Nutritional Supplementation of Naturally Occurring Vitamin D to Improve Hemorrhagic Stroke Outcomes

Vitamin D deficiency, if left untreated, is associated with bone disorders, cardiovascular damage, and an increased risk of ischemic stroke. While there are various nutritional options for the natural intake of vitamin D, we hope to elucidate the potential mechanisms dietary vitamin D may play in hemorrhagic stroke pathology. This scoping review outlines findings from studies relevant to the biochemical activity of vitamin D, the impact of vitamin D deficiency on hemorrhagic stroke outcomes, and the potential benefit of nutritional vitamin D on hemorrhagic stroke outcomes. Here, we analyze the relevant factors that can lead to vitamin D deficiency, and subsequently, a higher risk of hemorrhagic stroke incidence with worsened subsequent outcomes. The neuroprotective mechanisms through which vitamin D works to attenuate hemorrhagic stroke onset and post-stroke outcomes have not yet been thoroughly examined. However, researchers have proposed several potential protective mechanisms, including reduction of blood brain barrier disturbance by inhibiting the production of reactive oxygen species, mitigation of inflammation through a reduction of levels of proinflammatory cytokines, and prevention of cerebral vasospasm and delayed cerebral ischemia following subarachnoid hemorrhage and intracerebral hemorrhage. While more research is needed and there are limitations to vitamin D supplementation, vitamin D as a whole may play a significant role in the dynamics of hemorrhagic stroke. Further research should focus on expanding our understanding of the neuroprotective capacity and mechanisms of vitamin D, as well as how vitamin D supplementation could serve as an effective course of treatment of hemorrhagic strokes.

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The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease

Nutrients ◽

10.3390/nu11102458 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2458 ◽

Cited By ~ 4

Author(s):

Paschou ◽

Kosmopoulos ◽

Nikas ◽

Spartalis ◽

Kassi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

General Population ◽

Vitamin D Deficiency ◽

Strong Association ◽

Vitamin D Supplementation ◽

Obese Adults ◽

Increased Risk ◽

High Prevalence ◽

The Impact

The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.

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Implications of Vitamin D Research in Chickens can Advance Human Nutrition and Perspectives for the Future

Current Developments in Nutrition ◽

10.1093/cdn/nzab018 ◽

2021 ◽

Author(s):

Matthew F Warren ◽

Kimberly A Livingston

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

The Body ◽

Human Nutrition ◽

Vitamin D Metabolites ◽

Vitamin D Metabolism ◽

Related Research ◽

Vitamin D Intake ◽

Increased Risk

Abstract The risk of vitamin D insufficiency in humans is a global problem that requires improving ways to increase vitamin D intake. Supplements are a primary means for increasing vitamin D intake, but without a clear consensus on what constitutes vitamin D sufficiency, there is toxicity risk with taking supplements. Chickens have been used in many vitamin D-related research studies, especially studies involving vitamin D supplementation. Our state-of-the-art review evaluates vitamin D metabolism and how the different hydroxylated forms are synthesized. We provide an overview with how vitamin D is absorbed, transported, excreted, and what tissues in the body store vitamin D metabolites. We also discuss a number of studies involving vitamin D supplementation with broilers and laying hens. Vitamin D deficiency and toxicity are also described and how they can be caused. The vitamin D receptor (VDR) is important for vitamin D metabolism. However, there is much more that can be understood with VDR in chickens. Potential research aims involving vitamin D and chickens should explore VDR mechanisms which could lead to newer insights with VDR. Utilizing chickens in future research to help with elucidating vitamin D mechanisms has great potential to advance human nutrition. Finding ways to increase vitamin D intake will be necessary because the coronavirus 2019 disease (COVID-19) pandemic is leading to increased risk of vitamin D deficiency in many populations. Chickens can provide a dual purpose with addressing pandemic-caused vitamin D deficiency: 1) vitamin D supplementation gives chickens added value with possibly leading to vitamin D-enriched meat and egg products; and 2) chickens’ use in research provides data for translational research. Expanding vitamin D-related research in chickens to include more nutritional aims in vitamin D status has great implications with developing better strategies to improve human health.

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Abstract T P146: Vitamin D Deficiency is Associated With Stroke in Black and White Participants of the REGARDS Study

Stroke ◽

10.1161/str.45.suppl_1.tp146 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Suzanne E Judd ◽

Virginia J Howard ◽

Paul Muntner ◽

Brett M Kissela ◽

Bhupesh Panwar ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Racial Differences ◽

Sex Education ◽

The United States ◽

Dietary Vitamin ◽

Equal Distribution ◽

Black And White ◽

Increased Risk ◽

Regards Study

Objective: Black Americans are at greater risk of both stroke and vitamin D deficiency than white Americans. We have previously shown that both higher dietary vitamin D and sunlight exposure are associated with decreased risk of stroke; however, serum 25(OH) is thought to be a better marker of vitamin D status. Methods: Using a case cohort design, we examined the association of plasma 25(OH)D with incident stroke in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a cohort of black and white participants from across the United States enrolled between 2003 and 2007. Medical records were reviewed by physicians and strokes were classified on the basis of symptoms and neuroimaging. Strokes through July 1, 2011 were included. A stratified cohort sample was selected to ensure approximately equal numbers of black and white participants and an equal distribution across ages. We used Cox proportional hazards models weighted back to the original 30,239 participants, excluding those with history of stroke. Serum 25(OH)D was measured by Immunodetection Systems ELISA. Results: Over mean follow-up of 4.4 years, there were 539 ischemic and 71 hemorrhagic strokes. The stroke-free sub-cohort included 939 participants. After adjustment for age, race, sex, education, diabetes, hypertension, smoking, atrial fibrillation, heart disease, physical activity, kidney function, calcium and phosphorous, 25(OH)D level 30 ng/mL. The direction of association was similar for hemorrhagic stroke though not statistically significant (HR=1.59; 95%CI=0.78, 3.24). Vitamin D deficiency was associated with an increased risk of all stroke (HR=1.54; 95%CI=1.05, 2.23). This effect was greater in blacks (HR=2.09; 95%CI=1.09, 3.99) than whites (HR=1.38; 95%CI=0.78, 2.42). Results were not as strong when we modeled 25(OH)D as a continuous variable (HR=0.99 per 1 ng/ml change in 25(OH)D; 95%CI=0.98, 1.01). Discussion: Similar to low vitamin D intake, vitamin D deficiency is a risk factor for incident stroke. These findings support evidence from cardiovascular and cancer epidemiology that treating low 25(OH)D may prevent strokes.

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Prevalence of 25-hydroxyvitamin D deficiency in subgroups of elderly persons with anemia: association with anemia of inflammation

Blood ◽

10.1182/blood-2010-09-309708 ◽

2011 ◽

Vol 117 (10) ◽

pp. 2800-2806 ◽

Cited By ~ 69

Author(s):

Todd S. Perlstein ◽

Reena Pande ◽

Nancy Berliner ◽

Gary J. Vanasse

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Levels ◽

The Elderly ◽

Vitamin D Supplementation ◽

World Health ◽

Elderly Persons ◽

Increased Risk ◽

Health Organization ◽

Anemia Of Inflammation

AbstractAnemia and vitamin D deficiency are conditions that both result in significant morbidity and increase with age. The potential relationship between them remains poorly understood, particularly in the elderly. We used the Third National Health and Nutrition Examination Survey to examine the association of vitamin D deficiency with anemia subtypes in persons aged ≥ 60 years. Vitamin D deficiency was defined as serum levels < 20 ng/mL, and anemia was defined according to World Health Organization criteria. Vitamin D deficiency was associated with anemia prevalence independent of age, sex, or race/ethnicity (odds ratio, 1.47; 95% confidence interval, 1.06-2.05; P = .02) and varied significantly by anemia subtype (P overall = .003). The prevalence of vitamin D deficiency was 33.3% in the nonanemic population, 56% in anemia of inflammation (AI; P = .008), and 33.0% in unexplained anemia (P = .55). Non-Hispanic blacks had a 7-fold increased risk of AI compared with whites, and this was partially attenuated after adjusting for vitamin D deficiency. These data show that vitamin D deficiency is associated with specific subtypes of anemia in the elderly, especially in those with AI. Vitamin D may suppress inflammatory pathways, and studies to determine whether vitamin D supplementation ameliorates AI are warranted.

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Influence of Supplementary Vitamin D on the Prognostic Pathway of Type1 Diabetes Among Children

Biomedical & Pharmacology Journal ◽

10.13005/bpj/2126 ◽

2021 ◽

Vol 14 (1) ◽

pp. 303-309

Author(s):

Mostafa Hassan Ragab ◽

Eman Monir Sherif ◽

Nadia Badawy Abd- El Gawad ◽

Safaa Mohamed Elserougy ◽

Eman Essam Shaban ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Serum Vitamin ◽

Vitamin D Supplementation ◽

Oral Vitamin ◽

Intake Assessment ◽

Serum Vitamin D ◽

Vitamin D Levels ◽

Egyptian Children ◽

The Impact

Diabetes is one of the commonest chronic diseases worldwide. Vitamin D deficiency showed to be increasing, and have a potential role in autoimmune diseases among which in type 1 diabetes. The aim The aim of the study was to assess the impact of oral vitamin D supplementation on blood glucose (HbA1C) in T1DM patients and to find out the role of vitamin D as a biomarker for follow of T1DM patients compared to HbA1C. Subjects and methods: A randomized interventional clinical study was designed. The study enrolled 60 children patients with T1DM. Only 45 children continued to the end of study. Initial (pre-intake) assessment included history taking, clinical examination, and measurement of serum 25-OH vitamin D3 and serum HbA1C. These children received oral vitamin D supplements for 3 months then post-intake assessment were done again. Results: The study showed that serum vitamin D was deficient among Egyptian children and adolescents with T1DM (mean 11.4±3.4 ng/ml). , 53.33% of the patients had vitamin D deficiency with a 35.6% had insufficiency and 11.11% were VD sufficient. Patients received oral vitamin D supplementation for 3 months after which marked improvement in the levels of serum vitamin D levels and HA1C, 87.5% and 86.5% respectively.

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Are Indian obese children and adolescents at increased risk for Vitamin D deficiency?

Indian Journal of Medical Sciences ◽

10.25259/ijms_510_2020 ◽

2021 ◽

Vol 0 ◽

pp. 1-5

Author(s):

Aashima Dabas ◽

T. Aravind ◽

Sangeeta Yadav ◽

Mukta Mantan ◽

Smita Kaushik

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Obese Children ◽

Indian Children ◽

Hydroxyvitamin D ◽

Increased Risk ◽

High Risk Factor ◽

25 Hydroxyvitamin D ◽

Obese Subjects

Objectives: Obesity has been mentioned as a high risk factor for Vitamin D deficiency (VDD) requiring supplementation in Indian children. Material and Methods: Forty obese and age-matched non-obese subjects (age 5–18 years) were assessed for lifestyle parameters, metabolic profile, and serum 25-hydroxyvitamin D (25OHD). VDD was defined as serum 25OHD < 12 ng/mL. Results: Mean 25OHD was comparable among obese and controls (15.0 ± 9.95 and 15.1 ± 4.79 ng/mL; P = 0.97) with VDD seen in 82% of cases and 85% of controls. Pubertal cases had lower 25OHD values than prepubertal obese cases (10.78 ± 4.69 and 17.2 ± 11 ng/mL; P = 0.06). Mean duration of physical activity (<2 h/week) and screen time (>2 h/day) was similar across prepubertal and pubertal groups and between obese and controls. Obesity was not associated with risk for VDD among cases and controls (odds ratio 0.83, 95% C.I. 0.25–2.7, P = 0.76). Conclusion: Obese pubertal subjects were more at risk for VDD than prepubertal subjects. Routine Vitamin D supplementation to obese Indian children may be considered during adolescence.

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Low Vitamin D Levels Predict Mortality in Ankylosing Spondylitis Patients: A Nationwide Population-Based Cohort Study

Nutrients ◽

10.3390/nu12051400 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1400

Author(s):

Niv Ben-Shabat ◽

Abdulla Watad ◽

Aviv Shabat ◽

Nicola Luigi Bragazzi ◽

Doron Comaneshter ◽

...

Keyword(s):

Vitamin D ◽

Cohort Study ◽

Ankylosing Spondylitis ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Health Maintenance ◽

Increased Risk ◽

Vitamin D Levels ◽

All Cause Mortality

In this study, we aimed to examine the effect of vitamin D deficiency on all-cause mortality in ankylosing spondylitis (AS) patients and in the general population. This is a retrospective-cohort study based on the electronic database of the largest health-maintenance organization in Israel. AS patients who were first diagnosed between 2002–2007 were included. Controls were matched by age, gender and enrollment-time. Follow-up continued until death or end of study follow-up on 1 July 2019. Laboratory measures of serum 25-hydroxyvitamin-D levels during the entire follow-up period were obtained. A total of 919 AS patients and 4519 controls with a mean time of follow-up of 14.3 years were included. The mean age at the time of enrollment was 52 years, and 22% of them were females. AS was associated with a higher proportion of vitamin D deficiency (odds ratio 1.27 [95% confidence-interval (CI) 1.03–1.58]). In AS patients, insufficient levels of vitamin D (<30 ng/mL) were significantly associated with increased incidence of all-cause mortality (hazard ratio (HR) 1.59 [95% CI 1.02–2.50]). This association was more prominent with the decrease in vitamin D levels (< 20 ng/mL, HR 1.63 [95% CI 1.03–2.60]; <10 ng/mL, HR 1.79 [95% CI 1.01–3.20]) and among male patients (<30 ng/mL, HR 2.11 [95% CI 1.20–3.72]; <20 ng/mL, HR 2.12 [95% CI 1.19–3.80]; <10 ng/mL, HR 2.23 [95% CI 1.12–4.43]). However, inadequate levels of vitamin D among controls were not associated with an increased all-cause mortality. Our study has shown that vitamin D deficiency is more common in AS patients than controls and is linked to an increased risk for all-cause mortality. These results emphasize the need for randomized-controlled trials to evaluate the benefits of vitamin D supplementation as a secondary prevention of mortality in patients with chronic inflammatory rheumatic disease.

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Abstract 469: Vitamin D Deficiency Potentiates Restenosis Following Coronary Angioplasty in Hypercholesterolemic Swine

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.32.suppl_1.a469 ◽

2012 ◽

Vol 32 (suppl_1) ◽

Author(s):

Gaurav K Gupta ◽

Tanupriya Agrawal ◽

Michael G Del Core ◽

William J Hunter ◽

Devendra K Agrawal

Keyword(s):

Vitamin D ◽

Coronary Artery ◽

Vitamin D Deficiency ◽

Balloon Angioplasty ◽

Coronary Intervention ◽

Vitamin D Supplementation ◽

High Cholesterol Diet ◽

Cholesterol Diet ◽

High Cholesterol ◽

Increased Risk

Introduction: Vitamin D is a sectosteroid that functions through vitamin D receptor (VDR), a transcription factor, which regulates various downstream signaling pathways and controls the transcription of many targets genes. Vitamin D deficiency is associated increased risk of incident congestive heart failure, myocardial infarction, and cardiovascular disease mortality. However, most of the studies which identified an association between lower vitamin D intake or lower 25-hydroxyvitamin D and increased risk of cardiovascular disease are observational or cross-sectional studies. There has been no careful study evaluating the effect of vitamin D supplementation on coronary artery disease outcome following coronary intervention. Objective: The purpose of this study was to examine the effect of vitamin D deficiency and vitamin D supplementation on coronary artery restenosis following balloon angioplasty in hypercholesterolemic Yucatan microswine. Methods: Twelve female microswine were fed vitamin D-deficient or vitamin D-sufficient high cholesterol diet. At six months, animals underwent coronary angioplasty. Following coronary intervention swine in the vitamin D-sufficient high cholesterol diet group received supplementation of 1,000 IU or 3,000 IU of vitamin D3. Six months later, angiogram was performed followed by optical coherence tomography to monitor the development of intimal hyperplasia and restenosis. At the end of 12 months animals were euthanized, coronary arteries were harvested and morphological and histological studies were performed. Results: Findings from the optical coherence tomography and histomorphometric studies showed a significant decrease in neointimal hyperplasia, increase in in-segment lumen diameter, and decrease in the intima-media ratio in coronary arteries following balloon angioplasty in swine with vitamin D supplementation compared to the animals with vitamin D-deficient status. In the in-vitro studies, calcitriol inhibited proliferation of coronary artery smooth muscle cells. Conclusion: These data suggest that vitamin D deficiency increases intimal hyperplasia and restenosis following coronary balloon angioplasty in hypercholesterolemic swine. Since vitamin D inhibits smooth muscle cell proliferation, supplementation of non-secosteroidal VDR ligands prior to coronary intervention could help in preventing the neointimal formation and restenosis.

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Impact of vitamin D supplementation on health-care use in a 25-hydroxyvitamin D-tested population in France: a population-based descriptive cohort study

Public Health Nutrition ◽

10.1017/s136898001400038x ◽

2014 ◽

Vol 18 (3) ◽

pp. 554-561 ◽

Cited By ~ 1

Author(s):

Pascal Caillet ◽

Susan B Jaglal ◽

Laurent Laforest ◽

Roland Chapurlat ◽

Muriel Rabilloud ◽

...

Keyword(s):

Health Care ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Muscle Relaxant ◽

Vitamin D Supplementation ◽

Insurance Fund ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

The Impact ◽

Health Care Claims

AbstractObjectiveChronic vitamin D deficiency has been associated in some patients with diffuse musculoskeletal pain. These unspecific symptoms may partly explain why vitamin D deficiency is often diagnosed late. Our aim was to analyse health-care claims after vitamin D supplementation in patients likely to have vitamin D deficiency.DesignAmbulatory health-care claims were compared before and after a vitamin D supplementation prescribed following a 25-hydroxyvitamin D assay.SettingHealth Insurance Fund (FHIF) database of the Rhône-Alpes area, France.SubjectsAmong patients reimbursed for a 25-hydroxyvitamin D assay between 1 December 2008 and 31 January 2009, those supplemented with vitamin D after the assay were matched on the date of assay to patients who did not receive vitamin D.ResultsAmong the 3023 patients who had a 25-hydroxyvitamin D assay, 935 were consequently supplemented and matched to 935 patients not supplemented. Their median age was 50·0 and 49·5 years, respectively. Patients supplemented decreased their muscle relaxant consumption whereas no change was observed in the reference group, the difference between the two groups was significant (P=0·03). Second and third Pain Relief Ladder prescriptions decreased in both groups but not significantly differently between groups (P=0·58). There was a decrease in prescriptions of biological examination in both groups with no significant difference.ConclusionsBesides a decrease in muscle relaxant prescriptions in the supplemented group, it was difficult to assess the impact of vitamin D supplementation in patients likely to have vitamin D deficiency. Prospective cohort studies and randomized trials are needed to assess the efficiency of screening and supplementing vitamin D deficiency.

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Effects of Moderate Sun Exposure and Vitamin D Supplementation on Serum 25-Hydroxyvitamin D Concentration Among Malay Women

Current Developments in Nutrition ◽

10.1093/cdn/nzab059_005 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1304-1304

Author(s):

Norliyana Aris ◽

Hamid Jan Bin Jan Mohamed ◽

Wan Mohd Izani Bin Wan Mohamed

Keyword(s):

Vitamin D ◽

Placebo Group ◽

Vitamin D Deficiency ◽

Sun Exposure ◽

Vitamin D Supplementation ◽

Dietary Vitamin ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D ◽

Hands And Feet ◽

Vitamin D Supplement

Abstract Objectives Known as ‘sunshine vitamin’, sun exposure is a major and natural source of vitamin D. This study aimed to investigate the effects of moderate sun exposure and vitamin D supplementation on vitamin D concentration among Malay women in Kelantan, Malaysia. Methods A quasi-experimental study design was carried out among female indoor workers with vitamin D deficiency (serum 25-hydroxyvitamin D < 50 nmol/l) for 12 weeks to evaluate the effects of moderate sun exposure (n = 19; 15 minutes sun exposure biweekly on face, lower arms, hands and feet), vitamin D supplementation (n = 15; 50 000 IU cholecalciferol weekly) and placebo (n = 15) on serum 25-hydroxyvitamin D (25(OH)D) levels. Data was collected twice from each respondent, firstly during baseline and secondly during endpoint. Body composition measurements (body fat percentage and body mass index), fasting blood test (serum 25(OH)D level) and questionnaire (socio-demographic, physical activity and dietary vitamin D intake) were conducted. The vitamin D classification was based on the 2011 Endocrine Society Clinical Practice Guidelines. Repeated measure ANOVA within group analysis was applied. Results The baseline characteristics did not differ significantly among study groups except for age (F = 6.15, p = 0.004). After 12 weeks, serum 25(OH)D levels increased significantly in sun exposure (mean difference (MD) = 14.27 nmol/l, p < 0.001) and vitamin D supplement group (MD = 14.30 nmol/l, p < 0.001) but not in the placebo group (MD = 1.63 nmol/l, p = 0.067). Conclusions The 12-weeks intervention with moderate sun exposure and vitamin D supplementation showed a similar significant increment in serum 25(OH)D levels. However, no changes in serum 25(OH)D was observed in the placebo group. These results showed that sunlight exposure and vitamin D supplement were equally helpful in improving serum 25(OH)D levels in participants with vitamin D deficiency. Funding Sources Short Term Research Grant, Universiti Sains Malaysia.

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