Vitamin D, liver-related biomarkers, and distribution of fat and lean mass in young patients with Fontan circulation

Abstract Introduction/aim: Young patients with Fontan circulation may have low serum 25-hydroxyvitamin D levels, an affected liver, and unhealthy body compositions. This study aimed to explore the association between vitamin D intake/levels, liver biomarkers, and body composition in young Fontan patients. Method: We collected prospective data in 2017 to 2018, obtained with food-frequency questionnaires, biochemical analyses of liver biomarkers, and dual-energy X-ray absorptiometry scans in 44 children with Fontan circulation. Body compositions were compared to matched controls (n = 38). Linear regression analyses were used to investigate associations of biomarkers, leg pain, and lean mass on serum levels of 25-hydroxyvitamin D. Biomarkers were converted to z scores and differences were evaluated within the Fontan patients. Results: Our Fontan patients had a daily mean vitamin D intake of 9.9 µg and a mean serum 25-hydroxyvitamin D of 56 nmol/L. These factors were not associated with fat or lean mass, leg pain, or biomarkers of liver status. The Fontan patients had significantly less lean mass, but higher fat mass than controls. Male adolescents with Fontan circulation had a greater mean abdominal fat mass than male controls and higher cholesterol levels than females with Fontan circulation. Conclusion: Vitamin D intake and serum levels were not associated with body composition or liver biomarkers in the Fontan group, but the Fontan group had lower lean mass and higher fat mass than controls. The more pronounced abdominal fat mass in male adolescents with Fontan circulation might increase metabolic risks later in life.

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Vitamin D intake, serum 25-hydroxyvitamin D status and response to moderate vitamin D3 supplementation: a randomised controlled trial in East African and Finnish women

British Journal Of Nutrition ◽

10.1017/s000711451700397x ◽

2018 ◽

Vol 119 (4) ◽

pp. 431-441 ◽

Cited By ~ 5

Author(s):

Folasade A. Adebayo ◽

Suvi T. Itkonen ◽

Taina Öhman ◽

Essi Skaffari ◽

Elisa M. Saarnio ◽

...

Keyword(s):

Vitamin D ◽

Randomised Controlled Trial ◽

Ethnic Differences ◽

Repeated Measures ◽

Controlled Trial ◽

East African ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D ◽

Randomised Controlled

AbstractInsufficient vitamin D status (serum 25-hydroxyvitamin D (S-25(OH)D)<50 nmol/l) is common among immigrants living at the northern latitudes. We investigated ethnic differences in response of S-25(OH)D to vitamin D3 supplementation, through a 5-month randomised controlled trial, in East African and Finnish women in Southern Finland (60°N) from December 2014 to May 2015. Vitamin D intakes (dietary and supplemental) were also examined. Altogether, 191 subjects were screened and 147 women (East Africans n 72, Finns n 75) aged 21–64 years were randomised to receive placebo or 10 or 20 µg of vitamin D3/d. S-25(OH)D concentrations were assessed by liquid chromatography–tandem MS. At screening, 56 % of East Africans and 9 % of Finns had S-25(OH)D<50 nmol/l. Total vitamin D intake was higher in East Africans than in Finns (24·2 (sd 14·3) v. 15·2 (sd 13·4) µg/d, P<0·001). Baseline mean S-25(OH)D concentrations were higher in Finns (60·5 (sd=16·3) nmol/l) than in East Africans (51·5 (sd 15·4) nmol/l) (P=0·001). In repeated-measures ANCOVA (adjusted for baseline S-25(OH)D), mean S-25(OH)D increased by 8·5 and 10·0 nmol/l with a 10-µg dose and by 10·7 and 17·1 nmol/l with a 20-µg dose for Finns and East Africans, respectively (P>0·05 for differences between ethnic groups). In conclusion, high prevalence of vitamin D insufficiency existed among East African women living in Finland, despite higher vitamin D intake than their Finnish peers. Moderate vitamin D3 supplementation was effective in increasing S-25(OH)D in both groups of women, and no ethnic differences existed in the response to supplementation.

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Insufficient autumn vitamin D intake and low vitamin D status in 7-year-old Icelandic children

Public Health Nutrition ◽

10.1017/s1368980013003558 ◽

2014 ◽

Vol 18 (2) ◽

pp. 208-217 ◽

Cited By ~ 6

Author(s):

Adda Bjarnadottir ◽

Asa Gudrun Kristjansdottir ◽

Hannes Hrafnkelsson ◽

Erlingur Johannsson ◽

Kristjan Thor Magnusson ◽

...

Keyword(s):

Vitamin D ◽

Cardiorespiratory Fitness ◽

Sunlight Exposure ◽

Vitamin D Status ◽

Blood Samples ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

School Based ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplements

AbstractObjectiveThe aim was to investigate autumn vitamin D intake and status in 7-year-old Icelanders, fitting BMI and cardiorespiratory fitness as predictors.DesignThree-day food records and fasting blood samples were collected evenly from September to November, and cardiorespiratory fitness was measured with an ergometer bike. Food and nutrient intakes were calculated, and serum 25-hydroxyvitamin D (s-25(OH)D) and serum parathyroid hormone were analysed. Suboptimal vitamin D status was defined s-25(OH)D <50 nmol/l, and deficient status as s-25(OH)D <25 nmol/l.SettingSchool-based study in Reykjavik, Iceland in 2006.SubjectsOf the 7-year-olds studied (n 265), 165 returned valid intake information (62 %), 158 gave blood samples (60 %) and 120 gave both (45 %).ResultsRecommended vitamin D intake (10 μg/d) was reached by 22·4 % of the children and 65·2 % had s-25(OH)D <50 nmol/l. Median s-25(OH)D was higher for children taking vitamin D supplements (49·2 nmol/l v. 43·2 nmol/l, respectively; P < 0·0 0 1). Median s-25(OH)D was lower in November (36·7 nmol/l) than in September (59·9 nmol/l; P < 0·001). The regression model showed that week of autumn accounted for 18·9 % of the variance in s-25(OH)D (P < 0·001), vitamin D intake 5·2 % (P < 0·004) and cardiorespiratory fitness 4·6 % (P < 0·005).ConclusionsA minority of children followed the vitamin D recommendations and 65 % had suboptimal vitamin D status during the autumn. Week of autumn was more strongly associated with vitamin D status than diet or cardiorespiratory fitness, which associated with vitamin D status to a similar extent. These results demonstrate the importance of sunlight exposure during summer to prevent suboptimal vitamin D status in young schoolchildren during autumn in northern countries. An increased effort is needed for enabling adherence to the vitamin D recommendations and increasing outdoor activities for sunlight exposure.

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Recommended intakes of vitamin D to optimise health, associated circulating 25-hydroxyvitamin D concentrations, and dosing regimens to treat deficiency: workshop report and overview of current literature

Journal of Nutritional Science ◽

10.1017/jns.2015.10 ◽

2015 ◽

Vol 4 ◽

Cited By ~ 33

Author(s):

Michiel G. J. Balvers ◽

Elske M. Brouwer-Brolsma ◽

Silvia Endenburg ◽

Lisette C. P. G. M. de Groot ◽

Frans J. Kok ◽

...

Keyword(s):

Vitamin D ◽

The Netherlands ◽

Vitamin D Deficiency ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

Skeletal Disease ◽

Health Council ◽

Dosing Regimens ◽

25 Hydroxyvitamin D

AbstractVitamin D is a fat-soluble hormone that traditionally has been linked to bone health. Recently, its involvement has been extended to other (extra-skeletal) disease areas, such as cancer, CVD, energy metabolism and autoimmune diseases. Vitamin D deficiency is a worldwide problem, and several recommendation-setting bodies have published guidelines for adequate vitamin D intake and status. However, recommendations from, for example, the Health Council of the Netherlands do not provide advice on how to treat vitamin D deficiency, a condition that is often encountered in the clinic. In addition, these recommendations provide guidelines for the maintenance of ‘minimum levels’, and do not advise on ‘optimum levels’ of vitamin D intake/status to further improve health. The NutriProfiel project, a collaboration between the Gelderse Vallei Hospital (Ede, the Netherlands) and the Division of Human Nutrition of Wageningen University (Wageningen, the Netherlands), was initiated to formulate a protocol for the treatment of vitamin deficiency and for the maintenance of optimal vitamin D status. To discuss the controversies around treatment of deficiency and optimal vitamin D status and intakes, a workshop meeting was organised with clinicians, scientists and dietitians. In addition, a literature review was conducted to collect recent information on optimal intake of vitamins, their optimal circulating concentrations, and effective dosing regimens to treat deficiency. This information has been translated into the NutriProfiel advice, which is outlined in this article.

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Vitamin D Status in Japanese Adults: Relationship of Serum 25-Hydroxyvitamin D with Simultaneously Measured Dietary Vitamin D Intake and Ultraviolet Ray Exposure

Nutrients ◽

10.3390/nu12030743 ◽

2020 ◽

Vol 12 (3) ◽

pp. 743 ◽

Cited By ~ 2

Author(s):

Keiko Asakura ◽

Norihito Etoh ◽

Haruhiko Imamura ◽

Takehiro Michikawa ◽

Takahiro Nakamura ◽

...

Keyword(s):

Vitamin D ◽

Exposure Time ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Uv Exposure ◽

Dietary Vitamin ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D ◽

Ultraviolet Ray

Vitamin D insufficiency/deficiency is prevalent worldwide. We investigated the effect of vitamin D intake and ultraviolet ray (UV) exposure on serum vitamin D concentration in Japan. A total of 107 healthy adult participants were recruited from Hokkaido (43° N) and Kumamoto (33° N) prefectures. All participants undertook surveys in both summer and winter. Serum 25-hydroxyvitamin D (25(OH)D3) was examined, and vitamin D intake was assessed with a diet history questionnaire. UV exposure was measured with a wearable UV dosimeter. Regression analysis was performed to investigate the relationship between these factors, with covariates such as sun avoidance behavior. The prevalence of vitamin D insufficiency (serum 25(OH)D3; 12 ng/mL (30 nmol/L) ≤ and <20 ng/mL (50 nmol/L))/deficiency (<12 ng/mL) was 47.7% in summer and 82.2% in winter. UV exposure time was short in Kumamoto (the urban area), at 11.6 min in summer and 14.9 min in winter. In Hokkaido (the rural area), UV exposure time was 58.3 min in summer and 22.5 min in winter. Vitamin D intake was significantly associated with serum 25(OH)D3, and a 1 μg/1000kcal increase in intake was necessary to increase 25(OH)D3 by 0.88 ng/mL in summer and by 1.7 ng/mL in winter. UV exposure time was significantly associated with serum 25(OH)D3 in summer, and a 10 min increase in UV exposure time was necessary to increase 25(OH)D3 by 0.47 ng/mL. Although consideration of personal occupation and lifestyle is necessary, most Japanese may need to increase both vitamin D intake and UV exposure.

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Vitamin D intake to attain a desired serum 25-hydroxyvitamin D concentration

American Journal of Clinical Nutrition ◽

10.1093/ajcn/87.6.1952 ◽

2008 ◽

Vol 87 (6) ◽

pp. 1952-1958 ◽

Cited By ~ 214

Author(s):

John F Aloia ◽

Manish Patel ◽

Rhett DiMaano ◽

Melissa Li-Ng ◽

Sonia A Talwar ◽

...

Keyword(s):

Vitamin D ◽

Hydroxyvitamin D ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D

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Low serum 25-hydroxyvitamin D levels and secondary hyperparathyroidism in Fontan patients

Cardiology in the Young ◽

10.1017/s1047951115001444 ◽

2015 ◽

Vol 26 (5) ◽

pp. 876-884 ◽

Cited By ~ 8

Author(s):

Finn Holler ◽

Tobias Hannes ◽

Ingo Germund ◽

Mathias Emmel ◽

Heike Hoyer-Kuhn ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Systemic Inflammation ◽

Neutrophil To Lymphocyte Ratio ◽

Protein Losing Enteropathy ◽

Lymphocyte Ratio ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Fontan Patients

AbstractBackgroundLimited data exist on the vitamin D status in Fontan patients. We determined the prevalence and potential risk factors of vitamin D deficiency in this patient subset.Methods and resultsData were collected from 27 Fontan patients (55.6% male, mean age 8.1±5.3 years). Protein-losing enteropathy was diagnosed in six patients (22.2%). Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level of <20 ng/ml. The neutrophil-to-lymphocyte ratio, a marker of systemic inflammation, was calculated. Associations between laboratory measurements and patient characteristics were explored. Mean serum 25-hydroxyvitamin D level was 14.1±10.4 ng/ml. Vitamin D deficiency was found in 19/27 patients (70.3%). Only skin type was associated with vitamin D deficiency (p=0.04). Hyperparathyroidism was present in 5/21 (23.8%) patients, and was more prevalent in patients with protein-losing enteropathy (p<0.001). Parathyroid hormone levels correlated with parameters of systemic inflammation (neutrophil-to-lymphocyte ratio: r=0.484, p=0.026; relative lymphocyte count: r=−0.635, p=0.002). Vitamin D supplementation significantly increased serum 25-hydroxyvitamin D levels (p<0.0001), and was accompanied by a reduction in parathyroid hormone concentrations (p=0.032).ConclusionsA high prevalence of vitamin D deficiency was found among Fontan patients, independent of age, time after Fontan procedure, ventricular morphology, and presence of protein-losing enteropathy. A potentially important link between parathyroid hormone levels and systemic inflammation is suggested.

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