Effect of maternal vitamin D supplementation on nasal pneumococcal acquisition, carriage dynamics and carriage density in infants in Dhaka, Bangladesh

Abstract Background Invasive pneumococcal disease is a major cause of infant morbidity and death worldwide. Vitamin D promotes anti-pneumococcal immune responses in vitro, but whether improvements in infant vitamin D status modify risks of nasal pneumococcal acquisition in early life is not known. Methods This is a secondary analysis of data collected in a trial cohort in Dhaka, Bangladesh. Acute respiratory infection (ARI) surveillance was conducted from 0 to 6 months of age among 1060 infants of women randomized to one of four pre/post-partum vitamin D dose combinations or placebo. Nasal swab samples were collected based on standardized ARI criteria, and pneumococcal DNA quantified by qPCR. Hazards ratios of pneumococcal acquisition and carriage dynamics were estimated using interval-censored survival and multi-state modelling. Results Pneumococcal carriage was detected at least once in 90% of infants by 6 months of age; overall, 69% of swabs were positive (2616/3792). There were no differences between any vitamin D group and placebo in the hazards of pneumococcal acquisition, carriage dynamics, or carriage density (p > 0.05 for all comparisons). Conclusion Despite in vitro data suggesting that vitamin D promoted immune responses against pneumococcus, improvements in postnatal vitamin D status did not reduce the rate, alter age of onset, or change dynamics of nasal pneumococcal colonization in early infancy. Trial registration Registered in ClinicalTrials.gov with the registration number of NCT02388516 and first posted on March 17, 2015.

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Vitamin D in the Prevention and Treatment of Osteoarthritis: From Clinical Interventions to Cellular Evidence

Nutrients ◽

10.3390/nu11020243 ◽

2019 ◽

Vol 11 (2) ◽

pp. 243 ◽

Cited By ~ 3

Author(s):

Clara Yongjoo Park

Keyword(s):

Vitamin D ◽

Observational Studies ◽

Pilot Trial ◽

Clinical Results ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Randomized Controlled ◽

The Relationship

Older adults are recommended vitamin D to prevent fractures. Though this population is also at risk of osteoarthritis (OA), the effect of vitamin D on OA is unclear and may differ by disease state. The relationship between vitamin D and OA during OA initiation and progression were considered in this narrative review of in vivo and in vitro studies. Regarding OA initiation in humans, the small number of published observational studies suggest a lack of association between induction of OA and vitamin D status. Most randomized controlled trials were performed in White OA patients with relatively high vitamin D status (>50 nmol/L). These studies found no benefit of vitamin D supplementation on OA progression. However, subset analyses and one randomized controlled pilot trial indicated that vitamin D supplementation may alleviate joint pain in OA patients with low vitamin D status (<50 nmol/L). As the etiology of OA is recently being more fully uncovered, better animal and cell models are needed. According to currently available clinical results, evidence is lacking to set a vitamin D level to prevent OA, and increasing vitamin D status above 50 nmol/L does not seem to benefit OA patients.

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Vitamin D status and associated factors among HIV-infected children and adolescents on antiretroviral therapy in Kampala, Uganda

PLoS ONE ◽

10.1371/journal.pone.0253689 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253689

Author(s):

Thereza Were Piloya ◽

Sabrina Bakeera–Kitaka ◽

Grace Paul Kisitu ◽

Richard Idro ◽

Sarah E. Cusick

Keyword(s):

Vitamin D ◽

Immune Responses ◽

Serum Vitamin ◽

Vitamin D Insufficiency ◽

Vitamin D Supplementation ◽

P Value ◽

Vitamin D Status ◽

Cross Sectional ◽

Serum Vitamin D ◽

Art Initiation

Background A high prevalence of suboptimal serum vitamin D has been reported among HIV infected children even in countries with high sunshine abundance throughout the year. Vitamin D is a potent immune modulator of innate and adaptive immune responses. Vitamin D regulates immune responses through the vitamin D receptor on CD4 cells. We aimed to determine the vitamin D status of HIV infected children and factors associated with suboptimal vitamin D. Methods This was a cross sectional study. We enrolled children aged between 6 months and 12 years attending an outpatient paediatric HIV clinic. Serum 25-hydroxyvitamin D (25(OH)D) was measured using the electrochemoluminisence method. Suboptimal vitamin D was defined as 25(OH)D <30 ng/ml, vitamin D insufficiency and deficiency were 21–29 ng/ml and <20 ng/ml respectively. Anthropometry, physical exam and medical history were documented. Logistic regression was performed. Results We enrolled 376 children with mean age (sd) 8.05 years (3.03), a median (IQR) duration of ART of 5.9 years (3.2–8.4). Majority of the children (64%) had been exposed to non nucleoside reverse transcriptase inhibitors (NNRTIs). A third were severely immunosuppressed (CD4% ≤15%) at ART initiation. At the time of the study, the majority (89%) were virologically suppressed (VL <1000 copies/ml). Prevalence of 25(OH)D <30 ng/ml was 49 (13%) of 375 participants and 11 (3%) had 25(OH)D <20 ng/ml. Lopinavir/ritonavir regimen was independently associated with 25(OH)D <30 ng/ml; OR 0.27 CI (0.13–0.57), p value-0.002. Serum 25(OH)D <20 ng/ml was associated with CD4 count ≤15% at ART initiation OR 6.55(1.30–32.9), p value—0.023 and use of NNRTIs; OR 10.9(1.22–96.2), p value—0.03. Conclusion We found a low prevalence of suboptimal vitamin D compared to earlier reports. Severe immunosuppression at ART initiation and use of NNRTIs increases odds of deficiency. Vitamin D supplementation should be considered in severely immunosuppressed children initiating ART.

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Vitamin D Deficiency/Insufficiency and Challenges in Developing Global Vitamin D Fortification and Supplementation Policy in Adults

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000117 ◽

2012 ◽

Vol 82 (4) ◽

pp. 237-259 ◽

Cited By ~ 9

Author(s):

Moshe Ben-Shoshan

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Search Strategy ◽

Epidemiologic Studies ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Societal Burden ◽

Time Period ◽

New Guidelines ◽

In Cis

This review summarizes studies discussing vitamin D status in adults and reveals that vitamin D deficiency/insufficiency is highly prevalent in adults and that current fortification and supplementation policies are inadequate. Background and aims: Studies suggest a crucial role for adequate vitamin D status in various health conditions including bone metabolism, cancer, cardiovascular diseases, and allergies. However, relatively little is known about poor vitamin D status and unmet needs in adults. This report aims to highlight the contribution of epidemiologic studies (through the identification of health effects and societal burden) to the development of vitamin D fortification and supplementation policies and reveal unmet global challenges in adults. Methods: In order to assess worldwide vitamin D status in adults, the search strategy combined the medical literature database MEDLINE (using PubMed) for the time period between January 1, 1980 and February 28, 2011, using the key words vitamin D deficiency and insufficiency, and included articles in which access to full text was possible and in which healthy adults were assessed according to one of four commonly used vitamin D threshold classifications. Results: This report reveals that vitamin D deficiency occurs in 4.10 % [95 % CI (confidence interval), 3.93 %, 4.27 %] to 55.05 % (54.07 %, 56.03 %) of adults, while insufficiency occurs in 26.07 % (24.82 %, 27.33 %) to 78.50 % (77.85 %, 79.16 %), depending on the classification used. However, lack of overlap in CIs and high value of I2 statistics indicate considerable heterogeneity between studies. Further, certain populations (i. e. dark-skinned individuals, immigrants, and pregnant women) may be at higher risk for poor vitamin D status. Conclusion: Current policies for vitamin D supplementation and fortification are inadequate and new guidelines are required to improve vitamin D status in adults.

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KH 1060 - A NEW VITAMIN D ANALOGUE WITH POTENT EFFECTS ON CELL-MEDIATED IMMUNE RESPONSES IN VITRO

Vitamin D ◽

10.1515/9783110850345-167 ◽

1991 ◽

pp. 516-517 ◽

Cited By ~ 3

Keyword(s):

Vitamin D ◽

Immune Responses ◽

Vitamin D Analogue

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Does vitamin D supplementation prevent SARS-CoV-2 infection in military personnel? Review of the evidence

BMJ Military Health ◽

10.1136/bmjmilitary-2020-001686 ◽

2021 ◽

pp. bmjmilitary-2020-001686

Author(s):

Iain T Parsons ◽

R M Gifford ◽

M J Stacey ◽

L E Lamb ◽

M K O'Shea ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Military Studies ◽

Vitamin D Receptors ◽

Area Of Interest ◽

Military Populations ◽

Tract Infections ◽

Recruit Training

For most individuals residing in Northwestern Europe, maintaining replete vitamin D status throughout the year is unlikely without vitamin D supplementation and deficiency remains common. Military studies have investigated the association with vitamin D status, and subsequent supplementation, with the risk of stress fractures particularly during recruit training. The expression of nuclear vitamin D receptors and vitamin D metabolic enzymes in immune cells additionally provides a rationale for the potential role of vitamin D in maintaining immune homeostasis. One particular area of interest has been in the prevention of acute respiratory tract infections (ARTIs). The aims of this review were to consider the evidence of vitamin D supplementation in military populations in the prevention of ARTIs, including SARS-CoV-2 infection and consequent COVID-19 illness. The occupational/organisational importance of reducing transmission of SARS-CoV-2, especially where infected young adults may be asymptomatic, presymptomatic or paucisymptomatic, is also discussed.

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Bone mineral density at age 7 years does not associate with adherence to vitamin D supplementation guidelines in infancy or vitamin D status in pregnancy and childhood: An Odense Child Cohort study

British Journal Of Nutrition ◽

10.1017/s0007114521000301 ◽

2021 ◽

pp. 1-33

Author(s):

Signe Monrad Nørgaard ◽

Christine Dalgård ◽

Malene Søborg Heidemann ◽

Anders Jørgen Schou ◽

Henrik Thybo Christesen

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Bone Mineral ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Mineral Density ◽

Mineral Concentration ◽

High Adherence ◽

Bone Mineralisation ◽

In Pregnancy

Abstract Vitamin D supplementation in infancy is recommended to prevent rickets. At the population level, its effects on bone mineralisation are largely unknown. We aimed to explore whether adherence to national vitamin D supplementation guidelines (10 µg/day up to age 2 years), supplementation at ages 5 and 7 years, and serum 25-hydroxyvitamin D (s-25(OH)D) at various time points associated with bone mineral density (BMD) at age 7 years in the Odense Child Cohort, Denmark (n=1,194). High adherence was defined as supplementation with 10 µg vitamin D 6-7 times per week during ≥ 80 % of the observation time. S-25(OH)D was analysed using liquid chromatography-tandem mass spectrometry. Total-body-less-head (TBLH) BMD was measured by dual-energy X-ray absorptiometry. At median age 18.1 months, 53.9 % (n=475/881) reported high adherence. The median s-25(OH)D was 64.7, 78.8, 46.0, and 71.8 nmol/l in early pregnancy, late pregnancy, cord blood, and at 5 years, respectively. The mean (SD) TBLH BMD at median age 7.1 years was 0.613 (0.049) g/cm2 (z-score +0.363 (0.824)). In adjusted analyses, vitamin D supplementation up to 18 months, and at 5 and 7 years, was not associated with TBLH BMD. Similarly, no robust associations were found between TBLH BMD and s-25(OH)D at any time point. No associations were found for TBLH bone mineral concentration or bone area. In this population with relatively high s-25(OH)D concentrations, no consistent associations were found between adherence to vitamin D supplementation recommendations or vitamin D status in pregnancy or childhood, and bone mineralisation at age 7 years.

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The effect of calcium and vitamin D supplementation on obesity in postmenopausal women: secondary analysis for a large-scale, placebo controlled, double-blind, 4-year longitudinal clinical trial

Nutrition & Metabolism ◽

10.1186/1743-7075-7-62 ◽

2010 ◽

Vol 7 (1) ◽

pp. 62 ◽

Cited By ~ 31

Author(s):

Jiapeng Zhou ◽

Lan-Juan Zhao ◽

Patrice Watson ◽

Qin Zhang ◽

Joan M Lappe

Keyword(s):

Clinical Trial ◽

Vitamin D ◽

Postmenopausal Women ◽

Large Scale ◽

Secondary Analysis ◽

Vitamin D Supplementation ◽

Double Blind

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Modifiable factors of vitamin D status among a Brazilian osteoporotic population attended a public outpatient clinic

Arquivos Brasileiros de Endocrinologia & Metabologia ◽

10.1590/0004-2730000003393 ◽

2014 ◽

Vol 58 (5) ◽

pp. 572-582 ◽

Cited By ~ 3

Author(s):

Marília Brasilio Rodrigues Camargo ◽

llda Sizue Kunii ◽

Lilian Fukusima Hayashi ◽

Patrícia Muszkat ◽

Catherine Gusman Anelli ◽

...

Keyword(s):

Physical Activity ◽

Vitamin D ◽

Dietary Habits ◽

Vitamin D Supplementation ◽

Community Dwelling ◽

Vitamin D Status ◽

Mineral Density ◽

Cross Sectional ◽

Modifiable Factors ◽

The Mean

Objectives To evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian osteoporotic patients and the modifiable factors of vitamin D status in this population. Subjects and methods In a cross-sectional study, 363 community-dwelling patients who sought specialized medical care were evaluated between autumn and spring in São Paulo, Brazil. Serum levels of 25(OH)D and parathormone (PTH), biochemical and anthropometric measurements, and bone density scans were obtained. The group was assessed using two questionnaires: one questionnaire covered lifestyle and dietary habits, skin phototype, sun exposure, medical conditions, and levels of vitamin D supplementation (cholecalciferol); the other questionnaire assessed health-related quality-of-life. Logistic regression and a decision tree were used to assess the association between the variables and the adequacy of vitamin D status. Results The mean age of the overall sample was 67.9 ± 8.6 years, and the mean 25(OH)D concentration was 24.8 ng/mL. The prevalence of inadequate vitamin D status was high (73.3%), although 81.5% of the subjects were receiving cholecalciferol (mean dose of 8,169 IU/week). 25(OH)D was positively correlated with femoral neck bone mineral density and negatively correlated with PTH. In the multivariate analysis, the dose of cholecalciferol, engagement in physical activity and the month of the year (September) were associated with improvement in vitamin D status. Conclusions In this osteoporotic population, vitamin D supplementation of 7,000 IU/week is not enough to reach the desired 25(OH)D concentration (≥ 30 ng/mL). Engagement in physical activity and the month of the year are modifiable factors of the vitamin D status in this population.

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Vitamin D Status and Severe COVID-19 Disease Outcomes in Hospitalized Patients

Journal of Primary Care & Community Health ◽

10.1177/21501327211041206 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110412

Author(s):

Jennifer L. Pecina ◽

Stephen P. Merry ◽

John G. Park ◽

Tom D. Thacher

Keyword(s):

Vitamin D ◽

Assisted Ventilation ◽

Vitamin D Supplementation ◽

Hospitalized Patients ◽

Vitamin D Status ◽

Icu Admission ◽

Hydroxyvitamin D ◽

Duration Of Hospitalization ◽

D Values ◽

Relationship Of

Background: Vitamin D deficiency may increase the risk of severe COVID-19 disease. Objectives: To determine if 25-hydroxyvitamin D [25(OH)D] levels in patients hospitalized for COVID-19 were associated with the clinical outcomes of days on oxygen, duration of hospitalization, ICU admission, need for assisted ventilation, or mortality. Methods: We conducted a retrospective study of 92 patients admitted to the hospital with SARS-CoV-2 infection between April 16, 2020 and October 17, 2020. Multivariable regression was performed to assess the independent relationship of 25(OH)D values on outcomes, adjusting for significant covariates and the hospitalization day the level was tested. Results: About 15 patients (16.3%) had 25(OH)D levels <20 ng/mL. Only 1 patient (3.4%) who had documented vitamin D supplementation prior to admission had 25(OH)D <20 ng/mL. Serum 25(OH)D concentrations were not significantly associated with any of our primary outcomes of days on oxygen, duration of hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, or mortality in any of the adjusted multivariable models. Adjusting for the hospital day of 25(OH)D sampling did not alter the relationship of 25(OH)D with any outcomes. Conclusion: Vitamin D status was not related to any of the primary outcomes reflecting severity of COVID-19 in hospitalized patients. However, our sample size may have lacked sufficient power to demonstrate a small effect of vitamin D status on these outcomes.

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