scholarly journals Controversies Surrounding Vitamin D: Focus on Supplementation and Cancer

Author(s):  
Salvatore Minisola ◽  
Federica Ferrone ◽  
Vittoria Danese ◽  
Veronica Cecchetti ◽  
Jessica Pepe ◽  
...  

There has recently been a huge number of publications concerning various aspects of vitamin D, from the physiological to therapeutic fields. However, as a consequence of this very fast-growing scientific area, some issues still remain surrounded by uncertainties, without a final agreement having been reached. Examples include the definitions of vitamin D sufficiency and insufficiency, (i.e., 20 vs. 30 ng/mL), the relationship between 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone, (i.e., linear vs. no linear), the referent to consider, (i.e., total vs. free determination), the utility of screening versus universal supplementation, and so on. In this review, the issues related to vitamin D supplementation in subjects with documented hypovitaminosis, and the role of vitamin D in cancer will be concisely considered. Daily, weekly, or monthly administration of cholecalciferol generally leads to essentially similar results in terms of an increase in 25(OH)D serum levels. However, we should also consider possible differences related to a number of variables, (i.e., efficiency of intestinal absorption, binding to vitamin D binding protein, and so on). Thus, adherence to therapy may be more important than the dose regimen chosen in order to allow long-term compliance in a sometimes very old population already swamped by many drugs. It is difficult to draw firm conclusions at present regarding the relationship between cancer and vitamin D. In vitro and preclinical studies seem to have been more convincing than clinical investigations. Positive results in human studies have been mainly derived from post-hoc analyses, secondary end-points or meta-analyses, with the last showing not a decrease in cancer incidence but rather in mortality. We must therefore proceed with a word of caution. Until it has been clearly demonstrated that there is a causal relationship, these positive “non-primary, end-point results” should be considered as a background for generating new hypotheses for future investigations.

Cancers ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 347 ◽  
Author(s):  
Mitsuyoshi Urashima ◽  
Mai Okuyama ◽  
Taisuke Akutsu ◽  
Hironori Ohdaira ◽  
Mutsumi Kaji ◽  
...  

Vitamin D has been shown to suppress the growth of cancer cells. Cancer cells are believed to take up bioavailable 25-hydroxyvitamin D (25[OH]D) (i.e., not bound to vitamin-D-binding protein (DBP)) more efficiently than DBP-bound 25(OH)D. Our aim was to use this bioavailable 25(OH)D, rather than total 25(OH)D, as a biomarker of vitamin D deficiency to investigate whether vitamin D supplementation improves the relapse-free survival (RFS) of patients with digestive tract cancer from the esophagus to the rectum by conducting a post hoc analysis of the AMATERASU trial (UMIN000001977). The bioavailable 25(OH)D levels were calculated via an equation using data of serum total 25(OH)D, albumin, and DBP levels, and DBP genotypes (rs7041 and rs4588). We estimated bioavailable 25(OH) levels in 355 patients. In a subgroup of patients with low bioavailable 25(OH)D levels (<median) (n = 177), 5 year RFS was 77% in the vitamin D group vs. 58% in the placebo group (hazard ratio, 0.54; 95% confidence interval, 0.31–0.95; p = 0.03), whereas no significant difference was seen in a subgroup of patients with high bioavailable 25(OH)D levels (p for interaction = 0.046). We hypothesize that vitamin D supplementation may be effective in improving RFS among digestive tract cancer patients with low bioavailable 25(OH)D levels.


Nutrients ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 243 ◽  
Author(s):  
Clara Yongjoo Park

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.


2005 ◽  
Vol 11 (3) ◽  
pp. 266-271 ◽  
Author(s):  
M Soilu-Hänninen ◽  
L Airas ◽  
I Mononen ◽  
A Heikkilä ◽  
M Viljanen ◽  
...  

Past sun exposure and vitamin D supplementation have been associated with a reduction in the risk of MS. We measured the serum concentration of 25-hydroxyvitamin D (25[OH]D) at the time of MS diagnosis in 40 MS patients and 40 controls. We found no difference in the serum levels of 25(OH)D between MS patients and controls when all samples or samples obtained during winter months were compared, but MS patients had significantly lower serum 25(OH)D concentrations in June to September than the controls. The vitamin D stores were adequate for bone metabolism (> 37 nmol/L) in 70% of MS patients throughout the year and within the hypovitaminosis level (< 37 nmol/L) in 30% of MS patients at some time of the year. During MS-relapses, 25(OH)D levels were lower than in remission, but mostly within the reference range observed in relation with normal bone metabolism. We conclude that the vitamin D stores in most MS patients are adequate for their normal bone metabolism. However, lower vitamin D levels during MS relapses than in remission suggest that vitamin D could be involved in the regulation of the clinical disease activity of MS. The optimal serum levels of vitamin D for the regulation of immune responses remain to be determined.


Author(s):  
Dina Keumala Sari ◽  
Nurfida Khairina Arrasyid ◽  
Y. S. Harahap

Previous studies have not been able to show with certainty the effect of vitamin D supplementation in tuberculosis patients. The objective of this study is to determine whether vitamin D supplementation to patients with tuberculosis could influence 25-hydroxyvitamin D (25(OH)D) and calcium serum levels. The results, after 28 days, the vitamin D supplementation showed significant increase of 25(OH)D serum level at the end point (p=0.001), but not for the calcium serum level (p=0.3). The Conclusions is supplementation with 1,000 IU vitamin D per day increased the 25(OH)D serum level but there was no association with the calcium serum level.


2020 ◽  
Vol 5 (2) ◽  
pp. e34-e34
Author(s):  
Yasaman Koohshoori ◽  
Ehsan Ramanian ◽  
Nasrin Moradi ◽  
Shahrzad Shadabi ◽  
Minoo Motahhar ◽  
...  

Introduction: Coronavirus disease 2019 (COVID-19) from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the most important epidemiological events in the past 100 years has become, the consequences for public health and economic systems around the world. Vitamin D is an important micronutrient that has been reported to improve immunity and protect against respiratory diseases. In this study, we intend to review articles that examine the relationship between COVID-19 and vitamin D. Methods: This is a review that uses articles from studies published in 2020 on the relationship between COVID-19 and vitamin D in databases such as; Web of Science, Science Direct, SID, Magiran, Google Scholar and PubMed. Keywords used included; serum levels of 25-hydroxyvitamin D, vitamin D, COVID-19, SARS-COV-2 and coronavirus 2. With this search, 32 articles were finally selected for this purpose and their results were reviewed Results: Of the 32 studies reviewed, only three showed no association between vitamin D levels in the blood and COVID-19 disease. Other studies had a relationship between the severity of the disease, mortality rate and length of hospital stay, in different age, gender and location groups. Conclusion: It seems that the level of vitamin D in the blood has a potential effect on COVID-19 disease. Checking the serum vitamin D levels and supplementation in people with hypovitaminosis D can be a good solution to reduce the complications and problems caused by COVID-19.


2020 ◽  
Vol 29 (Sup7) ◽  
pp. S24-S30 ◽  
Author(s):  
Karen Smith ◽  
Susan Hewlings

Objective: Hard-to-heal wounds are a major biological, psychological, social and financial burden on both individual patients and the broader health system. They are associated with a variety of comorbidities and have a complex aetiology, but are typically associated with nutritional deficiencies, such as low vitamin D levels. This systematic literature review evaluates the current research regarding the connection between inadequate vitamin D status and wound healing. Method: PubMed and EBSCO databases were searched following PRISMA guidelines for primary research studies relating to pressure ulcers, diabetic ulcers or venous ulcers and vitamin D status. Results: A total of 10 studies, involving 2359 participants, met the inclusion criteria. There was a strong correlation between low levels of 25-hydroxyvitamin D and the presence of all three types of hard-to-heal wounds. Conclusion: Research suggests a correlation between low vitamin D levels and hard-to-heal wounds. However, it is not clear if the relationship is causal or only correlational. There is also emerging evidence on the use of vitamin D supplementation for the treatment of hard-to-heal wounds. More research is needed to understand the correlation between vitamin D and hard-to-heal wounds.


2013 ◽  
Vol 41 (4) ◽  
pp. 704-708 ◽  
Author(s):  
Linda Björkhem-Bergman ◽  
Hanna Nylén ◽  
Anna-Carin Norlin ◽  
Jonatan D. Lindh ◽  
Lena Ekström ◽  
...  

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 130
Author(s):  
Giulia Bivona ◽  
Caterina Maria Gambino ◽  
Bruna Lo Sasso ◽  
Concetta Scazzone ◽  
Rosaria Vincenza Giglio ◽  
...  

Vitamin D is a steroid hormone regulating calcium-phosphorus homeostasis, immune response and brain function. In the past thirty years, an increasing number of cohort studies, meta-analyses and randomized controlled trials (RTCs) evaluated the serum levels of 25-hydroxyvitamin D [25(OH)D], which is considered the Vitamin D status biomarker, in patients affected by neurological, psychiatric and autoimmune diseases. Although an association between low 25(OH)D serum levels and the prevalence of these diseases has been found, it is still unclear whether the serum 25(OH)D measurement can be clinically useful as a biomarker for diagnosis, prognosis and predicting treatment response in neurodegeneration, mental illness and immune-mediated disorders. The lack of standardized data, as well as discrepancies among the studies (in the analytical methods, cut-offs, endpoints and study sets), weakened the findings achieved, hindered pooling data, and, consequently, hampered drawing conclusions. This narrative review summarizes the main findings from the studies performed on serum 25(OH)D in neurological, psychiatric and autoimmune diseases, and clarifies whether or not serum 25(OH)D can be used as a reliable biomarker in these diseases.


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