scholarly journals Prevalence and Prognostic Implications of Vitamin D Deficiency in Chronic Kidney Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Yoshitsugu Obi ◽  
Takayuki Hamano ◽  
Yoshitaka Isaka
Keyword(s):  
Chronic Kidney Disease ◽  
Vitamin D ◽  
Kidney Disease ◽  
Vitamin D Deficiency ◽  
Mineral Metabolism ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Definition Of

Vitamin D is an important nutrient involved in bone mineral metabolism, and vitamin D status is reflected by serum total 25-hydroxyvitamin D (25[OH]D) concentrations. Vitamin D deficiency is highly prevalent in patients with chronic kidney disease (CKD), and nutritional vitamin D supplementation decreases elevated parathyroid hormone concentrations in subgroups of these patients. Furthermore, vitamin D is supposed to have pleiotropic effects on various diseases such as cardiovascular diseases, malignancies, infectious diseases, diabetes, and autoimmune diseases. Indeed, there is cumulative evidence showing the associations of low vitamin D with the development and progression of CKD, cardiovascular complication, and high mortality. Recently, genetic polymorphisms in vitamin D-binding protein have received great attention because they largely affect bioavailable 25(OH)D concentrations. This finding suggests that the serum total 25(OH)D concentrations would not be comparable among different gene polymorphisms and thus may be inappropriate as an index of vitamin D status. This finding may refute the conventional definition of vitamin D status based solely on serum total 25(OH)D concentrations.

scholarly journals Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions

2018 ◽  
Vol 40 (4) ◽  
pp. 1109-1151 ◽  
Author(s):  
Roger Bouillon ◽  
Claudio Marcocci ◽  
Geert Carmeliet ◽  
Daniel Bikle ◽  
John H White ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Human Subjects ◽  
Osteoporotic Fractures ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Elderly Subjects ◽  
Vitamin D Status ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.

scholarly journals Vitamin D Metabolism and Guidelines for Vitamin D Supplementation

2020 ◽  
Vol 41 (3) ◽  
pp. 103-126
Author(s):  
Indra Ramasamy
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Vitamin D Metabolism ◽  
Hydroxyvitamin D ◽  
Response Data ◽  
Vitamin D Intake ◽  
25 Hydroxyvitamin D ◽  
Significant Health

Vitamin D is essential for bone health and is known to be involved in immunomodulation and cell proliferation. Vitamin D status remains a significant health issue worldwide. However, there has been no clear consensus on vitamin D deficiency and its measurement in serum, and clinical practice of vitamin D deficiency treatment remains inconsistent. The major circulating metabolite of vitamin D, 25-hydroxyvitamin D (25(OH)D), is widely used as a biomarker of vitamin D status. Other metabolic pathways are recognised as important to vitamin D function and measurement of other metabolites may become important in the future. The utility of free 25(OH)D rather than total 25(OH)D needs further assessment. Data used to estimate the vitamin D intake required to achieve a serum 25(OH)D concentration were drawn from individual studies which reported dose-response data. The studies differ in their choice of subjects, dose of vitamin D, frequency of dosing regimen and methods used for the measurement of 25(OH)D concentration. Baseline 25(OH)D, body mass index, ethnicity, type of vitamin D (D2 or D3) and genetics affect the response of serum 25(OH)D to vitamin D supplementation. The diversity of opinions that exist on this topic are reflected in the guidelines. Government and scientific societies have published their recommendations for vitamin D intake which vary from 400–1000 IU/d (10–25 µg/d) for an average adult. It was not possible to establish a range of serum 25(OH)D concentrations associated with selected non-musculoskeletal health outcomes. To recommend treatment targets, future studies need to be on infants, children, pregnant and lactating women.

scholarly journals Efficacy of Weekly Split versus Single Doses of Ergocalciferol on Serum 25-Hydroxyvitamin D among Patients on Continuous Ambulatory Peritoneal Dialysis: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Naowanit Nata ◽  
Jessada Kanchanasinitth ◽  
Pamila Tasanavipas ◽  
Ouppatham Supasyndh ◽  
Bancha Satirapoj
Keyword(s):  
Vitamin D ◽  
Single Dose ◽  
Peritoneal Dialysis ◽  
Vitamin D Deficiency ◽  
Continuous Ambulatory Peritoneal Dialysis ◽  
Dose Group ◽  
Vitamin D Supplementation ◽  
Split Dose ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

Background. Vitamin D deficiency is a common problem among patients on continuous ambulatory peritoneal dialysis (CAPD). Vitamin D supplementation leads to reduced serum parathyroid hormone levels and improved cardiovascular markers. Different doses and time intervals of oral vitamin D supplementation may differ in each patient on dialysis. The study aimed to evaluate the efficacy of weekly split and single dose of ergocalciferol at 60,000 IU on serum 25-hydroxyvitamin D (25(OH)D) among patients on CAPD. Methods. A randomized study was conducted among patients on CAPD with vitamin D deficiency or insufficiency (25(OH)D < 30 ng/mL). Patients were randomly assigned to two groups: the split dose group was given ergocalciferol 20,000 IU three times weekly and the single dose group was given ergocalciferol 60,000 IU once weekly for 8 weeks. Main outcomes measured serum 25(OH)D concentrations, serum calcium, serum phosphate, and intact parathyroid levels at 8 weeks after being enrolled. Results. Of 128 screened patients, 50 met the criteria for eligibility and were randomized. At 8 weeks after treatment, mean serum 25(OH)D concentrations significantly increased from baseline 22.7 ± 5.9 to 29.5 ± 9.5 ng/mL P = 0.004 in the split dose group and 22.9 ± 5.3 to 31.2 ± 12.3 ng/mL P = 0.003 in the single dose group. No significant change was found in increase of serum 25(OH)D between the two groups P = 0.561 . At the end of study, a similar proportion of patients in both groups reached the desirable serum concentration of 25(OH)D ≥ 30 ng/mL (60% in the single group vs. 40% in the split group, P = 0.258 ). No significant cases of hypercalcemia, hyperphosphatemia, or serious adverse events occurred during the study. Conclusion. Weekly single and split doses of ergocalciferol 60,000 IU achieved similar effects on serum 25(OH)D levels among patients on CAPD with vitamin D insufficiency or deficiency, suggesting that weekly single dose would be prescribed for adequate vitamin D repletion. This trial is registered with TCTR20200821005.

VITAMIN D SUPPLEMENTATION IN FEMALE NURSES: THE EFFECTS ON SERUM 25-HYDROXYVITAMIN D, AND NON-SPECIFIC MUSCULOSKELETAL PAIN

2015 ◽  
Vol 18 (02) ◽  
pp. 1550008 ◽  
Author(s):  
Negin Masoudi Alavi ◽  
Mahla Madani ◽  
Mohsen Taghizadeh ◽  
Mohammad Reza Sharif
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Musculoskeletal Pain ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Single High Dose ◽  
Hydroxyvitamin D ◽  
Before And After ◽  
25 Hydroxyvitamin D ◽  
Female Nurses

Purpose: To investigate the effect of weekly single high dose vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D], and non-specific musculoskeletal pain in female nurses. Methods: In this prospective study in Kashan/Iran, from April 1, 2014, through September 30, 2014, the 150 nurses with vitamin D deficiency received the weekly pearls of 50,000 units of vitamin D3 for 10 weeks. The serum level of 25(OH)D was measured before and after supplement therapy. The subjects were also asked to complete the Extended Nordic Musculoskeletal Questionnaire. All analyses were conducted with SPSS version 16. Results: After 10 weeks of intervention there was [Formula: see text][Formula: see text]ng/mL increase in 25(OH)D. The 82 nurses (54.7%) had 25(OH)D in normal range, while the 68 nurses (45.3%) were still vitamin D deficient. Weight could explain 15.4% increase in 25(OH)D. Before intervention 135 (90%), of nurses reported musculoskeletal pain in at least one region, after intervention this number decreased to 72.7%. There was a statistically significant improvement in musculoskeletal pain in neck, shoulders, upper back, lower back, hips/tights, knees, and ankles/feet after intervention. Conclusions: The weekly single high dose of vitamin D for 10 weeks could resolve vitamin D deficiency in about half of the patients. Patients with non-specific musculoskeletal pain might benefit from vitamin D supplementation.

scholarly journals Cholecalciferol v. ergocalciferol for 25-hydroxyvitamin D (25(OH)D) repletion in chronic kidney disease: a randomised clinical trial

2016 ◽  
Vol 116 (12) ◽  
pp. 2074-2081 ◽  
Author(s):  
James B. Wetmore ◽  
Cassandra Kimber ◽  
Jonathan D. Mahnken ◽  
Jason R. Stubbs
Keyword(s):  
Clinical Trial ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Mineral Metabolism ◽  
Substantial Reduction ◽  
Randomised Clinical Trial ◽  
Optimal Method ◽  
Hydroxyvitamin D ◽  
Significant Difference ◽  
25 Hydroxyvitamin D

AbstractPatients with chronic kidney disease (CKD) demonstrate complex mineral metabolism derangements and a high prevalence of vitamin D deficiency. However, the optimal method of 25-hydroxyvitamin D (25(OH)D) repletion is unknown, and trials analysing the comparative efficacy of cholecalciferol and ergocalciferol in this population are lacking. We conducted a randomised clinical trial of cholecalciferol 1250μg (50 000 IU) weekly v. ergocalciferol 1250μg (50 000 IU) weekly for 12 weeks in forty-four non-dialysis-dependent patients with stage 3–5 CKD. The primary outcome was change in total 25(OH)D from baseline to week 12 (immediately after therapy). Secondary analyses included the change in 1,25-dihydroxyvitamin D (1,25(OH)2D), parathyroid hormone (PTH), D2 and D3 sub-fractions of 25(OH)D and 1,25(OH)2D and total 25(OH)D from baseline to week 18 (6 weeks after therapy). Cholecalciferol therapy yielded a greater change in total 25(OH)D (45·0 (sd 16·5) ng/ml) v. ergocalciferol (30·7 (sd 15·3) ng/ml) from baseline to week 12 (P<0·01); this observation partially resulted from a substantial reduction in the 25(OH)D3 sub-fraction with ergocalciferol. However, following cessation of therapy, no statistical difference was observed for total 25(OH)D change from baseline to week 18 between cholecalciferol and ergocalciferol groups (22·4 (sd 12·7) v. 17·6 (sd 8·9) ng/ml, respectively; P=0·17). We observed no significant difference between these therapies with regard to changes in serum PTH or 1,25(OH)2D. Therapy with cholecalciferol, compared with ergocalciferol, is more effective at raising serum 25(OH)D in non-dialysis-dependent CKD patients while active therapy is ongoing. However, levels of 25(OH)D declined substantially in both arms following cessation of therapy, suggesting the need for maintenance therapy to sustain levels.

Vitamin D status in infancy and cardiometabolic health in adolescence

2020 ◽  
Vol 113 (1) ◽  
pp. 104-112
Author(s):  
Joshua Garfein ◽  
Kerry S Flannagan ◽  
Sheila Gahagan ◽  
Raquel Burrows ◽  
Betsy Lozoff ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Fat ◽  
Early Life ◽  
Vitamin D Supplementation ◽  
Lower Percentage ◽  
Cardiometabolic Health ◽  
Vitamin D Status ◽  
Percentage Body Fat ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

ABSTRACT Background Vitamin D deficiency is associated with obesity-related conditions, but the role of early life vitamin D status on the development of obesity is poorly understood. Objectives We assessed whether serum 25-hydroxyvitamin D [25(OH)D] at age 1 y was related to metabolic health through adolescence. Methods We quantified serum 25(OH)D in samples obtained at age 1 y from 306 participants in a cohort study in Santiago, Chile. Anthropometry was performed at ages 5, 10, and 16/17 y. At 16/17 y, we determined body composition using DXA and quantified metabolic parameters in a blood sample. We examined the associations of infancy 25(OH)D with BMI-for-age z-score (BMIZ) at ages 5, 10, and 16/17 y; with percentage fat and percentage lean body mass at age 16/17 y; and with a metabolic syndrome (MetS) score and its components at age 16/17 y. Results Infancy 25(OH)D was inversely associated with BMIZ in childhood. Every 25-nmol/L difference in 25(OH)D was related to an adjusted 0.11 units lower BMIZ at age 5 y (95% CI: −0.20, −0.03; P = 0.01) and a 0.09 unit lower BMIZ change from ages 1 to 5 y (95% CI: −0.17, −0.01; P = 0.02). Also, every 25-nmol/L 25(OH)D in infancy was associated with an adjusted 1.3 points lower percentage body fat mass (95% CI: −2.2, −0.4; P = 0.005) and an adjusted 0.03 units lower MetS score (95% CI: −0.05, −0.01; P = 0.01) at age 16/17 y, through inverse associations with waist circumference and the HOMA-IR. Conclusions Serum 25(OH)D at age 1 y is inversely associated with childhood BMIZ, percentage body fat at age 16/17 y, and a MetS score at age 16/17 y. Intervention studies are warranted to examine the effects of vitamin D supplementation in early life on long-term cardiometabolic outcomes.

scholarly journals Oral vitamin D supplementation has a lower bioavailability and reduces hypersecretion of parathyroid hormone and insulin resistance in obese Chinese males

2014 ◽  
Vol 18 (12) ◽  
pp. 2211-2219 ◽  
Author(s):  
Ji-Chang Zhou ◽  
Yu-Mei Zhu ◽  
Zheng Chen ◽  
Jun-Luan Mo ◽  
Feng-Zhu Xie ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Vitamin D ◽  
Parathyroid Hormone ◽  
Vitamin D Supplementation ◽  
Normal Weight ◽  
Vitamin D Status ◽  
Intervention Trial ◽  
Oral Vitamin ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

AbstractObjectiveTo examine the vitamin D status, SNP of the vitamin D receptor gene (VDR) and the effects of vitamin D supplementation on parathyroid hormone and insulin secretion in adult males with obesity or normal weight in a subtropical Chinese city.DesignAn intervention trial.SettingShenzhen City, Guangdong Province, China.SubjectsFrom a cross-sectional survey conducted from June to July, eighty-two normal-weight and ninety-nine obese males (18–69 years) were screened to analyse their vitamin D status and for five SNP of VDR. From these individuals, in the same season of a different year, obese and normal-weight male volunteers (twenty-one per group) were included for an intervention trial with oral vitamin D supplementation at 1250 µg/week for 8 weeks.ResultsFor the survey, there was no significant difference (P>0·05) in baseline circulating 25-hydroxyvitamin D concentrations or in the percentages of participants in different categories of vitamin D status between the two groups. The VDR SNP, rs3782905, was significantly associated with obesity (P=0·043), but none of the examined SNP were correlated with serum 25-hydroxyvitamin D when adjusted for age, BMI and study group. After vitamin D supplementation, serum 25-hydroxyvitamin D concentration, hypersecretions of parathyroid hormone and insulin, and insulin resistance in the obese were changed beneficially (P<0·05); however, the increase in serum 25-hydroxyvitamin D was less than that of the normal-weight men.ConclusionsFor obese and normal-weight men of subtropical China, the summer baseline vitamin D status was similar. However, oral vitamin D supplementation revealed a decreased bioavailability of vitamin D in obese men and ameliorated their hypersecretion of parathyroid hormone and insulin resistance.

scholarly journals 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

2015 ◽  
Vol 4 ◽  
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.

Vitamin D status of children in Kerala, southern India

2019 ◽  
Vol 23 (7) ◽  
pp. 1179-1183 ◽  
Author(s):  
Madhava Vijayakumar ◽  
Vijayalakshmi Bhatia ◽  
Biju George
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Sun Exposure ◽  
Southern India ◽  
Fish Diet ◽  
Vitamin D Status ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D

AbstractObjectiveTo study plasma 25-hydroxyvitamin D (25(OH)D) status of children in Kerala, southern India, and its relationship with sociodemographic variables.DesignCross-sectional observational study.SettingTertiary government hospital.ParticipantsChildren (n 296) with trivial acute illness were enrolled. Sun exposure and Ca and vitamin D intakes (7 d dietary recall) were documented. Serum Ca, P, alkaline phosphatase, plasma 25(OH)D and parathyroid hormone (PTH) were measured.ResultsPrevalence of vitamin D deficiency (plasma 25(OH)D <30 nmol/l) was 11·1% (median, interquartile range (IQR): 52·6, 38·4–65·6 nmol/l). Children who ate fish daily had significantly higher plasma 25(OH)D than those who did not (median, IQR: 52·5, 40·8–68·9 v. 49·1, 36·2–60·7 nmol/l; P = 0·02). Those investigated in the months of March–May showed highest 25(OH)D v. those enrolled during other times (median, IQR: 58·7, 45·6–81·4 v. 45·5, 35·6–57·4 nmol/l; P <0·001). Plasma 25(OH)D correlated positively with serum P (r = 0·24, P <0·001) and Ca intake (r = 0·16, P 0·03), negatively with age (r = −0·13, P 0·03) and PTH (r = −0·22, P <0·001.). On linear regression, summer season (March–May), lower age, daily fish intake and higher Ca intake were independently associated with plasma 25(OH)D.ConclusionsPrevalence of vitamin D deficiency is low in Kerala. The natural fish diet of coastal Kerala and the latitude may be protective. Public health policy in India should take account of this geographical diversity.

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