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

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.

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-hui Zhang ◽  
Xiao Xu ◽  
Hai-chen Pi ◽  
Zhi-kai Yang ◽  
David W. Johnson ◽  
...  

Abstract Background Vitamin D deficiency has been shown to be closely associated with peritoneal dialysis (PD)-related peritonitis. The aim of this study is to examine the feasibility of conducting a large, powered randomized controlled trial to determine the effects of vitamin D supplementation on the risk of PD-related peritonitis in patients who have already experienced an episode of peritonitis. Methods This prospective, open-label randomized controlled pilot trial with blinded end-points aims to determine the feasibility of oral vitamin D supplementation and to explore its effects on the risk of subsequent PD-related peritonitis among PD patients who have recovered from a recent episode of peritonitis. Eligible patients will be randomized 1:1 to either oral vitamin D supplementation (2000 IU per day; intervention group) or no vitamin D supplementation (control group) in addition to usual care according to International Society for Peritoneal Dialysis guidelines. The sample size will be 30 patients for both groups. All participants will be followed for 12 months. The primary outcome is the assessment of feasibility (recruitment success, retention, adherence, safety) and fidelity (change in serum 25-hydroxyvitamin D level during follow-up) for a large, powered randomized controlled trial to determine the effects of vitamin D on the risk of PD-related peritonitis in the future. Secondary outcomes include time to peritonitis occurrence, recovery of peritonitis, peritonitis-related transition to hemodialysis, and peritonitis-related death (defined as death within 30 days of peritonitis onset). Discussion This is the first randomized controlled trail investigating the effects of vitamin D supplementation on the risk of subsequent PD-related peritonitis among patients on PD. The findings for this pilot study will determine the feasibility of conducting a full-scale randomized controlled trail, which may provide a new strategy for preventing PD-related peritonitis among PD patients. Trial registration Clinicaltrails.gov, NCT03264625. Registered on 29 August 2017.


Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 942 ◽  
Author(s):  
Marcela M. Mendes ◽  
Kathryn H. Hart ◽  
Susan A. Lanham-New ◽  
Patrícia B. Botelho

Optimal vitamin D status has commonly been defined as the level of 25-hydroxyvitamin D (25(OH)D) at which parathyroid hormone (PTH) concentrations would be maximally suppressed, represented by an observed minimum plateau. Previous findings indicate a large variation in this plateau, with values ranging from <30 nmol/L up to 100 nmol/L. This disparity in values might be explained by differences in study design and methodology, ethnicity, age, gender and latitude. This study aimed to investigate the concentration of 25(OH)D at which PTH concentrations were suppressed in Brazilian women living in opposite latitudes (high vs. low: i.e., UK and Brazil), during wintertime. Using data from the D-SOL study (Interaction between Vitamin D Supplementation and Sunlight Exposure in Women Living in Opposite Latitudes), the association between 25(OH)D status and PTH levels were examined in 135 Brazilian women (56 living in England and 79 living in Brazil, aged 20–59 years old). Mean PTH concentrations for Brazilian women with vitamin D deficiency (<25 nmol/L) were significantly higher compared to those with vitamin D insufficiency (25–49.9 nmol/L) (p < 0.01), vitamin D adequacy (50–74.9 nmol/L) (p < 0.01) and those with optimal vitamin D status (>75 nmol/L) (p < 0.001). Regression modelling was used to investigate the relationship between serum 25(OH)D and PTH for the sample as a whole and for each group separately. A cubic model was statistically significant for the total sample (p < 0.001), whereas a linear model presented the best fit for Brazilian women living in England (p = 0.04) and there were no statistically significant models fitted for Brazilian women living in Brazil. The cubic model suggests that 25(OH)D concentrations above 70–80 nmol/L are optimal to suppress the parathyroid gland in Brazilian women. These findings contribute to a better understanding of the relationship between 25(OH)D and PTH in populations living in a low latitude location and are of great relevance for discussions regarding the estimation of optimal cut-offs for vitamin D levels in the Brazilian population as well as for other low latitude locations.


1987 ◽  
Vol 930 (2) ◽  
pp. 193-200 ◽  
Author(s):  
Kenneth R. Feingold ◽  
Mary L. Williams ◽  
Sreekumar Pillai ◽  
Gopinathan K. Menon ◽  
Bernard P. Halloran ◽  
...  
Keyword(s):  

Children ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. 7 ◽  
Author(s):  
Charles Fink ◽  
Rachel Peters ◽  
Jennifer Koplin ◽  
Justin Brown ◽  
Katrina Allen

Vitamin D is critical to children’s skeletal development and health. Despite this, the factors which determine vitamin D concentrations during infancy remain incompletely understood. This article reviews the literature assessing the factors which can affect vitamin D status in infancy, including antenatal and postnatal vitamin D supplementation. Observational data supports that dietary intake of vitamin D, UV exposure, and geographic factors contribute significantly to infants’ vitamin D status, but the relationship is unclear regarding genetic variation, ethnicity, and maternal vitamin D status. Randomised controlled trials have compared higher versus lower doses of infant vitamin D supplementation, but no studies have compared infant vitamin D supplementation to placebo and eliminated external sources of vitamin D to fully quantify its effect on vitamin D status. Knowledge gaps remain regarding the factors associated with optimal vitamin D concentrations in infants—including key factors such as ethnicity and genetic variation—and further studies are needed.


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.


Author(s):  
Christos Ioannou

ABSTRACT There is increasing incidence of vitamin D deficiency in pregnancy in developed countries. Dark skinned women who have migrated and live in higher latitudes are at greatest risk. Vitamin D supplementation is now recommended in several countries, yet its impact on fetal growth remains unclear. Observational studies suggest a possible correlation between maternal serum vitaminD and birth weight. However, differences in birth weight can be confounded by soft-tissue growth and placental function. The effect on vitamin D on bone mineral indices using dual energy X-ray absorptiometry is difficult to ascertain in the neonatal period and therefore remains unclear. Prenatal ultrasound is a safe and practical modality for assessing skeletal growth, yet very few studies have investigated fetal growth in the context of vitamin D status: one study has demonstrated no correlation with femur length, whereas two studies have shown positive correlations with femur length and femur volume respectively. The effect of vitamin D supplementation on birth weight has been investigated in seven interventional studies. However, there is considerable methodological heterogeneity and high risk of bias among some of them. Meta-analysis of well conducted randomized controlled trials (RCTs) has not demonstrated a significant effect on birth weight. The effect of vitamin D supplementation on ultrasound markers of fetal growth has not been reported to date. In summary, there is weak evidence that maternal vitamin D status may have a positive association with measures of fetal skeletal growth. However, if such an association exists, it is not clear whether it is causal or spurious. Randomized controlled trials of vitamin D supplementation are needed, where fetal ultrasound and neonatal bone mineral indices will be reported as primary outcome measures. How to cite this article Ioannou C. Maternal Vitamin D Deficiency and Fetal Growth. Donald School J Ultrasound Obstet Gynecol 2015;9(3):223-229.


2021 ◽  
Vol 17 (7) ◽  
pp. 557-561
Author(s):  
L.A. Nikitiuk ◽  
Korsak Yu.

Background. In spite of large volume of data linking vitamin D with cardiovascular morbidity, autoimmunity, cancer, and virtually every organ system, vitamin D and thyroid is a lesser-known aspect of vitamin D in clinical practice. The association between vitamin D deficiency and thyroid cancer is controversial. Some studies have demonstrated that higher serum vitamin D levels might protect against thyroid cancer, whereas others have not, or have even indicated the opposite to to be the case. This review intends to highlight the current literature on the impact of vitamin D status on thyroid cancer. Materials and methods. References for this review were identified through searches of PubMed for articles published to from 2005 to June 2021 using the terms “thyroid cancer” and “vitamin D”. Results. A large volume of medical literature is available from observational studies linking vitamin D with thyroid cancer. Data from interventional studies documenting beneficial effects of vitamin D on thyroid autoimmunity is also available, but lesser than that from observational studies. Short-term high dose oral vitamin D supplementation reduces TPOAb titers. Certain vitamin D receptor (VDR) gene polymorphism have been linked to increased occurrence of autoimmune thyroid disorders. Vitamin D deficiency, decreased circulating calcitriol has been linked to increased thyroid cancer. Certain VDR gene polymorphisms have been linked with increased as well as decreased occurrence of thyroid cancer. Data is scant on use of vitamin D and its analogues for treating thyroid cancer. The results suggest that Vitamin D deficiency may have value as a negative prognostic indicator in papillary thyroid cancer and that pre-operative laboratory evaluation may be less useful. This is important because Vitamin D deficiency is modifiable. Conclusions. In spite of large volume of medical literature from observational studies linking vitamin D with thyroid cancer, meaningful concrete clinical data on impact of vitamin D supplementation on hard clinical end points in these disorders is lacking, and should be the primary area of research in the next decade.


2021 ◽  
Vol 8 ◽  
Author(s):  
Ziyi Li ◽  
Liangzhi Wu ◽  
Junguo Zhang ◽  
Xin Huang ◽  
Lehana Thabane ◽  
...  

Objective: Laboratory findings indicated that vitamin D might have a potent protective effect on breast cancer, but epidemiology studies reported conflicting results. The aim of the study was to conduct a systematic review and meta-analysis to clarify the efficacy of vitamin D supplementation on risk of breast cancer.Methods: MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and abstracts of three major conferences were searched (up to December 8, 2020). Parallel randomized controlled trials (RCTs) examining the efficacy of vitamin D supplementation on risk of breast cancer or change of mammography compared with placebo in females were included. Data were meta-analyzed using a random-effects model. Bayesian meta-analysis was conducted to synthesize the results using data from observational studies as priors.Results: Seven RCTs were identified for effect of vitamin D on risk of breast cancer, with 19,137 females included for meta-analysis. No statistically significant effect of vitamin D on risk of breast cancer was found in classical random-effects meta-analysis (risk ratio = 1.04, 95% confidence interval: 0.84–1.28, p = 0.71). When Bayesian meta-analyses were conducted, results remained non-significant. There was no statistically significant effect of vitamin D on mammography density observed: mean difference = 0.46, 95% confidence interval: −2.06 to 2.98, p = 0.72.Conclusion: There is insufficient evidence to support the efficacy of vitamin D supplementation in breast cancer risk and change of mammography density. The protective effect of vitamin D on risk of breast cancer from previous observational studies may be overestimated.Systematic Review Registration: PROSPERO, identifier CRD42019138718.


2021 ◽  
Vol 30 (Sup6) ◽  
pp. S4-S10
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.


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