birjand, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Falmer, Brighton, Sussex, BN19PH, UK
| | - Ebrahim Miri-Moghaddam
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
| |
Collapse
|
5
|
Safari S, Rafraf M, Malekian M, Molani-Gol R, Asghari-Jafarabadi M, Mobasseri M. Effects of vitamin D supplementation on metabolic parameters, serum irisin and obesity values in women with subclinical hypothyroidism: a double-blind randomized controlled trial. Front Endocrinol (Lausanne) 2023; 14:1306470. [PMID: 38179303 PMCID: PMC10764604 DOI: 10.3389/fendo.2023.1306470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Purpose Subclinical hypothyroidism is an early, mild form of hypothyroidism that may progress to overt hypothyroidism if untreated. The current study aimed to assess the effects of vitamin D supplementation on hormonal (thyroid stimulating hormone [TSH], triiodothyronine, thyroxine, and free thyroxine) parameters, lipid profiles, serum irisin, and obesity indices in women with subclinical hypothyroidism. Methods The present randomized, double-blind, placebo-controlled clinical trial was carried out on 44 women with subclinical hypothyroidism. The participants were allocated to two groups (22 patients in each group) that received vitamin D (50,000 IU/week) or placebo for 12 weeks. Fasting blood samples, anthropometric and body composition measurements, physical activity levels, and dietary intakes were collected at baseline and at the end of the study. Results Vitamin D supplementation significantly decreased TSH, total cholesterol, and fat mass percentage, and significantly increased serum vitamin D and irisin levels and fat-free mass percentage compared to the control group (all, p<0.05). Changes in thyroid hormones, other lipid profiles, and anthropometric indices were not significantly different between the groups. Conclusion Our study indicates that vitamin D administration improves serum TSH, total cholesterol, irisin, and body composition in women with subclinical hypothyroidism. More well-designed clinical trials are required to confirm these findings and clarify the effects of vitamin D supplementation on both genders of patients.Clinical trial registration: https://www.irct.ir/trial/57482, Identifier IRCT20100408003664N25.
Collapse
Affiliation(s)
- Sara Safari
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahsa Malekian
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, VIC, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Majid Mobasseri
- Endocrine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
6
|
Behers BJ, Melchor J, Behers BM, Meng Z, Swanson PJ, Paterson HI, Mendez Araque SJ, Davis JL, Gerhold CJ, Shah RS, Thompson AJ, Patel BS, Mouratidis RW, Sweeney MJ. Vitamins and Minerals for Blood Pressure Reduction in the General, Normotensive Population: A Systematic Review and Meta-Analysis of Six Supplements. Nutrients 2023; 15:4223. [PMID: 37836507 PMCID: PMC10574336 DOI: 10.3390/nu15194223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.
Collapse
Affiliation(s)
- Benjamin J. Behers
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Julian Melchor
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Brett M. Behers
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Zhuo Meng
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Palmer J. Swanson
- Department of Statistics, Florida State University, 117 N Woodward Ave., Tallahassee, FL 32306, USA; (Z.M.); (P.J.S.)
| | - Hunter I. Paterson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Samuel J. Mendez Araque
- College of Medicine, University of South Florida, 560 Channel Side Drive MDD 54, Tampa, FL 33602, USA; (B.M.B.); (S.J.M.A.)
| | - Joshua L. Davis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Cameron J. Gerhold
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Rushabh S. Shah
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Anthony J. Thompson
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Binit S. Patel
- Internal Medicine Residency, Florida State University, 1700 South Tamiami Trail, Sarasota, FL 34239, USA;
| | - Roxann W. Mouratidis
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| | - Michael J. Sweeney
- College of Medicine, Florida State University, 1115 W Call Street, Tallahassee, FL 32304, USA; (J.M.); (H.I.P.); (J.L.D.); (C.J.G.); (R.S.S.); (A.J.T.); (R.W.M.); (M.J.S.)
| |
Collapse
|
7
|
Yu Z, Zhao D, Liu X. Nutritional supplements improve cardiovascular risk factors in overweight and obese patients: A Bayesian network meta-analysis. Front Nutr 2023; 10:1140019. [PMID: 37063314 PMCID: PMC10098366 DOI: 10.3389/fnut.2023.1140019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/09/2023] [Indexed: 04/18/2023] Open
Abstract
Background Overweight and obesity are considered as one of the major risk factors for cardiovascular diseases (CVD). At present, many studies have proved that multiple nutritional supplements play an active role in metabolic diseases. However, the comparative efficacy of different nutritional supplements in improving indicators of cardiometabolic risk in obese and overweight patients is uncertain. Methods Cochrane Library, PubMed, Embase, and Web of Science were searched for the period from January 1990 to March 2022. A random-effect model was built in the Bayesian network meta-analysis. The surface under the cumulative ranking analysis (SUCRA) and clustering rank analysis was performed for ranking the effects. Results The study included 65 RCTs with 4,241 patients. In terms of glucose control, probiotic was more conductive to improve FBG (MD: -0.90; 95%CrI: -1.41 to -0.38), FINS (MD: -2.05; 95%CrI: -4.27 to -0.02), HOMA-IR (MD: -2.59; 95%CI -3.42 to -1.76). Probiotic (MD: -11.15, 95%CrI -22.16 to -1.26), omega-3 (MD: -9.45; 95%CrI: -20.69 to -0.93), VD (MD: -17.86; 95%CrI: -35.53 to -0.27), and probiotic +omega-3 (MD: 5.24; 95%CrI: 0.78 to 9.63) were beneficial to the improvement of TGs, TC and HDL-C, respectively. The SUCRA revealed that probiotic might be the best intervention to reduce FBG, FINS, HOMA-IR; Simultaneously, α-lipoic acid, VD, and probiotic + omega-3 might be the best intervention to improve TGs, TC, and HDL-C, respectively. Cluster-rank results revealed probiotic had the best comprehensive improvement effect on glucose metabolism, and probiotic + omega-3 may have a better comprehensive improvement effect on lipid metabolism (cluster-rank value for FBG and FINS: 3290.50 and for TGs and HDL-C: 2117.61). Conclusion Nutritional supplementation is effective on CVD risk factors in overweight and obese patients. Probiotic supplementation might be the best intervention for blood glucose control; VD, probiotic + omega-3 have a better impact on improving lipid metabolism. Further studies are required to verify the current findings.
Collapse
|
8
|
Vitamin D Levels as an Important Predictor for Type 2 Diabetes Mellitus and Weight Regain Post-Sleeve Gastrectomy. Nutrients 2022; 14:nu14102052. [PMID: 35631192 PMCID: PMC9143791 DOI: 10.3390/nu14102052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 01/06/2023] Open
Abstract
Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m2). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits.
Collapse
|
9
|
Radkhah N, Shabbidar S, Zarezadeh M, Safaeiyan A, Barzegar A. Effects of vitamin D supplementation on apolipoprotein A1 and B100 levels in adults: Systematic review and meta-analysis of controlled clinical trials. J Cardiovasc Thorac Res 2021; 13:190-197. [PMID: 34630965 PMCID: PMC8493225 DOI: 10.34172/jcvtr.2021.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 02/10/2021] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of death around the world. According to the studies, apolipoproteins A1 and B100 play crucial role in CVD development and progression. Also, findings have indicated the positive role of vitamin D on these factors. Thus, we conducted the present meta-analysis of randomized controlled trials (RCTs) to demonstrate the impact of vitamin D supplementation on apolipoproteins A1 and B100 levels in adults. PubMed and Scopus databases and Google Scholar were searched up to 21 December 2020. Relevant articles were screened, extracted, and assessed for quality based on the Cochrane collaboration's risk of bias tool. Data analysis conducted by random-effect model and expressed by standardized mean difference (SMD). The heterogeneity between studies was assessed by I-squared (I2) test. Subgroups and sensitivity Analyses were also conducted. Seven RCTs were identified investigating the impact of vitamin D on Apo A1 levels and six on Apo B100 levels. The findings showed the insignificant effect of vitamin D supplementation on Apo A1 (SMD=0.26 mg/dL; 95% confidence interval (CI), -0.10, 0.61; P = 0.155) and Apo B100 (standardized mean difference (SMD)=-0.06 mg/dL; 95% CI, -0.24, 0.12; P = 0.530) in adults. There was a significant between-study heterogeneity in Apo A1 (I2=89.3%, P < 0.001) and Apo B100 (I2 = 57.1%, P = 0.030). However, significant increase in Apo A1 in daily dosage of vitamin D (SMD=0.56 mg/dL; 95% CI, 0.02, 1.11; P = 0.044) and ≤12 weeks of supplementation duration (SMD=0.71 mg/dL; 95% CI, 0.08, 1.34; P = 0.028) was observed. No significant effects of vitamin D on Apo A1 and Apo B100 levels after subgroup analysis by mean age, gender, study population, dosage and duration of study. Overall, daily vitamin D supplementation and ≤12 weeks of supplementation might have beneficial effects in increasing Apo A1 levels, however, future high-quality trials considering these a primary outcome are required.
Collapse
Affiliation(s)
- Nima Radkhah
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Shabbidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Zarezadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.,Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abdolrasoul Safaeiyan
- Department of Vital Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Barzegar
- Department of Community Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
10
|
Vigna L, Lonati C, Tirelli AS, Napolitano F, Turolo S, Ingenito MR, Tomaino L, Rossi P, Riboldi L. Effects of Vitamin D Supplefmentation on Outcome of Low-Calorie Diet in Workers Presenting Obesity or Overweight: A Retrospective Observational Study. J Am Coll Nutr 2021; 41:343-351. [PMID: 34125662 DOI: 10.1080/07315724.2021.1902879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIM Growing evidence underscores the inverse association between serum vitamin D (vit D) and chronic conditions such as metabolic syndrome, diabetes and obesity. The aim of this retrospective study was to compare weight loss and metabolic serum biomarkers in subjects on low-calorie diet receiving vit D supplementation versus those not receiving it. METHODS The study considered 405 indoor sedentary workers with overweight/obesity and vit D insufficiency, who participated to a health fitness program between 2011-2013. Participants were recommended a moderately-low calorie diet plus vit D supplementation with 150,000 or 900,000 IU cumulative over 6 months in case of hypovitaminosis D (according to the guidelines at the enrollment), while those with optimal levels were recommended only diet. Participants were evaluated at baseline (T0), and after 6 months (T1). Anthropometric parameters, BMI, waist circumference (WC), serum 25-hydroxyvitamin D concentration ([25(OH)D]) and glycated hemoglobin (HbA1c) were assessed at T0 and T1. RESULTS Participants fell into one of three groups: (A) not supplemented, (B) receiving 150,000 IU and (C) receiving 900,000 IU cumulative over 6 months. Overall, the supplementation was associated with increased [25(OH)D], but only the dosage of group C was associated with the achievement of optimal vit D status. A significantly greater weight decrease was observed in group B (-4.1 kg) and C (-4.5 kg) compared to untreated (-1.2 kg). WC reduction was higher in the vit D groups (group B: -3.95 cm; group C; -6.20 cm; untreated: -3.21 cm; p < 0.05). When setting the threshold for obesity at BMI > 30kg/m2, [25(OH)D] no longer correlated with body fat or weight. [25(OH)D] inversely correlated with the Homeostatic Model Assessment for Insulin Resistance and remained significant after adjustment for BMI. CONCLUSIONS Higher [25(OH)D] levels were associated to a greater weight loss and enhanced the beneficial effects of a reduced-calorie diet in individuals with BMI > 30 kg/m2.
Collapse
Affiliation(s)
- Luisella Vigna
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Caterina Lonati
- Center for Preclinical Research, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Amedea Silvia Tirelli
- Laboratory of Clinical Chemistry and Microbiology, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Filomena Napolitano
- Department of Clinical and Community Sciences (DISCCO), Università degli Studi di Milano, Milan, Italy
| | - Stefano Turolo
- UOC Nephrology Dialysis and Pediatric Transplantation, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Rosaria Ingenito
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Tomaino
- Department of Clinical and Community Sciences (DISCCO), Università degli Studi di Milano, Milan, Italy
| | - Paola Rossi
- Department of Biology and Biotechnology "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Luciano Riboldi
- Department of Preventive Medicine, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| |
Collapse
|
11
|
Miao J, Bachmann KN, Huang S, Su YR, Dusek J, Newton-Cheh C, Arora P, Wang TJ. Effects of Vitamin D Supplementation on Cardiovascular and Glycemic Biomarkers. J Am Heart Assoc 2021; 10:e017727. [PMID: 33960201 PMCID: PMC8200713 DOI: 10.1161/jaha.120.017727] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Experimental and observational studies have suggested a link between vitamin D and cardiovascular and metabolic disease, but this has not been confirmed in randomized controlled trials. We sought to determine whether vitamin D supplementation reduces biomarkers of insulin resistance, inflammation, neurohormonal activation, and lipids. Methods and Results This was a prespecified, secondary analysis of the DAYLIGHT (Vitamin D Therapy in Individuals at High Risk of Hypertension) randomized controlled trial. We measured circulating homeostatic model assessment of insulin resistance, hs-CRP (high-sensitivity C-reactive protein), N-terminal pro-B-type natriuretic peptide, renin, aldosterone, and lipids at baseline and at 6 months in 289 individuals with low vitamin D status (25-hydroxyvitamin-D [25-OH-D] ≤25 ng/mL) receiving low-dose (400 IU/d) versus high-dose (4000 IU/d) vitamin D3 for 6 months. A meta-analysis of randomized controlled trials reporting biomarker changes after vitamin D supplementation was then performed. Levels of 25-OH-D increased in the high-dose relative to the low-dose vitamin D group (+15.5 versus +4.6 ng/mL, P<0.001). Changes in biomarkers of glycemia, inflammation, and neurohormonal activation did not differ by dose. Lipids did not differ between groups, other than triglycerides, which increased in the high-dose compared with the low-dose group (+11.3 versus -6.2 mg/dL, P<0.001). The meta-analysis showed potential modest decreases in homeostatic model assessment of insulin resistance and hs-CRP, but no changes in low-density lipoprotein, after vitamin D supplementation compared with control groups. Conclusions In the DAYLIGHT randomized controlled trial, high-dose vitamin D supplementation did not improve biomarkers of glycemia, inflammation, neurohormonal activation, or lipids. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01240512.
Collapse
Affiliation(s)
- Jennifer Miao
- Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Katherine N Bachmann
- Veterans Health AdministrationTennessee Valley Healthcare System Nashville TN.,Division of Diabetes, Endocrinology, and Metabolism Department of Medicine Vanderbilt University Medical Center Nashville TN.,Vanderbilt Translational and Clinical Cardiovascular Research Center Vanderbilt University School of Medicine Nashville TN
| | - Shi Huang
- Vanderbilt Translational and Clinical Cardiovascular Research Center Vanderbilt University School of Medicine Nashville TN.,Department of Biostatistics Vanderbilt University Medical Center Nashville TN
| | - Yan Ru Su
- Division of Cardiovascular Medicine Department of Medicine Vanderbilt University Medical Center Nashville TN
| | - Jeffery Dusek
- Department of Family Medicine and Community Health Case Western University Medical Center Cleveland OH
| | | | - Pankaj Arora
- Division of Cardiovascular Disease University of Alabama at Birmingham Birmingham AL.,Section of Cardiology Birmingham Veterans Affairs Medical Center Birmingham AL
| | - Thomas J Wang
- Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX
| |
Collapse
|
12
|
Valle M, Mitchell PL, Pilon G, St-Pierre P, Varin T, Richard D, Vohl MC, Jacques H, Delvin E, Levy E, Gagnon C, Bazinet L, Marette A. Cholecalciferol Supplementation Does Not Prevent the Development of Metabolic Syndrome or Enhance the Beneficial Effects of Omega-3 Fatty Acids in Obese Mice. J Nutr 2021; 151:1175-1189. [PMID: 33851198 PMCID: PMC8112766 DOI: 10.1093/jn/nxab002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/30/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cholecalciferol (D3) may improve inflammation, and thus provide protection from cardiometabolic diseases (CMD), although controversy remains. Omega-3 fatty acids (ω-3FA) may also prevent the development of CMD, but the combined effects of ω-3FA and D3 are not fully understood. OBJECTIVES We determined the chronic independent and combined effects of D3 and ω-3FA on body weight, glucose homeostasis, and markers of inflammation in obese mice. METHODS We gave 8-week-old male C57BL/6J mice, which had been fed a high-fat, high-sucrose (HF) diet (65.5% kcal fat, 19.8% kcal carbohydrate, and 14% kcal protein) for 12 weeks, either a standard D3 dose (+SD3; 1400 IU D3/kg diet) or a high D3 dose (+HD3; 15,000 IU D3/kg diet). We fed 1 +SD3 group and 1 +HD3 group with 4.36% (w/w) fish oil (+ω-3FA; 44% eicosapentaenoic acid, 25% docosahexaenoic acid), and fed the other 2 groups with corn oil [+omega-6 fatty acids (ω-6FA)]. A fifth group was fed a low-fat (LF; 15.5% kcal) diet. LF and HF+ω-6+SD3 differences were tested by a Student's t-test and HF treatment differences were tested by a 2-way ANOVA. RESULTS D3 supplementation in the +HD3 groups did not significantly increase plasma total 25-hydroxyvitamin D and 25-hydroxyvitamin D3 [25(OH)D3] versus the +SD3 groups, but it increased 3-epi-25-hydroxyvitamin D3 levels by 3.4 ng/mL in the HF+ω-6+HD3 group and 4.0 ng/mL in the HF+ω-3+HD3 group, representing 30% and 70%, respectively, of the total 25(OH)D3 increase. Energy expenditure increased in those mice fed diets +ω-3FA, by 3.9% in the HF+ω-3+SD3 group and 7.4% in the HF+ω-3+HD3 group, but it did not translate into lower body weight. The glucose tolerance curves of the HF+ω-3+SD3 and HF+ω-3+HD3 groups were improved by 11% and 17%, respectively, as compared to the respective +ω-6FA groups. D3 supplementation, within the ω-3FA groups, altered the gut microbiota by increasing the abundance of S24-7 and Lachnospiraceae taxa compared to the standard dose, while within the ω-6FA groups, D3 supplementation did not modulate specific taxa. CONCLUSIONS Overall, D3 supplementation does not prevent CMD or enhance the beneficial effects of ω-3FA in vitamin D-sufficient obese mice.
Collapse
Affiliation(s)
- Marion Valle
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada
| | - Patricia L Mitchell
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada
| | - Geneviève Pilon
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada
| | - Philippe St-Pierre
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada
| | - Thibault Varin
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada
| | - Denis Richard
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Department of Medicine, Laval University, Québec City, QC, Canada
| | - Marie-Claude Vohl
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada,School of Nutrition, Laval University, Québec, QC, Canada
| | - Hélène Jacques
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada,School of Nutrition, Laval University, Québec, QC, Canada
| | - Edgar Delvin
- Department of Nutrition and Biochemistry, Sainte Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
| | - Emile Levy
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada,Department of Nutrition and Biochemistry, Sainte Justine Hospital Research Centre, University of Montreal, Montreal, QC, Canada
| | - Claudia Gagnon
- Québec Heart and Lung Institute Research Centre, Faculty of Medicine, Laval University, Québec City, QC, Canada,Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada,Department of Medicine, Laval University, Québec City, QC, Canada,Endocrinology and Nephrology Unit, Centre hospitalier universitaire de Québec Research Centre, Québec City, QC, Canada
| | - Laurent Bazinet
- Institute of Nutrition and Functional Foods, Laval University, Québec City, QC, Canada,Department of Food Sciences, Laboratory of Food Processing and ElectroMembrane Processes, Laval University, Québec City, QC, Canada
| | | |
Collapse
|
13
|
Zhang D, Cheng C, Wang Y, Xue Y, Liu Y, Li W, Li X. Serum 25-Hydroxyvitamin D Concentrations and Cardiometabolic Biomarkers in Chinese Rural Population. Horm Metab Res 2021; 53:105-111. [PMID: 33513643 DOI: 10.1055/a-1342-7098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There is a paucity of data on the relation between serum 25-hydroxyvitamin D [25(OH)D] concentration and cardiometabolic biomarkers in the Chinese population. To comprehensively and quantitatively examine the association of 25(OH)D and cardiometabolic traits, we conducted a cross-sectional study in the Chinese rural population. Serum 25(OH)D and eight cardiometabolic biomarkers were measured in 1714 individuals from Henan province, China. Scatter plot was used to visualize the distribution and correlation of 25(OH)D and cardiometabolic indicators. Moreover, multivariate linear regressions and restricted cubic spline (RCS) functions were performed to examine the quantitative association between the serum 25(OH)D and cardiometabolic parameters. The median serum 25(OH)D level was 19.94 ng/ml in all participants, with an estimated 50.12% presenting vitamin D deficiency. Serum 25(OH)D level showed significantly modest association with cardiometabolic parameters (p<0.05) except for diastolic blood pressure (r=0.03, p=0.22). Multiple linear regression models showed that 25(OH)D concentration was positively associated with high-density lipoprotein cholesterol (HDL-C) and negatively associated with low-density lipoprotein cholesterol (LDL-C) and fasting serum glucose (GLU). The results of restricted cubic spline models indicated a positively linear association of 25(OH)D with HDL-C (p for overall<0.001, p for nonlinearity=0.191) and a negatively linear association with GLU (p for overall=0.024, p for nonlinearity=0.095). Overall, vitamin D deficiency was very common among Chinese rural population living near the 34 degrees north latitude. Besides, there were significant association between 25(OH)D concentrations and cardiometabolic biomarkers including HDL-C and GLU levels. Future longitudinal studies and randomized trials are warranted to clarify the causal relationship.
Collapse
Affiliation(s)
- Dongdong Zhang
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, Zhengzhou University, Zhengzhou, Henan, China
| | - Yan Wang
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| | - Yuan Xue
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| | - Yiming Liu
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| | - Xing Li
- Department of Nutrition and Food Hygiene, Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
14
|
Vitamin D and Cardiovascular Disease, with Emphasis on Hypertension, Atherosclerosis, and Heart Failure. Int J Mol Sci 2020; 21:ijms21186483. [PMID: 32899880 PMCID: PMC7555466 DOI: 10.3390/ijms21186483] [Citation(s) in RCA: 157] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/24/2020] [Accepted: 08/31/2020] [Indexed: 12/14/2022] Open
Abstract
Vitamin D deficiency is the most common nutritional deficiency, affecting almost one billion people worldwide. Vitamin D is mostly known for its role in intestinal calcium absorption and bone mineralization. However, the observation of seasonal changes in blood pressure and the subsequent identification of vitamin D receptor (VDR) and 1α-hydroxylase in cardiomyocytes, as well as endothelial and vascular smooth muscle cells, implicated a role of vitamin D in the cardiovascular system. Animal studies provided compelling evidence that vitamin D signaling is essential for cardiovascular integrity, especially for the regulation of vascular tone and as an antifibrotic and antihypertrophic signaling pathway in the heart. In addition, observational studies reported an association between vitamin D deficiency and risk of hypertension, atherosclerosis, and heart failure. However, recent clinical intervention studies failed to prove the causal relationship between vitamin D supplementation and beneficial effects on cardiovascular health. In this review, we aim to highlight our current understanding of the role of vitamin D in the cardiovascular system and to find potential explanations for the large discrepancies between the outcome of experimental studies and clinical intervention trials.
Collapse
|
15
|
de Oliveira LF, de Azevedo LG, da Mota Santana J, de Sales LPC, Pereira-Santos M. Obesity and overweight decreases the effect of vitamin D supplementation in adults: systematic review and meta-analysis of randomized controlled trials. Rev Endocr Metab Disord 2020; 21:67-76. [PMID: 31832878 DOI: 10.1007/s11154-019-09527-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Overweight and obesity are associated with vitamin D deficiency (VitD), which are both important health problems. Reduced serum vitamin D levels has been registered in all phases of life and is commonly associated with the genesis of overweight and obesity. Thus, the objective of this review with meta-analysis was to investigate and evidence the efficacy of vitamin D supplementation in vitamin D. Interventional studies were searched for in 5 databases, without restriction of publication date or language. The absolute mean difference was used as a summary measure of the selected studies. A total of 2370 studies were identified, of which 18 descriptive articles were eligible - based on criteria and variables of selection and exclusion. Then the data were synthesized and submitted to meta-analysis. The results evidence that after supplementation individuals with obesity presented increased serum vitamin D 39.83 nmol/L (95% CI: 34.06-45.61) in relation to the control/placebo group. However, the obese state decreased serum vitamin D concentration by -38.17 nmol/L (95% CI: -59.90/-16.44) compared to the normal weight group. In addition, increasing the dose of VitD supplementation does not appear to contribute significantly to increased serum VitD levels. The study observed that obesity in adults reduced the effect of vitamin D supplementation. Therefore, research should be developed on the optimal dose of vitamin D supplementation for people with obesity.Systematic Review Registration: PROSPERO number CRD42018091.
Collapse
Affiliation(s)
- Lara Fonseca de Oliveira
- Center of Biological and Health Sciences, Universidade Federal do Oeste da Bahia, Barreiras, Brazil
| | | | | | | | - Marcos Pereira-Santos
- Collective Health Institute, Universidade Federal da Bahia, Av. Basílio da Gama, s/n, Campus Universitário do Canela, Salvador, Bahia, 40110-040, Brazil.
| |
Collapse
|
16
|
Zhang D, Cheng C, Wang Y, Sun H, Yu S, Xue Y, Liu Y, Li W, Li X. Effect of Vitamin D on Blood Pressure and Hypertension in the General Population: An Update Meta-Analysis of Cohort Studies and Randomized Controlled Trials. Prev Chronic Dis 2020; 17:E03. [PMID: 31922371 PMCID: PMC6977781 DOI: 10.5888/pcd17.190307] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The effect of vitamin D supplementation on blood pressure has been explored in previous meta-analyses, but whether the association is causal in the general population is still unknown. We evaluated the association comprehensively and quantitatively. Methods We searched PubMed and Embase for relevant cohort studies and randomized controlled trials (RCTs). We used a 2-step generalized least-squares method to assess the dose–response association of circulating 25-hydroxyvitamin D (25[OH]D) and hypertension and a fixed-effects model to pool the weighted mean differences (WMDs) and corresponding 95% confidence intervals (95% CIs) of blood pressure across RCTs. Results We identified 11 cohort studies and 27 RCTs, with 43,320 and 3,810 participants, respectively. The dose–response relationship between circulating 25(OH)D levels and hypertension risk was approximately L-shaped (Pnonlinearity = .04), suggesting that the risk of hypertension increased substantially below 75 nmol/L as 25(OH)D decreased, but it remained significant over the range of 75–130 nmol/L. However, pooled results of RCTs showed that there was no significant reduction in systolic blood pressure (WMD, −0.00 mm Hg; 95% CI, −0.71 to 0.71) or diastolic blood pressure (WMD, 0.19 mm Hg; 95% CI, −0.29 to 0.67) after vitamin D intervention. Conclusions The results of this meta-analysis indicate that supplementation with vitamin D does not lower blood pressure in the general population. RCTs with long-term interventions and a sufficient number of participants who have low levels of vitamin D are needed to validate these findings.
Collapse
Affiliation(s)
- Dongdong Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Henan, China
| | - Yan Wang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Hualei Sun
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Songcheng Yu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Yuan Xue
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Yiming Liu
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| | - Wenjie Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, 100 Kexue Ave, Zhengzhou, 450001 Henan, China.
| | - Xing Li
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Henan, China
| |
Collapse
|
17
|
He S, Hao X. The effect of vitamin D3 on blood pressure in people with vitamin D deficiency: A system review and meta-analysis. Medicine (Baltimore) 2019; 98:e15284. [PMID: 31083159 PMCID: PMC6531166 DOI: 10.1097/md.0000000000015284] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To evaluate the effect of vitamin D3 on blood pressure in people with vitamin D deficiency. METHODS Randomized controlled trials (RCTs) were electronically searched databases including CNKI, VIP, WanFang Data, the Cochrane Library, PubMed, and EMbase which were about oral vitamin D3 among people with vitamin D deficiency from inception to December 2017. Two reviewers independently screened literature according to the inclusion and extracted data; meta-analysis was performed using RevMan5.3. RESULTS A total of 17 RCTs with 22 arms involving 1687 participants were included. The results of meta-analysis showed that, there were no significant differences between the vitamin D deficiency group and the control group on the level of change in systolic pressure (ΔSBP) [weighted mean difference (WMD) = -1.94, 95% confidence interval (CI) (-3.93,0.04) P = .06] and on the level of change in diastolic pressure (ΔDBP) [WMD = -0.50, 95% CI (-1.17, 0.17) P = .14]. The results of subgroups showed that, there were statistically significant differences in the age of >50 years subgroup on ΔSBP [WMD = -2.32, 95% CI (-4.39, -0.25) P = .03]; there were statistically significant differences in the hypertension subgroup on ΔSBP [WMD = -6.58, 95% CI (-8.72, -4.44) P <.00001]; there were statistically significant differences in the hypertension subgroup on ΔDBP [WMD = -3.07, 95% CI (-4.66, -1.48) P = .0002]; there were statistically significant differences in the body mass index (BMI) >30 subgroup on ΔSBP [WMD = -3.51, 95% CI (-5.96, -1.07) P = .005]. CONCLUSION Oral vitamin D3 has no significant effect on blood pressure in people with vitamin D deficiency. It reduces systolic blood pressure in people with vitamin D deficiency that was older than 50 years old or obese. It reduces systolic blood pressure and diastolic pressure in people with both vitamin D deficiency and hypertension.
Collapse
|
18
|
Zhu K, Oddy WH, Holt P, Ping-Delfos WCS, McVeigh J, Straker L, Mori TA, Lye S, Pennell C, Walsh JP. Relationship Between Vitamin D Status From Childhood to Early Adulthood With Body Composition in Young Australian Adults. J Endocr Soc 2019; 3:563-576. [PMID: 30805568 PMCID: PMC6382407 DOI: 10.1210/js.2018-00349] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 01/16/2019] [Indexed: 02/08/2023] Open
Abstract
Context Vitamin D plays a role in the differentiation and metabolism of skeletal muscle and, possibly, adipose tissue; however, the relationship between vitamin D status during growth and body composition in early adulthood is unclear. Objective We examined associations between vitamin D status in childhood, adolescence, and early adulthood with body composition at age 20 years. Design, Setting, Participants We studied 821 offspring (385 females) of the Western Australian Pregnancy Cohort Study who had ≥3 serum 25-hydroxyvitamin D [25(OH)D] at age 6, 14, 17, and 20 years and body composition assessed at age 20 using dual-energy x-ray absorptiometry. The participants were grouped into four vitamin D status trajectories: consistently lower, decreasing, increasing, and consistently higher. Results The mean serum 25(OH)D at the study visits was 72.7 to 86.8 nmol/L. In males, serum 25(OH)D at 17 and 20 years was positively associated with lean body mass (LBM), and 25(OH)D at age 20 correlated negatively with fat body mass (FBM). Males with a consistently higher 25(OH)D trajectory had a 2.3- to 3.7-kg greater LBM and 4.1- to 6.0-kg lower FBM at 20 years compared with those with consistently lower or decreasing trajectories (P < 0.05 for all). In females, 25(OH)D at 14, 17, and 20 years was negatively associated with FBM. Females with increasing or consistently higher 25(OH)D trajectories had a 5.2- to 6.8-kg lower FBM at age 20 compared with those with a consistently lower trajectory (P < 0.05 for all). Conclusions In the present predominantly white, relatively vitamin D-replete cohort, a higher vitamin D status trajectory from childhood to early adulthood was associated with a greater LBM in males and lower FBM in both sexes at age 20.
Collapse
Affiliation(s)
- Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Patrick Holt
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Wendy Chan She Ping-Delfos
- General Practice and Primary Health Care Research Unit, School of Medicine (Fremantle), University of Notre Dame, Perth, Western Australia, Australia
| | - Joanne McVeigh
- School of Occupational Therapy and Social Work, Curtin University, Perth, Western Australia, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Trevor A Mori
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Stephen Lye
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Craig Pennell
- School of Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Medical School, University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
19
|
Exebio JC, Ajabshir S, Campa A, Li T, Zarini GG, Huffman FG. The Effect of Vitamin D Supplementation on Blood Lipids in Minorities with Type 2 Diabetes. INTERNATIONAL JOURNAL OF DIABETES AND CLINICAL RESEARCH 2018; 5:093. [PMID: 31497649 PMCID: PMC6731032 DOI: 10.23937/2377-3634/1410093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Vitamin D deficiency and type 2 diabetes are common among Hispanics and African Americans in the US. The aim of the study was to determine the effect of supplemental vitamin D intake (4000 IU/day or 6000 IU/day of vitamin D3 over a 6-month period) on blood lipids in a sample of African Americans and Hispanics with type 2 diabetes and vitamin D insufficiency. MATERIALS AND METHODS Participants (n = 75) were recruited by community outreach. Participants in both groups were required to take either 4000 IU or 6000 IU of vitamin D (Cholecalciferol) per day given in the form of a pill in a single daily dose. Mixed model was used to compare treatment effects (4000 IU vs. 6000 IU) on the outcome variables. Bonferroni multiple comparison test was used to detect significant changes from baseline, 3 months, and 6 months. RESULTS A significant decrease in total cholesterol (from 193.88 ± 41.03 to 180.48 ± 27.53 mg/dl, P = 0.040) and triglycerides (from 201.44 ± 91.35 to 172.92 ± 76.87 mg/dl, P = 0.037) was found for the 6000 IU group at 6 months. The significance was lost after adjusting for confounders. CONCLUSION Our results suggest that the positive effect of vitamin D supplementation on lipid profile may be mediated by other cofactors related to vitamin D metabolism among Hispanic and African American participants with type 2 diabetes.
Collapse
Affiliation(s)
- Joel C Exebio
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
- Dietetics and Nutrition Department, School of Allied Health, Keiser University, USA
| | - Sahar Ajabshir
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
- Cellular Biology and Pharmacology Department, Herbert Wertheim College of Medicine, Florida International University, USA
| | - Adriana Campa
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Tan Li
- Biostatistics Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Gustavo G Zarini
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| | - Fatma G Huffman
- Dietetics and Nutrition Department, Robert Stempel College of Public Health and Social Work, Florida International University, USA
| |
Collapse
|
20
|
Mirhosseini N, Rainsbury J, Kimball SM. Vitamin D Supplementation, Serum 25(OH)D Concentrations and Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis. Front Cardiovasc Med 2018; 5:87. [PMID: 30050908 PMCID: PMC6052909 DOI: 10.3389/fcvm.2018.00087] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/18/2018] [Indexed: 12/15/2022] Open
Abstract
Background: Cardiovascular disease (CVD) risk factors are associated with low serum 25 hydroxyvitamin D (25(OH)D) concentrations in observational studies; however, clinical trial findings are inconsistent. Objective: We assessed the effect of vitamin D supplementation and increased serum 25(OH)D concentrations on CVD risk factors in a systemic review and meta-analysis of randomized controlled trials (RCTs). Design: MEDLINE, CINAHL, EMBASE, and Google Scholar were searched for RCTs that evaluated vitamin D supplementation and cardiovascular outcomes [blood pressure, parathyroid hormone (PTH), serum high-sensitivity C-reactive protein (hs-CRP), total cholesterol, high and low density lipoprotein (HDL and LDL, respectively), triglycerides, peak wave velocity (PWV) and Augmentation Index (AI)] from 1992 through 2017. Meta-analysis was based on a random-effects model and inverse variance method to calculate standardized mean difference (SMD) as effect sizes, followed by a leave-one-out method for sensitivity analysis. Risk of publication bias was assessed using Cochrane checklist and Begg funnel plots. The systematic review is registered as CRD42015025346. Results: We identified 2341 studies from which 81 met inclusion criteria. The meta-analysis indicated a significant reduction in systolic blood pressure (SMD = −0.102 ± 0.04 mmHg, 95% confidence interval (CI), −0.20 to −0.03), diastolic blood pressure (SMD = −0.07 ± 0.03 mmHg, 95% CI, −0.14 to −0.006), serum PTH (SMD = −0.66 ± 0.08 ng/L, 95% CI, −0.82 to −0.49), hs-CRP (SMD = −0.20 ± 0.07 mg/L, 95% CI, −0.34 to −0.06), total cholesterol (SMD = −0.15 ± 0.06 mmol/L, 95% CI, −0.25 to −0.04), LDL (SMD = −0.10 ± 0.05 mmol/L, 95% CI, −0.20 to −0.003), triglycerides (SMD = −0.12 ± 0.06 mmol/L, 95% CI, −0.23 to −0.003) and a significant increase in HDL (SMD = 0.09 ± 0.04 mmol/L, 95% CI, 0.00 to 0.17) with vitamin D supplementation. These findings remained significant in sensitivity analyses for blood pressure, lipid profile, serum PTH, and serum hs-CRP. There was no significant effect of vitamin D supplementation on PWV (SMD = −0.20 ± 0.13 m/s, 95% CI, −0.46 to 0.06, p = 0.14) and AI (SMD = −0.09 ± 0.14%, 95% CI, −0.37 to 0.19, p = 0.52) for vitamin D supplemented groups. Conclusion: These findings suggest that vitamin D supplementation may act to protect against CVD through improving risk factors, including high blood pressure, elevated PTH, dyslipidemia, and inflammation.
Collapse
Affiliation(s)
| | | | - Samantha M Kimball
- Pure North S'Energy Foundation, Calgary, AB, Canada.,St. Mary's University, Calgary, AB, Canada
| |
Collapse
|
21
|
Roosta S, Kharadmand M, Teymoori F, Birjandi M, Adine A, Falahi E. Effect of vitamin D supplementation on anthropometric indices among overweight and obese women: A double blind randomized controlled clinical trial. Diabetes Metab Syndr 2018; 12:537-541. [PMID: 29615318 DOI: 10.1016/j.dsx.2018.03.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/26/2018] [Indexed: 01/09/2023]
Abstract
AIMS The aim of this study was to investigate effect of vitamin D supplementation on anthropometric indices among women with overweight and obesity. METHODS This double blind randomize clinical trial was conducted on 66 overweight and obese women. Those in intervention group received oral supplement of vitamin D 50,000 IU (1250 mcg) per 25 day and in control group participants received placebo for 3 months. Anthropometric indices were measured before and after 3 months intervention. Before the intervention a 24-h dietary recall (3 days) were used to assess dietary intake of individuals. Independent t test and multivariate repeated measure were used to data analysis. RESULTS The mean difference of anthropometric indices, serum calcium, 25 (OH) D3 and serum PTH between the intervention and control groups were significant (P < 0/05). However, no significant differences in serum phosphorus between the intervention and control groups were seen. CONCLUSION Supplementation with vitamin D 50 μg for each day for 3 months resulted in a significant reduction in anthropometric indices in women with obesity and overweight with normal primary 25(OH) D3 serum levels.
Collapse
Affiliation(s)
- Sajjad Roosta
- Student Research Committee, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran
| | - Mina Kharadmand
- School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mehdi Birjandi
- School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran
| | - Ahmad Adine
- Deputy of Food and Drug, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran
| | - Ebrahim Falahi
- Nutritional Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Islamic Republic of Iran.
| |
Collapse
|
22
|
Carreras-Badosa G, Armero-Bujaldón C, Solé-Amat L, Prats-Puig A, Díaz-Roldán F, Soriano-Rodriguez P, de Zegher F, Ibañez L, Bassols J, López-Bermejo A. Serum 25-hydroxyvitamin D and cardiovascular disease risk factors in women with excessive weight gain during pregnancy and in their offspring at age 5-6 years. Int J Obes (Lond) 2018; 42:1019-1028. [PMID: 29777240 DOI: 10.1038/s41366-018-0101-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 04/03/2018] [Accepted: 04/10/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTIVE Low 25-hydroxyvitamin D levels [25(OH)D] may increase the risk for cardiovascular disease (CVD). In pregnant women excessive weight gain and 25(OH)D deficiency are common complications and both could have deleterious consequences on their children. We aimed to study the relationship between serum 25(OH)D and CVD risk factors in pregnant women and in their offspring at school age. SUBJECTS/METHODS Fasting serum 25(OH)D and its bioavailable fraction were quantified in 310 healthy pregnant women [with adequate (n = 113), insufficient (n = 113) and excessive (n = 84) weight gain]. A follow-up at 5-6 years was performed in sixty-six children born of these mothers. Lipids, insulin, glucose, and high-sensitivity C-reactive protein (hsCRP) were measured in all subjects. Children's carotid intima-media thickness (cIMT) together with visceral and intra-abdominal fat were measured by ultrasonography. RESULTS Lower maternal 25(OH)D concentrations were associated with lower maternal age, and higher body mass index, triglycerides and hsCRP (all p < 0.05). In women with excessive weight gain during gestation, serum 25(OH)D concentrations showed independent associations with maternal hsCRP (β = -0.283 p = 0.03) and triglycerides (β = -0.436, p = 0.005). Maternal serum 25(OH)D concentrations were also independently associated with cIMT (β = -0.288, p = 0.04), visceral fat (β = -0.281, p = 0.01) and intra-abdominal fat (β = -0.248, p = 0.01) in their children at 5-6 years. CONCLUSIONS Lower serum 25(OH)D concentrations were related to CVD risk factors in pregnant woman and in their offspring. The cardiometabolic consequences of low 25(OH)D concentrations during pregnancy could be aggravated by excessive weight gain during gestation.
Collapse
Affiliation(s)
- Gemma Carreras-Badosa
- Pediatric Endocrinology Group, Institut d'Investigació Biomèdica de Girona, Girona, Spain
| | | | | | - Anna Prats-Puig
- Pediatric Endocrinology Group, Institut d'Investigació Biomèdica de Girona, Girona, Spain.,Physiotherapy, Escola Universitaria EUSES, Girona, Spain
| | - Ferran Díaz-Roldán
- Pediatric Endocrinology Group, Institut d'Investigació Biomèdica de Girona, Girona, Spain.,Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain
| | | | | | - Lourdes Ibañez
- Institut de Recerca Pediàtrica San Joan de Déu, Universitat de Barcelona, Barcelona, Spain.,CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain
| | - Judit Bassols
- Maternal-Fetal Metabolic Group, Institut d'Investigació Biomèdica de Girona, Girona, Spain.
| | - Abel López-Bermejo
- Pediatric Endocrinology Group, Institut d'Investigació Biomèdica de Girona, Girona, Spain. .,Pediatrics, Hospital Dr. Josep Trueta, Girona, Spain.
| |
Collapse
|
23
|
Vitamin D supplementation and lipoprotein metabolism: A randomized controlled trial. J Clin Lipidol 2018; 12:588-596.e4. [PMID: 29653812 DOI: 10.1016/j.jacl.2018.03.079] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 03/01/2018] [Accepted: 03/12/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND Vitamin D deficiency is associated with an unfavorable lipid profile, but whether and how vitamin D supplementation affects lipid metabolism is unclear. OBJECTIVE To examine the effects of vitamin D supplementation on lipid and lipoprotein parameters. METHODS This is a post hoc analysis of the single-center, double-blind, randomized, placebo-controlled Styrian Vitamin D Hypertension Trial (2011-2014). Two hundred individuals with arterial hypertension and 25-hydroxyvitamin D concentrations of <75 nmol/L were randomized to 2800 IU of vitamin D daily or placebo for 8 weeks. RESULTS One hundred sixty-three participants (62.2 [53.1-68.4] years of age; 46% women) had available lipid data and were included in this analysis. Vitamin D supplementation significantly increased total cholesterol, triglycerides, very-low-density lipoprotein (VLDL) triglycerides, low-density lipoprotein (LDL) triglycerides, high-density lipoprotein (HDL) triglycerides, apolipoprotein B (ApoB), LDL-ApoB, ApoCII, ApoCIII, phospholipids, and ApoE (P < .05 for all). Except for ApoCII and ApoCIII and HDL-triglycerides, all other treatment effects remained statistically significant after adjustment for multiple testing with the Benjamini and Hochberg false discovery rate method. There was a nonsignificant increase in LDL cholesterol. Furthermore, no significant effects were seen on free fatty acids, lipoprotein (a), ApoAI, ApoAII, VLDL cholesterol, VLDL-ApoB, HDL cholesterol, LDL diameter, and VLDL diameter. CONCLUSIONS The effects of vitamin D on lipid metabolism are potentially unfavorable. They require further investigation in view of the wide use of vitamin D testing and treatment.
Collapse
|
24
|
Mirzakhani H, Weiss ST, Litonjua AA. Reply. J Allergy Clin Immunol 2017; 141:829-830. [PMID: 29169707 DOI: 10.1016/j.jaci.2017.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/31/2017] [Indexed: 11/16/2022]
Affiliation(s)
- Hooman Mirzakhani
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass
| | - Scott T Weiss
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass; Partners Center for Personalized Medicine, Partners Health Care, Boston, Mass
| | - Augusto A Litonjua
- Division of Pediatric Pulmonary Medicine, Department of Pediatrics, Golisano Children's Hospital at Strong, University of Rochester Medical Center, Rochester, NY.
| |
Collapse
|
25
|
Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee SY. Vitamin D and Hypertension. Electrolyte Blood Press 2017; 15:1-11. [PMID: 29042901 PMCID: PMC5641496 DOI: 10.5049/ebp.2017.15.1.1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 04/11/2017] [Indexed: 12/11/2022] Open
Abstract
Vitamin D has the pleiotropic effects in multiple organ systems, and vitamin D deficiency was suggested to be associated with high blood pressure according to previous reports. Several interventional studies have examined the effect of vitamin D supplementation on high blood pressure patients, but the results have been inconsistent. In this article, we examined the literature that have proposed a mechanism involving vitamin D in the regulation of blood pressure and review previous observational and interventional studies that have shown the relationship between vitamin D and hypertension among various populations.
Collapse
Affiliation(s)
- Hye Yun Jeong
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kyung Mi Park
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Mi Jung Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong Ho Yang
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hoon Kim
- Division of Cardiology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - So-Young Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| |
Collapse
|
26
|
Smolders L, Plat J, Mensink RP. Dietary Strategies and Novel Pharmaceutical Approaches Targeting Serum ApoA-I Metabolism: A Systematic Overview. J Nutr Metab 2017; 2017:5415921. [PMID: 28695008 PMCID: PMC5485365 DOI: 10.1155/2017/5415921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/16/2017] [Indexed: 12/19/2022] Open
Abstract
The incidence of CHD is still increasing, which underscores the need for new preventive and therapeutic approaches to decrease CHD risk. In this respect, increasing apoA-I concentrations may be a promising approach, especially through increasing apoA-I synthesis. This review first provides insight into current knowledge on apoA-I production, clearance, and degradation, followed by a systematic review of dietary and novel pharmacological approaches to target apoA-I metabolism. For this, a systematic search was performed to identify randomized controlled intervention studies that examined effects of whole foods and (non)nutrients on apoA-I metabolism. In addition, novel pharmacological approaches were searched for, which were specifically developed to target apoA-I metabolism. We conclude that both dietary components and pharmacological approaches can be used to increase apoA-I concentrations or functionality. For the dietary components in particular, more knowledge about the underlying mechanisms is necessary, as increasing apoA-I per se does not necessarily translate into a reduced CHD risk.
Collapse
Affiliation(s)
- Lotte Smolders
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Jogchum Plat
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Ronald P. Mensink
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| |
Collapse
|
27
|
Savastano S, Barrea L, Savanelli MC, Nappi F, Di Somma C, Orio F, Colao A. Low vitamin D status and obesity: Role of nutritionist. Rev Endocr Metab Disord 2017; 18:215-225. [PMID: 28229265 DOI: 10.1007/s11154-017-9410-7] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Low vitamin D status and obesity have concomitantly reached epidemic levels worldwide. Up to now the direction of the association between low vitamin D status and obesity, the exact mechanisms responsible for this association and the clinical usefulness to increase vitamin D status for reducing adiposity still warrant further evaluation. The aim of the present review was to examine the current evidence linking low vitamin D status and obesity in relation to the role of the nutritionist. On the one side, considering obesity as a causal factor, low sun exposure in obese individuals due to their sedentary lifestyle and less outdoor activity, vitamin D sequestration in adipose tissue, and volumetric dilution of ingested or cutaneously synthesized vitamin D3 in the large fat mass of obese patients, might represent some of the factors playing a major role in the pathogenesis of the low vitamin D status. On the other side, the expression of both vitamin D3 receptors and enzymes responsible for vitamin D3 metabolism in adipocytes depicted a role for the low vitamin D status per se in the development of obesity by modulating adipocyte differentiation and lipid metabolism. Nutritionists need to accurately address the aspects influencing the low vitamin D status in obesity and the vitamin D supplementation in obese individuals.
Collapse
Affiliation(s)
- Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy
| | - Luigi Barrea
- I.O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | | | | | | | - Francesco Orio
- Department of Sports Science and Wellness, "Parthenope" University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131, Naples, Italy.
| |
Collapse
|
28
|
Barrea L, Savastano S, Di Somma C, Savanelli MC, Nappi F, Albanese L, Orio F, Colao A. Low serum vitamin D-status, air pollution and obesity: A dangerous liaison. Rev Endocr Metab Disord 2017; 18:207-214. [PMID: 27645613 PMCID: PMC5486902 DOI: 10.1007/s11154-016-9388-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this review is to provide a general overview of the possible associations among the vitamin D status, air pollution and obesity. Sunlight exposure accounts in humans for more than 90 % of the production of vitamin D. Among emerging factors influencing sunlight-induced synthesis of vitamin D, prospective and observational studies proved that air pollution constitutes an independent risk factor in the pathogenesis of vitamin D hypovitaminosis. In addition, environmental pollutants can affect risk of obesity when inhaled, in combination with unhealthy diet and lifestyle. In turn, obesity is closely associated with a low vitamin D status and many possible mechanisms have been proposed to explain this association. The associations of air pollution with low vitamin D status on the hand and with obesity on the other hand, could provide a rationale for considering obesity as a further link between air pollution and low vitamin D status. In this respect, a vicious cycle could operate among low vitamin D status, air pollution, and obesity, with additive detrimental effects on cardio-metabolic risk in obese individuals. Besides vitamin D supplementation, nutrient combination, used to maximize the protective effects against air pollution, might also contribute to improve the vitamin D status by attenuating the "obesogen" effects of air pollution.
Collapse
Affiliation(s)
- Luigi Barrea
- I. O.S. & COLEMAN Srl, 80011 Acerra, Naples, Italy
| | - Silvia Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | | | | | | | - Lidia Albanese
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Francesco Orio
- Department of Sports Science and Wellness, “Parthenope” University of Naples, Naples, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy
| |
Collapse
|
29
|
Luthold RV, Fernandes GR, Franco-de-Moraes AC, Folchetti LGD, Ferreira SRG. Gut microbiota interactions with the immunomodulatory role of vitamin D in normal individuals. Metabolism 2017; 69:76-86. [PMID: 28285654 DOI: 10.1016/j.metabol.2017.01.007] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/29/2016] [Accepted: 01/08/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Due to immunomodulatory properties, vitamin D status has been implicated in several diseases beyond the skeletal disorders. There is evidence that its deficiency deteriorates the gut barrier favoring translocation of endotoxins into the circulation and systemic inflammation. Few studies investigated whether the relationship between vitamin D status and metabolic disorders would be mediated by the gut microbiota composition. OBJECTIVE We examined the association between vitamin D intake and circulating levels of 25(OH)D with gut microbiota composition, inflammatory markers and biochemical profile in healthy individuals. METHODS In this cross-sectional analysis, 150 young healthy adults were stratified into tertiles of intake and concentrations of vitamin D and their clinical and inflammatory profiles were compared. The DESeq2 was used for comparisons of microbiota composition and the log2 fold changes (log2FC) represented the comparison against the reference level. The association between 25(OH)D and fecal microbiota (16S rRNA sequencing, V4 region) was tested by multiple linear regression. RESULTS Vitamin D intake was associated with its concentration (r=0.220, p=0.008). There were no significant differences in clinical and inflammatory variables across tertiles of intake. However, lipopolysaccharides increased with the reduction of 25(OH)D (p-trend <0.05). Prevotella was more abundant (log2FC 1.67, p<0.01), while Haemophilus and Veillonella were less abundant (log2FC -2.92 and -1.46, p<0.01, respectively) in the subset with the highest vitamin D intake (reference) than that observed in the other subset (first plus second tertiles). PCR (r=-0.170, p=0.039), E-selectin (r=-0.220, p=0.007) and abundances of Coprococcus (r=-0.215, p=0.008) and Bifdobacterium (r=-0.269, p=0.001) were inversely correlated with 25(OH)D. After adjusting for age, sex, season and BMI, 25(OH)D maintained inversely associated with Coprococcus (β=-9.414, p=0.045) and Bifdobacterium (β=-1.881, p=0.051), but significance disappeared following the addition of inflammatory markers in the regression models. CONCLUSION The role of vitamin D in the maintenance of immune homeostasis seems to occur in part by interacting with the gut microbiota. The attenuation of association of bacterial genera by inflammatory markers suggests that inflammation participate in part in the relationship between the gut microbiota and vitamin D concentration. Studies with appropriate design are necessary to address hypothesis raised in the current study.
Collapse
Affiliation(s)
- Renata V Luthold
- Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil
| | - Gabriel R Fernandes
- Oswaldo Cruz Foundation, René Rachou Research Center, Belo Horizonte, MG, Brazil
| | | | - Luciana G D Folchetti
- Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil
| | | |
Collapse
|
30
|
Dysfunctional immunometabolic effects of vitamin D deficiency, increased cardiometabolic risk. Potential epidemiological alert in America? ACTA ACUST UNITED AC 2017; 64:162-173. [PMID: 28440755 DOI: 10.1016/j.endinu.2016.11.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 11/01/2016] [Accepted: 11/18/2016] [Indexed: 12/22/2022]
Abstract
Vitamin D deficiency is a serious public health problem worldwide that affects not only skeletal health, but also a wide range of acute and chronic diseases. However, there is still skepticism because of the lack of randomized, controlled trials to support association studies on the benefits of vitamin D for non-skeletal health. This review was based on articles published during the 1980-2015 obtained from the Cochrane Central Register of controlled trials, MEDLINE and PubMed, and focuses on recent challenges with regard to the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D levels from dietary sources, supplements, and sun exposure. The effect of vitamin D on epigenetic fetal programming and regulation of genes that may potentially explain why vitamin D could have such lifelong comprehensive health benefits is reviewed. Optimization of vitamin D levels in children and adults around the world has potential benefits to improve skeletal health and to reduce the risk of chronic diseases, including some types of cancer, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, and severe cardiovascular disorders such as atherothrombosis, neurocognitive disorders, and mortality.
Collapse
|
31
|
Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman J R, Djafarian K. Effect of vitamin D3 supplementation on blood pressure in adults: An updated meta-analysis. Nutr Metab Cardiovasc Dis 2016; 26:663-673. [PMID: 27287826 DOI: 10.1016/j.numecd.2016.04.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIMS Previous randomized clinical trials (RCTs) of the effects of vitamin D3 supplementation (VD3S) on blood pressure have generated inconsistent results. We evaluated the effect of VD3S on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in a meta-analysis. DATA SYNTHESIS Literature searches of PubMed, Scopus, Ovid, and Google scholar for publications in English were conducted up to April 2015. RCTs that assessed the effect of VD3S on SBP and DBP were selected. CONCLUSIONS A total of 30 RCTs with 41 arms including 4744 participants were included. The mean duration of the studies was 5.6 ± 4.0 months, and doses of VD3S varied between 200 and 12,000 IU/day. VD3S had no effect on SBP (-0.68 mmHg, 95%CI: -2.19 to 0.84), and DBP (-0.57 mmHg, 95%CI: -1.36 to 0.22). Subgroup analysis revealed that daily vitamin D3 therapy at a dose of >800 IU/day for <6 months in subjects ≥50 years old reduced both SBP and DBP (p < 0.001). In addition, VD3S showed hypotensive effects in healthy subjects and hypertensive patients, but a hypertensive effect in overweight and obese subjects. However, after excluding overweight and obese subjects, VD3S significantly reduced SBP and DBP. VD3S in combination with calcium supplementation significantly elevated SBP (3.64 mmHg, 95%CI: 3.15-4.13) and DBP (1.71 mmHg, 95%CI: 1.25-2.18). No evidence of publication bias was found. The effects of VD3S on blood pressure depend on dose of supplementation, treatment regimens, trial duration, and population subgroup. Supplementation may be beneficial at daily doses >800 IU/day for <6 months in subjects ≥50 years old.
Collapse
Affiliation(s)
- M Golzarand
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - S Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - G Koochakpoor
- School of Paramedicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Tehran, Iran
| | - R Speakman J
- Institute of Biological and Environmental Sciences, University of Aberdeen, Aberdeen, Scotland, UK; Institute of Genetics and Developmental Biology, Chinese Academy of Sciences, Beijing, China.
| | - K Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
32
|
Robinson PC, Choi HK, Do R, Merriman TR. Insight into rheumatological cause and effect through the use of Mendelian randomization. Nat Rev Rheumatol 2016; 12:486-96. [PMID: 27411906 DOI: 10.1038/nrrheum.2016.102] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Establishing causality of risk factors is important to determine the pathogenetic mechanisms underlying rheumatic diseases, and can facilitate the design of interventions to improve care for affected patients. The presence of unmeasured confounders, as well as reverse causation, is a challenge to the assignment of causality in observational studies. Alleles for genetic variants are randomly inherited at meiosis. Mendelian randomization analysis uses these genetic variants to test whether a particular risk factor is causal for a disease outcome. In this Review of the Mendelian randomization technique, we discuss published results and potential applications in rheumatology, as well as the general clinical utility and limitations of the approach.
Collapse
Affiliation(s)
- Philip C Robinson
- School of Medicine, Faculty of Medicine and Biomedical Sciences, University of Queensland, Herston Road, Brisbane, Queensland 4006, Australia.,Department of Rheumatology, Royal Brisbane and Women's Hospital, Butterfield St and Bowen Bridge Rd, Brisbane, Queensland 4029, Australia
| | - Hyon K Choi
- Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Harvard Medical School, Boston, Massachusetts 02114, USA
| | - Ron Do
- Genetics and Genome Sciences, Mount Sinai School of Medicine, 1 Gustav L. Levy Place, New York 10029-5674, USA
| | - Tony R Merriman
- Department of Biochemistry, 710 Cumberland Street, University of Otago, Dunedin 9054, New Zealand
| |
Collapse
|
33
|
Pannu PK, Calton EK, Soares MJ. Calcium and Vitamin D in Obesity and Related Chronic Disease. ADVANCES IN FOOD AND NUTRITION RESEARCH 2016; 77:57-100. [PMID: 26944102 DOI: 10.1016/bs.afnr.2015.11.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
There is a pandemic of lifestyle-related diseases. In both developed and lesser developed countries of the world, an inadequacy of calcium intake and low vitamin D status is common. In this chapter, we explore a mechanistic framework that links calcium and vitamin D status to chronic conditions including obesity, systemic inflammation, endothelial dysfunction, dyslipidemia and cardiovascular disease, and type 2 diabetes mellitus. We also update the available clinical evidence, mainly from randomized controlled trials, to provide a synthesis of evidence in favor or against these hypotheses. There is consistent data to support calcium increasing whole body fat oxidation and increasing fecal fat excretion, while there is good cellular evidence for vitamin D reducing inflammation. Clinical trials support a marginal reduction in circulating lipids and some meta-analysis support an increase in insulin sensitivity following vitamin D. However, these mechanistic pathways and intermediate biomarkers of disease do not consistently transcribe into measurable health outcomes. Cementing the benefits of calcium and vitamin D for extraskeletal health needs a reexamination of the target 25(OH)D level to be achieved and the minimum duration of future trials.
Collapse
Affiliation(s)
- Poonam K Pannu
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Emily K Calton
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Mario J Soares
- School of Public Health, Curtin Health Innovation Research Institute-Metabolic Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| |
Collapse
|
34
|
Zhang M, Li P, Zhu Y, Chang H, Wang X, Liu W, Zhang Y, Huang G. Higher visceral fat area increases the risk of vitamin D insufficiency and deficiency in Chinese adults. Nutr Metab (Lond) 2015; 12:50. [PMID: 26612998 PMCID: PMC4660664 DOI: 10.1186/s12986-015-0046-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 11/19/2015] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND Visceral fat area (VFA), a novel sex-specific index for visceral fat obesity (VFO) might play a major role in the development of vitamin D deficiency. However, the association between VFA and vitamin D insufficiency and deficiency in Chinese population is less clear. The aim of this study was to explore the population-level association between VFA and vitamin D insufficiency and deficiency among Chinese men and women. METHODS This cross-sectional study involved 1105 adults aged 20-70 years living in Tianjin who were randomly selected and medically examined. All subjects underwent the bioelectrical impedance analysis (BIA) method to estimate the VFA. Serum 25-hydroxyvitamin D3 (25(OH) D3) level was assayed by the high-performance liquid chromatography (HPLC) method and defined insufficiency and deficiency following recommended cutoffs. The association between VFA and vitamin D insufficiency and deficiency was estimated using binary regression analysis. RESULTS The total prevalence of vitamin D insufficiency (25(OH) D3: 20-29 μg/L) and deficiency (25(OH) D3 < 20 μg/L) were 26.60 % and 24.89 %, respectively. Significant negative association was observed for VFA with serum 25(OH) D3 levels in men and pre-menopausal women (P < 0.05), not in post-menopausal women (P > 0.05). Moreover, increased VFA was observed to be associated with higher vitamin D insufficiency or deficiency risk with a positive dose-response trend (P for trend < 0.001). As compared to individuals with the lowest VFA, those who had the highest VFA were at 4.9-fold risk of vitamin D insufficiency and deficiency [95 % confidence interval (95 % CI): 1.792-13.365] in men and 1.8-fold risk of vitamin D insufficiency and deficiency (95 % CI: 1.051-3.210) in pre-menopausal women, but not in post-menopausal women [odds ratio (OR) (95 % CI): 2.326(0.903-5.991)]. CONCLUSIONS These results suggest that higher VFA increases the risk of vitamin D insufficiency and deficiency in men and pre-menopausal women, but not in post-menopausal women. VFA is a better and convenience surrogate marker for visceral adipose measurement and could be used in identifying the risk of vitamin D insufficiency and deficiency in routine health examination.
Collapse
Affiliation(s)
- Meilin Zhang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Ping Li
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Yufeng Zhu
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Hong Chang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
- />Department of Rehabilitation and Sports Medicine, Tianjin Medical University, Tianjin, 300070 China
| | - Xuan Wang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| | - Weiqiao Liu
- />Health Education and Guidance Center of Heping District, Tianjin, 300040 China
| | - Yuwen Zhang
- />Health Education and Guidance Center of Heping District, Tianjin, 300040 China
| | - Guowei Huang
- />Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, 300070 China
| |
Collapse
|
35
|
Chen S, Sun Y, Agrawal DK. Vitamin D deficiency and essential hypertension. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2015; 9:885-901. [PMID: 26419755 PMCID: PMC4641765 DOI: 10.1016/j.jash.2015.08.009] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 07/14/2015] [Accepted: 08/11/2015] [Indexed: 12/19/2022]
Abstract
Essential hypertension (EH) results when the balance between vasoconstriction and vasodilation is shifted in favor of vasoconstriction. This balance is controlled by the interaction of genetic and epigenetic factors. When there is an unstable balance, vitamin D deficiency as an epigenetic factor triggers a shift to the side of vasoconstriction. In this article, we critically analyze clinical findings on the effect of vitamin D on blood pressure, combined with progress in molecular mechanisms. We find that vitamin D repletion exerts a clinically significant antihypertensive effect in vitamin D-deficient EH patients. Of note, a few trials reported no antihypertensive effect from vitamin D due to suboptimal study design. Short-term vitamin D supplementation has no effect on blood pressure in normotensive subjects. This could explain the mixed results and may provide a theoretical basis for future trials to identify beneficial effects of vitamin D in intervention for EH.
Collapse
Affiliation(s)
- Songcang Chen
- Center for Clinical & Translational Science and Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA.
| | - Yingxian Sun
- Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang, People's Republic of China
| | - Devendra K Agrawal
- Center for Clinical & Translational Science and Department of Biomedical Sciences, Creighton University School of Medicine, Omaha, NE, USA
| |
Collapse
|
36
|
Manousopoulou A, Al-Daghri NM, Garbis SD, Chrousos GP. Vitamin D and cardiovascular risk among adults with obesity: a systematic review and meta-analysis. Eur J Clin Invest 2015. [PMID: 26222607 DOI: 10.1111/eci.12510] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obesity is a risk factor for both vitamin D deficiency and cardiovascular disease. A link between vitamin D status optimisation and improved cardiometabolic profile among adults with obesity could inform public health initiatives. METHODS PubMed, Embase and Web of Science were searched for interventional studies examining the effects of vitamin D status improvement on cardiovascular risk factors (anthropometric measures, lipid profile, blood pressure, glucose tolerance) among nondiabetic adults with obesity. RESULTS Seventeen publications reporting results from 11 different studies were included. Number of participants ranged from 34 to 1179 subjects. Duration was between 6 weeks and 4 years. Vitamin D was administered as a supplement in ten studies (1000 IU daily to 120 000 IU fortnightly). In one study, participants were advised to increase sunlight exposure and dietary vitamin D intake. The random and fixed-effects meta-analysis showed that vitamin D significantly increased systolic blood pressure and LDL-C levels. The fixed-effects model also indicated a significant decrease in triglyceride levels, which was not evident using the random-effects model. Caution should be given to these results given the small number of studies used and the high heterogeneity between studies for the two latter outcomes. Additionally, a subset of eligible studies with compatible data presentation was included in the meta-analysis. CONCLUSION This systematic review highlights a paucity of interventional studies examining the effects of vitamin D status improvement on cardiovascular risk factors among otherwise healthy adults with obesity. Large-scale studies at pharmacologically relevant doses and with sufficient duration are warranted.
Collapse
Affiliation(s)
- Antigoni Manousopoulou
- Clinical and Experimental Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Nasser M Al-Daghri
- Biomarkers Research Program, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.,Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, Riyadh, Saudi Arabia
| | - Spiros D Garbis
- Clinical and Experimental Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,Cancer Sciences Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - George P Chrousos
- Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, King Saud University, Riyadh, Saudi Arabia.,1st Department of Pediatrics, University of Athens, Athens, Greece
| |
Collapse
|
37
|
Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, Alvarez JA, Boxer RS, Dalbeni A, Gepner AD, Isbel NM, Larsen T, Nagpal J, Petchey WG, Stricker H, Strobel F, Tangpricha V, Toxqui L, Vaquero MP, Wamberg L, Zittermann A, Witham MD. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data. JAMA Intern Med 2015; 175:745-54. [PMID: 25775274 PMCID: PMC5966296 DOI: 10.1001/jamainternmed.2015.0237] [Citation(s) in RCA: 222] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
IMPORTANCE Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear. OBJECTIVE To systematically review whether supplementation with vitamin D or its analogues reduce BP. DATA SOURCES We searched MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.com augmented by a hand search of references from the included articles and previous reviews. Google was searched for gray literature (ie, material not published in recognized scientific journals). No language restrictions were applied. The search period spanned January 1, 1966, through March 31, 2014. STUDY SELECTION We included randomized placebo-controlled clinical trials that used vitamin D supplementation for a minimum of 4 weeks for any indication and reported BP data. Studies were included if they used active or inactive forms of vitamin D or vitamin D analogues. Cointerventions were permitted if identical in all treatment arms. DATA EXTRACTION AND SYNTHESIS We extracted data on baseline demographics, 25-hydroxyvitamin D levels, systolic and diastolic BP (SBP and DBP), and change in BP from baseline to the final follow-up. Individual patient data on age, sex, medication use, diabetes mellitus, baseline and follow-up BP, and 25-hydroxyvitamin D levels were requested from the authors of the included studies. For trial-level data, between-group differences in BP change were combined in a random-effects model. For individual patient data, between-group differences in BP at the final follow up, adjusted for baseline BP, were calculated before combining in a random-effects model. MAIN OUTCOMES AND MEASURES Difference in SBP and DBP measured in an office setting. RESULTS We included 46 trials (4541 participants) in the trial-level meta-analysis. Individual patient data were obtained for 27 trials (3092 participants). At the trial level, no effect of vitamin D supplementation was seen on SBP (effect size, 0.0 [95% CI, -0.8 to 0.8] mm Hg; P=.97; I2=21%) or DBP (effect size, -0.1 [95% CI, -0.6 to 0.5] mm Hg; P=.84; I2=20%). Similar results were found analyzing individual patient data for SBP (effect size, -0.5 [95% CI, -1.3 to 0.4] mm Hg; P=.27; I2=0%) and DBP (effect size, 0.2 [95% CI, -0.3 to 0.7] mm Hg; P=.38; I2=0%). Subgroup analysis did not reveal any baseline factor predictive of a better response to therapy. CONCLUSIONS AND RELEVANCE Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.
Collapse
Affiliation(s)
- Louise A Beveridge
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Allan D Struthers
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Faisel Khan
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Institute of Clinical Medicine, UiT (Universitetet i Tromsø), The Arctic University of Norway, Tromsø, Norway
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Helen M Macdonald
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, Scotland
| | - Jessica A Alvarez
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Rebecca S Boxer
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora
| | - Andrea Dalbeni
- Department of Medicine, University of Verona, Verona, Italy
| | - Adam D Gepner
- Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison
| | - Nicole M Isbel
- Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Thomas Larsen
- Department of Medical Research, Holstebro Hospital, Holstebro, Denmark
| | - Jitender Nagpal
- Department of Pediatrics and Clinical Epidemiology, Sitaram Bhartia Institute of Science and Research, New Delhi, India
| | - William G Petchey
- Department of Nephrology, Cambridge University Hospitals NHS (National Health Service) Foundation Trust, Cambridge, England
| | - Hans Stricker
- Angiology Unit, Ospedale La Carità, Locarno, Switzerland
| | - Franziska Strobel
- Department of Internal Medicine, Asklepios-Paulinenklinik, Wiesbaden, Germany
| | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Laura Toxqui
- Department of Metabolism and Nutrition, Institute of Food Science, Technology, and Nutrition, Spanish National Research Council, Madrid, Spain
| | - M Pilar Vaquero
- Department of Metabolism and Nutrition, Institute of Food Science, Technology, and Nutrition, Spanish National Research Council, Madrid, Spain
| | - Louise Wamberg
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Armin Zittermann
- Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bochum, Germany
| | - Miles D Witham
- Medical Research Institute, University of Dundee, Ninewells Hospital, Dundee, Scotland
| |
Collapse
|
38
|
Masiá M, Gutiérrez F. [Vitamin D deficiency: one more piece of the puzzle of cardiovascular risk in human immunodeficiency virus-infected patients?]. Med Clin (Barc) 2015; 144:118-20. [PMID: 25500352 DOI: 10.1016/j.medcli.2014.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 09/25/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Mar Masiá
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario de Elche, Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, España.
| | - Félix Gutiérrez
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital General Universitario de Elche, Facultad de Medicina, Universidad Miguel Hernández, Elche, Alicante, España
| |
Collapse
|
39
|
Grant WB, Mascitelli L, Goldstein MR. Comment on Ryan et al., an investigation of association between chronic musculoskeletal pain and cardiovascular disease in the Health Survey for England (2008). Eur J Pain 2015; 18:893-4. [PMID: 24807296 DOI: 10.1002/j.1532-2149.2014.503.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- W B Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, USA
| | | | | |
Collapse
|
40
|
Scragg R, Slow S, Stewart AW, Jennings LC, Chambers ST, Priest PC, Florkowski CM, Camargo CA, Murdoch DR. Long-Term High-Dose Vitamin D
3
Supplementation and Blood Pressure in Healthy Adults. Hypertension 2014; 64:725-30. [DOI: 10.1161/hypertensionaha.114.03466] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous randomized controlled trials of vitamin D supplementation and blood pressure (BP) mainly have given vitamin D for short periods (<6 months) or at low doses (400 IU per day). This study aims to determine whether long-term high-dose vitamin D taken for 18 months lowers BP. Adults were recruited from a healthcare organization or university into a double-blind controlled trial and randomized to receive either vitamin D
3
200 000 IU for 2 months followed by 100 000 IU monthly up to 18 months (n=161) or placebo (n=161). BP was measured at baseline, 5, and 18 months. Subjects had a mean (SD) age of 47.6 (9.7) years, 75% were women, and 94% were of European ancestry (white). Mean (SD) 25-hydroxyvitamin D
3
changed from 73 (22) nmol/L at baseline to 124 (28) nmol/L at 18 months in the vitamin D group, and from 71 (22) nmol/L to 56 (22) nmol/L in the placebo group. Mean BP was similar for the vitamin D and placebo groups at baseline (123.4/76.3 versus 122.6/75.6 mm Hg; respectively). The mean change (95% confidence interval) in BP at 18 months minus baseline in the vitamin D group compared with placebo group was −0.6 (−2.8 to 1.6) mm Hg for systolic (
P
=0.61) and 0.5 (−1.1, 2.2) mm Hg for diastolic (
P
=0.53). Long-term vitamin D supplementation, which increased mean 25-hydroxyvitamin D
3
concentration >100 nmol/L for 18 months, had no effect on systolic or diastolic BP in predominantly white, healthy adults without severe vitamin D deficiency. Beneficial effects on BP cannot be ruled out for other populations.
Collapse
Affiliation(s)
- Robert Scragg
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Sandy Slow
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Alistair W. Stewart
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Lance C. Jennings
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Stephen T. Chambers
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Patricia C. Priest
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Christopher M. Florkowski
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - Carlos A. Camargo
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| | - David R. Murdoch
- From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.)
| |
Collapse
|
41
|
Browne RW, Weinstock-Guttman B, Zivadinov R, Horakova D, Bodziak ML, Tamaño-Blanco M, Badgett D, Tyblova M, Vaneckova M, Seidl Z, Krasensky J, Bergsland N, Ramasamy DP, Hagemeier J, Qu J, Havrdova E, Ramanathan M. Serum lipoprotein composition and vitamin D metabolite levels in clinically isolated syndromes: Results from a multi-center study. J Steroid Biochem Mol Biol 2014; 143:424-33. [PMID: 24950029 DOI: 10.1016/j.jsbmb.2014.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 06/09/2014] [Accepted: 06/11/2014] [Indexed: 12/21/2022]
Abstract
CONTEXT High serum cholesterol is adversely associated with clinical and imaging disease progression outcomes in multiple sclerosis (MS) and in clinically isolated syndrome (CIS), the earliest stage of MS. Low vitamin D levels are associated with an increased risk of disease progression. OBJECTIVES To investigate the mechanisms mediating the adverse effects of cholesterol in CIS and to determine the role of the nexus between the vitamin D3 (D3) and cholesterol pathways. DESIGN Multi-center, prospective, longitudinal prospective study. SETTING University hospital multiple sclerosis centers. INTERVENTION Serum samples were obtained prior to any treatment from study subjects. METHODS Serum obtained prior to any treatment from 172 CIS patients enrolled in a multi-center, prospective, longitudinal study (119 females: 53 males, age: 28.1 ± SD 8.1 years) were analyzed for high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), ApoAII, ApoB, ApoE, and lipoprotein-a. Levels of 25-hydroxy vitamin D3 (25(OH)D3), 1,25-dihydroxy D3, and 24,25-dihydroxy D3 were measured using liquid chromatography-mass spectrometry. RESULTS Greater levels of HDL-C biomarkers (e.g., HDL-C itself, ApoAI, ApoAII and paroxonase arylesterase activity) and LDL-C biomarkers (e.g., LDL-C itself, Apo B) were associated with greater 25(OH)D3. The effects of HDL-C biomarkers were stronger than those of LDL-C. Free cholesterol and cholesteryl ester levels were positively associated with higher 25(OH)D3 levels. Cholesterol palmitate was particularly potent. The nexus between the D3 and cholesterol pathways was proximal to, or in linkage disequilibrium with, 7-dehydrocholesterol reductase DHCR7 rs1790349, endothelial lipase LIPG rs4939883 and proprotein convertase subtilisin/kexin type 9 PCSK9 rs11206510. CONCLUSIONS The associations between cholesterol biomarkers and vitamin D metabolite levels in CIS are consistent with the biochemical inter-dependence between the two pathways. Cholesterol biomarkers should be considered for inclusion as covariates when assessing vitamin D levels in CIS.
Collapse
Affiliation(s)
- Richard W Browne
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | | | - Robert Zivadinov
- Department of Neurology, State University of New York, Buffalo, NY, USA; Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Dana Horakova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Mary Lou Bodziak
- Department of Biotechnical and Clinical Laboratory Sciences, State University of New York, Buffalo, NY, USA
| | - Miriam Tamaño-Blanco
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Darlene Badgett
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Michaela Tyblova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Manuela Vaneckova
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Zdenek Seidl
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Jan Krasensky
- Department of Radiology, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Niels Bergsland
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; IRCCS, S. Maria Nascente, Don Gnocchi Foundation, Milan, Italy
| | - Deepa P Ramasamy
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jesper Hagemeier
- Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA
| | - Jun Qu
- Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA
| | - Eva Havrdova
- Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, 1st Faculty of Medicine and General University Hospital, Charles University, Prague, Czech Republic
| | - Murali Ramanathan
- Department of Neurology, State University of New York, Buffalo, NY, USA; Department of Pharmaceutical Sciences, State University of New York, Buffalo, NY, USA.
| |
Collapse
|
42
|
Carbone F, Mach F, Vuilleumier N, Montecucco F. Potential pathophysiological role for the vitamin D deficiency in essential hypertension. World J Cardiol 2014; 6:260-276. [PMID: 24944756 PMCID: PMC4062123 DOI: 10.4330/wjc.v6.i5.260] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 03/24/2014] [Accepted: 04/11/2014] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency has been indicated as a pandemic emerging public health problem. In addition to the well-known role on calcium-phosphorus homeostasis in the bone, vitamin D-mediated processes have been recently investigated on other diseases, such as infections, cancer and cardiovascular diseases. Recently, both the discovery of paracrine actions of vitamin D (recognized as “local vitamin D system”) and the link of vitamin D with renin-angiotensin-aldosterone system and the fibroblast growth factor 23/klotho pathways highlighted its active cardiovascular activity. Focusing on hypertension, this review summarizes the more recent experimental evidence involving the vitamin D system and deficiency in the cardiovascular pathophysiology. In particular, we updated the vascular synthesis/catabolism of vitamin D and its complex interactions between the various endocrine networks involved in the regulation of blood pressure in humans. On the other hand, the conflicting results emerged from the comparison between observational and interventional studies emphasize the fragmentary nature of our knowledge in the field of vitamin D and hypertension, strongly suggesting the need of further researches in this field.
Collapse
|
43
|
Kayaniyil S, Harris SB, Retnakaran R, Vieth R, Knight JA, Gerstein HC, Perkins BA, Zinman B, Hanley AJ. Prospective association of 25(OH)D with metabolic syndrome. Clin Endocrinol (Oxf) 2014; 80:502-7. [PMID: 23452164 DOI: 10.1111/cen.12190] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/02/2013] [Accepted: 02/22/2013] [Indexed: 02/06/2023]
Abstract
CONTEXT Vitamin D may play a role in the aetiology of the metabolic syndrome (MetS), yet the majority of previous studies have been cross-sectional, and the limited number of prospective studies has yielded inconsistent results. OBJECTIVE To examine the prospective association of vitamin D [25-hydroxyvitamin D, 25(OH)D] with MetS in a multi-ethnic cohort of adults in Ontario, Canada. DESIGN Nondiabetic individuals with pre-existing MetS risk factors were recruited for participation in the PROspective Metabolism and ISlet cell Evaluation (PROMISE) cohort study, a longitudinal study of the determinants of insulin resistance and MetS. METHODS Of the 654 participants enrolled at baseline, 489 attended a 3-year follow-up visit. There were 301 participants eligible for the analysis of 25(OH)D with incident MetS (age 49·2 ± 9·3 years old, 75·4% female), after excluding 188 (38·5%) prevalent MetS cases at baseline. Longitudinal change in MetS components was assessed in the entire follow-up cohort. RESULTS There were 76 (15·5%) participants who developed MetS over the 3-years of follow-up. Multivariate logistic regression analyses indicated a decreased risk of MetS at follow-up per standard deviation increase in baseline 25(OH)D after adjustment for sociodemographics, season, baseline and change in supplement use and physical activity and insulin resistance (OR = 0·63, 95% CI 0·44-0·90). Multivariate linear regression analyses revealed a significant inverse association of baseline 25(OH)D with fasting glucose at follow-up (β = -0·0005, P = 0·025). CONCLUSIONS There was a significant inverse association of baseline 25(OH)D with incident MetS, which may be partly driven by its association with glucose homoeostasis.
Collapse
Affiliation(s)
- Sheena Kayaniyil
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Messa P, Curreri M, Regalia A, Alfieri CM. Vitamin D and the cardiovascular system: an overview of the recent literature. Am J Cardiovasc Drugs 2014; 14:1-14. [PMID: 24122604 DOI: 10.1007/s40256-013-0047-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Since the discovery that the enzyme catalyzing the synthesis of the most active natural vitamin D metabolite(calcitriol) and the vitamin D-specific receptor (VDR)were expressed in a wide range of tissues and organs, not only involved in the mineral metabolism (MM), there has been increasing interest on the putative ‘non classical’ roles of vitamin D metabolites, particularly on their possible effects on the cardiovascular (CV) system. These hypothetical CV effects of vitamin D gained particular interesting the nephrology field, given the high prevalence of CV disease in patients affected by either acute or chronic kidney diseases. However, notwithstanding a huge amount of experimental data suggesting a possible protective role of vitamin D on the CV system, the conclusions of two recent meta-analyses from the Cochrane group and a recent statement from the Institute of Medicine, based on a complete revision of the available data, concluded that there is no clear evidence for a role of vitamin D other than that strictly associated with bone health. However, a continuous and increasing flow of new studies still continues to add information on this topic. In the present review, we have tried to critically address the data added on this topicin the last 2 years, considering separately the experimental,observational, and intervention studies that have appeared in PubMed in the last 2 years, discussing the data providing proof, pro or contra, the involvement of vitamin D in CV disease, both in the absence or presence of kidney function impairment.
Collapse
|
45
|
Angelakis E, Oddoze C, Raoult D. Vitamin D and prolonged treatment with photosensitivity-associated antibiotics. Antimicrob Agents Chemother 2013; 57:6409-10. [PMID: 24100505 PMCID: PMC3837883 DOI: 10.1128/aac.01969-13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Emmanouil Angelakis
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS-IRD 198 UMR 6236, Université de la Méditerranée, Faculté de Médecine, Marseille, France
| | - Christiane Oddoze
- Clinical Laboratory, Laboratoire de Biochimie Endocrinienne, CHU Timone, Marseille, France
| | - Didier Raoult
- Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, URMITE CNRS-IRD 198 UMR 6236, Université de la Méditerranée, Faculté de Médecine, Marseille, France
| |
Collapse
|
46
|
Ku YC, Liu ME, Ku CS, Liu TY, Lin SL. Relationship between vitamin D deficiency and cardiovascular disease. World J Cardiol 2013; 5:337-346. [PMID: 24109497 PMCID: PMC3783986 DOI: 10.4330/wjc.v5.i9.337] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 09/04/2013] [Indexed: 02/06/2023] Open
Abstract
Epidemiological studies have found that low 25-hydroxyvitamin D levels may be associated with coronary risk factors and adverse cardiovascular outcomes. Additionally, vitamin D deficiency causes an increase in parathyroid hormone, which increases insulin resistance and is associated with diabetes, hypertension, inflammation, and increased cardiovascular risk. In this review, we analyze the association between vitamin D supplementation and the reduction in cardiovascular disease. The role of vitamin D deficiency in cardiovascular morbidity and mortality is still controversial, and larger scale, randomized placebo controlled trials are needed to investigate whether oral vitamin D supplementation can reduce cardiovascular risk. Given the low cost, safety, and demonstrated benefit of higher 25-hydroxyvitamin D levels, vitamin D supplementation should become a public health priority for combating common and costly chronic cardiovascular diseases.
Collapse
|
47
|
Vitamin D and cardiovascular disease. Nutrients 2013; 5:3005-21. [PMID: 23912328 PMCID: PMC3775239 DOI: 10.3390/nu5083005] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 06/25/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023] Open
Abstract
Vitamin D deficiency, as well as cardiovascular diseases (CVD) and related risk factors are highly prevalent worldwide and frequently co-occur. Vitamin D has long been known to be an essential part of bone metabolism, although recent evidence suggests that vitamin D plays a key role in the pathophysiology of other diseases, including CVD, as well. In this review, we aim to summarize the most recent data on the involvement of vitamin D deficiency in the development of major cardiovascular risk factors: hypertension, obesity and dyslipidemia, type 2 diabetes, chronic kidney disease and endothelial dysfunction. In addition, we outline the most recent observational, as well as interventional data on the influence of vitamin D on CVD. Since it is still an unresolved issue whether vitamin D deficiency is causally involved in the pathogenesis of CVD, data from randomized controlled trials (RCTs) designed to assess the impact of vitamin D supplementation on cardiovascular outcomes are awaited with anticipation. At present, we can only conclude that vitamin D deficiency is an independent cardiovascular risk factor, but whether vitamin D supplementation can significantly improve cardiovascular outcomes is still largely unknown.
Collapse
|
48
|
Vimaleswaran KS, Berry DJ, Lu C, Tikkanen E, Pilz S, Hiraki LT, Cooper JD, Dastani Z, Li R, Houston DK, Wood AR, Michaëlsson K, Vandenput L, Zgaga L, Yerges-Armstrong LM, McCarthy MI, Dupuis J, Kaakinen M, Kleber ME, Jameson K, Arden N, Raitakari O, Viikari J, Lohman KK, Ferrucci L, Melhus H, Ingelsson E, Byberg L, Lind L, Lorentzon M, Salomaa V, Campbell H, Dunlop M, Mitchell BD, Herzig KH, Pouta A, Hartikainen AL, the Genetic Investigation of Anthropometric Traits (GIANT) consortium, Streeten EA, Theodoratou E, Jula A, Wareham NJ, Ohlsson C, Frayling TM, Kritchevsky SB, Spector TD, Richards JB, Lehtimäki T, Ouwehand WH, Kraft P, Cooper C, März W, Power C, Loos RJF, Wang TJ, Järvelin MR, Whittaker JC, Hingorani AD, Hyppönen E. Causal relationship between obesity and vitamin D status: bi-directional Mendelian randomization analysis of multiple cohorts. PLoS Med 2013; 10:e1001383. [PMID: 23393431 PMCID: PMC3564800 DOI: 10.1371/journal.pmed.1001383] [Citation(s) in RCA: 668] [Impact Index Per Article: 55.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 12/24/2012] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obesity is associated with vitamin D deficiency, and both are areas of active public health concern. We explored the causality and direction of the relationship between body mass index (BMI) and 25-hydroxyvitamin D [25(OH)D] using genetic markers as instrumental variables (IVs) in bi-directional Mendelian randomization (MR) analysis. METHODS AND FINDINGS We used information from 21 adult cohorts (up to 42,024 participants) with 12 BMI-related SNPs (combined in an allelic score) to produce an instrument for BMI and four SNPs associated with 25(OH)D (combined in two allelic scores, separately for genes encoding its synthesis or metabolism) as an instrument for vitamin D. Regression estimates for the IVs (allele scores) were generated within-study and pooled by meta-analysis to generate summary effects. Associations between vitamin D scores and BMI were confirmed in the Genetic Investigation of Anthropometric Traits (GIANT) consortium (n = 123,864). Each 1 kg/m(2) higher BMI was associated with 1.15% lower 25(OH)D (p = 6.52×10⁻²⁷). The BMI allele score was associated both with BMI (p = 6.30×10⁻⁶²) and 25(OH)D (-0.06% [95% CI -0.10 to -0.02], p = 0.004) in the cohorts that underwent meta-analysis. The two vitamin D allele scores were strongly associated with 25(OH)D (p≤8.07×10⁻⁵⁷ for both scores) but not with BMI (synthesis score, p = 0.88; metabolism score, p = 0.08) in the meta-analysis. A 10% higher genetically instrumented BMI was associated with 4.2% lower 25(OH)D concentrations (IV ratio: -4.2 [95% CI -7.1 to -1.3], p = 0.005). No association was seen for genetically instrumented 25(OH)D with BMI, a finding that was confirmed using data from the GIANT consortium (p≥0.57 for both vitamin D scores). CONCLUSIONS On the basis of a bi-directional genetic approach that limits confounding, our study suggests that a higher BMI leads to lower 25(OH)D, while any effects of lower 25(OH)D increasing BMI are likely to be small. Population level interventions to reduce BMI are expected to decrease the prevalence of vitamin D deficiency.
Collapse
Affiliation(s)
- Karani S. Vimaleswaran
- Centre for Paediatric Epidemiology and Biostatistics and MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom
| | - Diane J. Berry
- Centre for Paediatric Epidemiology and Biostatistics and MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom
| | - Chen Lu
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Emmi Tikkanen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, Helsinki, Finland
- National Institute for Health and Welfare, Helsinki, Finland
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Austria
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Linda T. Hiraki
- Program in Molecular and Genetic Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Jason D. Cooper
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Zari Dastani
- Department of Epidemiology, Biostatistics and Occupational Health, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Rui Li
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Denise K. Houston
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, United States of America
| | - Andrew R. Wood
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Karl Michaëlsson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Liesbeth Vandenput
- Center for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lina Zgaga
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Andrija Stampar School of Public Health, Medical School University of Zagreb, Zagreb, Croatia
| | - Laura M. Yerges-Armstrong
- University of Maryland School of Medicine, Division of Endocrinology, Baltimore, Maryland, United States of America
| | - Mark I. McCarthy
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Headington, Oxford, United Kingdom
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, United Kingdom
- Oxford NIHR Biomedical Research Centre, Churchill Hospital, Headington, Oxford, United Kingdom
| | - Josée Dupuis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States of America
- National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, United States of America
| | - Marika Kaakinen
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
| | - Marcus E. Kleber
- LURIC Study non-profit LLC, Freiburg, Germany and Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Karen Jameson
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Nigel Arden
- NIHR Musculoskeletal BRU, Botnar Research Centre, Oxford, United Kingdom
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Olli Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku and Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Jorma Viikari
- Department of Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Kurt K. Lohman
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, North Carolina, United States of America
| | - Luigi Ferrucci
- Clinical Research Branch, Harbor Hospital, Baltimore, Maryland, United States of America
| | - Håkan Melhus
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Ingelsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mattias Lorentzon
- Center for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Harry Campbell
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Malcolm Dunlop
- Colon Cancer Genetics Group and Academic Coloproctology, Institute of Genetics and Molecular Medicine, University of Edinburgh, United Kingdom
- MRC Human Genetics Unit Western General Hospital Edinburgh, United Kingdom
| | - Braxton D. Mitchell
- University of Maryland School of Medicine, Division of Endocrinology, Baltimore, Maryland, United States of America
| | - Karl-Heinz Herzig
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
- Institute of Biomedicine, University of Oulu, Oulu, Finland
- Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Anneli Pouta
- Department of Public Health Science and General Practice, University of Oulu, Oulu, Finland
| | - Anna-Liisa Hartikainen
- Department of Obstetrics and Gynaecology and Public Health and General Practice, University of Oulu, Oulu, Finland
| | | | - Elizabeth A. Streeten
- University of Maryland School of Medicine, Division of Endocrinology, Baltimore, Maryland, United States of America
| | - Evropi Theodoratou
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Antti Jula
- National Institute for Health and Welfare, Helsinki, Finland
| | - Nicholas J. Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Claes Ohlsson
- Center for Bone and Arthritis Research, Department of Internal Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Timothy M. Frayling
- Genetics of Complex Traits, Peninsula College of Medicine and Dentistry, University of Exeter, Exeter, United Kingdom
| | - Stephen B. Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, North Carolina, United States of America
| | - Timothy D. Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - J. Brent Richards
- Departments of Medicine, Human Genetics, Epidemiology and Biostatistics, Lady Davis Institute, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and University of Tampere, Tampere, Finland
| | - Willem H. Ouwehand
- Department of Haematology, University of Cambridge, United Kingdom
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
- NHS Blood and Transplant, Cambridge, United Kingdom
| | - Peter Kraft
- Program in Molecular and Genetic Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, United Kingdom
| | - Winfried März
- Synlab Academy, Mannheim, Germany
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
| | - Chris Power
- Centre for Paediatric Epidemiology and Biostatistics and MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom
| | - Ruth J. F. Loos
- MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Thomas J. Wang
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Marjo-Riitta Järvelin
- Institute of Health Sciences and Biocenter Oulu, University of Oulu, Oulu, Finland
- Department of Biostatistics and Epidemiology, School of Public Health, MRC-HPA Centre for Environment and Health, Imperial College, Faculty of Medicine, London, United Kingdom
- Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
| | - John C. Whittaker
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Quantitative Sciences, GlaxoSmithKline, Stevenage, United Kingdom
| | - Aroon D. Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, Division of Population Health, University College London, London, United Kingdom
- Division of Medicine, Centre for Clinical Pharmacology, University College London, London, United Kingdom
| | - Elina Hyppönen
- Centre for Paediatric Epidemiology and Biostatistics and MRC Centre of Epidemiology for Child Health, UCL Institute of Child Health, London, United Kingdom
- * E-mail:
| |
Collapse
|
49
|
Abstract
OBJECTIVE To review the current literature regarding vitamin D insufficiency and supplementation in major illnesses. DESIGN AND METHODS We reviewed Pubmed-indexed, English language manuscripts from January, 2003 to June, 2012 using search terms related to vitamin D, all-cause mortality, cardiovascular disease, pulmonary disease, diabetes mellitus, and cancer. OUTCOME MEASURES Incidence of disease, risk ratios associated with 25-hydroxyvitamin D [25(OH)D] levels, and/or vitamin D supplementation schedules were documented. RESULTS Although 25(OH)D levels ≥20 ng/mL were often associated with improved health outcomes, evidence suggests that 25(OH)D levels ≥30 ng/mL may confer additional health benefits. CONCLUSIONS Based on the available evidence, vitamin D supplementation to restore 25(OH)D levels within a range of 30-50 ng/mL is reasonable in order to optimize potential benefits and minimize potential risks. This, of course, should be considered in the context of individual patient needs and co-morbidities.
Collapse
Affiliation(s)
- Sadeq A Quraishi
- Vitamin D In Stress (ViDIS) Laboratory, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 5 Fruit Street, GRJ 402, Boston, MA 02114, USA,
| | - Carlos A Camargo
- Emergency Medicine Network (EMNet) Coordinating Center, Department of Emergency Medicine, Massachusetts General Hospital, 326 Cambridge St, Suite 410, Boston, MA 02114,
| |
Collapse
|