Vitamin D und kardiovaskuläre Erkrankungen: Standortbestimmung 2012/Vitamin D and cardiovascular diseases: where do we stand in 2012?

2012 ◽  
Vol 36 (5) ◽  
Author(s):  
Stefan Pilz ◽  
Winfried März
Keyword(s):  
Vitamin D ◽  
Cardiovascular Diseases ◽  
Kardiovaskuläre Erkrankungen ◽  
Arterielle Hypertonie ◽  
Vitamin D Supplementation ◽  
Kardiovaskuläre Risikofaktoren ◽  
Randomisierte Kontrollierte Studien ◽  
Kardiovaskuläre Ereignisse ◽  
Knock Out ◽  
25 Hydroxy Vitamin D

ZusammenfassungEs mehren sich die Hinweise, dass Vitamin D eine Rolle bei der Entstehung kardiovaskulärer Krankheiten spielen könnte. Vitamin D-Rezeptor (VDR) und Enzyme des Vitamin D-Stoffwechsels kommen im Gefäßsystem und im Herzen vor. VDR knock out Mäuse leiden an Herz-Kreislauf-Erkrankungen (HKE) und selektive Inaktivierung des VDR in Herzmuskelzellen verursacht Myokardhypertrophie. Viele, jedoch nicht alle Beobachtungsstudien haben gezeigt, dass Vitamin D-Mangel mit HKE und deren Risikofaktoren assoziiert ist. Niedrige Konzentrationen von 25-Hydroxy-Vitamin D (25 [OH] D) sind ein unabhängiger Risikofaktor für kardiovaskuläre Ereignisse, insbesondere für Schlaganfall und plötzlichen Herztod. Es gibt nur wenige randomisierte, kontrollierte Studien (RCT) zu diesem Thema, deren Aussagen durch die zusätzliche Gabe von Kalzium, welches das Risiko für kardiovaskuläre Erkrankungen (KVE) erhöhen kann, eingeschränkt sind. Studien, in denen nur Vitamin D supplementiert wurde, haben teilweise, aber nicht durchweg positive Auswirkungen auf kardiovaskuläre Risikofaktoren wie arterielle Hypertonie gezeitigt. Eine Reihe von großen Studien zu den Auswirkungen der Supplementierung von Vitamin D auf kardiovaskuläre Ereignisse und Mortalität haben bereits begonnen. Deren Design ist aber zum Beispiel wegen des Einschlusses von Personen mit relativ hohen 25 (OH) D-Spiegeln problematisch. Die Evidenz für allgemeine Empfehlungen zur Einnahme von Vitamin D zur Vorbeugung und Behandlung von KVE ist damit noch nicht hinreichend. Prävention und Behandlung eines Vitamin D-Mangels sind aber aufgrund der Wirkungen der Vitamin-D-Supplementation auf den Bewegungsapparat schon heute gerechtfertigt.

Weniger akute Atemwegsinfekte durch Vitamin-D-Supplementation?

2018 ◽  
Vol 97 (08) ◽  
pp. 524-525
Author(s):  
Klaus Weckbecker
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Individual Participant Data ◽  
Individual Participant ◽  
25 Hydroxy Vitamin D ◽  
25 Oh Vitamin D ◽  
Tract Infections

Martineau AR. et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017; 356: i6583 Vitamin D spielt Studien zufolge auch eine Rolle bei der Abwehr pathogener Keime: 25-Hydroxy-Vitamin D (25[OH] Vitamin D) unterstützt z. B. die Synthese antimikrobieller Peptide. Es gibt also eine mögliche Erklärung für die Beobachtung, dass Personen mit niedrigen Vitamin-D-Spiegeln besonders empfindlich gegenüber respiratorischen Infekten sind. Untersuchungen zu einer präventiven Wirkung des Vitamin D verliefen jedoch zum Teil widersprüchlich.

Demographic Characteristics, Risk Factors, and Presenting Features of Children with Symptomatic Nutritional Rickets: A French Series

2020 ◽  
Vol 93 (5) ◽  
pp. 304-312
Author(s):  
Claire Flot ◽  
Valérie Porquet-Bordes ◽  
Justine Bacchetta ◽  
Anya Rothenbuhler ◽  
Anne Lienhardt-Roussie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Pediatric Population ◽  
Vitamin D Supplementation ◽  
Demographic Characteristics ◽  
Total Serum ◽  
Nutritional Rickets ◽  
Total Serum Calcium ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

<b><i>Aim:</i></b> To describe the demographic characteristics, risk factors, and presenting features of children with symptomatic nutritional rickets in France. <b><i>Methods:</i></b> This is a retrospective study of 38 children diagnosed with nutritional rickets from 1998 to 2019. <b><i>Results:</i></b> We observed a higher frequency of rickets in males (74 vs. 26%), in young children (median age at diagnosis: 23 months; 82% were younger than 5 years), and in children with a non-Caucasian ethnic background (89%). Most children were exclusively breastfed (78%) without adequate vitamin D supplementation (89%). The most common presentations were bowed legs (63%), hypocalcemic seizures (21%), and growth retardation (11%). Approximately half (62%) of the children were hypocalcemic. The children presenting with hypocalcemic seizures were significantly younger (0.8 vs. 2.2 years; <i>p</i> = 0.041) and had lower total serum calcium levels (1.44 vs. 2.17 mmol/L; <i>p</i> &#x3c; 0.0001), higher phosphatemia (1.43 vs. 1.23 mmol/L; <i>p</i> = 0.020), and lower 25-hydroxy vitamin D levels (3 vs. 7 ng/mL; <i>p</i> = 0.020) but similar parathyroid hormone levels (357 vs. 289 ng/mL; <i>p</i> = 0.940) compared to rickets cases who did not experience hypocalcemic seizures. A dilated cardiomyopathy was detected in 14% of the children who had undergone echocardiography. <b><i>Conclusion:</i></b> Nutritional rickets remains endemic in the pediatric population and its most severe forms can have life-threatening sequelae. Health practitioners need to be cognizant of these facts to raise awareness and screen high-risk populations.

scholarly journals Cholecalciferol or Calcifediol in the Management of Vitamin D Deficiency

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1617 ◽  
Author(s):  
Manuel Sosa Henríquez ◽  
M. Jesús Gómez de Tejada Romero
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Musculoskeletal Diseases ◽  
Scientific Evidence ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Negative Consequences ◽  
Skeletal Health ◽  
Comparative Review ◽  
25 Hydroxy Vitamin D

Vitamin D deficiency is a global health problem due to its high prevalence and its negative consequences on musculoskeletal and extra-skeletal health. In our comparative review of the two exogenous vitamin D supplementation options most used in our care setting, we found that cholecalciferol has more scientific evidence with positive results than calcifediol in musculoskeletal diseases and that it is the form of vitamin D of choice in the most accepted and internationally recognized clinical guidelines on the management of osteoporosis. Cholecalciferol, unlike calcifediol, guarantees an exact dosage in IU (International Units) of vitamin D and has pharmacokinetic properties that allow either daily or even weekly, fortnightly, or monthly administration in its equivalent doses, which can facilitate adherence to treatment. Regardless of the pattern of administration, cholecalciferol may be more likely to achieve serum levels of 25(OH)D (25-hydroxy-vitamin D) of 30–50 ng/mL, an interval considered optimal for maximum benefit at the lowest risk. In summary, the form of vitamin D of choice for exogenous supplementation should be cholecalciferol, with calcifediol reserved for patients with liver failure or severe intestinal malabsorption syndromes.

scholarly journals Analyzing Adherence to Prenatal Supplement: Does Pill Count Measure Up?

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Kristie E. Appelgren ◽  
Paul J. Nietert ◽  
Thomas C. Hulsey ◽  
Bruce W. Hollis ◽  
Carol L. Wagner
Keyword(s):  
Vitamin D ◽  
Vitamin D Supplementation ◽  
Pill Count ◽  
Sensitivity Analyses ◽  
Multivariate Logistic Regression Model ◽  
Alternative Approach ◽  
Pill Counts ◽  
25 Hydroxy Vitamin D ◽  
State Variation ◽  
Definition Of

Objective. To determine if adherence as measured by pill count would show a significant association with serum-based measures of adherence.Methods. Data were obtained from a prenatal vitamin D supplementation trial where subjects were stratified by race and randomized into three dosing groups: 400 (control), 2000, or 4000 IU vitaminD3/day. One measurement of adherence was obtained via pill counts remaining compared to a novel definition for adherence using serum 25-hydroxy-vitamin D (25-OH-D) levels (absolute change in 25(OH)D over the study period and the subject's steady-state variation in their 25(OH)D levels). A multivariate logistic regression model examined whether mean percent adherence by pill count was significantly associated with the adherence measure by serum metabolite levels.Results. Subjects' mean percentage of adherence by pill count was not a significant predictor of adherence by serum metabolite levels. This finding was robust across a series of sensitivity analyses.Conclusions. Based on our novel definition of adherence, pill count was not a reliable predictor of adherence to protocol, and calls into question how adherence is measured in clinical research. Our findings have implications regarding the determination of efficacy of medications under study and offer an alternative approach to measuring adherence of long half-life supplements/medications.

scholarly journals Inflammatory activity and vitamin D levels in an MS population treated with rituximab

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982659 ◽  
Author(s):  
Johan Linden ◽  
Gabriel Granåsen ◽  
Jonatan Salzer ◽  
Anders Svenningsson ◽  
Peter Sundström
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Magnetic Resonance ◽  
Vitamin D Supplementation ◽  
Inflammatory Activity ◽  
T2 Lesions ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Multiple Sclerosis Patients

Background Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed. Objective To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels. Methods Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health. Results In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects. Conclusion The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.

scholarly journals Characterizing the Assessment and Management of Vitamin D Levels in Patients with Osteoporosis in Clinical Practice: A Chart Review Initiative

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jonathan D. Adachi ◽  
Jacques P. Brown ◽  
George Ioannidis
Keyword(s):  
Vitamin D ◽  
Clinical Practice ◽  
Bone Health ◽  
Chart Review ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Vitamin D Supplements

Though vitamin D is important for bone health, little is known about the monitoring and management of vitamin D levels in patients with osteoporosis in clinical practice—a deficit this chart review initiative aimed to remedy. A total of 52 physicians completed profiles for 983 patients being treated for osteoporosis between November 2008 and April 2009. Information collected included demographics; fracture risk factors; availability and level of serum vitamin D measurements; and information on osteoporosis medications and calcium and vitamin D supplementation. Physicians also evaluated patients’ current regimens and detailed proposed changes, if applicable. Nearly 85% of patients were prescribed calcium and vitamin D supplements. Serum 25-hydroxy vitamin D levels were available for 73% of patients. Of these patients, approximately 50% had levels less than 80 nmol/L, which contrasts with the 37% thought to have “unsatisfactory” vitamin D levels based on physician perceptions. Physicians felt 26% of patients would benefit from additional vitamin D supplementation. However, no changes to the osteoporosis regimen were suggested for 48% of patients perceived to have “unsatisfactory” vitamin D levels. The results underscore the importance of considering vitamin D status when looking to optimize bone health.

scholarly journals Does Serum Vitamin D Concentration Modify the Association Between Arthritis and Cardiovascular Diseases in Both Sexes?

2020 ◽  
Author(s):  
Rachelle Saade ◽  
Danielle Laurin ◽  
Clermont E. Dionne
Keyword(s):  
Vitamin D ◽  
Cardiovascular Diseases ◽  
Protective Factors ◽  
Inflammatory Arthritis ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Cross Sectional ◽  
Men And Women ◽  
Serum Vitamin D ◽  
The Impact

Abstract Background: The scientific literature shows an association between inflammatory arthritis and cardiovascular diseases (CVD) with inflammation being a shared characteristic between the two types of diseases. Among patients with arthritis, it is possible that the protective factors against inflammation, such as vitamin D, are also protective factors against the development of CVD. This effect may be different according to sex.Objective: To evaluate the impact of serum vitamin D concentration on the association between arthritis and CVD separately among men and women (effect modification of vitamin D and sex).Methods: Data came from a large representative sample of the US population: the National Health and Nutrition Examination Survey (NHANES) 2005-2006, which included 3406 adults aged between 20 and 69 years. Measurements of arthritis (primary independent variable) and CVD (dependent variable) were taken during face-to-face interviews, while the measurement of serum vitamin D was carried out on blood samples. Multivariate logistic regression analyses were performed in which the combined modifying effect of vitamin D (<20 ng/ml/> 20 ng/ml) and sex was tested, and adjusted for several potentially confounding variables.Results: Arthritis was statistically associated with CVD in both men and women, with <20 ng/ml or >20 ng/ml serum vitamin D. In men, the adjusted ratio of the odds ratios (ROR) comparing the association at <20 ng/ml vitamin D concentration to the association at >20 ng/ml concentration was 0.8 (95% CI 0.5 to 1.5); in women, the adjusted ROR was 0.7 (95% CI 0.3 to 1.5). Conclusions: In this large cross-sectional study, arthritis and CVD were statistically associated, but this association was not modified by sex nor vitamin D concentrations. Vitamin D supplementation is not recommended as part of the management of patients of both sexes suffering from inflammatory arthritis to prevent CVD.

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