Vitamin D in Elderly

Vitamin D deficiency is common in elderly people, especially in patients with comorbidity and polypharmcy. In this group, low vitamin D plasma concentration is related to osteoporosis, osteomalacia, sarcopenia and myalgia. Vitamin D status in geriatric population is an effect of joint interaction of all vitamin D metabolic pathways, aging processes and multimorbidity. Therefore, all factors interfering with individual metabolic stages may affect 25-hydroxyvitamin D plasma concentration. The known factors affecting vitamin D metabolism interfere with cytochrome CYP3A4 activity. The phenomenon of drugs and vitamin D interactions is observed first and foremost in patients with comorbidity. This is a typical example of the situation where a lack of “hard evidence” is not synonymous with the possible lack of adverse effects. Geriatric giants, such as sarcopenia (progressive and generalized loss of skeletal muscle mass and strength) or cognitive decline, strongly influence elderly patients. Sarcopenia is one of the musculoskeletal consequences of hypovitaminosis D. These consequences are related to a higher risk of adverse outcomes, such as fracture, physical disability, a poor quality of life and death. This can lead not only to an increased risk of falls and fractures, but is also one of the main causes of frailty syndrome in the aging population. Generally, Vitamin D plasma concentration is significantly lower in participants with osteoporosis and muscle deterioration. In some observational and uncontrolled treatment studies, vitamin D supplementation led to a reduction of proximal myopathy and muscle pain. The most positive results were found in subjects with severe vitamin D deficiency and in patients avoiding high doses of vitamin D. However, the role of vitamin D in muscle pathologies is not clear and research has provided conflicting results. This is most likely due to the heterogeneity of the subjects, vitamin D doses and environmental factors.

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Vitamin D Deficiency in Older Patients—Problems of Sarcopenia, Drug Interactions, Management in Deficiency

Nutrients ◽

10.3390/nu13041247 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1247

Author(s):

Małgorzata Kupisz-Urbańska ◽

Paweł Płudowski ◽

Ewa Marcinowska-Suchowierska

Keyword(s):

Vitamin D ◽

Plasma Concentration ◽

Vitamin D Deficiency ◽

Bone Fractures ◽

Hypovitaminosis D ◽

Vitamin D Supplementation ◽

Adverse Outcomes ◽

Vitamin D Metabolism ◽

Increased Risk ◽

Vitamin D Levels

Vitamin D deficiency frequently occurs in older people, especially in individuals with comorbidity and polypharmacotherapy. In this group, low vitamin D plasma concentration is related to osteoporosis, osteomalacia, sarcopenia and myalgia. Vitamin D levels in humans is an effect of the joint interaction of all vitamin D metabolic pathways. Therefore, all factors interfering with individual metabolic stages may affect 25-hydroxyvitamin D plasma concentration. The known factors affecting vitamin D metabolism interfere with cytochrome CYP3A4 activity. There is another group of factors that impairs intestinal vitamin D absorption. The phenomenon of drugs and vitamin D interactions is observed first and foremost in patients with comorbidity. This is a typical situation, where the absence of “hard evidence” is not synonymous with the possible lack of adverse effects. Osteoporosis and sarcopenia (generalized and progressive decrease of skeletal muscle mass and strength) are some of the musculoskeletal consequences of hypovitaminosis D. These consequences are related to an increased risk of adverse outcomes, including bone fractures, physical disabilities, and a lower quality of life. This can lead not only to an increased risk of falls and fractures but is also one of the main causes of frailty syndrome in the aging population. Generally, Vitamin D plasma concentration is significantly lower in subjects with osteoporosis and muscle deterioration. In some observational and uncontrolled treatment studies, vitamin D supplementation resulted in a reduction of proximal myopathy and muscle pain. The most conclusive results were found in subjects with severe vitamin D deficiency and in patients avoiding large doses of vitamin D. However, the role of vitamin D in muscle pathologies is not clear and research has provided conflicting results. This is plausibly due to the heterogeneity of the subjects, vitamin D doses and environmental factors. This report presents data on some problems with vitamin D deficiency in the elderly population and the management of vitamin D deficiency D in successful or unsuccessful aging.

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Effects of Genetic and Nongenetic Factors on Total and Bioavailable 25(OH)D Responses to Vitamin D Supplementation

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2016-2930 ◽

2016 ◽

Vol 102 (1) ◽

pp. 100-110 ◽

Cited By ~ 20

Author(s):

Pang Yao ◽

Liang Sun ◽

Ling Lu ◽

Hong Ding ◽

Xiafei Chen ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D3 ◽

Controlled Trial ◽

Vitamin D Supplementation ◽

Inverse Association ◽

Vitamin D Metabolism ◽

Hydroxyvitamin D ◽

Vitamin D3 Supplementation ◽

Double Blinded

Abstract Context: Little is known about how genetic and nongenetic factors modify responses of vitamin D supplementation in nonwhite populations. Objective: To investigate factors modifying 25-hydroxyvitamin D [25(OH)D] and bioavailable 25(OH)D [25(OH)DBio] responses after vitamin D3 supplementation. Design, Setting, Participants, and Intervention: In this 20-week, randomized, double-blinded, placebo-controlled trial, 448 Chinese with vitamin D deficiency received 2000 IU/d vitamin D3 or placebo. Main Outcome Measures: Serum 25(OH)D, vitamin D-binding protein (VDBP), parathyroid hormone (PTH) and calcium were measured, and 25(OH)DBio was calculated based on VDBP levels. Six common polymorphisms in vitamin D metabolism genes were genotyped. Results: Between-arm net changes were +30.6 ± 1.7 nmol/L for 25(OH)D, +2.7 ± 0.2 nmol/L for 25(OH)DBio, and −5.2 ± 1.2 pg/mL for PTH, corresponding to 70% [95% confidence interval (CI), 62.8% to 77.2%] net reversion rate for vitamin D deficiency at week 20 (P < 0.001). Only 25(OH)DBio change was positively associated with calcium change (P < 0.001). Genetic factors (GC-rs4588/GC-rs7041, VDR-rs2228570, and CYP2R1-rs10741657; P ≤ 0.04) showed stronger influences on 25(OH)D or 25(OH)DBio responses than nongenetic factors, including baseline value, body mass index, and sex. An inverse association of PTH-25(OH)D was demonstrated only at 25(OH)D of <50.8 (95% CI, 43.6 to 59.0) nmol/L. Conclusions: Supplemented 2000 IU/d vitamin D3 raised 25(OH)D and 25(OH)DBio but was unable to correct deficiency in 25% of Chinese participants, which might be partially attributed to the effect of genetic modification. More studies are needed to elucidate appropriate vitamin D recommendations for Asians and the potential clinical implications of 25(OH)DBio.

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Vitamin D Metabolism and Guidelines for Vitamin D Supplementation

10.33176/aacb-20-00006 ◽

2020 ◽

Vol 41 (3) ◽

pp. 103-126

Author(s):

Indra Ramasamy

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Vitamin D Supplementation ◽

Vitamin D Status ◽

Vitamin D Metabolism ◽

Hydroxyvitamin D ◽

Response Data ◽

Vitamin D Intake ◽

25 Hydroxyvitamin D ◽

Significant Health

Vitamin D is essential for bone health and is known to be involved in immunomodulation and cell proliferation. Vitamin D status remains a significant health issue worldwide. However, there has been no clear consensus on vitamin D deficiency and its measurement in serum, and clinical practice of vitamin D deficiency treatment remains inconsistent. The major circulating metabolite of vitamin D, 25-hydroxyvitamin D (25(OH)D), is widely used as a biomarker of vitamin D status. Other metabolic pathways are recognised as important to vitamin D function and measurement of other metabolites may become important in the future. The utility of free 25(OH)D rather than total 25(OH)D needs further assessment. Data used to estimate the vitamin D intake required to achieve a serum 25(OH)D concentration were drawn from individual studies which reported dose-response data. The studies differ in their choice of subjects, dose of vitamin D, frequency of dosing regimen and methods used for the measurement of 25(OH)D concentration. Baseline 25(OH)D, body mass index, ethnicity, type of vitamin D (D2 or D3) and genetics affect the response of serum 25(OH)D to vitamin D supplementation. The diversity of opinions that exist on this topic are reflected in the guidelines. Government and scientific societies have published their recommendations for vitamin D intake which vary from 400–1000 IU/d (10–25 µg/d) for an average adult. It was not possible to establish a range of serum 25(OH)D concentrations associated with selected non-musculoskeletal health outcomes. To recommend treatment targets, future studies need to be on infants, children, pregnant and lactating women.

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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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Efficacy of Weekly Split versus Single Doses of Ergocalciferol on Serum 25-Hydroxyvitamin D among Patients on Continuous Ambulatory Peritoneal Dialysis: A Randomized Controlled Trial

International Journal of Nephrology ◽

10.1155/2021/5521689 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Naowanit Nata ◽

Jessada Kanchanasinitth ◽

Pamila Tasanavipas ◽

Ouppatham Supasyndh ◽

Bancha Satirapoj

Keyword(s):

Vitamin D ◽

Single Dose ◽

Peritoneal Dialysis ◽

Vitamin D Deficiency ◽

Continuous Ambulatory Peritoneal Dialysis ◽

Dose Group ◽

Vitamin D Supplementation ◽

Split Dose ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

Background. Vitamin D deficiency is a common problem among patients on continuous ambulatory peritoneal dialysis (CAPD). Vitamin D supplementation leads to reduced serum parathyroid hormone levels and improved cardiovascular markers. Different doses and time intervals of oral vitamin D supplementation may differ in each patient on dialysis. The study aimed to evaluate the efficacy of weekly split and single dose of ergocalciferol at 60,000 IU on serum 25-hydroxyvitamin D (25(OH)D) among patients on CAPD. Methods. A randomized study was conducted among patients on CAPD with vitamin D deficiency or insufficiency (25(OH)D < 30 ng/mL). Patients were randomly assigned to two groups: the split dose group was given ergocalciferol 20,000 IU three times weekly and the single dose group was given ergocalciferol 60,000 IU once weekly for 8 weeks. Main outcomes measured serum 25(OH)D concentrations, serum calcium, serum phosphate, and intact parathyroid levels at 8 weeks after being enrolled. Results. Of 128 screened patients, 50 met the criteria for eligibility and were randomized. At 8 weeks after treatment, mean serum 25(OH)D concentrations significantly increased from baseline 22.7 ± 5.9 to 29.5 ± 9.5 ng/mL P = 0.004 in the split dose group and 22.9 ± 5.3 to 31.2 ± 12.3 ng/mL P = 0.003 in the single dose group. No significant change was found in increase of serum 25(OH)D between the two groups P = 0.561 . At the end of study, a similar proportion of patients in both groups reached the desirable serum concentration of 25(OH)D ≥ 30 ng/mL (60% in the single group vs. 40% in the split group, P = 0.258 ). No significant cases of hypercalcemia, hyperphosphatemia, or serious adverse events occurred during the study. Conclusion. Weekly single and split doses of ergocalciferol 60,000 IU achieved similar effects on serum 25(OH)D levels among patients on CAPD with vitamin D insufficiency or deficiency, suggesting that weekly single dose would be prescribed for adequate vitamin D repletion. This trial is registered with TCTR20200821005.

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VITAMIN D SUPPLEMENTATION IN FEMALE NURSES: THE EFFECTS ON SERUM 25-HYDROXYVITAMIN D, AND NON-SPECIFIC MUSCULOSKELETAL PAIN

Journal of Musculoskeletal Research ◽

10.1142/s0218957715500086 ◽

2015 ◽

Vol 18 (02) ◽

pp. 1550008 ◽

Cited By ~ 2

Author(s):

Negin Masoudi Alavi ◽

Mahla Madani ◽

Mohsen Taghizadeh ◽

Mohammad Reza Sharif

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Musculoskeletal Pain ◽

Vitamin D Supplementation ◽

High Dose ◽

Single High Dose ◽

Hydroxyvitamin D ◽

Before And After ◽

25 Hydroxyvitamin D ◽

Female Nurses

Purpose: To investigate the effect of weekly single high dose vitamin D supplementation on serum 25-hydroxyvitamin D [25(OH)D], and non-specific musculoskeletal pain in female nurses. Methods: In this prospective study in Kashan/Iran, from April 1, 2014, through September 30, 2014, the 150 nurses with vitamin D deficiency received the weekly pearls of 50,000 units of vitamin D3 for 10 weeks. The serum level of 25(OH)D was measured before and after supplement therapy. The subjects were also asked to complete the Extended Nordic Musculoskeletal Questionnaire. All analyses were conducted with SPSS version 16. Results: After 10 weeks of intervention there was [Formula: see text][Formula: see text]ng/mL increase in 25(OH)D. The 82 nurses (54.7%) had 25(OH)D in normal range, while the 68 nurses (45.3%) were still vitamin D deficient. Weight could explain 15.4% increase in 25(OH)D. Before intervention 135 (90%), of nurses reported musculoskeletal pain in at least one region, after intervention this number decreased to 72.7%. There was a statistically significant improvement in musculoskeletal pain in neck, shoulders, upper back, lower back, hips/tights, knees, and ankles/feet after intervention. Conclusions: The weekly single high dose of vitamin D for 10 weeks could resolve vitamin D deficiency in about half of the patients. Patients with non-specific musculoskeletal pain might benefit from vitamin D supplementation.

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Skeletal and Extraskeletal Actions of Vitamin D: Current Evidence and Outstanding Questions

Endocrine Reviews ◽

10.1210/er.2018-00126 ◽

2018 ◽

Vol 40 (4) ◽

pp. 1109-1151 ◽

Cited By ~ 110

Author(s):

Roger Bouillon ◽

Claudio Marcocci ◽

Geert Carmeliet ◽

Daniel Bikle ◽

John H White ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Human Subjects ◽

Osteoporotic Fractures ◽

Vitamin D Supplementation ◽

Current Evidence ◽

Elderly Subjects ◽

Vitamin D Status ◽

Hydroxyvitamin D ◽

25 Hydroxyvitamin D

AbstractThe etiology of endemic rickets was discovered a century ago. Vitamin D is the precursor of 25-hydroxyvitamin D and other metabolites, including 1,25(OH)2D, the ligand for the vitamin D receptor (VDR). The effects of the vitamin D endocrine system on bone and its growth plate are primarily indirect and mediated by its effect on intestinal calcium transport and serum calcium and phosphate homeostasis. Rickets and osteomalacia can be prevented by daily supplements of 400 IU of vitamin D. Vitamin D deficiency (serum 25-hydroxyvitamin D <50 nmol/L) accelerates bone turnover, bone loss, and osteoporotic fractures. These risks can be reduced by 800 IU of vitamin D together with an appropriate calcium intake, given to institutionalized or vitamin D–deficient elderly subjects. VDR and vitamin D metabolic enzymes are widely expressed. Numerous genetic, molecular, cellular, and animal studies strongly suggest that vitamin D signaling has many extraskeletal effects. These include regulation of cell proliferation, immune and muscle function, skin differentiation, and reproduction, as well as vascular and metabolic properties. From observational studies in human subjects, poor vitamin D status is associated with nearly all diseases predicted by these extraskeletal actions. Results of randomized controlled trials and Mendelian randomization studies are supportive of vitamin D supplementation in reducing the incidence of some diseases, but, globally, conclusions are mixed. These findings point to a need for continued ongoing and future basic and clinical studies to better define whether vitamin D status can be optimized to improve many aspects of human health. Vitamin D deficiency enhances the risk of osteoporotic fractures and is associated with many diseases. We review what is established and what is plausible regarding the health effects of vitamin D.

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Managing plasma P concentrations in beef heifers with a slow release vitamin D supplementation

Animal Production Science ◽

10.1071/an17601 ◽

2020 ◽

Vol 60 (5) ◽

pp. 610

Author(s):

N. W. Tomkins ◽

R. Elliott ◽

J. J. McGrath ◽

T. Schatz

Keyword(s):

Vitamin D ◽

Plasma Concentration ◽

Growth Rates ◽

Slow Release ◽

Plasma Concentrations ◽

Vitamin D Supplementation ◽

Placebo Control ◽

Elevated Plasma ◽

Hydroxyvitamin D ◽

Rumen Bolus

Context In extensive northern grazing systems, supplementation of P is recommended to maximise cattle growth rates and reproduction. Improving the absorption of P for the animal by influencing metabolic pathways has the potential to improve both the productivity and profitability of extensive livestock enterprises. Aims This study evaluated the efficacy of rumen bolus containing 25-hydroxyvitamin D (25OHD), commercially available as Hy-D®, and/or monensin on blood P and Ca concentrations in young cattle. Methods A total of 84 heifers, initial liveweight (mean ± s.e.m.) 184 ± 2.0 kg, were allocated to four groups, dosed with one of four slow release bolus: (1) placebo (control), (2) monensin (120 mg/day), (3) Hy-D® (6 mg/day), or (4) monensin with Hy-D®, and managed on a common unimproved native pasture from August 2012 to February 2013. On four occasions postdosing, liveweight, hip height and body condition scores were recorded, and individual faecal and jugular blood samples were collected. Key results Supplementation with monensin had a significant effect (P < 0.05) on average daily gains for the first 25 days. Interactions between 25OHD and monensin and time × monensin were also significant (P < 0.05). After 188 days, heifers receiving monensin or 25OHD + monensin were 5 and 10 kg heavier respectively, compared with their counterparts in the control and 25OHD groups. Plasma P concentrations at 25 days were 6.6 mg/dL, then increased to between 8.5 and 9.0 mg/dL and maintained this level for up to 109 days with a bolus releasing 6.0 mg/day 25OHD. Conclusions The study demonstrated that sustained and elevated plasma concentrations of both 25OHD and P, compared with control animals, can be achieved. The slow release rumen bolus maintained an elevated plasma concentration of 25OHD, and indicated that a target plasma concentration for 25OHD for increasing P absorption in beef cattle is between 200 and 300 ng/mL. Implications Supplementation of a metabolite of vitamin D influences P metabolism in Brahman heifers under grazing conditions. Integration with standard supplementation practices would optimise growth rates and reproductive performance.

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Vitamin D Metabolism Is Significantly Impaired in COVID-19 Inpatients

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.572 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A281-A282

Author(s):

Alexandra Povaliaeva ◽

Liudmila Ya Rozhinskaya ◽

Ekaterina A Pigarova ◽

Larisa K Dzeranova ◽

Nino N Katamadze ◽

...

Keyword(s):

Vitamin D ◽

Secondary Hyperparathyroidism ◽

Vitamin D Deficiency ◽

Serum Calcium ◽

Vitamin D Supplementation ◽

Vitamin D Metabolites ◽

Lung Involvement ◽

Hydroxylase Activity ◽

Vitamin D Metabolism ◽

Vitamin D Levels

Abstract Objective: to assess the state of vitamin D metabolism in patients hospitalized with COVID-19 infection. Materials and methods: We examined 49 patients, which were hospitalized for inpatient treatment of COVID-19 infection from May to June 2020. Study group included 24 men (49%) and 25 women (51%), median age 58 years [48; 70], BMI 26.4 kg/m2 [24.3; 30.5]. All patients were diagnosed with pneumonia due to SARS-CoV-2 with median percent of lung involvement equal to 29% [14; 37], 22 patients (45%) required oxygen support upon admission. Median SpO2 was equal to 95% (92; 97), median NEWS score was equal to 3 [2; 6]. Participants were tested for vitamin D metabolites (25(OH)D3, 1,25(OH)2D3, 3-epi-25(OH)D3, 24,25(OH)2D3 and D3) by UPLC-MS/MS, free 25(OH)D and vitamin D-binding protein by ELISA, as well as PTH by electrochemiluminescence immunoassay and routine biochemical parameters of blood serum (calcium, phosphorus, albumin) at the time of admission. Results: patients had in general very low 25()D3 levels - median 10.9 ng/mL [6.9; 15.6], corresponding to a pronounced vitamin D deficiency in half of the patients. Levels of 24,25(OH)2D3 were also low – 0.5 ng/mL [0.2; 0.9], and resulting vitamin D metabolite ratios (25(OH)D3/24,25(OH)2D3) were high-normal or elevated in most patients – 24.1 [19.0; 39.2], indicating decreased activity of 24-hydroxylase. Levels of 1,25(OH)2D3, on the contrary, were high-normal or elevated - 57 pg/mL [46; 79], which, in accordance with 25(OH)D3/1,25(OH)2D3 ratio (219 [134; 266]) suggests an increase in 1α-hydroxylase activity. Median level of 3-epi-25(OH)D3 was 0.7 ng/mL [0.4; 1.0] and D3 metabolite was detectable only in 6 patients. Median DBP level was 432 mg/L [382; 498], median free 25(OH)D was 5.6 pg/mL [3.3; 6.7], median calculated free 25(OH)D was 2.0 pg/mL [1.4; 3.3]. Most patients had albumin-adjusted serum calcium level in the lower half of reference range (median 2.24 mmol/L [2.14; 2.34]). Seven patients had secondary hyperparathyroidism and one patient had primary hyperparathyroidism, the rest of the patients had PTH levels within the normal range.25(OH)D3 levels showed significant negative correlation with percent of lung involvement (r = -0.36, p<0.05) and positive correlation with SpO2 (r = 0.4, p<0.05). 1,25(OH)2D3 levels correlated positively with 25(OH)D3 levels (r = 0.38, p<0.05) and did not correlate significantly with PTH levels (p>0.05). Conclusion: Our data suggests that hospitalized patients with COVID-19 infection have significant impairment of vitamin D metabolism, in particular, an increase in 1α-hydroxylase activity, which cannot be fully explained by pre-existing conditions such as vitamin D deficiency and secondary hyperparathyroidism. The observed profound vitamin D deficiency and association of vitamin D levels with markers of disease severity indicate the importance of vitamin D supplementation in these patients.

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Effects of vitamin D supplementation on 25(OH)D levels and blood pressure in the elderly: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.24623.2 ◽

2020 ◽

Vol 9 ◽

pp. 633

Author(s):

Farapti Farapti ◽

Chusnul Fadilla ◽

Niwanda Yogiswara ◽

Merryana Adriani

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Meta Analysis ◽

The Elderly ◽

Vitamin D Supplementation ◽

Control Groups ◽

Elderly Age ◽

Hydroxyvitamin D ◽

And Control

Background: Hypertension and vitamin D deficiency are prevalent among the elderly. This study evaluated the effects of vitamin D supplementation on changes in serum 25-hydroxyvitamin D (25(OH)D) levels and blood pressure (BP) in the elderly (age > 60 years). Methods: Randomized controlled trials from electronic databases on the elderly taking oral vitamin D, until the end of March 2019, were selected. Two reviewers independently screened the literature on the basis of specific inclusion criteria. The primary outcomes were serum 25(OH)D level, systolic BP (SBP), and diastolic BP (DBP) changes. Results: Our analysis revealed significant differences in serum 25(OH)D level changes between the vitamin D and control groups (mean difference [MD] = 13.84; 95% confidence interval [CI] = 10.21–17.47; P < 0.000). There were no significant differences in SBP and DBP changes between the vitamin D and control groups. Subgroup analysis revealed significant differences in SBP changes between the hypertensive and vitamin D-deficient subgroups (MD = –4.01; 95% CI = –7.45 to –0.57; P = 0.02 and MD = –1.91; 95% CI = –3.48 to –0.34; P = 0.02, respectively), and DBP changes only in the hypertensive subgroup (MD = –2.22; 95% CI = –4.1 to –0.34; P = 0.02). Conclusions: Vitamin D supplementation significantly increases 25(OH)D levels and seems beneficial in lowering BP, specifically in the elderly with elevated BP and vitamin D deficiency.

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