scholarly journals Association between vitamin D deficiency and exercise capacity in patients with CKD, a cross-sectional analysis

2020 ◽  
Author(s):  
Emma L Watson ◽  
Thomas J Wilkinson ◽  
Tom F O’Sullivan ◽  
Luke A Baker ◽  
Douglas W Gould ◽  
...  

AbstractEvidence is growing for a role of vitamin D in regulating skeletal muscle mass, strength and functional capacity. Given the role the kidneys play in activating total vitamin D, and the high prevalence of vitamin D deficiency in Chronic Kidney Disease (CKD), it is possible that deficiency contributes to the low levels of physical function and muscle mass in these patients. This is a secondary cross-sectional analysis of previously published interventional study, with ex vivo follow up work. 34 CKD patients at stages G3b-5 (eGFR 25.5 ± 8.3ml/min/1.73m2; age 61 ± 12 years) were recruited, with a sub-group (n=20) also donating a muscle biopsy. Vitamin D and associated metabolites were analysed in plasma by liquid chromatography tandem-mass spectroscopy and correlated to a range of physiological tests of muscle size, function, exercise capacity and body composition. The effects of 1α,25(OH)2D3 supplementation on myogenesis and myotube size was investigated in primary skeletal muscle cells from vitamin D deficient donors. In vivo, there was no association between total or active vitamin D and muscle size or strength, but a significant correlation with was seen with the total form. Ex vivo, 1α,25(OH)2D3 supplementation reduced IL-6 mRNA expression, but had no effect upon proliferation, differentiation or myotube diameter. This early preliminary work suggests that vitamin D deficiency is not a prominent factor driving the loss of muscle mass in CKD, but may play a role in reduced exercise capacity.

2012 ◽  
Vol 17 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Charlotte Dupuy ◽  
V. Lauwers-Cances ◽  
G. Abellan Van Kan ◽  
S. Gillette ◽  
A. -M. Schott ◽  
...  

2015 ◽  
Vol 83 (6) ◽  
pp. 1114-1119 ◽  
Author(s):  
Vijay M. Ravindra ◽  
Jakub Godzik ◽  
Jian Guan ◽  
Andrew T. Dailey ◽  
Meic H. Schmidt ◽  
...  

2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711209
Author(s):  
Artaza Gilani ◽  
Sheena Ramsay ◽  
Paul Welsh ◽  
Olia Papacosta ◽  
Lucy Lennon ◽  
...  

BackgroundThere is growing interest in the role of vitamin D in extra-skeletal health, including postural hypotension. Postural hypotension is found in 1 in 5 community-dwelling adults aged 60 years and above. It increases risk of falls, fractures, cardiovascular disease and all-cause mortality. Better understanding of the aetiology of postural hypotension may help yield more effective treatment options than those that are currently available.AimThe aim of this study was to investigate the association between circulating vitamin D, parathyroid hormone and postural hypotension.MethodThis was a cross-sectional analysis of 3620 community-dwelling men living in the UK (mean age 68.6 years; standard deviation 5.5 years). Vitamin D status (nmol/L) was categorised as sufficient (≥50), insufficient (≥25 – <50), or deficient (<25). Parathyroid hormone levels were categorised by quintiles. Postural hypotension was defined by consensus criteria as a decrease in systolic blood pressure ≥20 mmHg and/or diastolic blood pressure ≥10 mmHg that occurred within three minutes of standing.ResultsCompared to sufficient levels of vitamin D, vitamin D deficiency increased risk of postural hypotension that specifically occurred within one minute of standing (OR 1.51, 95% CI = 1.06 to 2.15) in multinomial, multiple logistic regression. Neither vitamin D insufficiency, nor elevated parathyroid hormone, were associated with postural hypotension.ConclusionIn this study, vitamin D deficiency was associated with increased risk of postural hypotension. Further research may help clarify whether treating vitamin D deficiency can reduce the degree of postural hypotension, or if preventing the progression to vitamin D deficiency can reduce the incidence of postural hypotension.


2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Nestor Martínez-Zavala ◽  
Guillermo Nahúm López-Sánchez ◽  
Alma Vergara-Lopez ◽  
Norberto Carlos Chávez-Tapia ◽  
Misael Uribe ◽  
...  

2020 ◽  
Author(s):  
Artaza Gilani ◽  
Sheena E Ramsay ◽  
Paul Welsh ◽  
Olia Papacosta ◽  
Lucy T Lennon ◽  
...  

Abstract Background orthostatic hypotension (OH) that occurs within, or at, 1 minute of standing is associated with higher risk of falls, myocardial infarction, syncope and mortality, compared to OH that occurs after 1 minute of standing. Whether vitamin D deficiency increases the risk of OH is controversial. Methods this was a cross-sectional analysis of 3,620 older, community-dwelling men. Multinomial, multiple logistic regression models were used to calculate the risk of OH across categories of vitamin D status (deficient [&lt;25 nmol/l], insufficient [≥25–&lt;50 nmol/l] and sufficient [≥50 nmol/l]) and parathyroid hormone quintile. Results men with vitamin D deficiency were more likely to have OH that occurred within 1 minute of standing in univariate logistic regression (OR 1.88, 95% CI 1.40–2.53) and multinomial, multiple logistic regression (OR 1.51, 95% CI 1.06–2.15), compared to men with sufficient levels of vitamin D. Vitamin D insufficiency was not associated with the risk of OH. Elevated parathyroid hormone was not associated with risk of OH. Conclusion the absence of an association between vitamin D insufficiency and risk of OH and the presence of an association between vitamin D deficiency and risk of OH suggest that there may be a threshold effect; it is only below a particular level of vitamin D that risk of OH is increased. In this cohort, the threshold was &lt;25 nmol/l. Future work should investigate whether treating vitamin D deficiency can improve postural blood pressure or if preventing vitamin D deficiency reduces the incidence of OH.


2020 ◽  
pp. bmjspcare-2020-002457
Author(s):  
Daniel C McFarland ◽  
Madalyn Fernbach ◽  
William S Breitbart ◽  
Christian Nelson

BackgroundDepression and vitamin D deficiency are common in patients with lung cancer and have prognostic implications in cancer settings. However, their relationship and concomitant survival implications have not been evaluated in patients with metastatic lung cancer specifically. We hypothesised that vitamin D deficiency would be associated with depression and inferior cancer-related survival in patients receiving therapies for stage IV lung cancer.MethodsThis was a cross-sectional analysis of vitamin D, depression and lung cancer characteristics. Vitamin D levels were stratified by level (no deficiency ≥30 units, mild deficiency 20 to 29 units and moderate-to-severe <20 units). Depression was measured by the Hospital Anxiety and Depression Scale-Depression (HADS-D). Survival estimations were made using Cox proportional hazard model and Kaplan-Meier analyses.ResultsVitamin D deficiency was evident in almost half of the sample (n=98) and was associated with significant depression (HADS-D ≥8) (χ2=4.35, p<0.001) even when controlling for age, sex and inflammation (β=-0.21, p=0.03). Vitamin D deficiency and depression were associated with worse survival and showed evidence of an interaction effect (HR 1.5, p=0.04).ConclusionVitamin D deficiency is associated with depression in patients with metastatic lung cancer. Depression modulates the survival implications of vitamin D deficiency in this population. The role of vitamin D deficiency in cancer-related depression warrants further investigation since both are amenable to treatment. Psychological and nutritional prognostic considerations may help inform treatment paradigms that enhance quality of life and survival.


2016 ◽  
Vol 12 (1) ◽  
Author(s):  
María Fernanda Carrillo-Vega ◽  
Carmen García-Peña ◽  
Luis Miguel Gutiérrez-Robledo ◽  
Mario Ulises Pérez-Zepeda

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