|
1
|
Samarakoon N, Chang T, Gunasekara V, Ratnayake P, Jayatillake R, Udagama P. Selected serum cytokines and vitamin D levels as potential prognostic markers of acute ischemic stroke. PLoS One 2024; 19:e0299631. [PMID: 38870172 PMCID: PMC11175438 DOI: 10.1371/journal.pone.0299631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/13/2024] [Indexed: 06/15/2024] Open
Abstract
Inflammation-derived oxidative stress is postulated to contribute to neuronal damage leading to poor clinical outcomes in Acute Ischemic Stroke (AIS). We aimed to investigate the association between serum levels of selected cytokines (IL-1β, IFN-γ, IL-4), and vitamin D in ischemic stroke progression, and their accuracy in predicting AIS prognosis, among Sri Lankans. We compared 60 AIS patients admitted in 4 phases post-stroke onset (<6 h; 6-24 h; 24-48 h; 48-96 h; n = 15/phase), with 15 age- and sex-matched controls. The 30-day functional outcome (FO) was assessed using the modified Rankin Scale (mRS). Serum cytokine and vitamin D levels were quantified using sandwich ELISAs, and competitive ELISA, respectively. The CombiROC web tool established optimal prognostic biomarker combinations. Serum IL-1β and IFN-γ were elevated in all four phases following stroke onset while IL-4 was elevated exclusively in the recovery phase (48-96 h) (p<0.05). Th1 bias polarization of the Th1:Th2 cytokine (IFN-γ:IL-4) ratio occurred with AIS progression while a Th2 bias occurred during AIS recovery (p<0.05). Lower serum IL-1β and higher IL-4 levels were associated with a good FO (p<0.05), while lower Vitamin D levels were related to a poor FO (p = 0.001). The triple-biomarker panel, IL-4- IFN-γ -Vit D, accurately predicted AIS prognosis (sensitivity = 100%, specificity = 91.9%, area under the curve = 0.98). Serum immunologic mediators IFN-γ, IL-4, and vitamin D may be useful biomarkers of AIS prognosis and may serve as therapeutic targets in improving stroke outcomes. Vitamin D supplementation may improve the prognosis of AIS patients. Furthermore, binary logistic model fitted for FO indicated Th1:Th2 cytokine ratio (IFN-γ:IL-4), vitamin D status, history of stroke, and ischemic heart disease as significant predictors of AIS prognosis.
Collapse
Affiliation(s)
- Nirmali Samarakoon
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Thashi Chang
- Faculty of Medicine, Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
| | - Vimukthi Gunasekara
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Praneeth Ratnayake
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| | - Rasika Jayatillake
- Faculty of Science, Department of Statistics, University of Colombo, Colombo, Sri Lanka
| | - Preethi Udagama
- Faculty of Science, Department of Zoology and Environment Sciences, University of Colombo, Colombo, Sri Lanka
| |
Collapse
|
|
2
|
Bohdanowicz-Pawlak A, Lwow F. Differences in Chronic Low-Grade Inflammation and Metabolic Disturbances between VDR Genotypes in an Ethnically Homogenous Postmenopausal Female Population from Poland. Nutrients 2023; 15:2737. [PMID: 37375641 DOI: 10.3390/nu15122737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Vitamin D deficiency and changes in the endocrine system may stimulate systemic inflammation. VDR expression and the vitamin D concentration decrease with age, which is important in postmenopausal women for whom estrogen deficiency causes rapid bone loss. This group is, moreover, particularly at risk of developing atherosclerosis and its adverse consequences, such as chronic inflammation. The aim of this study was to assess the differentiation by the VDR genotype of the risk factors for so-called chronic low-grade inflammation and metabolic disorders. (2) We studied the differences between the anthropometric, metabolic, and inflammation parameters of VDR genotypes for Apa-I, Bsm-I, Fok-I, and Taq-I in a sample of 321 women aged 50-60 from an ethnically homogeneous urban population in Poland. (3) The TT Taq-I genotype presented a significantly higher rate of insulin resistance (HOMA) and lower serum levels of adiponectin than the other two genotypes. The AA genotype of the Bsm-I polymorphism was associated with a more atherogenic serum profile and significantly higher LDL and LDL/HDL values and Castelli Index. (4) Chronic low-grade inflammation was associated with the TT Taq-I genotype and presented a higher rate of insulin resistance. The AA genotype of the Bsm-I polymorphism presented a more atherogenic serum lipid profile and, therefore, a higher risk of developing cardiovascular disease.
Collapse
Affiliation(s)
- Anna Bohdanowicz-Pawlak
- Department of Endocrinology, Diabetology and Isotope Therapy, Wroclaw Medical University, Pasteur 4, 50-367 Wroclaw, Poland
| | - Felicja Lwow
- Department of Massage and Physical Therapy, Faculty of Physiotherapy, Wrocław University of Health and Sport Sciences, Paderewskiego 35, 51-612 Wroclaw, Poland
| |
Collapse
|
|
3
|
Hariri Z, Kord-Varkaneh H, Alyahya N, Prabahar K, Găman MA, Abu-Zaid A. Higher Dietary Vitamin D Intake Influences the Lipid Profile and hs-CRP Concentrations: Cross-Sectional Assessment Based on The National Health and Nutrition Examination Survey. Life (Basel) 2023; 13:life13020581. [PMID: 36836938 PMCID: PMC9965151 DOI: 10.3390/life13020581] [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] [Received: 12/13/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Background. An unanswered question in the field of nutrition is whether there is an association between vitamin D intake and the lipid profile in adults. We conducted this cross-sectional study in order to investigate the impact of vitamin D intake on the lipid profile of adults in the context of the 2017-2018 National Health and Nutrition Examination Survey (NHANES). Methods. Serum lipids and high-sensitivity C-reactive protein (hs-CRP) concentrations and the Vitamin D intake in 2588 people aged 19 to 70 years was collected using laboratory analysis and 24-h recall, respectively. The one-way ANOVA test was used to compare quantitative variables and the chi-squared test was used to compare qualitative ones. Multivariate logistic regression for three models was performed to assess the odds ratio (OR) of high total cholesterol (TC) (>200 mg/dL), triglycerides (TG) (>150 mg/dL), low-density lipoprotein cholesterol (LDL-C) (>115 mg/dL), high-density lipoprotein cholesterol (HDL-C) (<40 mg/dL) and hs-CRP (>1 mg/l) based on the tertiles of dietary vitamin D (D2 + D3) intake. Results. After adjusting for age, sex, race, body mass index, serum 25-hydroxyvitamin D2, alcohol intake, energy intake, protein intake, carbohydrate intake, fiber intake and fat intake, individuals in the tertile with the highest versus lowest vitamin D intake (>1 mcg/day vs. <0.10 mcg/day) had lower odds of displaying elevated TC, LDL-C and hs-CRP concentrations (OR 0.57; CI: 0.37 to 0.88; P-trend: 0.045, OR 0.59; CI: 0.34 to 1.01; P-trend: 0.025 and OR 0.67; CI: 0.45 to 0.99; P-trend: 0.048, respectively). Based on the results of the logistic regression, no correlation between vitamin D intake and changes in TG or HDL-C values was noted. Conclusions. Our cross-sectional study indicates that higher dietary vitamin D (D2 + D3) intake is associated with lower TC, LDL-C and hs-CRP levels. No relationship between dietary vitamin D intake and TG or HDL-C values was detected. Further large-scale randomized trials are needed to evaluate the actual association between dietary vitamin D intake and the lipid profile.
Collapse
Affiliation(s)
- Zahra Hariri
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran 19839-63113, Iran
| | - Noura Alyahya
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Hematology, Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, 022328 Bucharest, Romania
- Correspondence: (M.-A.G.); (A.A.-Z.)
| | - Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Correspondence: (M.-A.G.); (A.A.-Z.)
| |
Collapse
|
|
4
|
Chen YC, Li WC, Ke PH, Chen IC, Yu W, Huang HY, Xiong XJ, Chen JY. Association between metabolic body composition status and vitamin D deficiency: A cross-sectional study. Front Nutr 2022; 9:940183. [PMID: 35967768 PMCID: PMC9365955 DOI: 10.3389/fnut.2022.940183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/08/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate the risk of vitamin D deficiency in a relatively healthy Asian population, with (i) metabolically healthy normal weight (MHNW) (homeostasis model assessment-insulin resistance [HOMA-IR] < 2. 5 without metabolic syndrome [MS], body mass index [BMI] < 25), (ii) metabolically healthy obesity (MHO) (HOMA-IR < 2.5, without MS, BMI ≥ 25), (iii) metabolically unhealthy normal weight (MUNW) (HOMA-IR ≥ 2.5, or with MS, BMI < 25), and (iv) metabolically unhealthy obesity (MUO) (HOMA-IR ≥ 2.5, or with MS, BMI ≥ 25) stratified by age and sex. This cross-sectional study involved 6,655 participants aged ≥ 18 years who underwent health checkups between 2013 and 2016 at the Chang Gung Memorial Hospital. Cardiometabolic and inflammatory markers including anthropometric variables, glycemic indices, lipid profiles, high-sensitivity C-reactive protein (hs-CRP), and serum 25-hydroxy vitamin D levels, were retrospectively investigated. Compared to the MHNW group, the MHO group showed a higher odds ratio (OR) [1.35, 95% confidence interval (CI) 1.05-1.73] for vitamin D deficiency in men aged < 50 years. By contrast, in men aged > 50 years, the risk of vitamin D deficiency was higher in the MUO group (OR 1.44, 95% CI 1.05-1.97). Among women aged < and ≥ 50 years, the MUO group demonstrated the highest risk for vitamin D deficiency, OR 2.33 vs. 1.54, respectively. Our study revealed that in women of all ages and men aged > 50 years, MUO is associated with vitamin D deficiency and elevated levels of metabolic biomarkers. Among men aged < 50 years, MHO had the highest OR for vitamin D deficiency.
Collapse
Affiliation(s)
- Yi-Chuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan.,Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Pin-Hsuan Ke
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - I-Chun Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Hsiung-Ying Huang
- Department of Pulmonary and Critical Care Medicine, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Xue-Jie Xiong
- Department of Oncology, Xiamen Chang Gung Hospital Hua Qiao University, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan.,College of Medicine, Chang-Gung University, Taoyuan, Taiwan
| |
Collapse
|
|
5
|
Custódio IDD, Nunes FSM, Lima MTM, de Carvalho KP, Alves DS, Chiaretto JF, Canto PPL, Paiva CE, de Paiva Maia YC. Serum 25-hydroxyvitamin D and cancer-related fatigue: associations and effects on depression, anxiety, functional capacity and health-related quality of Life in breast cancer survivors during adjuvant endocrine therapy. BMC Cancer 2022; 22:860. [PMID: 35933326 PMCID: PMC9357315 DOI: 10.1186/s12885-022-09962-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/26/2022] [Indexed: 11/10/2022] Open
Abstract
Background The adjuvant treatment with Aromatase Inhibitor (AI) is considered standard of care for postmenopausal breast cancer (BC) women with hormone receptor-positive (HR +), however, it often causes adverse effects such as cancer-related fatigue (CRF). The high prevalence of vitamin D deficiency in postmenopausal women who start adjuvant AI supports the hypothesis that hypovitaminosis D would be one of the biological explanations for toxicity of AI. This study aimed to identify the relationship between 25-hydroxyvitamin D [25(OH)D] and CRF, and to analyze their associations and effects on depression, anxiety, functional disability, muscle/joint aches and HRQL. Methods This prospective study included 89 postmenopausal women diagnosed with HR + early BC in adjuvant endocrine therapy with AI. Anthropometric and body composition assessments were performed, as well as dietary assessments by application of 24-h dietary recall, at three time points, totaling 24 months of follow-up. The women completed the Cervantes Scale (CS), Hospital Anxiety and Depression Scale (HADS) and Health Assessment Questionnaire (HAQ). The CRF was determined from the Functional Assessment of Chronic Illness Therapy-fatigue (FACIT-F). The serum 25(OH)D was determined by electrochemiluminescence, with cut-off point above 75 nmol/L adopted as sufficiency. Generalized Linear Model (GLzM) and Generalized Mixed Model (GMM) analysis were used. Results At baseline, 36% (n = 32) of the women presented CRF and 39.3% (n = 35) had 25(OH)D below 75 nmol/L. None of the women reached the Estimated Average Requirements (EAR) of vitamin D. The causality between 25(OH)D and CRF was not significant. Longitudinally, lower levels of 25(OH)D had a negative effect on anxiety (p = 0.020), Menopause and Health (p = 0.033) and Vasomotor scores (p = 0.007). Also, the CRF had a negative effect on anxiety (p = 0.028); depression (p = 0.027); functional disability (p = 0.022); HRQL (p = 0.007); Menopause and Health (p = 0.042), Psychological (p = 0.008) and Couple Relations (p = 0.008) domains; and on Health (p = 0.019) and Aging (p = 0.036) subdomains. Vasomotor subdomain (β = -2.279, p = 0.045) and muscle/joint aches (β = -0.779, p = 0.013) were significant with CRF only at baseline. Conclusions This study found negative effect of body adiposity on CRF. Still, the clinical relevance of 25(OH)D and CRF is highlighted, especially that of CRF, considering the consistent impact on several adverse effects reported by BC survivors during adjuvant endocrine therapy. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09962-x.
Collapse
Affiliation(s)
- Isis Danyelle Dias Custódio
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Fernanda Silva Mazzutti Nunes
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Mariana Tavares Miranda Lima
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Kamila Pires de Carvalho
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Débora Santana Alves
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Juliana Freitas Chiaretto
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Paula Philbert Lajolo Canto
- Department of Clinical Oncology, Clinic's Hospital, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil
| | - Carlos Eduardo Paiva
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Sao Paulo, 14784-400, Brazil
| | - Yara Cristina de Paiva Maia
- Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil. .,Nutrition Course, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, 38405-320, Brazil.
| |
Collapse
|
|
6
|
The Role of Vitamin D in Stroke Prevention and the Effects of Its Supplementation for Post-Stroke Rehabilitation: A Narrative Review. Nutrients 2022; 14:nu14132761. [PMID: 35807941 PMCID: PMC9268813 DOI: 10.3390/nu14132761] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 01/27/2023] Open
Abstract
Hypovitaminosis D is a serious public health problem, representing an independent factor in mortality among the general population. Vitamin D deficiency may affect up to one billion people worldwide. Recently, the potential association between vitamin D levels and stroke has gained increasing attention. Many studies suggest that maintaining normal serum vitamin D levels is associated with improvement of the cardiovascular system and a reduction in stroke risk. As a neurosteroid, vitamin D influences brain development and function and immunomodulation and affects brain neuroplasticity. It supports many processes that maintain homeostasis in the body. As stroke is the second most common cause of death worldwide, more studies are needed to confirm the positive effects of vitamin D supplementation, its dosage at different stages of the disease, method of determination, and effect on stroke onset and recovery. Many studies on stroke survivors indicate that serum vitamin D levels only offer insignificant benefits and are not beneficial to recovery. This review article aims to highlight recent publications that have examined the potential of vitamin D supplementation to improve rehabilitation outcomes in stroke survivors. Particular attention has been paid to stroke prevention.
Collapse
|
|
7
|
Abd Elmonem HA, Mater SN, Eldeighdye SM. Protective role of vitamin D against radiation hazards in rats fed on high fat diet. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
|
8
|
Rihal V, Khan H, Kaur A, Singh TG. Vitamin D as therapeutic modulator in cerebrovascular diseases: a mechanistic perspectives. Crit Rev Food Sci Nutr 2022; 63:7772-7794. [PMID: 35285752 DOI: 10.1080/10408398.2022.2050349] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Vitamin D deficiency has been linked to several major chronic diseases, such as cardiovascular and neurodegenerative diseases, diabetes, and cancer, linked to oxidative stress, inflammation, and aging. Vitamin D deficiency appears to be particularly harmful to the cardiovascular system, as it can cause endothelial dysfunctioning and vascular abnormalities through the modulation of various downstream mechanisms. As a result, new research indicates that therapeutic approaches targeting vitamin D inadequacies or its significant downstream effects, such as impaired autophagy, abnormal pro-inflammatory and pro-oxidant reactions, may delay the onset and severity of major cerebrovascular disorders such as stroke and neurologic malformations. Vitamin D modulates the various molecular pathways, i.e., Nitric Oxide, PI3K-Akt Pathway, cAMP pathway, NF-kB Pathway, Sirtuin 1, Nrf2, FOXO, in cerebrovascular disorder. The current review shows evidence for vitamin D's mitigating or slowing the progression of these cerebrovascular disorders, which are significant causes of disability and death worldwide.
Collapse
Affiliation(s)
- Vivek Rihal
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Heena Khan
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | - Amarjot Kaur
- Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
| | | |
Collapse
|
|
9
|
Thomas A, Crivello F, Mazoyer B, Debette S, Tzourio C, Samieri C. Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults. Neurology 2021; 97:e2213-e2222. [PMID: 34732545 DOI: 10.1212/wnl.0000000000012916] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 09/15/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Fish intake may prevent cerebrovascular disease (CVD), yet the mechanisms are unclear, especially regarding its impact on subclinical damage. Assuming that fish may have pleiotropic effect on cerebrovascular health, we investigated the association of fish intake with global CVD burden based on brain MRI markers. METHODS This cross-sectional analysis included participants from the Three-City Dijon population-based cohort (age ≥65 years) without dementia, stroke, or history of hospitalized cardiovascular disease who underwent brain MRI with automated assessment of white matter hyperintensities, visual detection of covert infarcts, and grading of dilated perivascular spaces. Fish intake was assessed through a frequency questionnaire, and the primary outcome measure was defined as the first component of a factor analysis of mixed data applied to MRI markers. The association of fish intake with the CVD burden indicator was studied with linear regressions. RESULTS In total, 1,623 participants (mean age 72.3 years, 63% women) were included. The first component of factor analysis (32.4% of explained variance) was associated with higher levels of all 3 MRI markers. Higher fish intake was associated with lower CVD burden. In a model adjusted for total intracranial volume, compared to participants consuming fish <1 time per week, those consuming fish 2 to 3 and ≥4 times per week had a β = -0.19 (95% confidence interval -0.37 to -0.01) and β = -0.30 (-0.57 to -0.03) lower indicator of CVD burden, respectively (p trend < 0.001). We found evidence of effect modification by age such that the association of fish to CVD was stronger in younger participants (65-69 years) and not significant in participants ≥75 years of age. For comparison, in the younger age group, consuming fish 2 to 3 times a week was roughly equivalent (in the opposite direction) to the effect of hypertension. DISCUSSION In this large population-based study, higher frequency of fish intake was associated with lower CVD burden, especially among participants <75 years of age, suggesting a beneficial effect on brain vascular health before manifestation of overt brain disease. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that in individuals without stroke or dementia, higher fish intake is associated with lower subclinical CVD on MRI.
Collapse
Affiliation(s)
- Aline Thomas
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France.
| | - Fabrice Crivello
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France
| | - Bernard Mazoyer
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France
| | - Stephanie Debette
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France
| | - Christophe Tzourio
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France
| | - Cecilia Samieri
- From the University of Bordeaux (A.T., S.D., C.T., C.S.), INSERM, BPH, U1219; and University of Bordeaux (F.C., B.M.), CNRS, CEA, Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, France
| |
Collapse
|
|
10
|
The Relationship of Vitamin D Deficiency with Severity and Outcome of Acute Stroke. ACTA ACUST UNITED AC 2021; 59:351-358. [PMID: 33855844 DOI: 10.2478/rjim-2021-0013] [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: 10/31/2020] [Indexed: 12/14/2022]
Abstract
Background: There are currently conflicting results regarding the link between vitamin D deficiency and increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke.Methods: This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. The levels of 25-hydroxy vitamin D were evaluated by Electrochemiluminescence (ECL) technique. Clinical severity of stroke on admission as well as on discharge time were evaluated using the National Institutes of Health Stroke Scale (NIHSS) or Modified Rankin (mRS) tools.Results: Mean serum level of vitamin D was 25.51 ± 18.87 ng/mL, ranging from 3.0 to 98.6 ng/ml. There was a significant difference between the two groups (with and without vitamin D deficiency) in terms of stroke severity and disability, as reflected by mRS (P=0.003) and NIHSS evaluation (14.24 ± 9.23 versus 9.73 ± 7.36, P=0.003). Also, regarding patients' clinical condition, the mean NIHSS score in those with deficient and normal levels of vitamin D was 14.24 ± 9.23 and 9.73 ± 7.36, respectively with NIHSS score > 5 in 76.1% and 61.5%, respectively (P = 0.003).Conclusion: According to the results of study, vitamin D status can be related to the severity of stroke. However, considering the cross-sectional design of our study, it could not point out the causality between vitamin D deficiency and acute stroke and further studies are warranted. It is not possible to draw any conclusions in terms of causality. Further studies are required in order to assess the relationship between the serum vitamin D levels and stroke severity.
Collapse
|
|
11
|
Zhang M, Michos ED, Wang G, Wang X, Mueller NT. Associations of Cord Blood Vitamin D and Preeclampsia With Offspring Blood Pressure in Childhood and Adolescence. JAMA Netw Open 2020; 3:e2019046. [PMID: 33017029 PMCID: PMC7536588 DOI: 10.1001/jamanetworkopen.2020.19046] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE Maternal preeclampsia may be one of the early risk factors for childhood and adolescence elevated blood pressure (BP). It is unknown whether the intergenerational association between maternal preeclampsia and offspring BP differs by cord blood vitamin D levels. OBJECTIVE To assess the associations between maternal preeclampsia and offspring systolic BP (SBP) across childhood and adolescence and to test whether these associations vary by cord blood 25-hydroxyvitamin D [25(OH)D] concentrations (a biomarker of in utero vitamin D status). DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study analyzed 6669 SBP observations from 754 mother-child pairs from the Boston Birth Cohort, who were enrolled from December 1998 to June 2009. Data were analyzed from October 2019 to March 2020. EXPOSURES Physician-diagnosed maternal preeclampsia. Plasma 25(OH)D concentrations measured in cord blood samples collected at delivery. MAIN OUTCOMES AND MEASURES Repeated SBP measures between 3 and 18 years of age. The SBP percentile was calculated based on the 2017 American Academy of Pediatrics hypertension guidelines. Mean difference in SBP percentile in children born to mothers with vs without preeclampsia was compared across different cord blood 25(OH)D levels. RESULTS There were 6669 SBP observations from the 754 children; 50.0% were female and 18.6% were born preterm. Of the 754 mothers, 62.2% were Black and 10.5% had preeclampsia. Median cord blood 25(OH)D was 12.2 (interquartile range, 7.9-17.2) ng/mL. Maternal preeclampsia was associated with 5.34 (95% CI, 1.37-9.30) percentile higher SBP after adjusting for confounders. This association varied by quartiles of cord blood 25(OH)D concentrations: the differences in SBP percentile comparing children born to mothers with vs without preeclampsia were 10.56 (95% CI, 2.54-18.56) for quartile 1 (lowest), 7.36 (95% CI, -0.17 to 14.88) for quartile 2, 4.94 (95% CI, -3.07 to 12.96) for quartile 3, and -1.87 (95% CI, -9.71 to 5.96) for quartile 4 (highest). When cord blood 25(OH)D was analyzed continuously, children born to mothers with preeclampsia had 3.47 (95% CI, 0.77-6.18) percentile lower SBP per 5 ng/mL 25(OH)D increment. These associations did not differ by child sex or developmental stages. CONCLUSIONS AND RELEVANCE In this study of a US high-risk birth cohort, maternal preeclampsia was associated with higher offspring SBP from early childhood to adolescence. These associations were attenuated by higher cord blood 25(OH)D levels in a dose-response fashion. Additional studies, including clinical trials, are warranted.
Collapse
Affiliation(s)
- Mingyu Zhang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| | - Erin D. Michos
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Guoying Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Xiaobin Wang
- Center on the Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Division of General Pediatrics & Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Noel T. Mueller
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
|
12
|
Bener A, Al-Hamaq AOAA, Zughaier SM, Öztürk M, Ömer A. Assessment of the Role of Serum 25-Hydroxy Vitamin D Level on Coronary Heart Disease Risk With Stratification Among Patients With Type 2 Diabetes Mellitus. Angiology 2020; 72:86-92. [PMID: 32840113 DOI: 10.1177/0003319720951411] [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: 11/15/2022]
Abstract
We investigated the role of vitamin D on glycemic regulation and cardiac complications in patients with type 2 diabetes mellitus (T2DM). A total of 1139 patients (49.3% males vs 50.7% females) were included. Information on sociodemographic lifestyle, family history, blood pressure (BP), and coronary heart disease (CHD) complications was collected. Significant differences were found between males and females regarding age-groups (P = .002), body mass index (BMI; P = .008), physical activity (P = .010), sheesha smoking (P = .016), cigarette smoking (P = .002), hypertension (P = .050), metabolic syndrome (P = .026), and CHD (P = .020). There were significant differences between vitamin D deficiency, insufficiency, and sufficiency in relation to age-group (P = .002), income (P = .002), waist circumference (P = .002), hip circumference (P = .028), waist-hip ratio (P = .002), and BMI (P = .002). Further, mean values of hemoglobin, magnesium, creatinine, hemoglobin A1c (HbA1c), total cholesterol, uric acid, and diastolic BP were significantly higher among patients with vitamin D deficiency compared with those with insufficiency and sufficiency. Multiple logistic regression analysis revealed that 25-hydroxy vitamin D, 25(OH)D, HbA1c, waist circumference, uric acid, duration of T2DM, total cholesterol, systolic and diastolic BP, and BMI were strong predictor risk factors for CHD among patients with T2DM. The present study supports that 25(OH)D may have a direct effect on CHD and on its risk factors.
Collapse
Affiliation(s)
- Abdülbari Bener
- Department of Biostatistics and Medical Informatics, Cerrahpaşa Faculty of Medicine, 532719Istanbul University, Istanbul, Turkey.,Department of Evidence for Population Health Unit, School of Epidemiology and Health Sciences, The University of Manchester, United Kingdom.,Department of Endocrinology, International School of Medicine, 532719Istanbul Medipol University, Regenerative and Medicine Research Centre, Istanbul, Turkey
| | | | - Susu M Zughaier
- Department of Basic Medical Sciences, College of Medicine, QU Health, 61780Qatar University, Doha, Qatar
| | - Mustafa Öztürk
- Department of Endocrinology, International School of Medicine, 532719Istanbul Medipol University, Regenerative and Medicine Research Centre, Istanbul, Turkey
| | - Abdülkadir Ömer
- Department of Endocrinology, International School of Medicine, 532719Istanbul Medipol University, Regenerative and Medicine Research Centre, Istanbul, Turkey
| |
Collapse
|
|
13
|
Qian P, Cao X, Xu X, Duan M, Zhang Q, Huang G. Contribution of CYP24A1 variants in coronary heart disease among the Chinese population. Lipids Health Dis 2020; 19:181. [PMID: 32762692 PMCID: PMC7412795 DOI: 10.1186/s12944-020-01356-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
Background Cytochrome P450 (CYPs) participate in the mechanisms of cardiovascular disease. The purpose of this research was to evaluate the contributions of CYP24A1 variants to coronary heart disease (CHD) among the Chinese Han population. Methods This study included 505 CHD cases and 508 controls. Four variants of CYP24A1 (rs2762934, rs1570669, rs6068816 and rs2296241) were chosen and genotyped by the Agena MassARRAY system among the Chinese population. The linkage between CYP24A1 variants and CHD risk were assessed by logistic regression to compute the odds ratio (OR) and 95% confidence interval (CI). Then, multifactor dimensionality reduction (MDR) was applied to analyze the interactions of CYP24A1 variants. Results The results of this study showed that CYP24A1 rs6068816 significantly enhanced CHD risk in multiple genetic models (allele: P = 0.014; codominant: P = 0.015; dominant: P = 0.043; recessive: P = 0.040; additive: P = 0.013), whereas rs2296241 was likely to protect individuals from CHD (codominant: P = 0.019; recessive: P = 0.013; additive: P = 0.033). Stratification analysis revealed that CYP24A1 polymorphisms had strong relationships with CHD risk that were dependent on age, sex, Gensini grade and smoking status (P < 0.05). Moreover, a four-locus model (rs2762934, rs1570669, rs6068816 and rs2296241) had significant impact on CHD risk in MDR analysis. Conclusion It revealed that CYP24A1 variants were significantly linked with CHD susceptibility in the Chinese population.
Collapse
Affiliation(s)
- Peng Qian
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China
| | - Xuanchao Cao
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China
| | - Xianjing Xu
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China
| | - Mingqin Duan
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China
| | - Qian Zhang
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China
| | - Gairong Huang
- Department of Geriatrics, Henan Provincial People's Hospital, 7 weiwu road, Zhengzhou city, Henan province, 450003, P. R. China.
| |
Collapse
|
|
14
|
Hassanzadeh-Makoui R, Jamei M, Hassanzadeh-Makoui M, Khederlou H. Effects of Vitamin D on Left Ventricular Ejection Fraction in Patients with Systolic Heart Failure: A Double-Blind Randomized Clinical Trial. Int J Endocrinol Metab 2020; 18:e103528. [PMID: 33257907 PMCID: PMC7695351 DOI: 10.5812/ijem.103528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/02/2020] [Accepted: 08/22/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Heart failure is a pathophysiologic state in which the cardiac output is not able to supply the body with enough oxygen and nutrients. The prevalence of heart failure has increased dramatically over the last decades. Vitamin D levels in patients with chronic heart failure are lower than healthy controls, and vitamin D deficiency has a direct relationship with mortality. OBJECTIVES This study aimed to evaluate the effect of vitamin D on the improvement of left ventricular ejection fraction in patients with systolic heart failure. METHODS In this case-control clinical trial, 142 patients with chronic systolic heart failure were identified. Based on the inclusion and exclusion criteria, 114 patients were enrolled in the study and randomly divided into two groups. One group (n = 58) received 50,000 units of vitamin D capsules weekly for eight weeks, and the patients in the other group (n = 56) received a placebo. After excluding 15 patients from the placebo group and 17 patients from the intervention group during the study, according to the exclusion criteria, 41 patients were evaluated in both groups for ejection fraction changes after two months. RESULTS According to the results of this research, there were no statistically significant differences in the baseline parameters between the two studied groups. The intervention group consisted of 18 female and 23 male patients with a mean age of 61.68 ± 19.8 years. Moreover, the placebo group included 21 female and 20 male patients with a mean age of 62.12 ± 18.2 years. After a 2-month follow-up, the intervention group showed statistically significant changes in ejection fraction, end-diastolic volume, and heart failure class compared to the placebo group. Also, the serum level of albumin and vitamin D in the intervention group was significantly higher than the placebo group. CONCLUSIONS The results of this study show that vitamin D treatment can improve the ejection fraction and functional ability of patients with vitamin D deficiency. If more comprehensive studies support this hypothesis, vitamin D deficiency assessment and correction in patients with chronic heart failure may be recommended.
Collapse
Affiliation(s)
- Reza Hassanzadeh-Makoui
- Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Maziar Jamei
- Department of Cardiology, Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Masoud Hassanzadeh-Makoui
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamid Khederlou
- Resident of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
- Corresponding Author: Resident of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Tel: +98-9125426158,
| |
Collapse
|
|
15
|
Cheng K, Tang Q, Guo X, Karow NA, Wang C. High dose of dietary vitamin D 3 modulated the yellow catfish (Pelteobagrus fulvidraco) splenic innate immune response after Edwardsiella ictaluri infection. FISH & SHELLFISH IMMUNOLOGY 2020; 100:41-48. [PMID: 32142874 DOI: 10.1016/j.fsi.2020.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 06/10/2023]
Abstract
Vitamin D3 (VD3) has been shown to modulate the innate immune response in mammals but this has been rarely reported in fish. The current study found that increasing dietary VD3 content can reduce the density of yellow to dark brown pigmented macrophage aggregates (PMAs) in the spleens of yellow catfish infected with Edwardsiella ictaluri. The results of next-generation sequencing showed that a high dose of dietary VD3 (16,600 IU/kg) mainly affected the splenic immune response during Edwardsiella ictaluri infection via negative regulation of 'NF-κΒ transcription factor activity', 'NIK/NF-κΒ signaling' and the 'i-kappab kinase/NF-κΒ signaling' pathways. Follow-up qPCR showed that dietary VD3 increased the expression of NF-κΒ inhibitor iκb-α, decreased the expression of nf-κb p65, il-6, il1-β and tnf-α, and down-regulated the expression of nik, ikks and nf-κb p52 in the NIK/NF-kappaB signaling pathway. The above results indicate that dietary VD3 can modulate the splenic innate immune response of yellow catfish after Edwardsiella ictaluri infection by inhibiting the NF-κB activation signaling pathways.
Collapse
Affiliation(s)
- Ke Cheng
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Hubei Provincial Engineering Laboratory for Pond Aquaculture, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
| | - Qin Tang
- Department of Genetics, Albert Einstein College of Medicine, 1301 Morris Park Ave, Bronx, NY, 10461, USA
| | - Xun Guo
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Hubei Provincial Engineering Laboratory for Pond Aquaculture, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China
| | - Niel A Karow
- Department of Animal Biosciences, University of Guelph, ON, N1G 2W1, Canada
| | - Chunfang Wang
- Freshwater Aquaculture Collaborative Innovation Center of Hubei Province, Hubei Provincial Engineering Laboratory for Pond Aquaculture, College of Fisheries, Huazhong Agricultural University, Wuhan, 430070, China.
| |
Collapse
|
|
16
|
Kim HA, Perrelli A, Ragni A, Retta F, De Silva TM, Sobey CG, Retta SF. Vitamin D Deficiency and the Risk of Cerebrovascular Disease. Antioxidants (Basel) 2020; 9:antiox9040327. [PMID: 32316584 PMCID: PMC7222411 DOI: 10.3390/antiox9040327] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 02/07/2023] Open
Abstract
Vitamin D deficiency has been clearly linked to major chronic diseases associated with oxidative stress, inflammation, and aging, including cardiovascular and neurodegenerative diseases, diabetes, and cancer. In particular, the cardiovascular system appears to be highly sensitive to vitamin D deficiency, as this may result in endothelial dysfunction and vascular defects via multiple mechanisms. Accordingly, recent research developments have led to the proposal that pharmacological interventions targeting either vitamin D deficiency or its key downstream effects, including defective autophagy and abnormal pro-oxidant and pro-inflammatory responses, may be able to limit the onset and severity of major cerebrovascular diseases, such as stroke and cerebrovascular malformations. Here we review the available evidence supporting the role of vitamin D in preventing or limiting the development of these cerebrovascular diseases, which are leading causes of disability and death all over the world.
Collapse
Affiliation(s)
- Hyun Ah Kim
- Department of Physiology, Anatomy & Microbiology and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora 3086, Australia; (H.A.K.); (T.M.D.S.)
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton 3800, Australia
| | - Andrea Perrelli
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043 Torino, Italy;
- CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043 Torino, Italy
| | - Alberto Ragni
- Oncological Endocrinology Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Torino, 10126 Torino, Italy; (A.R.); (F.R.)
| | - Francesca Retta
- Oncological Endocrinology Unit, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Torino, 10126 Torino, Italy; (A.R.); (F.R.)
| | - T. Michael De Silva
- Department of Physiology, Anatomy & Microbiology and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora 3086, Australia; (H.A.K.); (T.M.D.S.)
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton 3800, Australia
| | - Christopher G. Sobey
- Department of Physiology, Anatomy & Microbiology and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora 3086, Australia; (H.A.K.); (T.M.D.S.)
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Pharmacology, Monash University, Clayton 3800, Australia
- Correspondence: (C.G.S.); (S.F.R.); Tel.: +61-3-94791316 (C.G.S.); +39-011-6706426 (S.F.R.)
| | - Saverio Francesco Retta
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043 Torino, Italy;
- CCM Italia Research Network, National Coordination Center at the Department of Clinical and Biological Sciences, University of Torino, Orbassano, 10043 Torino, Italy
- Correspondence: (C.G.S.); (S.F.R.); Tel.: +61-3-94791316 (C.G.S.); +39-011-6706426 (S.F.R.)
| |
Collapse
|
|
17
|
Vitamin D-related genes and cardiometabolic markers in healthy children: a Mendelian randomisation study. Br J Nutr 2020; 123:1138-1147. [DOI: 10.1017/s0007114520000148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractObservational studies show associations between low serum 25-hydroxyvitamin D (25(OH)D) and cardiometabolic risk markers. This Mendelian randomisation study examined associations between cardiometabolic markers in children and SNP in genes related to vitamin D metabolism (DHCR7; group-specific complement (GC); cytochrome P450 subfamily IIR1 (CYP2R1); and CYP24A1) and action (CYP27B1 and VDR). In 699 healthy 8–11-year-old children, we genotyped eleven SNP. We generated a genetic risk score based on SNP associated with low 25(OH)D and investigated associations between this and blood pressure, plasma lipids and insulin. Furthermore, we examined whether SNP related to vitamin D actions modified associations between 25(OH)D and the cardiometabolic markers. All GC and CYP2R1 SNP influenced serum 25(OH)D. A risk score based on four of the six SNP was associated with 3·4 (95 % CI 2·6, 4·2) mmol/l lower 25(OH)D per risk allele (P < 0·001), but was not associated with the cardiometabolic markers. However, interactions were indicated for the three VDR SNP (Pinteraction < 0·081) on associations between 25(OH)D and TAG, systolic blood pressure and insulin, which all decreased with increasing 25(OH)D only in major allele homozygotes (β –0·02 (95 % CI –0·04, –0·01) mmol/l; β –0·5 (95 % CI –0·9, –0·1) mmHg; and β –0·5 (95 % CI –1·4, 0·3) pmol/l, respectively). In conclusion, genetic variation affected 25(OH)D substantially, but the genetic score was not associated with cardiometabolic markers in children. However, VDR polymorphisms modified associations with vitamin D, which warrants further investigation of VDR's role in the relationship between vitamin D and cardiometabolic risk.
Collapse
|
|
18
|
Zhang Y, Darssan D, Pascoe EM, Johnson DW, Pi H, Dong J. Vitamin D status and mortality risk among patients on dialysis: a systematic review and meta-analysis of observational studies. Nephrol Dial Transplant 2019; 33:1742-1751. [PMID: 29481620 DOI: 10.1093/ndt/gfy016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 01/06/2018] [Indexed: 01/10/2023] Open
Abstract
Background Vitamin D deficiency is highly prevalent in patients on dialysis. Although vitamin D deficiency is closely associated with cardiovascular disease (CVD) and high mortality in the general population, the relationship between serum 25-hydroxyvitamin D [25(OH)D] and all-cause and cardiovascular mortality in dialysis patients is uncertain. We aim to explore the relationship between serum 25(OH)D levels and all-cause and cardiovascular mortality in dialysis patients. Methods This is a systematic review and meta-analysis of clinical studies among patients receiving maintenance dialysis. We did a systematic literature search in PubMed and Embase to identify studies reporting the relationship between serum 25(OH)D levels and all-cause and cardiovascular mortality in patients on dialysis. The search was last updated on 10 February 2017. Results The study included 18 moderate to high-quality cohort studies with an overall sample of 14 154 patients on dialysis. The relative risk of all-cause mortality per 10 ng/mL increase in serum 25(OH)D level was 0.78 [95% confidence interval (CI) 0.71-0.86], although there was marked heterogeneity (I2=96%, P < 0.01) that was partly explained by differences in CVD prevalence, baseline parathyroid hormone level and dialysis duration among included studies. The relative risk of cardiovascular mortality per 10 ng/mL increase in serum 25(OH)D level was 0.71 (95% CI 0.63-0.79), with substantial heterogeneity (I2=74%, P=0.004) that was largely explained by differences in study type and serum 25(OH)D measurement method. Conclusions In the present study, increased serum 25(OH)D level was significantly associated with lower all-cause mortality and lower cardiovascular mortality in dialysis patients.
Collapse
Affiliation(s)
- Yuhui Zhang
- Department of Medicine Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health; Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| | - Darsy Darssan
- Australasian Kidney Trials Network, Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia
| | - Elaine M Pascoe
- Australasian Kidney Trials Network, Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia
| | - David W Johnson
- Australasian Kidney Trials Network, Centre for Kidney Disease Research, University of Queensland, Brisbane, Australia.,Department of Kidney Disease, Translational Research Institute, Brisbane, Australia.,Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia
| | - Haichen Pi
- Department of Emergency Medicine, Peking University First Hospital, Beijing, China
| | - Jie Dong
- Department of Medicine Renal Division, Peking University First Hospital; Institute of Nephrology, Peking University; Key Laboratory of Renal Disease, Ministry of Health; Key Laboratory of Renal Disease, Ministry of Education, Beijing, China
| |
Collapse
|
|
19
|
Wang Y, Wang Y, Zhang B, Lin Y, Tan S, Lu Z. Depressed Serum 25-Hydroxyvitamin D Levels Increase Hospital Stay and Alter Glucose Homeostasis in First-ever Ischemic Stroke. Curr Neurovasc Res 2019; 16:340-347. [PMID: 31549956 DOI: 10.2174/1567202616666190924161947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/27/2019] [Accepted: 08/04/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Vitamin D deficiency is internationally recognized among the potentially modifiable risk factors for ischemic cardio-cerebrovascular diseases. However, the association between vitamin D deficiency and stroke morbidity or mortality remains insufficiently known. Our aim is to investigate their relevance to 25-hydroxyvitamin D [25(OH) D] levels and clinical severity and outcome after 3 months in first-ever ischemic stroke. METHODS Retrospective analysis of 356 consecutive patients in first-ever ischemic stroke between 2013 and 2015. Serum 25(OH) D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome after 3 months of onset was evaluated using the modified Rankin scale (mRS). RESULTS Among the 356 enrolled patients, HbA1c was higher in insufficiency/deficiency group than that in the sufficiency group (6.3 ± 1.7 vs. 5.9 ± 1.1, p =0.015). The hospital stay was longer in insufficiency/deficiency group than that in the sufficiency group (11 (8-17) vs. 9.5 (7-13), p = 0.035). There was a significant inversed trend between serum 25(OH) D levels and hospital stay (OR 0.960, P = 0.031), using logistic regression. CONCLUSION 25(OH)D levels are associated with glucose homeostasis, 25(OH) D contributes to increase the length of hospital stay. Low serum 25-OHD level is an independent predictor for hospital stay in first-ever ischemic stroke. Vitamin D deficiency did not predict functional outcome in the span of 3 months.
Collapse
Affiliation(s)
- Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yanqiang Wang
- Department of Neurology, The Affiliated Hospital of Wei Fang Medical University, Weifang, China
| | - Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yinyao Lin
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Sha Tan
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
|
20
|
Si J, Li K, Shan P, Yuan J. The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China. BMC Neurol 2019; 19:164. [PMID: 31315602 PMCID: PMC6636140 DOI: 10.1186/s12883-019-1395-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/05/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China. METHODS We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (> 20 ng/ml). RESULTS Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (Pinteraction = 0.001). CONCLUSION We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.
Collapse
Affiliation(s)
- Junzeng Si
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012 China
- Department of Neurology, Jinan City People’s Hospital, Jinan, 271199 China
| | - Kuibao Li
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020 China
| | - Peiyan Shan
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012 China
| | - Junliang Yuan
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020 China
| |
Collapse
|
|
21
|
Hu W, Liu D, Li Q, Wang L, Tang Q, Wang G. Decreasing serum 25-hydroxyvitamin D levels and risk of early neurological deterioration in patients with ischemic stroke. Brain Behav 2019; 9:e01227. [PMID: 30724487 PMCID: PMC6422815 DOI: 10.1002/brb3.1227] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 12/31/2018] [Accepted: 01/06/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND AND AIMS Vitamin D deficiency has been linked to a higher risk of ischemic stroke. We therefore explored the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and early neurological deterioration (END) after acute ischemic stroke in a hospital-based prospective study. METHODS From June 2016 to June 2018, patients with ischemic stroke within 48 hr from symptom onset were consecutively recruited. Serum 25(OH)D levels were measured at admission. END was defined as an increase of ≥1 point in motor power or ≥2 points in the total National Institute of Health Stroke Scale score within 7 days after admission. Multiple logistic regression models were performed to calculate the odds ratio (OR) and confidence intervals (CI) of 25(OH)D levels in predicting END. RESULTS A total of 478 subjects were enrolled, of which 136 (28.5%) patients developed END. The mean 25(OH)D levels were 49.5 ± 15.8 nmol/L. Univariate logistic regression analysis showed that advanced age, white matter lesions, high level of body mass index, diastolic blood pressure, fasting blood glucose and homocysteine, and low 25(OH)D levels were associated with END. Furthermore, multivariate regression analysis demonstrated that the first quartile of 25(OH)D concentrations [OR, 2.628; 95% CI,1.223-5.644; p = 0.013] was independently risk factor for END. CONCLUSIONS This study illustrated that lower 25(OH)D levels might be associated with an increasing risk of END in acute ischemic stroke patients.
Collapse
Affiliation(s)
- Wei Hu
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China
| | - Dezhi Liu
- Department of Neurology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Qin Li
- The Central Laboratory of Medical Research Center, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China
| | - Li Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China
| | - Qiqiang Tang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China
| | - Guoping Wang
- Department of Neurology, The First Affiliated Hospital of USTC, Division of Life Science and Medicine, University of Science and Technology of China, HeFei, Anhui, China
| |
Collapse
|
|
22
|
de la Iglesia D, Vallejo-Senra N, López-López A, Iglesias-Garcia J, Lariño-Noia J, Nieto-García L, Domínguez-Muñoz JE. Pancreatic exocrine insufficiency and cardiovascular risk in patients with chronic pancreatitis: A prospective, longitudinal cohort study. J Gastroenterol Hepatol 2019; 34:277-283. [PMID: 30156337 DOI: 10.1111/jgh.14460] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/20/2018] [Accepted: 08/22/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Previous studies have suggested that chronic pancreatitis (CP) is associated with increased risk of cardiovascular (CV) disease independently of other major risk factors. We evaluated the risk of CV events in a well-phenotyped cohort of patients with CP and its association with pancreatic exocrine insufficiency (PEI) among other CV risk factors. METHODS This was a prospective, longitudinal cohort study of patients with CP, followed up at the Pancreas Unit of the University Hospital of Santiago de Compostela, Spain. RESULTS Four hundred thirty patients were included (mean 47.8 ± 14.4 years of age, 79.1% male). Mean follow-up was 8.6 ± 4.6 years. CP etiology was toxic (alcohol and/or smoking) in 290 patients (67.4%). PEI and pancreatogenic diabetes mellitus (DM) were present in 29.3% and 29.5% of the patients, respectively. A total of 45 CV events was recorded (10.5%); 21 patients had a major CV event (stroke or myocardial infarction) and 27 developed clinically relevant peripheral arterial disease. A higher incidence of CV events was recorded in patients with PEI than in those without (incidence rate ratio 3.67, 95% confidence interval [CI] 1.92-7.24; P < 0.001). In the multivariate analysis, PEI without DM (OR 4.96; 95% CI 1.68 to 14.65), coexistence of PEI and DM (OR 6.54; 95% CI 2.71 to 15.77), arterial hypertension (OR 3.40; 95% CI 1.50 to 7.72), and smoking (OR 2.91, 95% CI 1.07 to 7.97) were independently associated with increased CV risk. CONCLUSIONS Together with known major CV risk factors like smoking and hypertension, PEI is significantly associated with the risk of CV events in patients with CP.
Collapse
Affiliation(s)
- Daniel de la Iglesia
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Nicolau Vallejo-Senra
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Andrea López-López
- Department of Cardiology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Julio Iglesias-Garcia
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jose Lariño-Noia
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Laura Nieto-García
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Enrique Domínguez-Muñoz
- Department of Gastroenterology and Hepatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.,Health Research Institute of Santiago (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| |
Collapse
|
|
23
|
Yang M, Liu J, Zhou X, Ding H, Xu J, Yang B, Sun B, Xiao D, Yu J, Gong Q. Correlation Analysis between Serum Vitamin D Levels and Lower Extremity Macrovascular Complications in Individuals with Type 2 Diabetes Mellitus. J Diabetes Res 2019; 2019:4251829. [PMID: 31871946 PMCID: PMC6906833 DOI: 10.1155/2019/4251829] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 11/13/2019] [Indexed: 11/18/2022] Open
Abstract
The correlation between serum 25-hydroxy vitamin D (25(OH)D) levels and lower extremity atherosclerotic disease and the predictive value of 25(OH)D for early-stage lower extremity atherosclerotic disease in patients with type 2 diabetes mellitus (T2DM) were explored. In total, 620 subjects (590 T2DM patients and 30 healthy subjects) completed a questionnaire. All subjects were divided into four groups according to serum 25(OH)D concentration quartile: Q1 (<12.18 ng/ml), Q2 (12.18~20.65 ng/ml), Q3 (20.65~31.97 ng/ml), and Q4 (>31.97 ng/ml). Participants were also divided into four groups based on the degree of lower extremity arteriostenosis: A1 (T2DM), A2 (T2DM with mild lower extremity vascular lesions (LEVL)), A3 (T2DM with moderate LEVL), and A4 (T2DM with severe LEVL). The incidence of lower extremity artery plaque was significantly higher in groups Q1 and Q2 than in group Q4 (both P < 0.05). The concentration of 25(OH)D was significantly lower in group A4 than in groups A1 and A2. Pearson correlation analysis revealed that the degree of lower extremity vascular stenosis was positively correlated with age, smoking, and HbA1c, CRP, and LDL-C levels and negatively correlated with 25(OH)D concentrations. Logistic regression analysis demonstrated that 25(OH)D concentrations exerted a protective effect against LEVL in T2DM patients. Serum 25(OH)D concentrations may be correlated with the incidence of macrovascular disease in T2DM patients. A low serum 25(OH)D concentration is an independent risk factor for lower extremity vascular pathological changes and acts as a prognostic index for lower extremity atherosclerotic disease.
Collapse
Affiliation(s)
- Mengxue Yang
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China
- Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China
| | - Jun Liu
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China
| | - Xue Zhou
- Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China
| | - Heyuan Ding
- Department of Endocrinology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China
| | - Jie Xu
- School of Public Health, Zunyi Medical University, Zunyi 563000, China
| | - Bo Yang
- Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China
| | - Bowen Sun
- Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China
| | - Dandan Xiao
- Department of Endocrinology, Zunyi Medical University, Zunyi 563000, China
| | - Jie Yu
- School of Public Health, Zunyi Medical University, Zunyi 563000, China
| | - Qihai Gong
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Laboratory of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi 563000, China
| |
Collapse
|
|
24
|
Pascale AV, Finelli R, Giannotti R, Visco V, Fabbricatore D, Matula I, Mazzeo P, Ragosa N, Massari A, Izzo R, Coscioni E, Illario M, Ciccarelli M, Trimarco B, Iaccarino G. Vitamin D, parathyroid hormone and cardiovascular risk: the good, the bad and the ugly. J Cardiovasc Med (Hagerstown) 2018; 19:62-66. [PMID: 29252600 PMCID: PMC5757656 DOI: 10.2459/jcm.0000000000000614] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
25-Hydroxyvitamin D insufficiency and increased cardiovascular risk (CVR) association is still debated. The vitamin D (VitD)-dependent parathyroid hormone (PTH) is considered as the possible actuator of VitD effects on CVR. To investigate the association of CVR, PTH and VitD, we carried out blood pressure measurements and blood samples and collected information on dietary habits, anamnestic, clinical and metabolic data of 451 participants in the Salerno area (Southern Italy) during the World Hypertension Day (17 May). CVR was calculated according to the Framingham CVR charts. The overall population mean age was 51.6 ± 0.7 years, and female sex was slightly prevalent (55%). VitD deficiency (<20 ng/ml) was most frequent (59.7%). In this population, VitD and CVR did not correlate. VitD and PTH inversely correlated (r = −0.265, P < 0.001) as expected. PTH was in direct correlation (r = 0.225, P < 0.001) with CVR. Elevated PTH (75 percentile; ≥49.5 pg/ml) levels identify a population with higher CVR (11.8 ± 0.5 vs. 8.5 ± 0.3, P < 0.001). In a multivariate analysis, both age and PTH correlate to CVR, but not VitD. In conclusion, VitD does not directly affect CVR in the overall population. Rather, increased PTH might be a better predictor of CVR.
Collapse
Affiliation(s)
| | - Rosa Finelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Rocco Giannotti
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Davide Fabbricatore
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Ida Matula
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Pietro Mazzeo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Nicola Ragosa
- Department of Cardiology, San Luca Hospital, Vallo della Lucania
| | - Angelo Massari
- San Giovanni di Dio e Rugi d'Aragona University Hospital, Salerno, Italy
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences, Federico II University
| | - Enrico Coscioni
- San Giovanni di Dio e Rugi d'Aragona University Hospital, Salerno, Italy
| | - Maddalena Illario
- Division of Health Innovation, Directorate General for Health Protection and Coordination of the Regional Health System.,Depatment of Medical and Translational Sciences, Federico II University and Hospital, Napoli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, Federico II University
| | - Guido Iaccarino
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi
| |
Collapse
|
|
25
|
Jensen BP, Saraf R, Ma J, Berry S, Grant CC, Camargo CA, Sies CW. Quantitation of 25-hydroxyvitamin D in dried blood spots by 2D LC-MS/MS without derivatization and correlation with serum in adult and pediatric studies. Clin Chim Acta 2018; 481:61-68. [DOI: 10.1016/j.cca.2018.02.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 02/18/2018] [Accepted: 02/19/2018] [Indexed: 11/15/2022]
|
|
26
|
Zhang B, Wang Y, Zhong Y, Liao S, Lu Z. Serum 25-hydroxyvitamin D deficiency predicts poor outcome among acute ischemic stroke patients without hypertension. Neurochem Int 2018; 118:91-95. [PMID: 29729873 DOI: 10.1016/j.neuint.2018.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/15/2018] [Accepted: 05/02/2018] [Indexed: 10/17/2022]
Abstract
25-Hydroxyvitamin D (25(OH)D) deficiency is a frequent condition in patients who suffer acute ischemic stroke (AIS), and several studies suggested that it may be associated with a poorer prognosis. Whether this association is affected by hypertension is unclear. Our aim was to investigate the association between 25(OH)D levels and both clinical severity and outcome after 3 months in AIS patients stratified by the history of hypertension. Consecutive first-ever AIS patients admitted to the Third Affiliated Hospital of Sun Yat-sen University, China were identified. Clinical information was collected. Serum 25(OH)D levels were measured at baseline. Stroke severity was assessed at admission using the National Institutes of Health Stroke Scale (NIHSS) score. Functional outcome was evaluated after 3 months of onset using the modified Rankin Scale (mRS). Multivariate analyses were performed using logistic regression models. During the study period, 377 patients were diagnosed as AIS and were included in the analysis. 25(OH)D deficiency was not associated with the risk of NIHSS at admission and 3 months mRS both in total patients and the hypertension subgroup. Among AIS without hypertension, 25(OH)D deficiency subjects had a significantly higher of NIHSS at admission and 3 months mRS compared with those with 25(OH)D ≥ 50 nmol/L. The odds ratios (95% confidence interval) were 5.51(1.83-16.60) and 4.63(1.53-14.05) in the multivariable adjusted model (P for linear trend < 0.05). Serum lower 25(OH)D levels can be seen as an independent prognostic factor of functional outcome in AIS without hypertension. Additional studies about improving prognosis of AIS by vitamin D supplementation could be first applied to these patients.
Collapse
Affiliation(s)
- Bingjun Zhang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yuge Wang
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yi Zhong
- Department of Dermatology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Siyuan Liao
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhengqi Lu
- Department of Neurology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
|
27
|
Makoui RH, Soltannejad Dizaji M, Khederlou H. Comparison of Serum Levels of Vitamin D in Patients With and Without Acute Coronary Syndrome. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2018. [DOI: 10.21859/ijcp-03201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|
|
28
|
Sorriento D, De Luca N, Trimarco B, Iaccarino G. The Antioxidant Therapy: New Insights in the Treatment of Hypertension. Front Physiol 2018; 9:258. [PMID: 29618986 PMCID: PMC5871811 DOI: 10.3389/fphys.2018.00258] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/06/2018] [Indexed: 12/12/2022] Open
Abstract
Reactive oxygen species (ROS) and reactive nitrogen species (RNS) play a key role in the regulation of the physiological and pathological signaling within the vasculature. In physiological conditions, a delicate balance between oxidants and antioxidants protects cells from the detrimental effects of ROS/RNS. Indeed, the imbalance between ROS/RNS production and antioxidant defense mechanisms leads to oxidative and nitrosative stress within the cell. These processes promote the vascular damage observed in chronic conditions, such as hypertension. The strong implication of ROS/RNS in the etiology of hypertension suggest that antioxidants could be effective in the treatment of this pathology. Indeed, in animal models of hypertension, the overexpression of antioxidants and the genetic modulation of oxidant systems have provided an encouraging proof of concept. Nevertheless, the translation of these strategies to human disease did not reach the expected success. This could be due to the complexity of this condition, whose etiology depends on multiple factors (smoking, diet, life styles, genetics, family history, comorbidities). Indeed, 95% of reported high blood pressure cases are deemed "essential hypertension," and at the molecular level, oxidative stress seems to be a common feature of hypertensive states. In this scenario, new therapies are emerging that could be useful to reduce oxidative stress in hypertension. It is now ascertained the role of Vitamin D deficiency in the development of essential hypertension and it has been shown that an appropriate high dose of Vitamin D significantly reduces blood pressure in hypertensive cohorts with vitamin D deficiency. Moreover, new drugs are emerging which have both antihypertensive action and antioxidant properties, such as celiprolol, carvedilol, nebivolol. Indeed, besides adrenergic desensitization, these kind of drugs are able to interfere with ROS/RNS generation and/or signaling, and are therefore considered promising therapeutics in the management of hypertension. In the present review we have dealt with the effectiveness of the antioxidant therapy in the management of hypertension. In particular, we discuss about Vitamin D and anti-hypertensive drugs with antioxidant properties.
Collapse
Affiliation(s)
- Daniela Sorriento
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Nicola De Luca
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Bruno Trimarco
- Dipartimento di Scienze Biomediche Avanzate, Università Federico II, Napoli, Italy
| | - Guido Iaccarino
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Salerno, Baronissi, Italy
| |
Collapse
|
|
29
|
Hacioglu Y, Karabag T, Piskinpasa ME, Sametoglu F, Yuksel Y. Impaired Cardiac Functions and Aortic Elastic Properties in Patients with Severe Vitamin D Deficiency. J Cardiovasc Echogr 2018; 28:171-176. [PMID: 30306021 PMCID: PMC6172887 DOI: 10.4103/jcecho.jcecho_82_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The study explored the effect of severe Vitamin D deficiency on cardiac functions and aortic elastic properties determined by echocardiography. Patients and Methods It included 56 patients with Vitamin D deficiency (Group 1; 16 men, 40 women; mean age 43.1 ± 11.4 years) and 42 healthy individuals with normal Vitamin D levels (Group 2; 11 men, 31 women; mean age 40.0 ± 7.5 years). Calcium, parathormone, alkaline phosphatase, and Vitamin D levels were measured from blood samples, and all participants underwent echocardiographic examination. Results Left ventricular diastolic functions were determined by both conventional and tissue Doppler methods and were found to be impaired in Group 1 compared to Group 2. Aortic distensibility was significantly reduced in Group 1 compared to Group 2, whereas aortic stiffness index was significantly increased. Left atrial active emptying volume and fraction (LAAEV and LAAEF) were significantly higher in Group 1 than in Group 2. There were significant negative correlations between Vitamin D level and LAAEV, LAAEF, and septal E/E' ratio and significant positive correlations between Vitamin D level and septal, lateral, anterior, and right ventricular annular E' velocities. Conclusion In severe Vitamin D deficiency, echocardiographically assessed diastolic functions appeared particularly impaired, and ventricular myocardial velocities and aortic elastic parameters were also adversely affected. In addition, LA mechanical functions were impaired, probably secondary to disturbed diastolic functions.
Collapse
Affiliation(s)
- Yalcin Hacioglu
- Department of Family Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Turgut Karabag
- Department of Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Emin Piskinpasa
- Department of Internal Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Fettah Sametoglu
- Department of Internal Medicine, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Yasin Yuksel
- Department of Cardiology, Istanbul Education and Research Hospital, Istanbul, Turkey
| |
Collapse
|
|
30
|
Dziedzic EA, Gąsior JS, Pawłowski M, Dąbrowski M. Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes. J Diabetes Res 2017; 2017:3929075. [PMID: 29230421 PMCID: PMC5688254 DOI: 10.1155/2017/3929075] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 09/27/2017] [Indexed: 12/21/2022] Open
Abstract
Several modifiable factors may influence cardiac function in diabetic patients. The aim of the study was to evaluate the influence of vitamin D level on the stage of coronary atherosclerosis in cardiac patients diagnosed with type 2 diabetes. The study was performed in 337 consecutive patients undergoing coronarography. The stage of atherosclerosis was evaluated using Coronary Artery Surgery Study Score. The plasma 25(OH)D concentration was determined by an electrochemiluminescence method. Patients without significant lesions in coronary arteries presented the highest 25(OH)D level, significantly higher than patients with one-, two-, and three-vessel coronary artery disease (CAD) (p < 0.01). Significantly lower level of the 25(OH)D was observed in patients hospitalized due to acute coronary syndrome (ACS) in comparison to patients hospitalized due to stable CAD (p < 0.001). Lower 25(OH)D levels were observed in patients with the history of myocardial infarction (MI) in comparison to patients without previous MI (p < 0.001). In cardiac patients with diabetes, the higher number of stenotic coronary arteries is associated with lower values of the 25(OH)D. A group of male cardiac patients with diabetes with significant stenosis in three coronary arteries, hospitalized due to acute coronary syndrome, with a history of previous MI and hyperlipidemia presented the lowest vitamin D level.
Collapse
Affiliation(s)
- Ewelina A. Dziedzic
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| | - Jakub S. Gąsior
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Mariusz Pawłowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Marek Dąbrowski
- Cardiology Clinic of Physiotherapy Division of the 2nd Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
- Department of Cardiology, Bielański Hospital, Warsaw, Poland
| |
Collapse
|
|
31
|
Licher S, de Bruijn RF, Wolters FJ, Zillikens MC, Ikram MA, Ikram MK. Vitamin D and the Risk of Dementia: The Rotterdam Study. J Alzheimers Dis 2017; 60:989-997. [DOI: 10.3233/jad-170407] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Silvan Licher
- Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Renée F.A.G. de Bruijn
- Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank J. Wolters
- Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M. Carola Zillikens
- Department of Internal Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M. Kamran Ikram
- Department of Epidemiology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC – University Medical Center Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
|
32
|
Ng BK, Lee CL, Lim PS, Othman H, Ismail NAM. Comparison of 25-hydroxyvitamin D and metabolic parameters between women with and without polycystic ovarian syndrome. Horm Mol Biol Clin Investig 2017; 31:/j/hmbci.ahead-of-print/hmbci-2016-0057/hmbci-2016-0057.xml. [PMID: 28586302 DOI: 10.1515/hmbci-2016-0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 02/24/2017] [Indexed: 11/15/2022]
Abstract
Background There is increasing evidence that supports the contribution of vitamin D deficiency in metabolic disturbances among women with polycystic ovarian syndrome (PCOS). The aim of this study was to compare 25-hydroxyvitamin D level and the prevalence of metabolic syndrome in the PCOS and normal women. Materials and methods A case-controlled study was conducted in a teaching hospital over a 6-month duration from June 2015 to January 2016. A total of 90 women, who consisted of 45 women with PCOS (study group) and 45 women without PCOS (control group), were recruited. Results The final analysis was of 80 women only and the prevalence of vitamin D deficiency (<20 ng/mL) was high between both groups, i.e. 93.7% but there was no significant difference (p = 0.874). Nevertheless, the prevalence of metabolic syndrome was significantly higher in the study group as compared to the control group (27.5% vs. 5.0%, p = 0.013). There was no statistically significant correlation between vitamin D level with clinical [age, weight, body mass index (BMI), waist and hip circumference, systolic and diastolic blood pressure (SBP and DPB, respectively)] and metabolic parameters (fasting glucose, triglycerides, cholesterol, high-density lipoprotein and low-density lipoprotein) among women with PCOS. However, height was positively correlated (r = 0.338, p = 0.033) and the contrary waist-hip ratio was negatively correlated with vitamin D level (r = -0.605, p = 0.048). Conclusion The prevalence of vitamin D deficiency was high in our study population. Nevertheless, the prevalence of metabolic syndrome was higher among women with PCOS as compared to women without PCOS.
Collapse
|
|
33
|
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
|
|
34
|
Aggarwal A, Srivastava S, Velmurugan M. Newer perspectives of coronary artery disease in young. World J Cardiol 2016; 8:728-734. [PMID: 28070240 PMCID: PMC5183972 DOI: 10.4330/wjc.v8.i12.728] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 10/03/2016] [Accepted: 11/02/2016] [Indexed: 02/06/2023] Open
Abstract
Coronary artery disease (CAD) occurring in less than 45 years of age is termed as young CAD. Recent studies show a prevalence of 1.2% of CAD cases in this age group. Ethnic wise south Asians especially Indians are more vulnerable to have CAD in young age group with a prevalence of 5% to 10%. Conventional risk factors such as smoking, diabetes, hypertension, obesity and family history seems to be as important as in older CAD subjects. But the prevalence of these risk factors seems to vary in younger subjects. By far the most commonly associated risk factor is smoking in young CAD. Several genes associated with lipoprotein metabolism are now found to be associated with young CAD like cholesterol ester transfer protein (CETP) gene, hepatic lipase gene, lipoprotein lipase gene, apo A1 gene, apo E gene and apo B. Biomarkers such as lipoprotein (a), fibrinogen, D-dimer, serum Wnt, gamma glutamyl transferase, vitamin D2 and osteocalcin are seems to be associated with premature CAD in some newer studies. In general CAD in young has better prognosis than older subjects. In terms of prognosis two risk factors obesity and current smoking are associated with poorer outcomes. Angiographic studies shows predominance of single vessel disease in young CAD patients. Like CAD in older person primary and secondary prevention plays an important role in prevention of new and further coronary events.
Collapse
|
|
35
|
Chai W, Fan JX, Wen M. Association of individual and community factors with C-reactive protein and 25-hydroxyvitamin D: Evidence from the National Health and Nutrition Examination Survey (NHANES). SSM Popul Health 2016; 2:889-896. [PMID: 27995178 PMCID: PMC5161036 DOI: 10.1016/j.ssmph.2016.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/21/2016] [Accepted: 11/14/2016] [Indexed: 01/09/2023] Open
Abstract
Many individual and community/neighborhood factors may contribute to inflammation and vitamin D deficiency leading to the development of chronic diseases. This study examined the associations of serum C-reactive protein (CRP) and 25-hydroxyvitamin D [25(OH)D] levels with individual and community/neighborhood (tract-level or county-level) factors using a nationally representative sample from 2001-2006 National Health and Nutrition Examination Survey (NHANES). Data from the 2001-2006 waves of the continuous NHANES was merged with the 2000 census and other neighborhood data sources constructed using geographic information system. Associations between multilevel factors and biomarker levels were assessed using multilevel random-intercept regression models. 6643 participants aged 19-65 (3402 men and 3241 women) were included in the analysis. Family income-to-needs ratio was inversely associated with CRP (P=0.002) and positively associated with 25(OH)D levels (P=0.0003). County crime rates were positively associated with CRP (P=0.007) and inversely associated with 25(OH)D levels (P=0.0002). The associations with income-to-needs ratio were significant in men [CRP; P=0.005; 25(OH)D, P=0.005] but not in women. For county crime rates, the association was only significant in women for CRP (P=0.004) and was significant in both men (P=0.01) and women (P=0.001) for 25(OH)D. Additionally, overall CRP was positively associated with age (P<0.0001), female sex (P<0.0001), Hispanic race/ethnicity (P=0.0001), current smokers (P<0.0001), body mass index (BMI, P<0.0001), and participants who were US-born (P=0.02). Non-Hispanic black (P<0.0001) and Hispanic race/ethnicity (P<0.0001), current smoker (P=0.047), and higher BMI (P<0.0001) were associated with lower serum 25(OH)D levels. No significant associations were observed between other community/neighborhood variables and serum CRP and 25(OH)D levels. The current results suggest that family income-to-needs ratio and county crime rate may be important contributors to chronic inflammation and vitamin D status.
Collapse
Affiliation(s)
- Weiwen Chai
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jessie X. Fan
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
|
36
|
Gupta GK, Agrawal T, Rai V, Del Core MG, Hunter WJ, Agrawal DK. Vitamin D Supplementation Reduces Intimal Hyperplasia and Restenosis following Coronary Intervention in Atherosclerotic Swine. PLoS One 2016; 11:e0156857. [PMID: 27271180 PMCID: PMC4894559 DOI: 10.1371/journal.pone.0156857] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 05/21/2016] [Indexed: 11/18/2022] Open
Abstract
Vitamin D is a fat-soluble steroid hormone that activates vitamin D receptor to regulate multiple downstream signaling pathways and transcription of various target genes. There is an association between vitamin D deficiency and increased risk for cardiovascular disease. However, most of the studies are observational and associative in nature with limited data on clinical application. Thus, there is a need for more prospective randomized controlled studies to determine whether or not vitamin D supplementation provides cardiovascular protection. In this study, we examined the effects of the deficiency and supplementation of vitamin D on coronary restenosis following coronary intervention in atherosclerotic Yucatan microswine. Twelve Yucatan microswine were fed vitamin D-deficient (n = 4) or -sufficient (n = 8) high cholesterol diet for 6-months followed by coronary intervention. Post-intervention, swine in the vitamin D-sufficient high cholesterol diet group received daily oral supplementation of either 1,000 IU (n = 4) or 3,000 IU (n = 4) vitamin D3. Six months later, optical coherence tomography (OCT) was performed to monitor the development of intimal hyperplasia and restenosis. Animals were euthanized to isolate arteries for histomorphometric and immunohistochemical studies. Animals had graded levels of serum 25(OH)D; vitamin D-deficient (15.33 ± 1.45 ng/ml), vitamin D-sufficient + 1,000 IU oral vitamin D post-intervention (32.27 ± 1.20 ng/ml), and vitamin D-sufficient + 3,000 IU oral vitamin D post-intervention (51.00 ± 3.47 ng/ml). Findings from the OCT and histomorphometric studies showed a decrease in intimal hyperplasia and restenosis in vitamin D-supplemented compared to vitamin D-deficient swine. Vitamin D supplementation significantly decreased serum levels of TNF-α and IFN-γ, upregulated serum levels of IL-10, and had no effect on serum IL-6 levels. These findings suggest that vitamin D supplementation limits neointimal formation following coronary intervention in atherosclerotic swine and provide the support for vitamin D supplementation to protect against the development of coronary restenosis.
Collapse
Affiliation(s)
- Gaurav K. Gupta
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
| | - Tanupriya Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
| | - Vikrant Rai
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
| | - Michael G. Del Core
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
| | - William J. Hunter
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
| | - Devendra K. Agrawal
- Department of Clinical and Translational Science, Creighton University School of Medicine, Omaha, NE, United States of America
- * E-mail:
| |
Collapse
|
|
37
|
Lawrence DW, Sharma B. A review of the neuroprotective role of vitamin D in traumatic brain injury with implications for supplementation post-concussion. Brain Inj 2016; 30:960-8. [DOI: 10.3109/02699052.2016.1147081] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
|
38
|
Snoddy AME, Buckley HR, Halcrow SE. More than metabolic: Considering the broader paleoepidemiological impact of vitamin D deficiency in bioarchaeology. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2016; 160:183-96. [PMID: 26926781 DOI: 10.1002/ajpa.22968] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/28/2016] [Accepted: 02/02/2016] [Indexed: 12/20/2022]
Abstract
Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Anne Marie E Snoddy
- Department of Anatomy, University of Otago, Dunedin, Otago, 9016, New Zealand
| | - Hallie R Buckley
- Department of Anatomy, University of Otago, Dunedin, Otago, 9016, New Zealand
| | - Siân E Halcrow
- Department of Anatomy, University of Otago, Dunedin, Otago, 9016, New Zealand
| |
Collapse
|
|
39
|
Belen E, Sungur A, Sungur MA. Vitamin D levels predict hospitalization and mortality in patients with heart failure. SCAND CARDIOVASC J 2015; 50:17-22. [PMID: 26395845 DOI: 10.3109/14017431.2015.1098725] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Low levels of vitamin D are closely associated with cardiovascular diseases. Heart failure (HF) is a major health problem globally, occurring with increasing frequency and characterised by poor prognosis despite therapy. We aimed to investigate the effect of vitamin D levels on hospitalisation and mortality in patients with HF. DESIGN Patients with ejection fraction <50% (n = 219) were included in this prospective study. Demographic, clinical and laboratory parameters were obtained at presentation. Patients were classified into Group 1 (vitamin D level ≤50 nmol/L) and Group 2 (vitamin D level >50 nmol/L). Median follow-up time was 12 months. Hospitalisation rates and overall survival were compared between groups. Independent predictors of hospitalisation and mortality were defined. RESULTS With a median follow-up period of 12 months, hospitalisation and overall death occurred more frequently in Group 1 than in Group 2 (23.4% vs 7.3% and 16.1% vs 1.2%, respectively; p < 0.005 for both).Vitamin D was defined as an independent predictor of hospitalisation and mortality.Higher levels were found to be associated with decreased hospitalisation (HR 0.89, 95% CI 0.84-0.95, p < 0.001) and mortality (HR 0.83, 95% CI 0.75-0.92, p < 0.001). CONCLUSIONS Vitamin D deficiency is highly prevalent in patients with HF, and low vitamin D levels are closely associated with increased hospitalisation and mortality.
Collapse
Affiliation(s)
- Erdal Belen
- a Department of Cardiology , Okmeydanı Training and Research Hospital , Istanbul , Turkey
| | - Aylin Sungur
- b Department of Cardiology , Kahramanmaras Necip Fazıl City Hospital , Kahramanmaras , Turkey
| | - Mustafa Azmi Sungur
- b Department of Cardiology , Kahramanmaras Necip Fazıl City Hospital , Kahramanmaras , Turkey
| |
Collapse
|
|
40
|
Lee JH, Choi JH, Kweon OJ, Park AJ. Discrepancy between Vitamin D Total Immunoassays due to Various Cross-reactivities. J Bone Metab 2015; 22:107-12. [PMID: 26389085 PMCID: PMC4572031 DOI: 10.11005/jbm.2015.22.3.107] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 08/24/2015] [Accepted: 08/24/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this study was to find out the cause of discrepancy between various automated immunoassays for 25-hydroxy-vitamin D (25-[OH]D). METHODS National Institute of Standards & Technology Standard Reference Material (SRM) 972a is SRM for 25-(OH)D and consists of 4 vials of frozen serum with different concentrations of 25-(OH)D. Each concentration was measured 6 times in 3 different immunoassays: ADVIA Vitamin D Total assay (Siemens Healthcare, Erlangen, Germany), ARCHITECT 25-(OH)D (Abbott Laboratories, Abbott Park, IL, USA), and COBAS Vitamin D Total assay (Roche Diagnostics, Basel, Switzerland). RESULTS When using the certified reference values of SRM 972a as it is, discarding the cross-reactivity of each immunoassay, for ADVIA, the coefficient of determination (R(2)) as a score of regression analysis was 0.8995 and maximal difference between measured value and certified reference value was 3.6 ng/mL in level 3. The R(2) and maximal differences of ARCHITECT were 0.5377 and 6.9 ng/mL, respectively, in level 4. Those of COBAS were 0.3674 and 22.3 ng/mL, respectively, in level 4. When considering cross-reactivities of each immunoassays to various 25-(OH)D metabolites, the ADVIA had R(2) and maximal difference of 0.9254 and 3.3 ng/mL, respectively, in level 3. For ARCHITECT, the R(2) and maximal differences were 0.7602 and 5.1 ng/mL, respectively, in level 1. Those of COBAS were 0.9284 and 4.9 ng/mL, respectively, in level 1. CONCLUSIONS The cause of discrepancies between vitamin D immunoassays was mainly on the difference in cross-reactivities to various vitamin D metabolites. The discrepancies can be considerably decreased by considering cross-reactivities of each immunoassay.
Collapse
Affiliation(s)
- Jun Hyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jee-Hye Choi
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Oh Joo Kweon
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ae Ja Park
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| |
Collapse
|
|
41
|
Jiang YZ, Manduchi E, Stoeckert CJ, Davies PF. Arterial endothelial methylome: differential DNA methylation in athero-susceptible disturbed flow regions in vivo. BMC Genomics 2015; 16:506. [PMID: 26148682 PMCID: PMC4492093 DOI: 10.1186/s12864-015-1656-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 05/26/2015] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Atherosclerosis is a heterogeneously distributed disease of arteries in which the endothelium plays an important central role. Spatial transcriptome profiling of endothelium in pre-lesional arteries has demonstrated differential phenotypes primed for athero-susceptibility at hemodynamic sites associated with disturbed blood flow. DNA methylation is a powerful epigenetic regulator of endothelial transcription recently associated with flow characteristics. We investigated differential DNA methylation in flow region-specific aortic endothelial cells in vivo in adult domestic male and female swine. RESULTS Genome-wide DNA methylation was profiled in endothelial cells (EC) isolated from two robust locations of differing patho-susceptibility:--an athero-susceptible site located at the inner curvature of the aortic arch (AA) and an athero-protected region in the descending thoracic (DT) aorta. Complete methylated DNA immunoprecipitation sequencing (MeDIP-seq) identified over 5500 endothelial differentially methylated regions (DMRs). DMR density was significantly enriched in exons and 5'UTR sequences of annotated genes, 60 of which are linked to cardiovascular disease. The set of DMR-associated genes was enriched in transcriptional regulation, pattern specification HOX loci, oxidative stress and the ER stress adaptive pathway, all categories linked to athero-susceptible endothelium. Examination of the relationship between DMR and mRNA in HOXA genes demonstrated a significant inverse relationship between CpG island promoter methylation and gene expression. Methylation-specific PCR (MSP) confirmed differential CpG methylation of HOXA genes, the ER stress gene ATF4, inflammatory regulator microRNA-10a and ARHGAP25 that encodes a negative regulator of Rho GTPases involved in cytoskeleton remodeling. Gender-specific DMRs associated with ciliogenesis that may be linked to defects in cilia development were also identified in AA DMRs. CONCLUSIONS An endothelial methylome analysis identifies epigenetic DMR characteristics associated with transcriptional regulation in regions of atherosusceptibility in swine aorta in vivo. The data represent the first methylome blueprint for spatio-temporal analyses of lesion susceptibility predisposing to endothelial dysfunction in complex flow environments in vivo.
Collapse
Affiliation(s)
- Yi-Zhou Jiang
- Department of Pathology & Laboratory Medicine and Institute for Medicine & Engineering, Perelman School of Medicine, University of Pennsylvania, 1010 Vagelos Building, 3340 Smith Walk, Philadelphia, PA, 19104, USA.
| | - Elisabetta Manduchi
- Department of Genetics and Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Christian J Stoeckert
- Department of Genetics and Institute for Biomedical Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Peter F Davies
- Department of Pathology & Laboratory Medicine and Institute for Medicine & Engineering, Perelman School of Medicine, University of Pennsylvania, 1010 Vagelos Building, 3340 Smith Walk, Philadelphia, PA, 19104, USA.
| |
Collapse
|
|
42
|
Turetsky A, Goddeau RP, Henninger N. Low Serum Vitamin D Is Independently Associated with Larger Lesion Volumes after Ischemic Stroke. J Stroke Cerebrovasc Dis 2015; 24:1555-63. [PMID: 26009498 DOI: 10.1016/j.jstrokecerebrovasdis.2015.03.051] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 01/13/2015] [Accepted: 03/15/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite its high prevalence, known association with vascular disease and stroke incidence and fatality, little is known about the contribution of vitamin D status to a worse outcome after ischemic stroke. Therefore, we sought to assess whether low serum 25-hydroxyvitamin D (25[OH]D), a marker of vitamin D status, is predictive of the ischemic infarct volume and whether it relates to a worse outcome. METHODS We retrospectively analyzed prospective, consecutive acute ischemic stroke patients evaluated from January 2013 to January 2014 at a tertiary referral center. All patients (n = 96) had a magnetic resonance imaging-proven acute ischemic stroke. Multivariable linear and logistic regression analyses were used to test whether vitamin D represents an independent predictor of infarct volume and poor 90-day outcome (modified Rankin Scale score of >2). RESULTS In univariable analyses, lacunar infarct etiology, lower admission National Institutes of Health Stroke Scale, and higher serum 25(OH)D concentration were associated with smaller infarct volumes (P < .05). The association of 25(OH)D with ischemic infarct volume was independent of other known predictors of the infarct extent (P = .001). Multivariable analyses showed that the risk for a poor 90-day outcome doubled with each 10-ng/mL decrease in serum 25(OH)D. CONCLUSIONS Low serum 25(OH)D was independently associated with larger ischemic infarct volume, which may partially explain observed worse outcomes in ischemic stroke patients with poor vitamin D status. Although causality remains to be proven, our results provide the rationale to further explore vitamin D as a promising marker for cerebral ischemic vulnerability and to identify stroke patients at high risk for poor outcome.
Collapse
Affiliation(s)
- Anya Turetsky
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Richard P Goddeau
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Nils Henninger
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts; Department of Psychiatry, University of Massachusetts Medical School, Worcester, Massachusetts.
| |
Collapse
|
|
43
|
Mohamad N, Ismet RI, Rofiee M, Bannur Z, Hennessy T, Selvaraj M, Ahmad A, Nor F, Abdul Rahman T, Md Isa K, Ismail A, Teh LK, Salleh MZ. Metabolomics and partial least square discriminant analysis to predict history of myocardial infarction of self-claimed healthy subjects: validity and feasibility for clinical practice. J Clin Bioinforma 2015; 5:3. [PMID: 25806102 PMCID: PMC4371619 DOI: 10.1186/s13336-015-0018-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Accepted: 02/27/2015] [Indexed: 02/07/2023] Open
Abstract
Background The dynamics of metabolomics in establishing a prediction model using partial least square discriminant analysis have enabled better disease diagnosis; with emphasis on early detection of diseases. We attempted to translate the metabolomics model to predict the health status of the Orang Asli community whom we have little information. The metabolite expressions of the healthy vs. diseased patients (cardiovascular) were compared. A metabotype model was developed and validated using partial least square discriminant analysis (PLSDA). Cardiovascular risks of the Orang Asli were predicted and confirmed by biochemistry profiles conducted concurrently. Results Fourteen (14) metabolites were determined as potential biomarkers for cardiovascular risks with receiver operating characteristic of more than 0.7. They include 15S-HETE (AUC = 0.997) and phosphorylcholine (AUC = 0.995). Seven Orang Asli were clustered with the patients’ group and may have ongoing cardiovascular risks and problems. This is supported by biochemistry tests results that showed abnormalities in cholesterol, triglyceride, HDL and LDL levels. Conclusions The disease prediction model based on metabolites is a useful diagnostic alternative as compared to the current single biomarker assays. The former is believed to be more cost effective since a single sample run is able to provide a more comprehensive disease profile, whilst the latter require different types of sampling tubes and blood volumes. Electronic supplementary material The online version of this article (doi:10.1186/s13336-015-0018-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Nornazliya Mohamad
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - Rose Iszati Ismet
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - MohdSalleh Rofiee
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - Zakaria Bannur
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - Thomas Hennessy
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia ; Life Sciences & Diagnostics Group, Translational Research Institute, Brisbane, Australia
| | - Manikandan Selvaraj
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - Aminuddin Ahmad
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor Malaysia
| | - FadzilahMohd Nor
- Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor Malaysia
| | | | - Kamarudzaman Md Isa
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - AdzroolIdzwan Ismail
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia
| | - Lay Kek Teh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia ; Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Selangor 42300 Malaysia
| | - Mohd Zaki Salleh
- Integrative Pharmacogenomics Institute (iPROMISE), Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Puncak Alam Malaysia, Selangor 42300 Malaysia ; Faculty of Pharmacy, Universiti Teknologi MARA (UiTM), Bandar Puncak Alam, Selangor 42300 Malaysia
| |
Collapse
|
|
44
|
Sunbul M, Bozbay M, Mammadov C, Cincin A, Atas H, Ozsenel EB, Sari I, Basaran Y. Effect of vitamin D deficiency and supplementation on myocardial deformation parameters and epicardial fat thickness in patients free of cardiovascular risk. Int J Cardiovasc Imaging 2015; 31:765-72. [DOI: 10.1007/s10554-015-0622-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 02/16/2015] [Indexed: 01/02/2023]
|
|
45
|
Fanari Z, Hammami S, Hammami MB, Hammami S, Abdellatif A. Vitamin D deficiency plays an important role in cardiac disease and affects patient outcome: Still a myth or a fact that needs exploration? J Saudi Heart Assoc 2015; 27:264-71. [PMID: 26557744 PMCID: PMC4614899 DOI: 10.1016/j.jsha.2015.02.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 02/01/2015] [Accepted: 02/08/2015] [Indexed: 02/07/2023] Open
Abstract
There is increasing evidence that a low vitamin D status may be an important and hitherto neglected factor of cardiovascular disease. This review is an overview of the current body of literature, and presents evidence of the mechanisms through which vitamin D deficiency affects the cardiovascular system in general and the heart in particular. Available data indicate that the majority of congestive heart failure patients have 25-hydroxyvitamin D deficiency. Furthermore, the low serum 25-hydroxyvitamin D level has a higher impact on hypertension, coronary artery disease an on the occurrence of relevant cardiac events. A serum 25-hydroxyvitamin D level below 75 nmol/l (30 ng/l) is generally regarded as vitamin D insufficiency in both adults and children, while a level below 50 nmol/l (20 ng/l) is considered deficiency. Levels below 50 nmol/l (20 ng/l) are linked independently to cardiovascular morbidity and mortality.
Collapse
Affiliation(s)
- Zaher Fanari
- Section of Cardiology, Christiana Care Health System, Newark, DE, USA
| | - Sumaya Hammami
- Section of Cardiology, Christiana Care Health System, Newark, DE, USA
| | | | - Safa Hammami
- Section of Cardiology, Christiana Care Health System, Newark, DE, USA
| | - Abdul Abdellatif
- Department of Medicine, Division of Nephrology, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
|
46
|
Yang L, Wu L, Fan Y, Ma J. Associations among four polymorphisms (BsmI, FokI, TaqI and ApaI) of vitamin D receptor gene and end-stage renal disease: a meta-analysis. Arch Med Res 2014; 46:1-7. [PMID: 25434518 DOI: 10.1016/j.arcmed.2014.11.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 11/21/2014] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND AIMS To evaluate the association between vitamin D receptor (VDR) BsmI, FokI, TaqI and ApaI gene polymorphisms and the risk of end-stage renal disease (ESRD). METHODS All eligible studies were included in our meta-analysis of a search of the PubMed, Cochrane and China National Knowledge Infrastructure (CNKI) databases according to predefined criteria. The fixed-effects or random-effects models were used to calculate the pooled odds ratio (OR) and corresponding 95% confidence interval (CI). RESULTS Thirteen studies including 1510 patients and 1812 controls were recruited for the analysis of the association between the VDR BsmI, FokI, TaqI and ApaI gene polymorphisms and the risk of ESRD.VDR BsmI B allele, BB genotype and bb genotype, FokI F allele, FF genotype and ff genotype, TaqI T allele, TT genotype and tt genotype, ApaI A allele, AA genotype and aa genotype were not associated with ESRD susceptibility for overall populations, Asians and Caucasians. CONCLUSIONS Results from the current study suggest that VDR BsmI, FokI, TaqI and ApaI gene polymorphisms are not associated with the risk of ESRD in the overall populations, Asians and Caucasians. However, more studies should be performed in the future.
Collapse
Affiliation(s)
- Lina Yang
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Lan Wu
- Department of Geriatrics, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Yi Fan
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China
| | - Jianfei Ma
- Department of Nephrology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
| |
Collapse
|
|
47
|
Schneider ALC, Lutsey PL, Alonso A, Gottesman RF, Sharrett AR, Carson KA, Gross M, Post WS, Knopman DS, Mosley TH, Michos ED. Vitamin D and cognitive function and dementia risk in a biracial cohort: the ARIC Brain MRI Study. Eur J Neurol 2014; 21:1211-8, e69-70. [PMID: 24846449 PMCID: PMC4114998 DOI: 10.1111/ene.12460] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/07/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Some recent studies in older, largely white populations suggest that vitamin D, measured by 25-hydroxyvitamin D [25(OH)D], is important for cognition, but such results may be affected by reverse causation. Measuring 25(OH)D in late middle age before poor cognition affects behavior may provide clearer results. METHODS This was a prospective cohort analysis of 1652 participants (52% white, 48% black) in the Atherosclerosis Risk in Communities (ARIC) Brain MRI Study. 25(OH)D was measured from serum collected in 1993-1995. Cognition was measured by the delayed word recall test (DWRT), the digit symbol substitution test (DSST) and the word fluency test (WFT). Dementia hospitalization was defined by ICD-9 codes. Adjusted linear, logistic and Cox proportional hazards models were used. RESULTS Mean age of participants was 62 years and 60% were female. Mean 25(OH)D was higher in whites than blacks (25.5 vs. 17.3 ng/ml, P < 0.001). Lower 25(OH)D was not associated with lower baseline scores or with greater DWRT, DSST or WFT decline over a median of 3 or 10 years of follow-up (P > 0.05). Over a median of 16.6 years, there were 145 incident hospitalized dementia cases. Although not statistically significant, lower levels of 25(OH)D were suggestive of an association with increased dementia risk [hazard ratio for lowest versus highest race-specific tertile: whites 1.32 (95% confidence interval 0.69, 2.55); blacks 1.53 (95% confidence interval 0.84, 2.79)]. CONCLUSIONS In contrast to prior studies performed in older white populations, our study of late middle age white and black participants did not find significant associations between lower levels of 25(OH)D with lower cognitive test scores at baseline, change in scores over time or dementia risk.
Collapse
Affiliation(s)
- A L C Schneider
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
|
48
|
Michos ED, Carson KA, Schneider ALC, Lutsey PL, Xing L, Sharrett AR, Alonso A, Coker LH, Gross M, Post W, Mosley TH, Gottesman RF. Vitamin D and subclinical cerebrovascular disease: the Atherosclerosis Risk in Communities brain magnetic resonance imaging study. JAMA Neurol 2014; 71:863-71. [PMID: 24861877 PMCID: PMC4218739 DOI: 10.1001/jamaneurol.2014.755] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Vitamin D deficiency has been associated with hypertension, diabetes mellitus, and incident stroke. Little is known about the association between vitamin D and subclinical cerebrovascular disease. OBJECTIVE To examine the relationship of 25-hydroxyvitamin D (25[OH]D) levels with cerebrovascular abnormalities as assessed on brain magnetic resonance imaging (MRI) among participants of the Atherosclerosis Risk in Communities (ARIC) Brain MRI study. DESIGN, SETTING, AND PARTICIPANTS Participants were white and black adults aged 55 to 72 years with no history of clinical stroke who underwent a cerebral MRI at ARIC visit 3 (n = 1622) and a second cerebral MRI approximately 10 years later (n = 888). EXPOSURES The 25(OH)D level was measured by mass spectrometry at visit 3, with levels adjusted for calendar month and categorized using race-specific quartiles. MAIN OUTCOMES AND MEASURES The cross-sectional and prospective associations of 25(OH)D levels with white matter hyperintensities (WMHs) and MRI-defined infarcts were investigated using multivariable regression models. RESULTS The mean age of the participants was 62 years, 59.6% were women, and 48.6% were black. Lower 25(OH)D levels were not significantly associated with WMH score of severity, prevalent high-grade WMH score (≥3), or prevalent infarcts in cross-sectional, multivariable-adjusted models (all P > .05). Similarly, no significant prospective associations were found for lower 25(OH)D levels with change in WMH volume, incident high WMH score (≥3), or incident infarcts on the follow-up MRI, which occurred approximately 10 years later. CONCLUSIONS AND RELEVANCE A single measure of 25(OH)D was not cross-sectionally associated with WMH grade or prevalent subclinical infarcts and was not prospectively associated with WMH progression or subclinical brain infarcts seen on serial cerebral MRIs obtained approximately 10 years apart. These findings do not support optimizing vitamin D levels for brain health.
Collapse
Affiliation(s)
- Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland2Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Kathryn A Carson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland3Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrea L C Schneider
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Li Xing
- Department of Statistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis
| | - Laura H Coker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Myron Gross
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis7Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis
| | - Wendy Post
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland2Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Rebecca F Gottesman
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland9Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
|
49
|
Krause R. Vitamin D and UV exposure in chronic kidney disease. DERMATO-ENDOCRINOLOGY 2014; 5:109-16. [PMID: 24494043 PMCID: PMC3897578 DOI: 10.4161/derm.24539] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 03/27/2013] [Accepted: 04/03/2013] [Indexed: 12/14/2022]
Abstract
With loss of renal function and decreasing glomerula filtration rate the serum levels of 25-hydroxyvitamin D [25(OH)D] as well as 1,25-dihydroxyvitamin D [1,25 (OH)2 D] often decrease simultaneously. In representative groups of German patients on renal replacement therapy (hemodialysis, peritoneal dialysis, kidney transplantation) our group retrospectively analyzed the vitamin D status over a period of 12 y (1995‒2006). Only 11% of patients had a serum level of 25(OH)D that was > 30 ng/ml, more than 70% had a level of 25(OH)D < 20 ng/ml. In clinical trials we used sun-simulating artificial lamps to produce vitamin D3 in the skin. Partial-body irradiation (15% of body surface) was used during the routine hemodialysis treatment. Whole-body UV exposure was done in a standing position three times a week before the hemodialysis treatment. With both procedures we observed an increase of the serum level of 25(OH)2D3 by approx. 35–50% over a period of 2‒3 mo, maintenance of trabecular bone mineral density and a normalization of systolic and diastolic blood pressure. Heart rate variability improved during the whole-body radiation intervention period by 20‒25%. Patients who continued the whole-body irradiation regularly two or three times before starting the routine hemodialysis session had maintained normal levels of circulating 25(OH)D3 and of 1,25(OH)2D3. Therefore, from our data it can be recommended that intermittent suberythemal UVB exposure with a sun-simulation spectrum is effective to treat and/or protect against vitamin D deficiency in chronic and end-stage kidney disease patients.
Collapse
Affiliation(s)
- Rolfdieter Krause
- Nephrological Center Berlin-Moabit; KfH Kuratorium for Dialysis and Kidney Transplantation; Research Group Medical Heliotherapy at the Department of Clinical Natural Medicine; Charité University Medical Center; Berlin, Germany
| |
Collapse
|
|
50
|
Bjelakovic G, Gluud LL, Nikolova D, Whitfield K, Krstic G, Wetterslev J, Gluud C. Vitamin D supplementation for prevention of cancer in adults. Cochrane Database Syst Rev 2014; 2014:CD007469. [PMID: 24953955 PMCID: PMC11285304 DOI: 10.1002/14651858.cd007469.pub2] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The evidence on whether vitamin D supplementation is effective in decreasing cancers is contradictory. OBJECTIVES To assess the beneficial and harmful effects of vitamin D supplementation for prevention of cancer in adults. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded, and the Conference Proceedings Citation Index-Science to February 2014. We scanned bibliographies of relevant publications and asked experts and pharmaceutical companies for additional trials. SELECTION CRITERIA We included randomised trials that compared vitamin D at any dose, duration, and route of administration versus placebo or no intervention in adults who were healthy or were recruited among the general population, or diagnosed with a specific disease. Vitamin D could have been administered as supplemental vitamin D (vitamin D₃ (cholecalciferol) or vitamin D₂ (ergocalciferol)), or an active form of vitamin D (1α-hydroxyvitamin D (alfacalcidol), or 1,25-dihydroxyvitamin D (calcitriol)). DATA COLLECTION AND ANALYSIS Two review authors extracted data independently. We conducted random-effects and fixed-effect model meta-analyses. For dichotomous outcomes, we calculated the risk ratios (RRs). We considered risk of bias in order to assess the risk of systematic errors. We conducted trial sequential analyses to assess the risk of random errors. MAIN RESULTS Eighteen randomised trials with 50,623 participants provided data for the analyses. All trials came from high-income countries. Most of the trials had a high risk of bias, mainly for-profit bias. Most trials included elderly community-dwelling women (aged 47 to 97 years). Vitamin D was administered for a weighted mean of six years. Fourteen trials tested vitamin D₃, one trial tested vitamin D₂, and three trials tested calcitriol supplementation. Cancer occurrence was observed in 1927/25,275 (7.6%) recipients of vitamin D versus 1943/25,348 (7.7%) recipients of control interventions (RR 1.00 (95% confidence interval (CI) 0.94 to 1.06); P = 0.88; I² = 0%; 18 trials; 50,623 participants; moderate quality evidence according to the GRADE instrument). Trial sequential analysis (TSA) of the 18 vitamin D trials shows that the futility area is reached after the 10th trial, allowing us to conclude that a possible intervention effect, if any, is lower than a 5% relative risk reduction. We did not observe substantial differences in the effect of vitamin D on cancer in subgroup analyses of trials at low risk of bias compared to trials at high risk of bias; of trials with no risk of for-profit bias compared to trials with risk of for-profit bias; of trials assessing primary prevention compared to trials assessing secondary prevention; of trials including participants with vitamin D levels below 20 ng/mL at entry compared to trials including participants with vitamin D levels of 20 ng/mL or more at entry; or of trials using concomitant calcium supplementation compared to trials without calcium. Vitamin D decreased all-cause mortality (1854/24,846 (7.5%) versus 2007/25,020 (8.0%); RR 0.93 (95% CI 0.88 to 0.98); P = 0.009; I² = 0%; 15 trials; 49,866 participants; moderate quality evidence), but TSA indicates that this finding could be due to random errors. Cancer occurrence was observed in 1918/24,908 (7.7%) recipients of vitamin D₃ versus 1933/24,983 (7.7%) in recipients of control interventions (RR 1.00 (95% CI 0.94 to 1.06); P = 0.88; I² = 0%; 14 trials; 49,891 participants; moderate quality evidence). TSA of the vitamin D₃ trials shows that the futility area is reached after the 10th trial, allowing us to conclude that a possible intervention effect, if any, is lower than a 5% relative risk reduction. Vitamin D₃ decreased cancer mortality (558/22,286 (2.5%) versus 634/22,206 (2.8%); RR 0.88 (95% CI 0.78 to 0.98); P = 0.02; I² = 0%; 4 trials; 44,492 participants; low quality evidence), but TSA indicates that this finding could be due to random errors. Vitamin D₃ combined with calcium increased nephrolithiasis (RR 1.17 (95% CI 1.03 to 1.34); P = 0.02; I² = 0%; 3 trials; 42,753 participants; moderate quality evidence). TSA, however, indicates that this finding could be due to random errors. We did not find any data on health-related quality of life or health economics in the randomised trials included in this review. AUTHORS' CONCLUSIONS There is currently no firm evidence that vitamin D supplementation decreases or increases cancer occurrence in predominantly elderly community-dwelling women. Vitamin D₃ supplementation decreased cancer mortality and vitamin D supplementation decreased all-cause mortality, but these estimates are at risk of type I errors due to the fact that too few participants were examined, and to risks of attrition bias originating from substantial dropout of participants. Combined vitamin D₃ and calcium supplements increased nephrolithiasis, whereas it remains unclear from the included trials whether vitamin D₃, calcium, or both were responsible for this effect. We need more trials on vitamin D supplementation, assessing the benefits and harms among younger participants, men, and people with low vitamin D status, and assessing longer duration of treatments as well as higher dosages of vitamin D. Follow-up of all participants is necessary to reduce attrition bias.
Collapse
Affiliation(s)
- Goran Bjelakovic
- Medical Faculty, University of NisDepartment of Internal MedicineZorana Djindjica 81NisSerbia18000
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
| | - Lise Lotte Gluud
- Copenhagen University Hospital HvidovreGastrounit, Medical DivisionKettegaards AlleHvidovreDenmark2650
| | - Dimitrinka Nikolova
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
| | - Kate Whitfield
- Rigshospitalet, Copenhagen University HospitalCopenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812CopenhagenDenmark
| | - Goran Krstic
- Environmental Health ServicesFraser Health Authority#218 ‐ 610 Sixth StreetNew WestminsterBCCanadaV3L 3C2
| | - Jørn Wetterslev
- Rigshospitalet, Copenhagen University HospitalCopenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812CopenhagenDenmark
| | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812, Rigshospitalet, Copenhagen University HospitalThe Cochrane Hepato‐Biliary GroupBlegdamsvej 9CopenhagenDenmarkDK‐2100
| | | |
Collapse
|