scholarly journals Vitamin D as Adjunctive Host-Directed Therapy in Tuberculosis: A Systematic Review

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Robert S. Wallis ◽  
Alimuddin Zumla
Keyword(s):  
Vitamin D ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Inflammatory Reactions ◽  
Future Studies ◽  
Randomized Controlled ◽  
Underlying Mechanisms ◽  
Reported Data ◽  
Tuberculosis Risk

Abstract Vitamin D plays an important role in innate defenses against intracellular pathogens. Seasonal vitamin D insufficiency (VDI) due to reduced sun exposure far from the equator increases tuberculosis risk. Eight randomized controlled trials examined vitamin D as adjunctive therapy during tuberculosis treatment. The studies varied substantially regarding patient genetic backgrounds, the extent of baseline VDI, the administered dose, the study endpoints, and the quality of the reported data. One carefully performed study in which moderately large vitamin D doses were given to markedly VDI patients found a benefit sufficient to support shortening treatment from 6 to 4 months, although other similar studies did not. Vitamin D is thought to have anti-inflammatory effects. However, 2 studies reported 3 vitamin D recipients with severe paradoxical inflammatory reactions. Future studies of vitamin D in tuberculosis in patients with specific genetic backgrounds must monitor these events closely to determine their risks and underlying mechanisms.

scholarly journals Does Vitamin D play a role in the management of Covid-19 in Brazil?

2020 ◽  
Vol 54 ◽  
pp. 53 ◽  
Author(s):  
Helena Ribeiro ◽  
Keila Valente de Souza de Santana ◽  
Sofia Lizarralde Oliver ◽  
Patricia Helen de Carvalho Rondó ◽  
Marcela Moraes Mendes ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trials ◽  
Respiratory Infections ◽  
Sun Exposure ◽  
Hypovitaminosis D ◽  
Controlled Trials ◽  
Vitamin D Status ◽  
Randomized Controlled ◽  
Vitamin D Levels

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

scholarly journals Nutrihealth Study: Seasonal Variation in Vitamin D Status Among the Slovenian Adult and Elderly Population

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1838 ◽  
Author(s):  
Maša Hribar ◽  
Hristo Hristov ◽  
Matej Gregorič ◽  
Urška Blaznik ◽  
Katja Zaletel ◽  
...  
Keyword(s):  
Vitamin D ◽  
Seasonal Variation ◽  
Vitamin D Deficiency ◽  
Elderly Population ◽  
Sun Exposure ◽  
Epidemiological Data ◽  
The Elderly ◽  
Vitamin D Insufficiency ◽  
Ultraviolet B ◽  
Vitamin D Status

Several studies conducted around the world showed substantial vitamin D insufficiency and deficiency among different population groups. Sources of vitamin D in the human body include ultraviolet B (UVB)-light-induced biosynthesis and dietary intake, but people’s diets are often poor in vitamin D. Furthermore, in many regions, sun exposure and the intensity of UVB irradiation during wintertime are not sufficient for vitamin D biosynthesis. In Slovenia, epidemiological data about vitamin D status in the population were investigated through a national Nutrihealth study—an extension to the national dietary survey SI.Menu (2017/18). The study was conducted on a representative sample of 125 adult (18–64 years) and 155 elderly (65–74 years old) subjects, enrolled in the study in different seasons. Their vitamin D status was determined by measuring the serum 25-hydroxy-vitamin D (25(OH)D) concentration. Thresholds for vitamin D deficiency and insufficiency were 25(OH)D levels below 30 and 50 nmol/L, respectively. Altogether, 24.9% of the adults and 23.5% of the elderly were found to be vitamin D deficient, while an insufficient status was found in 58.2% and 62.9%, respectively. A particularly concerning situation was observed during extended wintertime (November–April); vitamin D deficiency was found in 40.8% and 34.6%, and insufficient serum 25(OH)D levels were observed in 81.6% and 78.8%, respectively. The results of the study showed high seasonal variation in serum 25(OH)D levels in both the adult and elderly population, with deficiency being especially pronounced during wintertime. The prevalence of this deficiency in Slovenia is among the highest in Europe and poses a possible public health risk that needs to be addressed with appropriate recommendations and/or policy interventions.

The Effects of Vitamin D Deficiency and Insufficiency on the Endocrine and Paracrine Systems

2007 ◽  
Vol 9 (2) ◽  
pp. 117-129 ◽  
Author(s):  
Patricia T. Alpert ◽  
Ulfat Shaikh
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Vitamin D Insufficiency ◽  
Paracrine Effects ◽  
Breastfed Infants ◽  
Nutritional Rickets ◽  
Disease States

Individuals are capable of producing vitamin D with proper exposure to sunlight. However, several factors can interfere with the effectiveness of this process. Most sunscreens filter out UVB light, thus inhibiting vitamin D production. Individuals with more darkly pigmented skin have greater difficulty producing vitamin D because melanin acts as an effective natural sunscreen, requiring longer sun exposure to produce an adequate daily allotment of vitamin D. Additionally, solely breastfed infants whose mothers suffered from vitamin D deficiency or insufficiency when pregnant have smaller reserves of the nutrient and are at greater risk of developing nutritional rickets. Vitamin D deficiency leads to rickets, osteomalacia, and osteoporosis. Long-term vitamin D insufficiency can lead to paracrine effects such as type 1 diabetes, cancer, and multiple sclerosis. This article reviews the current literature on vitamin D deficiency and insufficiency and their relation to different disease states. Potential areas for research are discussed.

scholarly journals Health-related quality of life after successful surgery for primary hyperparathyroidism: no additive effect from vitamin D supplementation: results of a double-blind randomized study

2015 ◽  
Vol 172 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Viveca Åberg ◽  
Sophie Norenstedt ◽  
Jan Zedenius ◽  
Maria Sääf ◽  
Jörgen Nordenström ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Study Medication ◽  
Double Blind ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

ObjectiveVitamin D insufficiency is common in primary hyperparathyroidism (pHPT). Patients with pHPT frequently have a reduced health-related quality of life (HRQoL). Our objectives were to evaluate whether HRQoL in pHPT is associated with vitamin D insufficiency and whether vitamin D supplementation after parathyroidectomy (PTX) could improve HRQoL.DesignA randomized, double-blind study (ClinicalTrials.gov identifier: NCT00982722).MethodsThe study included 150 pHPT patients randomized, 6 weeks after PTX, to daily treatment with either cholecalciferol 1600 IU and calcium carbonate 1000 mg (D+) or calcium carbonate alone (D−). HRQoL was estimated with SF-36 before and after PTX and after 12 months of study medication.ResultsThree-quarters (77%) of the pHPT patients had vitamin D insufficiency, defined as 25OHD <50 nmol/l. The pHPT patients scored lower than a reference population in all domains of SF-36. A total of 135 patients completed the entire study period. Improvements in nearly all domains were registered at the follow-up 6 weeks after PTX. At the end of the study medication period, the D+ group had a significantly higher median serum (s-) 25OHD concentration (76 (65; 93) (lower; upper interquartile ranges) vs 48 (40; 62) nmol/l, P<0.001) and a lower plasma (p-) parathyroid hormone concentration (40 (34; 52) vs 49 (38; 66) ng/l, P=0.01) than the D− group. The improvements in HRQoL remained unchanged at the follow-up 1 year after PTX. Postoperative vitamin D supplementation had no obvious effect on HRQoL.ConclusionPTX resulted in significant improvements in HRQoL. Despite a high prevalence of vitamin D insufficiency, 1 year of postoperative vitamin D supplementation had no obvious beneficial effect on HRQoL.

Relationship between skin color, sun exposure, UV protection, fish intake and serum levels of vitamin D in Japanese older adults

2017 ◽  
Vol 47 (3) ◽  
pp. 409-422 ◽  
Author(s):  
Maria Marina Serrao Cabral ◽  
Angelo Jose Goncalves Bos ◽  
Hidemori Amano ◽  
Satoshi Seino ◽  
Shoji Shinkai
Keyword(s):  
Vitamin D ◽  
Skin Color ◽  
Sun Exposure ◽  
Serum Levels ◽  
Vitamin D Insufficiency ◽  
Fish Intake ◽  
Lower Prevalence ◽  
Homogeneous Population ◽  
Content Type ◽  
Japanese Older Adults

Purpose This paper aims to observe the possible relationship between skin color, sun exposure level, UV protection and food intake and serum levels of 25(OH) D in Japanese older adults. Design/methodology/approach Elderly (n = 131; 65-93 years old), followed by the Tokyo Metropolitan Institute of Gerontology in the Kusatsu (36°N) received a self-applicable questionnaire about the quantity and quality of the daily sun exposure and behavior to avoid the sun. A color analyzer measured each red (R), green (G) and blue (B) component of skin color, and dietary vitamin D was estimated by food frequency questionnaire. Serum 25(OH) D levels were collected and categorized as sufficiency (>30 ng/mL), insufficiency (between 20 and 30 ng/mL) and deficiency (<20 ng/mL). Findings High proportion of participants had insufficiency (53 per cent) and deficiency (25 per cent) levels of 25(OH) D. Insufficiency levels were more prevalent in women (57 per cent, p = 0.048) and in participants that use gloves (49 per cent, p = 0.054) and sunscreen on face (76 per cent, p = 0.003) as a sun protection way. Participants with sufficiency levels of 25(OH) D presented lower values of R (p = 0.067), G (p = 0. 007) and B (p = 0.001) of skin color (what is meaning darker skin) and a higher fish intake (12 times per week). Research limitations/implications The study is a cross-sectional design and brings a potential for measurement error in the recorded subjective variables. There is a memory bias in self-reported sun exposure and food consumption; however, in the multivariate analysis, it was demonstrated a significant association. Second, although the authors have sought to evaluate a number of variables that could affect the skin’s ability to synthesize vitamin D, there are many other factors that may affect this ability that could not be accounted for. Another limitation was the assessment of self-reported ultraviolet exposure data rather than direct measurement of exposure. Practical implications It was also concluded that darker skin color (a surrogate of longer-term sun exposure) participants had a lower prevalence of vitamin D insufficiency in this ethnic homogeneous population. When accessing patients’ skin color, the clinician must account for his or her ethnicity. Social implications Governments should regulate supplementation or food fortification with vitamin D, with special focus in countries with geographical location of insufficient solar radiation for skin synthesis of this vitamin. With this, it becomes a priority that a safe sun exposure ensures the sufficient serum levels of 25 (OH) D without the use of supplements. Originality/value This report was the first to analyze skin color components associated to vitamin D levels, finding that blue and green colors were significant. The clinical implication of this find is yet to understand. It was also concluded that darker skin color (a surrogate of longer-term sun exposure) participants had a lower prevalence of vitamin D insufficiency in this ethnic homogeneous population. When accessing patients’ skin color, the clinician must account for his or her ethnicity.

scholarly journals Effects of vitamin D optimization on quality of life of patients with fibromyalgia: A randomized controlled trial

2018 ◽  
Vol 32 (1) ◽  
pp. 167-172 ◽  
Author(s):  
Alireza Mirzaei ◽  
Mozhdeh Zabihiyeganeh ◽  
Seyed Adel Jahed ◽  
Elnaz Khiabani ◽  
Marzieh Nojomi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Vitamin D ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Randomized Controlled

scholarly journals Vitamin D and Muscle Health: A Systematic Review and Metaanalysis of Randomized Placebo-Controlled Trials

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A281-A281
Author(s):  
Lise Sofie Bislev ◽  
Diana Grove-Laugesen ◽  
Lars Rejnmark
Keyword(s):  
Vitamin D ◽  
Physical Performance ◽  
Vitamin D Insufficiency ◽  
Vitamin D Supplementation ◽  
Mean Difference ◽  
Controlled Trials ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Negative Effect ◽  
Muscle Health

Abstract Background: Data regarding effects of vitamin D on muscle function are inconsistent. Discrepancies between observational and placebo-controlled studies are an indisputable fact. Objective: To investigate effects of vitamin D supplementation vs placebo on muscle health. Data Sources: A systematic research of published randomized controlled trials published until October 2020 has been conducted on Medline, Cochrane Database of Systematics Reviews, Embase and Google Scholar. Study Selection: Participants treated with vitamin D2 or vitamin D3 supplementation vs placebo, with or without calcium co-supplementation. All studies despite administration form (daily, bolus and duration) and populations, except athletes, were included. The pre-defined end-points were maximum muscle strength (Newton) measured as handgrip, elbow flexion, elbow extension, knee flexion, and knee extension. Physical performance reported as Timed Up and Go test (s), Chair Rising Test (s), 6 minutes walking distance (m) and Standard Physical Performance Battery (points). Finally, muscle mass in term of total lean mass (kg) was included. As the end-point measures were standardized, we apriori used random model effects and mean difference. Data Synthesis: In total, 51 randomized controlled trials involving 7798 individuals were included. Of included studies, 14 studies included participants with vitamin D insufficiency (25(OH)D&lt;50 nmol/l) as inclusion criteria (19% of individuals). Outlier studies (N=1) were excluded. Analyses revealed a significant negative effect of vitamin D supplementation on knee flexion strength, mean difference -3.3 N, 95% CI (-6.63 to -0.03), I2=0%, n=765. The majority (8/12) of the studies used dosages &gt; 2800 IU/day. Time spend performing the TUG test was also significant longer in individuals treated with vitamin D as compared with placebo, mean difference at 0.15 s (95% CI 0.04 to 0.26), I2=0%, n=5175. Excluding studies using bolus therapy or daily dosages &gt; 2800 IU, the negative findings were no longer significant. No significant effect was found on the other measures of muscle strength, physical performance or muscle mass. In the minority of studies using vitamin D insufficiency as inclusion criteria, subgroup analysis revealed comparable effects of vitamin D and placebo. Conclusions: Overall, vitamin D do not have a beneficial effect on muscle health in non-athletes and may in some cases even have a negative effect. Subgroup analysis suggest that this finding may be dose-dependent. Our data do not support a beneficial effect on muscle health in vitamin D insufficient individuals, albeit only a minority of included studies investigated individuals suffering from vitamin D insufficiency. As an increasing number of studies report negative musculoskeletal effects including an increased fall risk, this study support the theory, that vitamin D should be dosed with care.

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