Research

14 pages, 2027 KiB

Open AccessArticle

The Relationship between Bone Health Parameters, Vitamin D and Iron Status, and Dietary Calcium Intake in Young Males

by Jadwiga Malczewska-Lenczowska, Olga Surała, Dominika Granda, Beata Szczepańska, Adam Czaplicki and Rafał Kubacki

Nutrients 2024, 16(2), 215; https://doi.org/10.3390/nu16020215 - 09 Jan 2024

Cited by 1 | Viewed by 1146

Abstract

Vitamin D, calcium, and iron are micronutrients crucial for bone health. However, their effect has been studied primarily in the cortical bone, with vitamin D status being assessed mainly from the total 25(OH)D serum fraction. The study aimed to investigate the impact of [...] Read more.

Vitamin D, calcium, and iron are micronutrients crucial for bone health. However, their effect has been studied primarily in the cortical bone, with vitamin D status being assessed mainly from the total 25(OH)D serum fraction. The study aimed to investigate the impact of vitamin D (total and free fraction) and iron status (i.e., serum ferritin or soluble transferrin receptor) and calcium intake (ADOS-Ca questionnaire) on lumbar cortical and trabecular bone. In a cohort of 113 male subjects (76 athletes, 37 non-athletes) aged 15–19, the lumbar spine status (Z-score, bone mineral apparent density (BMAD), and trabecular bone score (TBS)) was determined using dual-energy X-ray absorptiometry (DXA). Relationships between the examined micronutrients and bone health parameters were observed only in athletes. Free 25(OH)D was significantly (p < 0.001) correlated with Z-score and BMAD, while total 25(OH)D (p < 0.001) and iron status (ferritin, Fe stores; p < 0.01) correlated solely with BMAD. Free 25(OH)D and ferritin concentrations were the best determinants of bone status (R² = 0.330; p < 0.001) and explained 25% and 7% of the BMAD variance, respectively. No relationships were found between the micronutrients and TBS. The results confirmed the positive influence of vitamin D and iron on cortical, but not trabecular, bone status solely in physically active subjects. In athletes, free 25(OH)D seems to be a superior indicator of bone health to a total 25(OH)D fraction. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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17 pages, 4819 KiB

Open AccessArticle

Compromised NHE8 Expression Is Responsible for Vitamin D-Deficiency Induced Intestinal Barrier Dysfunction

by Yaoyu Guo, Yanni Li, Zeya Tang, Chong Geng, Xiaoxi Xie, Shuailing Song, Chunhui Wang and Xiao Li

Nutrients 2023, 15(22), 4834; https://doi.org/10.3390/nu15224834 - 19 Nov 2023

Viewed by 969

Abstract

Objectives: Vitamin D (VitD) and Vitamin D receptor (VDR) are suggested to play protective roles in the intestinal barrier in ulcerative colitis (UC). However, the underlying mechanisms remain elusive. Evidence demonstrates that Na⁺/H⁺ exchanger isoform 8 (NHE8, SLC9A8) [...] Read more.

Objectives: Vitamin D (VitD) and Vitamin D receptor (VDR) are suggested to play protective roles in the intestinal barrier in ulcerative colitis (UC). However, the underlying mechanisms remain elusive. Evidence demonstrates that Na⁺/H⁺ exchanger isoform 8 (NHE8, SLC9A8) is essential in maintaining intestinal homeostasis, regarded as a promising target for UC therapy. Thus, this study aims to investigate the effects of VitD/VDR on NHE8 in intestinal protection. Methods: VitD-deficient mice, VDR^−/− mice and NHE8^−/− mice were employed in this study. Colitis mice were established by supplementing DSS-containing water. Caco-2 cells and 3D-enteroids were used for in vitro studies. VDR siRNA (siVDR), VDR over-expression plasmid (pVDR), TNF-α and NF-κb p65 inhibitor QNZ were used for mechanical studies. The expression of interested proteins was detected by multiple techniques. Results: In colitis mice, paricalcitol upregulated NHE8 expression was accompanied by restoring colonic mucosal injury. In VitD-deficient and VDR^−/− colitis mice, NHE8 expression was compromised with more serious mucosal damage. Noteworthily, paricalcitol could not prevent intestinal barrier dysfunction and histological destruction in NHE8^−/− mice. In Caco-2 cells and enteroids, siVDR downregulated NHE8 expression, further promoted TNF-α-induced NHE8 downregulation and stimulated TNF-α-induced NF-κb p65 phosphorylation. Conversely, QNZ blocked TNF-α-induced NHE8 downregulation in the absence or presence of siVDR. Conclusions: Our study indicates depressed NHE8 expression is responsible for VitD-deficient-induced colitis aggravation. These findings provide novel insights into the molecular mechanisms of VitD/VDR in intestine protection in UC. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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10 pages, 657 KiB

Open AccessArticle

Vitamin D Status in Bipolar Disorder

by Zita Späth, Adelina Tmava-Berisha, Frederike T. Fellendorf, Tatjana Stross, Alexander Maget, Martina Platzer, Susanne A. Bengesser, Alfred Häussl, Ina Zwigl, Armin Birner, Robert Queissner, Katharina Stix, Linda Wels, Melanie Lenger, Nina Dalkner, Sieglinde Zelzer, Markus Herrmann and Eva Z. Reininghaus

Nutrients 2023, 15(22), 4752; https://doi.org/10.3390/nu15224752 - 11 Nov 2023

Viewed by 1221

Abstract

Vitamin D status may impact acute affective symptomatology and the severity of symptoms in patients with bipolar disorder (BD). Therefore, this cross-sectional study analyzed 25(OH)D, 24,25(OH)₂D, and the vitamin D metabolite ratio (VMR) in BD and correlated the results with clinical [...] Read more.

Vitamin D status may impact acute affective symptomatology and the severity of symptoms in patients with bipolar disorder (BD). Therefore, this cross-sectional study analyzed 25(OH)D, 24,25(OH)₂D, and the vitamin D metabolite ratio (VMR) in BD and correlated the results with clinical affective symptomatology and functionality. The inactive precursor 25(OH)D, and its principal catabolite 24,25(OH)₂D, were measured simultaneously with a validated liquid chromatography–tandem mass spectrometry method in 170 BD outpatients and 138 healthy controls. VMR was calculated as follows: VMR = 100×(24,25(OH)₂D/25(OH)D). The psychometric assessment comprised: Beck Depression Inventory-II, Hamilton Depression Rating Scale, Young Mania Rating Scale, Global Assessment of Functioning, and number of suicide attempts. We did not find a significant difference between patients and controls in the concentrations of 25(OH)D and 24,25(OH)₂D. Additionally, the VMR was comparable in both groups. The calculations for the clinical parameters showed a negative correlation between the Young Mania Rating Scale and 24,25(OH)₂D (r = −0.154, p = 0.040), as well as the Young Mania Rating Scale and the VMR (r = −0.238, p = 0.015). Based on the small effect size and the predominantly euthymic sample, further exploration in individuals with manic symptoms would be needed to confirm this association. In addition, long-term clinical markers and an assessment in different phases of the disease may provide additional insights. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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28 pages, 1843 KiB

Open AccessArticle

Relevance of Serum Levels and Functional Genetic Variants in Vitamin D Receptor Gene among Saudi Women with Gestational Diabetes Mellitus

by Imran Ali Khan, Maysoon Abdulhadi Alhaizan, Salwa Mohamed Neyazi, Malak Mohammed Al-Hakeem and Amal F. Alshammary

Nutrients 2023, 15(19), 4288; https://doi.org/10.3390/nu15194288 - 08 Oct 2023

Cited by 3 | Viewed by 1511

Abstract

Background: This study explored the association between ApaI–TaqI Single Nucleotide Polymorphisms (SNPs) in a Vitamin D receptor (VDR) and the risk of Gestational Diabetes Mellitus (GDM) in Saudi women, along with the serum levels of vitamin D. Methods: Ninety women with [...] Read more.

Background: This study explored the association between ApaI–TaqI Single Nucleotide Polymorphisms (SNPs) in a Vitamin D receptor (VDR) and the risk of Gestational Diabetes Mellitus (GDM) in Saudi women, along with the serum levels of vitamin D. Methods: Ninety women with GDM and 90 non-GDM women were enrolled, based on the inclusion and exclusion criteria for pregnant women enrolled in a single-center study. Blood samples were retrieved from 180 pregnant women using ethylenediaminetetraacetic acid (EDTA) tubes. Serum samples were used to measure the vitamin D, 25-hydroxyvitamin D (25(OH)D or calcidiol), and lipid profiles. Blood was used to measure the hemoglobin A1c levels and to isolate the DNA. The polymerase chain reaction (PCR) was performed for the ApaI (rs79785232), BsmI (rs1544410), FokI (rs2228570), and TaqI (rs731236) SNPs in the VDR gene using restriction fragment length polymorphism analysis. Validation was performed using Sanger sequencing. Statistical analyses were performed between the patients with and without GDM using various statistical software packages. Results: The Hardy–Weinberg equilibrium analysis was statistically significant (p > 0.05). The ApaI, BsmI, and TaqI SNPs were associated with alleles, genotypes, and different genetic models (p < 0.05). Vitamin D levels were associated with deficient levels (p = 0.0002), as well as with a normal and overweight body mass index (p = 0.0004). When vitamin D levels were measured with GDM covariates, the fasting plasma glucose (FPG) (p = 0.0001), postprandial blood glucose (PPBG) (p < 0.0001), oral glucose tolerance test (OGTT)-1 h (p = 0.005), high-density lipoprotein (p = 0.022), and low-density lipoprotein cholesterol (LDLc) (p = 0.001) levels were significantly different. When similar vitamin D levels were measured for each genotype, we confirmed that the ApaI SNP was associated with sufficient levels (p < 0.0001), whereas the BsmI, FokI, and TaqI (p < 0.05) were associated with insufficient levels. The logistic regression model confirmed that the first hour of the OGTT (p = 0.005) was strongly associated with GDM, whereas the analysis of variance confirmed that FPG and PPBG (p < 0.05) were strongly associated with all the SNPs evaluated in the VDR gene. Additionally, the second hour of the OGTT (p = 0.048) and LDLc (p = 0.049) were associated with the ApaI and FokI SNP. Moreover, the first hour OGTT (p = 0.045) and lipid profile parameters (p < 0.05) were associated. Haplotype analysis revealed positive associations among the examined SNPs, which seemed compatible with the hypothesis that variants and combinations of multiple SNP genotypes enhance the risk of GDM in women. Haplotype analysis revealed that different combinations of alleles, such as AGCC, CATT, CGTC, AGTC, and CATT (p < 0.05), were strongly associated. The linkage disequilibrium (LD) analysis showed a strong association with all combinations (p < 0.05). Among the gene–gene interactions, all possible combinations showed a positive association (p < 0.05). Conclusions: Low vitamin D levels were observed in women with GDM. The ApaI, BsmI, and TaqI SNPs were associated with genotype and allele frequencies (p < 0.05). Vitamin D and the SNPs in the VDR gene were associated, according to the ANOVA, logistic regression, haplotype analysis, LD analysis, and the generalized multifactor dimensionality reduction model (p < 0.05). Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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21 pages, 5521 KiB

Open AccessArticle

Disruption of Vitamin D Signaling Impairs Adaptation of Cerebrocortical Microcirculation to Carotid Artery Occlusion in Hyperandrogenic Female Mice

by Dorina Nagy, László Hricisák, Guillaume Peter Walford, Ágnes Lékai, Gábor Karácsony, Szabolcs Várbíró, Zoltán Ungvári, Zoltán Benyó and Éva Pál

Nutrients 2023, 15(18), 3869; https://doi.org/10.3390/nu15183869 - 05 Sep 2023

Cited by 1 | Viewed by 1331

Abstract

Vitamin D deficiency contributes to the pathogenesis of age-related cerebrovascular diseases, including ischemic stroke. Sex hormonal status may also influence the prevalence of these disorders, indicated by a heightened vulnerability among postmenopausal and hyperandrogenic women. To investigate the potential interaction between sex steroids [...] Read more.

Vitamin D deficiency contributes to the pathogenesis of age-related cerebrovascular diseases, including ischemic stroke. Sex hormonal status may also influence the prevalence of these disorders, indicated by a heightened vulnerability among postmenopausal and hyperandrogenic women. To investigate the potential interaction between sex steroids and disrupted vitamin D signaling in the cerebral microcirculation, we examined the cerebrovascular adaptation to unilateral carotid artery occlusion (CAO) in intact, ovariectomized, and hyperandrogenic female mice with normal or functionally inactive vitamin D receptor (VDR). We also analyzed the morphology of leptomeningeal anastomoses, which play a significant role in the compensation. Ablation of VDR by itself did not impact the cerebrocortical adaptation to CAO despite the reduced number of pial collaterals. While ovariectomy did not undermine compensatory mechanisms following CAO, androgen excess combined with VDR inactivity resulted in prolonged hypoperfusion in the cerebral cortex ipsilateral to the occlusion. These findings suggest that the cerebrovascular consequences of disrupted VDR signaling are less pronounced in females, providing a level of protection even after ovariectomy. Conversely, even short-term androgen excess with lacking VDR signaling may lead to unfavorable outcomes of ischemic stroke, highlighting the complex interplay between sex steroids and vitamin D in terms of cerebrovascular diseases. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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10 pages, 856 KiB

Open AccessArticle

VDR, SOD-2, and CYP24A1 Gene Expression in Different Genotypes of BsmI SNP of the Vitamin D Receptor Gene in Individuals with Hypovitaminosis

by Vanessa Rosa Retamoso, Fernanda Barbisan, Graziele Meira Moro, Patricia Maurer, Débora Vasquez Rubio, Lauren Flores Viera dos Santos, Lyana Berro Feijóo, Matias Nunes Frizzo, Ivana Beatrice Mânica da Cruz, Vanusa Manfredini, Ana Letícia Vargas Barcelos and Jacqueline da Costa Escobar Piccoli

Nutrients 2023, 15(16), 3565; https://doi.org/10.3390/nu15163565 - 13 Aug 2023

Cited by 1 | Viewed by 1137

Abstract

Background: Hypovitaminosis D is a public health problem due to its implications for various diseases. Vitamin D has numerous functions, such as modulating the metabolism of cellular tissues, and it is expressed through the vitamin D receptor (VDR) gene that may influence gene [...] Read more.

Background: Hypovitaminosis D is a public health problem due to its implications for various diseases. Vitamin D has numerous functions, such as modulating the metabolism of cellular tissues, and it is expressed through the vitamin D receptor (VDR) gene that may influence gene expression modulation, which plays an important role in vitamin D metabolism. Objective: To evaluate the effect of the genotypes of BsmI single nucleotide polymorphism (SNP) of the VDR gene on VDR, SOD2, and CYP24A1 gene expression in individuals with low serum vitamin D levels. Methods: This was a cross-sectional analytical study. After signing the informed consent form, individuals were invited to participate and answered a structured questionnaire with identification data. Blood was collected for biochemical analysis, and vitamin D was measured by chemiluminescence; BsmI polymorphism was determined using real-time polymerase chain reaction (PCR) assays with TaqMan allelic discrimination, and gene expression was conducted by qRT-PCR using QuantiFast SYBR^® Green PCR Master Mix. Data were analyzed using the SPSS 20.0 software, and differences were considered significant at p < 0.05. Results: 98 individuals with vitamin D ≤ 20 ng/dL were evaluated, and the BsmI SNP of the VDR gene showed CYP24A1 overexpression and low SOD2 expression. Conclusion: BsmI SNP of the VDR gene can modulate the expression of the genes evaluated without interfering with serum levels. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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12 pages, 612 KiB

Open AccessArticle

The Role of Vitamin D in Cardiovascular Diseases

by Man Hung, Wendy C. Birmingham, Monica Ocampo and Amir Mohajeri

Nutrients 2023, 15(16), 3547; https://doi.org/10.3390/nu15163547 - 11 Aug 2023

Cited by 2 | Viewed by 1924

Abstract

Cardiovascular diseases (CVD) are the leading cause of death in the United States. The previous literature demonstrates the importance of vitamin D for overall health, and a significant body of literature has examined the benefits of optimal serum 25-hydroxyvitamin D [25(OH)D] on cardiovascular [...] Read more.

Cardiovascular diseases (CVD) are the leading cause of death in the United States. The previous literature demonstrates the importance of vitamin D for overall health, and a significant body of literature has examined the benefits of optimal serum 25-hydroxyvitamin D [25(OH)D] on cardiovascular health, but the results remain inconclusive. The objective of this study was to determine the association between reported CVD and [25(OH)D]. We utilized the 2015–2018 National Health and Nutrition Examination Survey and included adults aged 20 years and older (n = 9825). CVD was defined as having a stroke, heart attack, heart failure, or coronary heart disease. Vitamin D status was categorized as a serum 25(OH)D deficiency at <30 nmol/L; insufficiency at 30 to 49.9 nmol/L; normal/optimal at 50 to 125 nmol/L; and adequacy at >125 nmol/L. Statistical analysis was performed using Chi-square tests, t-tests were conducted to investigate the differences in participant characteristics among those with CVD and without CVD, and regression models were used to explore the association between vitamin D levels and CVD status. We found 25(OH)D deficiency associated with CVD (Adjusted Odds Ratio (AOR) = 1.48; 95% CI = 1.11–1.98; p < 0.05). [25(OH)D] insufficiency was also associated with CVD (AOR = 1.28; 95% CI = 1.06–1.54; p < 0.05). The 25(OH)D adequacy was not associated with reported CVD. For the prevention of CVD, healthcare professionals may recommend the use of vitamin D supplementation to improve cardiovascular health in adults while considering individual needs. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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19 pages, 1610 KiB

Open AccessFeature PaperArticle

Optimal Serum 25(OH)D Levels and Vitamin D Intake in Korean Postmenopausal Women

by Hye Ran Shin, Ye Jin Lee and Sun Yung Ly

Nutrients 2023, 15(8), 1856; https://doi.org/10.3390/nu15081856 - 12 Apr 2023

Cited by 1 | Viewed by 1380

Abstract

Vitamin D plays a crucial role in regulating the growth and maintenance of the musculoskeletal system. Postmenopausal women are vulnerable to bone fractures because of the decrease in bone mineral density (BMD). Therefore, this study aimed to identify the determinants that influence BMD [...] Read more.

Vitamin D plays a crucial role in regulating the growth and maintenance of the musculoskeletal system. Postmenopausal women are vulnerable to bone fractures because of the decrease in bone mineral density (BMD). Therefore, this study aimed to identify the determinants that influence BMD and the 25(OH)D levels in Korean postmenopausal women. This study collected general and dietary intake information, measured biochemical indices, and conducted BMD tests in 96 postmenopausal women residing in a metropolitan area in Korea. This study analyzed factors that influenced serum 25-hydroxyvitamin D (25(OH)D) and BMD, as well as the correlation between the intact parathyroid hormone (iPTH) and serum 25(OH)D levels. The serum 25(OH)D levels increased by 0.226 ng/mL in the summertime, 0.314 ng/mL in the wintertime, and 0.370 ng/mL on annual average when vitamin D intake rose by 1 µg/1000 kcal. When the serum 25(OH)D levels were ≥18.9 ng/mL, the iPTH levels did not rapidly increase. To maintain the serum 25(OH)D levels at ≥18.9 ng/mL, a daily vitamin D intake of ≥13.21 µg was required. Consequently, consuming vitamin D-fortified foods or vitamin D supplements is necessary to improve both bone health and vitamin D nutritional status. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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10 pages, 267 KiB

Open AccessArticle

Prevalence and Risk Factors for Vitamin D Deficiency in Children and Adolescents in the Kingdom of Bahrain

by Buthaina Yusuf Al-Ajlan, Afnan Freije, Sabika Allehdan and Simone Perna

Nutrients 2023, 15(3), 494; https://doi.org/10.3390/nu15030494 - 18 Jan 2023

Cited by 1 | Viewed by 1948

Abstract

Background: Vitamin D deficiency has reached pandemic levels in the Middle East and North Africa (MENA) region, even though sunshine is abundant all year round for the cutaneous synthesis of vitamin D through the skin. This study aimed to determine the prevalence of [...] Read more.

Background: Vitamin D deficiency has reached pandemic levels in the Middle East and North Africa (MENA) region, even though sunshine is abundant all year round for the cutaneous synthesis of vitamin D through the skin. This study aimed to determine the prevalence of vitamin D deficiency and risk factors associated with serum 25-hydroxy vitamin D (25(OH)D) in children and adolescents aged from 10 to 19 years, as well as the possible associations of vitamin D with calcium, magnesium and phosphate levels. Methods: A multi-center, cross-sectional study was conducted between May and August 2019 at the Ministry of Health in the Kingdom of Bahrain. A total of 383 boys and girls were selected from five health centers from five different regions in the Kingdom of Bahrain. Information about sex, age, education level, weight, height, degree of sunlight exposure, and physical activity levels was recorded. A blood sample was taken from each participant to test serum levels of 25(OH)D, calcium, magnesium and phosphate. Results: The results revealed that 92.1% of the participants were deficient in vitamin D. A significantly higher percentage of boys (96.2%) were vitamin D deficient (<20 ng/mL) than girls (88.3%) (p value = 0.004). Vitamin D deficiency were more prevalent among overweight (96.8%) and obese (96.2%) participants than normal body weight and wasted participants (p value < 0.001). Being male, overweight, or obese was significantly positively associated with a risk of vitamin D deficiency. Vitamin D deficiency was significantly associated with low serum levels of magnesium. No significant associations were detected between vitamin D deficiency and calcium and phosphate serum levels. However, vitamin D deficiency was significantly associated with low serum level of magnesium (p value = 0.017). Conclusions: Our study revealed that vitamin D deficiency was more prevalent among overweight and obese adolescents and mostly boys rather than girls. Magnesium and phosphate were lower in adolescents and children with lower serum 25(OH)D, showing a clear association between these biomarkers and the 25(OH)D. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

Review

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14 pages, 1069 KiB

Open AccessReview

The Associations of Vitamin D with Ovarian Reserve Markers and Depression: A Narrative Literature Review

by Gyun-Ho Jeon

Nutrients 2024, 16(1), 96; https://doi.org/10.3390/nu16010096 - 27 Dec 2023

Viewed by 1157

Abstract

Since the identification of vitamin D receptors in both the female reproductive tract and the central nervous system, further data have shown that vitamin D is involved in the processes of reproductive and mental health. This paper reviews current research on the associations [...] Read more.

Since the identification of vitamin D receptors in both the female reproductive tract and the central nervous system, further data have shown that vitamin D is involved in the processes of reproductive and mental health. This paper reviews current research on the associations of vitamin D with ovarian reserve markers and depression and discusses the potential role of vitamin D in their relationships. There have been numerous studies reporting that vitamin D was significantly related to ovarian reserve markers and depression in basic or clinical research, but some observational and interventional clinical studies have shown inconsistent results. Nevertheless, recent meta-analyses of interventional studies have provided promising results showing that vitamin D supplementation significantly improves ovarian reserve metrics, especially in a subgroup of women with normal or diminished ovarian reserve, and decreases depressive symptoms and risk. The demonstration of an association of vitamin D with both ovarian reserve and depression could suggest that vitamin D may be another important key in explaining female reproductive depression. Larger-scale studies in standardized settings will be needed in order to gain further insight into the role of vitamin D in female reproduction and depression. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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21 pages, 5069 KiB

Open AccessReview

Controlling Chronic Diseases and Acute Infections with Vitamin D Sufficiency

by Sunil J. Wimalawansa

Nutrients 2023, 15(16), 3623; https://doi.org/10.3390/nu15163623 - 18 Aug 2023

Cited by 1 | Viewed by 4109

Abstract

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects [...] Read more.

Apart from developmental disabilities, the prevalence of chronic diseases increases with age especially in those with co-morbidities: vitamin D deficiency plays a major role in it. Whether vitamin D deficiency initiates and/or aggravates chronic diseases or vice versa is unclear. It adversely affects all body systems but can be eliminated using proper doses of vitamin D supplementation and/or safe daily sun exposure. Maintaining the population serum 25(OH)D concentration above 40 ng/mL (i.e., sufficiency) ensures a sound immune system, minimizing symptomatic diseases and reducing infections and the prevalence of chronic diseases. This is the most cost-effective way to keep a population healthy and reduce healthcare costs. Vitamin D facilitates physiological functions, overcoming pathologies such as chronic inflammation and oxidative stress and maintaining broader immune functions. These are vital to overcoming chronic diseases and infections. Therefore, in addition to following essential public health and nutritional guidance, maintaining vitamin D sufficiency should be an integral part of better health, preventing acute and chronic diseases and minimize their complications. Those with severe vitamin D deficiency have the highest burdens of co-morbidities and are more vulnerable to developing complications and untimely deaths. Vitamin D adequacy improves innate and adaptive immune systems. It controls excessive inflammation and oxidative stress, generates antimicrobial peptides, and neutralizes antibodies via immune cells. Consequently, vitamin D sufficiency reduces infections and associated complications and deaths. Maintaining vitamin D sufficiency reduces chronic disease burden, illnesses, hospitalizations, and all-cause mortality. Vulnerable communities, such as ethnic minorities living in temperate countries, older people, those with co-morbidities, routine night workers, and institutionalized persons, have the highest prevalence of vitamin D deficiency—they would significantly benefit from vitamin D and targeted micronutrient supplementation. At least now, health departments, authorities, and health insurance companies should start assessing, prioritizing, and encouraging this economical, non-prescription, safe micronutrient to prevent and treat acute and chronic diseases. This approach will significantly reduce morbidity, mortality, and healthcare costs and ensure healthy aging. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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17 pages, 1740 KiB

Open AccessReview

Vitamin D Deficiency in Chronic Childhood Disorders: Importance of Screening and Prevention

by Madhura Joshi and Suma Uday

Nutrients 2023, 15(12), 2805; https://doi.org/10.3390/nu15122805 - 19 Jun 2023

Cited by 2 | Viewed by 2246

Abstract

Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can result in rickets in children and osteomalacia in children and adults. Recent studies have demonstrated the [...] Read more.

Vitamin D plays a vital role in regulating calcium and phosphate metabolism and maintaining bone health. A state of prolonged or profound vitamin D deficiency (VDD) can result in rickets in children and osteomalacia in children and adults. Recent studies have demonstrated the pleiotropic action of vitamin D and identified its effects on multiple biological processes in addition to bone health. VDD is more prevalent in chronic childhood conditions such as long-standing systemic illnesses affecting the renal, liver, gastrointestinal, skin, neurologic and musculoskeletal systems. VDD superimposed on the underlying disease process and treatments that can adversely affect bone turnover can all add to the disease burden in these groups of children. The current review outlines the causes and mechanisms underlying poor bone health in certain groups of children and young people with chronic diseases with an emphasis on the proactive screening and treatment of VDD. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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16 pages, 1091 KiB

Open AccessReview

The Possible Influence of Vitamin D Levels on the Development of Atrial Fibrillation—An Update

by Szymon Graczyk, Arkadiusz Grzeczka, Urszula Pasławska and Pawel Kordowitzki

Nutrients 2023, 15(12), 2725; https://doi.org/10.3390/nu15122725 - 12 Jun 2023

Viewed by 2295

Abstract

Atrial fibrillation (AF) is a severe and most common supraventricular arrhythmia in humans, which, if left untreated or treated ineffectively, can lead to ischemic stroke or heart failure. It has been suggested that serum vitamin D (VitD) deficiency may be one of the [...] Read more.

Atrial fibrillation (AF) is a severe and most common supraventricular arrhythmia in humans, which, if left untreated or treated ineffectively, can lead to ischemic stroke or heart failure. It has been suggested that serum vitamin D (VitD) deficiency may be one of the critical factors influencing the onset of AF, especially in the period after cardiac surgery, such as coronary artery bypass grafting. Several papers have indicated that VitD supplementation reduces the risk of AF, significantly reducing the proportion of patients between the control and study groups in both the pre- and postoperative periods. Factors that increase the risk of AF from VitD deficiency are also further indicated, and these are age, gender, weight, season or comorbidities. In addition, the cardiodepressive mechanism of VitD is not fully understood; however, it is suggested that it acts through at least two pathways. The first indicates a direct effect of VitD on atrial muscle degradation, while the second is related to the modulation of cardiovascular depression factors. Despite many reports showing correlations between no VitD concentrations on the development of AF, this topic is still widely debated and the results from these papers are still subject to doubt. Therefore, this review aims at describing in detail the problem of correlation between VitD deficiency and the development of AF associated mainly with the postoperative period, i.e., after cardiac surgery, especially pathogenesis, and results of this correlation, taking into account recent studies, limitations and future perspectives. Due to the fact that this is still a topical problem, we believe that the collection of the latest reports and a detailed description of the problem is most appropriate in this case. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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17 pages, 1177 KiB

Open AccessEditor’s ChoiceReview

Serum 25-Hydroxyvitamin D and Cancer Risk: A Systematic Review of Mendelian Randomization Studies

by Thomas Lawler and Shaneda Warren Andersen

Nutrients 2023, 15(2), 422; https://doi.org/10.3390/nu15020422 - 13 Jan 2023

Cited by 9 | Viewed by 8407

Abstract

Epidemiological studies suggest that higher serum 25-hydroxyvitamin D is associated with lower risk for several cancers, including breast, prostate, colorectal, and lung cancers. To mitigate confounding, genetic instrumental variables (IVs) have been used to estimate causal associations between 25-hydroxivtamin D and cancer risk [...] Read more.

Epidemiological studies suggest that higher serum 25-hydroxyvitamin D is associated with lower risk for several cancers, including breast, prostate, colorectal, and lung cancers. To mitigate confounding, genetic instrumental variables (IVs) have been used to estimate causal associations between 25-hydroxivtamin D and cancer risk via Mendelian randomization (MR). We provide a systematic review of 31 MR studies concerning 25-hydroxyvitamin D and cancer incidence and mortality identified from biomedical databases. MR analyses were conducted almost exclusively in European-ancestry populations and identified no statistically significant associations between higher genetically predicted 25-hydroxyvitamin D and lower risk for total cancer or colorectal, breast, prostate, lung, or pancreatic cancers. In recent studies including ≥80 genetic IVs for 25-hydroxyvitamin D, null associations were reported for total cancer (odds ratio [95% confidence interval] per 1-standard deviation increase: 0.98 [0.93–1.04]), breast (1.00 [0.98–1.02]), colorectal (0.97 [0.88–1.07]), prostate (0.99 [0.98–1.01]), and lung cancer (1.00 [0.93–1.03]). A protective association was observed for ovarian cancer in the Ovarian Cancer Association Consortium (0.78 [0.63–0.96] per 20 nmol/L increase, p-trend = 0.03), but not in the UK Biobank (1.10 [0.80–1.51]). Null associations were reported for other tumor sites (bladder, endometrium, uterus, esophagus, oral cavity and pharynx, kidney, liver, thyroid, or neural cells). An inconsistent protective association for cancer-specific mortality was also observed. Results from MR analyses do not support causal associations between 25-hydroxyvitamin D and risk for cancer incidence or mortality. Studies including non-White populations may be valuable to understand low 25-hydroxyvitamin D as a modifiable risk factor in populations with a higher risk of common cancers, including African ancestry individuals. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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Open AccessReview

Role of Vitamin D in Celiac Disease and Inflammatory Bowel Diseases

by Claudia Infantino, Roberta Francavilla, Adriana Vella, Sabrina Cenni, Nicola Principi, Caterina Strisciuglio and Susanna Esposito

Nutrients 2022, 14(23), 5154; https://doi.org/10.3390/nu14235154 - 03 Dec 2022

Cited by 13 | Viewed by 3545

Abstract

Vitamin D (VD) is a pro-hormone that has long been known as a key regulator of calcium homeostasis and bone health in both children and adults. In recent years, studies have shown that VD may exert many extra-skeletal functions, mainly through a relevant [...] Read more.

Vitamin D (VD) is a pro-hormone that has long been known as a key regulator of calcium homeostasis and bone health in both children and adults. In recent years, studies have shown that VD may exert many extra-skeletal functions, mainly through a relevant modulation of the innate and adaptive immune system. This has suggested that VD could play a fundamental role in conditioning development, clinical course, and treatment of several autoimmune disorders, including celiac disease (CD) and inflammatory bowel diseases (IBDs). The main aim of this review is to evaluate the relationships between VD, CD, and IBDs. Literature analysis showed a potential impact of VD on CD and IBDs can be reasonably assumed based on the well-documented in vitro and in vivo VD activities on the gastrointestinal tract and the immune system. The evidence that VD can preserve intestinal mucosa from chemical and immunological damage and that VD modulation of the immune system functions can contrast the mechanisms that lead to the intestinal modifications characteristic of gastrointestinal autoimmune diseases has suggested that VD could play a role in controlling both the development and the course of CD and IBDs. Administration of VD in already diagnosed CD and IBD cases has not always significantly modified disease course. However, despite these relevant problems, most of the experts recommend monitoring of VD levels in patients with CD and IBDs and administration of supplements in patients with hypovitaminosis. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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33 pages, 798 KiB

Open AccessSystematic Review

Does Native Vitamin D Supplementation Have Pleiotropic Effects in Patients with End-Stage Kidney Disease? A Systematic Review of Randomized Trials

by Nathan G. Pilkey, Olivia Novosel, Angélique Roy, Tristin E. Wilson, Jaya Sharma, Sono Khan, Sanjana Kapuria, Michael A. Adams and Rachel M. Holden

Nutrients 2023, 15(13), 3072; https://doi.org/10.3390/nu15133072 - 07 Jul 2023

Cited by 1 | Viewed by 2306

Abstract

Vitamin D has been shown to have multiple pleiotropic effects beyond bone and mineral metabolism, with purported roles in cardiovascular disease, cancer, and host immunity. Vitamin D deficiency is common in patients with end-stage kidney disease (ESKD); however, current clinical practice has favored [...] Read more.

Vitamin D has been shown to have multiple pleiotropic effects beyond bone and mineral metabolism, with purported roles in cardiovascular disease, cancer, and host immunity. Vitamin D deficiency is common in patients with end-stage kidney disease (ESKD); however, current clinical practice has favored the use of the active hormone. Whether vitamin D deficiency should be corrected in patients with ESKD remains unclear, as few randomized trials have been conducted. In this systematic review, we summarize the current evidence examining whether vitamin D supplementation improves outcomes, beyond mineral metabolism, in patients with ESKD. Data from randomized controlled trials of adults with ESKD were obtained by searching Ovid MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the Web of Science Core Collection from inception to February 2023. Twenty-three trials composed of 2489 participants were identified for inclusion. Data were synthesized by two independent reviewers and summarized in tables organized by outcome. Outcomes included measures of mortality, cardiovascular disease, inflammation, muscle strength/function, nutrition, patient well-being, and outcomes specific to ESKD including erythropoietin usage, pruritus, and dialysis access maturation. The Cochrane risk of Bias Tool (RoB 2, 2019) was used to assess study quality. Overall, our findings indicate a minimal and varied benefit of native vitamin D supplementation. From the largest studies included, we determine that vitamin D has no demonstrated effect on patient-reported measures of well-being or utilization of erythropoietin, nor does it change levels of the inflammation biomarker C-reactive protein. Included trials were heterogeneous with regards to outcomes, and the majority studied small participant populations with a relatively short follow-up. We conclude that vitamin D supplementation corrects vitamin D deficiency and is safe and well-tolerated in humans with ESKD. However, it is not clear from clinical trials conducted to date that a causal pathway exists between 25(OH)D and pleiotropic effects that is responsive to vitamin D treatment. Full article

(This article belongs to the Special Issue Role of Vitamin D in Chronic Diseases)

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