The Effects of Vitamin D Supplementation and 25-hydroxyvitamin D Levels on The Risk of MI and Mortality

Abstract Objective Aim of the study was to examine the effects of the vitamin D (Vit-D) treatment and non-treatment on Vit-D-deficient patients without a prior history of myocardial infarction (MI). Materials and Methods This is an retrospective, observational, nested case-control study of patients (N=20,025) with low 25-hydroxyvitamin D [(25-OH)D] levels (<20 ng/ml) who received care at the Veterans Health Administration from 1999-2018. Patients were divided into three groups: Group A (untreated, levels ≤20 ng/ml), Group B (treated, levels 21-29 ng/ml), and Group C (treated, levels ≥30 ng/ml). The risk of MI and all-cause-mortality were compared utilizing propensity score-weighted cox-proportional hazard models. Results Among the cohort of 20,025 patients, the risk of MI was significantly lower in Group C, compared to Group B [hazard ratio (HR) 0.65, 95% CI; 0.49-0.85, P=.002] and Group A (HR 0.73, 95% CI; 0.55-0.96), P=.02). There was no difference in the risk of MI between Group B and Group A (HR 1.14, 95% CI; 0.91-1.42, P=.24]. Compared to Group A, both Group B (HR 0.59, 95% CI; 0.54-0.63, P<.001] and Group C (HR 0.61, 95% CI; 0.56-0.67, P<.001] had significantly lower all-cause-mortality. There was no difference in all-cause-mortality between Group B and Group C (HR 0.99, 95% CI; 0.89-1.09, P=.78). Conclusions In patients with Vit-D-deficiency and no prior history of MI, treatment to the (25-OH)D level of >20 ng/ml and >30 ng/ml was associated with a significantly lower risk of all-cause-mortality. The lower risk of MI was observed only in individuals maintaining the (25-OH)D levels ≥30 ng/ml.

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Vitamin D Dosing Strategies Among Jordanians With Hypovitaminosis D

Journal of Pharmacy Practice ◽

10.1177/0897190015626334 ◽

2016 ◽

Vol 30 (2) ◽

pp. 172-179 ◽

Cited By ~ 1

Author(s):

Nahla Khawaja ◽

Mohammed Liswi ◽

Mohammed El-Khateeb ◽

Dana Hyassat ◽

Dalila Bajawi ◽

...

Keyword(s):

Body Mass Index ◽

Vitamin D ◽

Hypovitaminosis D ◽

Hydroxyvitamin D ◽

Dosing Strategies ◽

Optimal Maintenance ◽

Group A ◽

25 Hydroxyvitamin D ◽

The Mean ◽

Group B

Objective: To compare between weekly and daily cholecalciferol in patients with hypovitaminosis D and to determine the optimal maintenance dose. Methods: Seventy-one volunteers with hypovitaminosis D were randomly assigned to 2 dose regimens: cholecalciferol 50 000 IU weekly for 8 weeks, then 50 000 IU monthly for 2 months (group A) and 7000 IU daily for 8 weeks, then 12 500 IU weekly for 2 months (group B). Cholecalciferol was stopped for 2 months and reintroduced as 50 000 IU bimonthly for group A and 50 000 IU monthly for group B. Results: Two months after therapy, the mean serum 25-hydroxyvitamin D (25(OH)D) level increased from 11.4 to 51.2 ng/mL and from 11.7 to 44.9 ng/mL in groups A and B, respectively ( P = .065). The levels of 25(OH)D declined similarly in both groups during maintenance and after holding therapy. After resuming cholecalciferol, 25(OH)D levels increased to 33.8 and 28.8 ng/mL in groups A and B, respectively ( P = .027). There was a negative correlation between serum 25(OH)D levels and body mass index (BMI; P = .040). Conclusion: Timing and frequency of the dosing (daily vs weekly) have no effect on the rise in serum 25(OH)D levels as long as the accumulative dose of cholecalciferol is similar. Cholecalciferol 50 000 IU bimonthly is required to maintain sufficient 25(OH)D levels.

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Is preoperative calcium and vitamin D supplementation effective in prevention of postoperative hypocalcaemia in thyroidectomised patients?

Archives of Medical Science ◽

10.5114/aoms/121044 ◽

2021 ◽

Author(s):

Anna Grzegory ◽

Lech Pomorski ◽

Konrad Pagacz ◽

Karol Sieniawski ◽

Krzysztof Kaczka

Keyword(s):

Vitamin D ◽

Calcium Carbonate ◽

Total Thyroidectomy ◽

Vitamin D Supplementation ◽

Oral Supplementation ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Group A ◽

25 Hydroxyvitamin D ◽

Group B

IntroductionHypocalcaemia remains the most common postoperative complication after total thyroidectomy. The purpose of the study was to evaluate the clinical usefulness of routine preoperative oral calcium and vitamin D supplementation in the prevention of hypocalcaemia after total thyroidectomy.Material and methodsOne hundred fifty-three consecutive patients with nontoxic multinodular goitre were randomly assigned to routinely receive (group B) or not to receive (group A) calcium carbonate (3 g/d) and alfacalcidol (1 µg/d) on the day before surgery and calcium carbonate (1 g/d) and alfacalcidol (1 µg/d) taken once in the morning on the day of operation. Their preoperative 25-hydroxyvitamin D (25-OHD) levels, hypocalcemic symptoms, serum calcium and parathyroid hormone (iPTH) levels were determined 6 and 24 hour postoperatively and 6 weeks after surgery.ResultsSymptomatic hypocalcaemia was observed in 41/153(26.79%) patients. The incidence of symptomatic hypocalcaemia was significantly lower in the supplemented group than in the group not receiving supplementation: 10 of 77 participants (12.99%) versus 31 of 76 patients (40.79%) (p<0.05). The rates of laboratory and severe hypocalcaemia (corrected calcium <2.0 mmol/l) were 67.11% and 28.95% in group A and 50.65% and 9.09% in group B, respectively (p=0.04, p<0.05). There were no significant differences between groups A and B in corrected calcium levels after surgery and postoperative decreases in corrected calcium levels (p=0.06). 112(73.20%) participants had 25-OHD<20 ng/ml. Vitamin D levels did not influence corrected calcium level changes (p=0.98).ConclusionsOral supplementation of calcium and alfacalcidol may help in the prevention of postthyroidectomy hypocalcaemia. Vitamin D deficiency was widespread among operated patients.

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Effect of vitamin D supplementation, directly or via breast milk for term infants, on serum 25 hydroxyvitamin D and related biochemistry, and propensity to infection: a randomised placebo-controlled trial

British Journal Of Nutrition ◽

10.1017/s0007114516001756 ◽

2016 ◽

Vol 116 (1) ◽

pp. 52-58 ◽

Cited By ~ 12

Author(s):

David D. Chandy ◽

Jahnavi Kare ◽

Shakal N. Singh ◽

Anjoo Agarwal ◽

Vinita Das ◽

...

Keyword(s):

Vitamin D ◽

Alkaline Phosphatase ◽

Controlled Trial ◽

Sun Exposure ◽

Vitamin D Supplementation ◽

Elevated Alkaline Phosphatase ◽

Hydroxyvitamin D ◽

Group A ◽

25 Hydroxyvitamin D ◽

Group B

AbstractWe assessed the effect of vitamin D supplementation on related biochemistry, infection and dentition of the infant. In a double-blind, placebo-controlled trial conducted in Lucknow, India (latitude 26°N), 230 mother –newborn pairs were randomised to receive, for 9 months, 3000µg/month oral vitamin D3 by the mother (group A) or 10µg/d by the infant (group B) or double placebo (group C). All babies received 15 min of sun exposure (unclothed) during massage. Infants’ median 25-hydroxyvitamin D (25(OH)D) was lower in group C (median 45·3; interquartile range (IQR) 22–59·5 nmol/l) than in groups A (median 60·8; IQR 41·3–80·5 nmol/l (P<0·01)) and B (median 61·3; IQR 41·3–75·3 nmol/l (P<0·05)) at 3·5 months. Infant 25(OH)D correlated negatively with infant parathyroid hormone (r −0·46, P<0·01). Elevated alkaline phosphatase (>7.5µkat/l) was significantly more frequent in group C babies (16 %) than in group A (4 %) or group B (0 %) babies. The number of days with respiratory or diarrhoeal infection by 9 months of age was higher in group C (median 46·5; IQR 14·8–73·3 d) than in group A (median 18·5; IQR 8·8–31·0 d (P<0·01)) or group B (median 13·0; IQR 7·0–28·5 (P<0·05)). We conclude that monthly maternal or daily infant supplementation with vitamin D along with sun exposure is superior to sun exposure alone in maintaining normal infant 25(OH)D at 3·5 months, and provide protection from elevated alkaline phosphatase and infectious morbidity.

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Advancing the Understanding of Vitamin D Status in Post-Thyroidectomy Hypocalcemia

International Journal of Endocrinology ◽

10.1155/2021/5598319 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Gurdeep Singh ◽

Fatima Irshaidat ◽

Christopher Lau ◽

Ariel Pedoeem ◽

Christine Feng ◽

...

Keyword(s):

Vitamin D ◽

Total Thyroidectomy ◽

Reference Range ◽

Common Complication ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

Group A ◽

25 Hydroxyvitamin D ◽

Group B

Background. Post-thyroidectomy hypocalcemia is the most common complication after total thyroidectomy. Studies to examine the role of low vitamin D in increasing post-thyroidectomy hypocalcemia incidence have produced varying results. This study aimed to assess whether vitamin D deficiency increases the risk of post-thyroidectomy hypocalcemia. Methods. This retrospective study involved 244 patients who underwent total thyroidectomy between 2014 and 2019. Patients were divided into two groups based on pre-operative vitamin D levels. Group A and Group B had pre-operative vitamin D (25-hydroxyvitamin D) levels of ≥20 ng/ml and <20 ng/ml (reference range for vitamin D is 30–100 ng/dl). The effect of vitamin D, gender, body mass index (BMI), and ethnicity on post-operative calcium and PTH levels was analyzed. Results. Post-operative calcium levels for Group A were not statistically different compared to Group B (8.52 ± 0.64 mg/dl vs. 8.45 ± 0.58 mg/dl (mean ± S.D.; p value = 0.352). The average post-operative PTH of the two groups did not differ significantly (Group A: 32.4 ± 27.5 pg/ml; Group B: 34.4 ± 41.7 pg/ml; p value = 0.761). Conclusion. Pre-operative vitamin D levels are not predictive of post-thyroidectomy hypocalcemia.

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Sex and body mass index dependent associations between serum 25-hydroxyvitamin D and pulse pressure in middle-aged and older US adults

Scientific Reports ◽

10.1038/s41598-021-88855-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jung Hyun Kwak ◽

Yoon-Hyeong Choi

Keyword(s):

Body Mass Index ◽

Vitamin D ◽

Body Mass ◽

Pulse Pressure ◽

Lower Risk ◽

Hydroxyvitamin D ◽

Vascular Stiffening ◽

25 Hydroxyvitamin D ◽

Dose Dependent ◽

Overweight Subjects

AbstractHigh pulse pressure (PP) is a valid indicator of arterial stiffness. Many studies have reported that vitamin D concentration is inversely associated with vascular stiffening. This association may differ depending on sex and body mass index (BMI). This study investigated the associations between vitamin D and PP and evaluated whether these associations differ according to sex and BMI, using data for individuals aged ≥ 50 years from the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were used as biomarkers of vitamin D levels. High PP was defined as ≥ 60 mmHg. Total 25(OH)D concentrations were dose-dependently associated with lower odds ratios (ORs) for high PP (p-trend = 0.01), after controlling for sociodemographic, behavioral, and dietary factors. When stratified by sex, there was a dose-dependent association between total 25(OH)D concentrations and lower risk of high PP (p-trend < 0.001) in females, but not in males. When stratified by BMI, there was a dose-dependent association between total 25(OH)D concentrations and lower risk of high PP (p-trend < 0.001) in non-overweight subjects, but not in overweight subjects. Improving the vitamin D status could delay elevation of PP and vascular stiffening in female and non-overweight subjects.

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Relationship Between Level of Serum 25-Hydroxyvitamin D and Risk of Squamous Cell Carcinoma in an Iranian Population

Dermatology Practical & Conceptual ◽

10.5826/dpc.0904a06 ◽

2019 ◽

pp. 278-282

Author(s):

Mahboobeh-Sadat Hosseini ◽

Fereshteh Salarvand ◽

Amir Houshang Ehsani ◽

Pedram Noormohammadpour ◽

Shadi Azizzadeh ◽

...

Keyword(s):

Vitamin D ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Outdoor Environment ◽

Hydroxyvitamin D ◽

Vitamin D Levels ◽

History Of ◽

25 Hydroxyvitamin D ◽

The Relationship

Background: The relationship between vitamin D and skin squamous cell carcinoma (SCC) is not well defined. Objective: To investigate the relationship between vitamin D levels and the incidence of skin SCC for the first time in Iran. Methods and Study Design: In this case-control study, 126 subjects were enrolled (63 in each group) out of referents to Razi Skin Hospital in Tehran in 2014. The risk factors for cancer gathered by self-reported questionnaires and blood samples were obtained to measure the level of 25-hydroxyvitamin D. Multivariate logistic regression was used to neutralize the effect of confounding factors. Results: Cases of SCC were more likely to be in men, older than 49 years and working in an outdoor environment, and with longtime exposure to sunlight and a personal history of skin cancers. Family history of skin cancer and of cigarette smoking were not significantly related to SCC. In the SCC and control groups, 69.8% and 31.7%, respectively, had sufficient levels of vitamin D (P < 0.001). Mean level of 25-hydroxyvitamin D was 40.99 ng/mL in the SCC group and 26.34 ng/mL in the control group (P < 0.05). In the unadjusted model, the level of vitamin D as a continuous variable was positively related to SCC risk. In the adjusted model, vitamin D did not independently predict the likelihood of SCC. Conclusion: Vitamin D level and SCC risk are directly related, although not in an independent fashion. Indeed, this relation is severely confounded by exposure to sunlight, which was evidenced by an increased vitamin D level in the people working outside and the higher prevalence of SCC in the same population.

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Association of serum 25-hydroxyvitamin D concentrations with all-cause and cause-specific mortality among individuals with diabetes mellitus

10.2337/figshare.12863750.v1 ◽

2020 ◽

Author(s):

Zhenzhen Wan ◽

Jingyu Guo ◽

An Pan ◽

Chen Chen ◽

Liegang Liu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Vitamin D ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

All Cause Mortality ◽

Specific Mortality ◽

25 Hydroxyvitamin D ◽

Nationally Representative ◽

Reduced Risk ◽

Cvd Mortality

Objective: The evidence regarding vitamin D status and mortality among diabetes is scarce. This study aimed to examine the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cause-specific mortality among adults with <a>diabetes mellitus</a>. Research Design and Methods: This study included 6329 adults with diabetes from the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 2001-2014. Death outcomes were ascertained by linkage to National Death Index records through 31 December 2015. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence (CIs) for mortality from all causes, cardiovascular disease (CVD), and cancer. Results: The weighted mean (95% CI) level of serum 25(OH)D was 57.7 (56.6, 58.8) nmol/L, and 46.6% had deficient vitamin D (<50 nmol/L [20 ng/mL]). <a>Higher </a>serum 25(OH)D levels were significantly associated with lower levels of glucose, insulin, HOMA-IR, HbA1c, blood lipids, and C-reactive protein at baseline (all Ptrend<0.05). During 55126 person-years of follow-up, 2056 deaths were documented, including 605 CVD deaths and 309 cancer deaths. <a>After multivariate adjustment, higher </a>serum 25(OH)D levels were significantly and linearly associated with lower all-cause and CVD mortality: there was a 31% reduced risk of all-cause mortality and a 38% reduced risk of CVD mortality per one unit increment in natural log-transformed 25(OH)D (both P<0.001). Compared with participants with 25(OH)D <25 nmol/L, the multivariate-adjusted HRs and 95% CI for participants with 25(OH)D >75 nmol/L were 0.59 (0.43, 0.83) for all-cause mortality (Ptrend=0.003), 0.50 (0.29, 0.86) for CVD mortality (Ptrend=0.02), and 0.49 (0.23, 1.04) for cancer mortality (Ptrend=0.12). Conclusions: In a nationally representative sample of US adults with diabetes, higher serum 25(OH)D levels were significantly associated with lower all-cause and CVD mortality. These findings suggest that maintaining adequate vitamin D status may lower mortality risk in individuals with diabetes.

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Effect of supplementation with vitamin D2-enhanced mushrooms on vitamin D status in healthy adults

Journal of Nutritional Science ◽

10.1017/jns.2013.22 ◽

2013 ◽

Vol 2 ◽

Cited By ~ 15

Author(s):

Magdalena Stepien ◽

Louise O'Mahony ◽

Aifric O'Sullivan ◽

John Collier ◽

William D. Fraser ◽

...

Keyword(s):

Vitamin D ◽

Plasminogen Activator Inhibitor ◽

Healthy Adults ◽

Vitamin D Status ◽

Plasminogen Activator Inhibitor 1 ◽

Daily Consumption ◽

Hydroxyvitamin D ◽

The Metabolic Syndrome ◽

Group A ◽

25 Hydroxyvitamin D

AbstractVitamin D deficiency is emerging worldwide and many studies now suggest its role in the development of several chronic diseases. Due to the low level of vitamin D naturally occurring in food there is a need for supplementation and use of vitamin D-enhanced products. The aim of the present study was to determine if daily consumption of vitamin D2-enhanced mushrooms increased vitamin D status in free-living healthy adults or affected markers of the metabolic syndrome. A total of ninety volunteers (aged 40–65 years) were randomly assigned to one of two 4-week studies: mushroom study (15 µg vitamin D2 or placebo mushroom powder) and capsule study (15 µg vitamin D3 or placebo capsules). Consumption of vitamin D2-enhanced mushrooms increased serum 25-hydroxyvitamin D2 (25(OH)D2) by 128 % from baseline (3·9 (sd 1·9) nmol/l; P < 0·05). Serum 25(OH)D3 increased significantly in the vitamin D3 capsule group (a 55 % increase from a baseline of 44.0 (sd 17·1) nmol/l; P < 0·05). Vitamin D status (25(OH)D) was affected only in the vitamin D3 group. Plasminogen activator inhibitor-1 was lowered by vitamin D2 intake. Vitamin D2 from enhanced mushrooms was bioavailable and increased serum 25(OH)D2 concentration with no significant effect on 25(OH)D3 or total 25(OH)D.

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Associations between Serum-Intact Parathyroid Hormone, Serum 25-Hydroxyvitamin D. Oral Vitamin D Analogs and Metabolic Syndrome in Peritoneal Dialysis Patients: A Multi-Center Cross-Sectional Study

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00001 ◽

2014 ◽

Vol 34 (4) ◽

pp. 447-455 ◽

Cited By ~ 6

Author(s):

Jie Dong ◽

Qin Wang ◽

Meng-Hua Chen ◽

Hui-Ping Zhao ◽

Tong-Ying Zhu ◽

...

Keyword(s):

Metabolic Syndrome ◽

Vitamin D ◽

Peritoneal Dialysis ◽

Parathyroid Hormone ◽

Lower Risk ◽

Intact Parathyroid Hormone ◽

Oral Vitamin ◽

Vitamin D Analogs ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Introduction Although previous studies have suggested associations between serum intact parathyroid hormone (iPTH), 25-hydroxyvitamin D (25(OH)D) and metabolic syndrome (MS) in the general population, these associations are still uncharacterized in peritoneal dialysis (PD) patients. Methods In total, 837 prevalent PD patients from 5 centers in China were enrolled between April 1, 2011 and November 1, 2011. The demographic data, biochemical parameters and medical records were collected, except for serum 25(OH)D which was measured in 347 of 837 patients. The definition of MS was modified from National Cholesterol Education Program Third Adult Treatment Panel (NCEP-ATPIII). Results 55.4% of 837 patients were found to have MS. The median concentration of iPTH, 25(OH)D and doses of oral vitamin D analogs for participants with MS was significantly lower than those without MS. The iPTH, 25(OH)D values and doses of vitamin D analogs were all associated with one or more components of MS. After multivariate adjustment, Low serum iPTH values and oral vitamin D analogs, rather than serum 25(OH)D, were significantly associated with the presence of MS, abnormal fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HDL-C). Compared to iPTH < 130pg/mL, iPTH 130–585 pg/mL and > 585pg/mL were associated with a lower risk of MS with adjusted odds ratio (OR) of 0.59 and 0.33, respectively. Taking vitamin D analogs was also associated with a lower risk of MS with adjusted OR of 0.55. Conclusions Serum iPTH and the use of active vitamin D supplements rather than serum 25(OH)D were independently associated with the presence of MS in patients on PD.

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The Risk of All-Cause Mortality Is Inversely Related to Serum 25(OH)D Levels

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2012-1747 ◽

2012 ◽

Vol 97 (8) ◽

pp. 2792-2798 ◽

Cited By ~ 37

Author(s):

Walid Saliba ◽

Ofra Barnett ◽

Hedy S. Rennert ◽

Gad Rennert

Keyword(s):

Vitamin D ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Vital Status ◽

Hydroxyvitamin D ◽

All Cause Mortality ◽

General Population Cohort ◽

25 Hydroxyvitamin D ◽

Vitamin D Supplements

Abstract Context and Objectives: Vitamin D plays a key role in maintaining bone health, but evidence for its nonskeletal effects is inconsistent. This study aims to examine the association between serum 25-hydroxyvitamin D [25(OH)D] levels and all-cause mortality in a large general population cohort. Design, Participants, and Setting: Using the computerized database of the largest health care provider in Israel, we identified a cohort of subjects 20 years old or older with serum 25(OH)D levels measured between January 2008 and December 2009. Vital status was ascertained through August 2011. Results: Median follow-up was 28.5 months (interquartile range 23.8–33.5 months); 7,247 of 182,152 participants (4.0%) died. Subjects who died had significantly lower serum 25(OH)D levels (mean 44.8 ± 24.2 nmol/liter) than those alive at the end of follow-up (51.0 ± 23.2 nmol/liter), P < 0.001. After adjustment for age, gender, ethnicity, and seasonality, the hazard ratio (HR) for all-cause mortality was 2.02 [95% confidence interval (CI) 1.89–2.15] for the lowest serum 25(OH)D quartile (<33.8 nmol/liter) compared with the highest. After further adjustment for comorbidity, use of vitamin D supplements and statins, smoking, socioeconomic status, and body mass index, the HR was 1.81 (95% CI 1.69–1.95). This remained, even after adjustment for serum low-density lipoprotein, high-density lipoprotein, calcium level (corrected for serum albumin levels), and glomerular filtration rate, 1.85 (95% CI 1.70–2.01). The fully adjusted HR associated with being in the second 25(OH)D quartile (33.8–49.4 nmol/liter) was 1.25 (95% CI 1.16–1.34). Conclusions: All-cause mortality is independently and inversely associated with serum 25(OH)D levels at levels less than 50 nmol/liter.

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