Improvement In Vitamin Research Articles

Serum concentrations of vitamin D and organ dysfunction in patients with severe sepsis and septic shock.

ObjectivesTo evaluate the serum concentrations of vitamin D and their variations in patients with severe sepsis or septic shock and in control subjects upon admission and after 7 days of hospitalization in the intensive care unit and to correlate these concentrations with the severity of organ dysfunction.MethodsThis case-control, prospective, observational study involved patients aged > 18 years with severe sepsis or septic shock paired with a control group. Serum vitamin D concentrations were measured at inclusion (D0) and on the seventh day after inclusion (D7). Severe deficiency was defined as vitamin D levels < 10ng/ml, deficiency as levels between 10 and 20ng/ml, insufficiency as levels between 20 and 30ng/ml, and sufficiency as levels ≥ 30ng/mL. We considered a change to a higher ranking, together with a 50% increase in the absolute concentration, to represent an improvement.ResultsWe included 51 patients (26 with septic shock and 25 controls). The prevalence of vitamin D concentration ≤ 30ng/ml was 98%. There was no correlation between the serum concentration of vitamin D at D0 and the SOFA score at D0 or D7 either in the general population or in the group with septic shock. Patients with improvement in vitamin D deficiency had an improved SOFA score at D7 (p = 0.013).ConclusionIn the population studied, patients with septic shock showed improvement in the serum concentrations of vitamin D on the seventh day compared with the controls. We also found a correlation between higher vitamin D concentrations and a greater decrease in the severity of organ dysfunction.

Vitamin E supplementation in people with cystic fibrosis.

People with cystic fibrosis are at an increased risk of fat-soluble vitamin deficiency including vitamin E. Vitamin E deficiency can cause a host of conditions such as haemolytic anaemia, cerebellar ataxia and cognitive difficulties. Vitamin E supplementation is widely recommended in cystic fibrosis and aims to ameliorate this deficiency. To determine the effects of any level of vitamin E supplementation on the frequency of vitamin E deficiency disorders in people with cystic fibrosis. We searched the Cochrane Group's Cystic Fibrosis Trials Register and also searched international trial registers for any ongoing clinical trials that were not identified during our register search.Date of last search of the Register: 10 February 2014. Date of last search of international trial registers: 30 August 2014. Randomised controlled trials and quasi-randomised controlled trials comparing any preparation of vitamin E supplementation to placebo or no supplement, regardless of dosage or duration. Two authors extracted outcome data from each study (published information) and assessed the risk of bias of each included study. Four studies with a total of 141 participants were included in the review, two of these were in children (aged six months to 14.5 years), and the other two did not specify participants' age. All studies used different formulations and doses of vitamin E for various durations of treatment (10 days to six months). Two studies compared the supplementation of fat-soluble as well as water-soluble formulations to no supplementation in different arms of the same study. A third study compared a water-soluble formulation to a placebo; and in the fourth study a fat-soluble formulation of vitamin E was assessed against placebo.At one month, three months and six months, water-soluble vitamin E significantly improved serum vitamin E levels compared with control: at one month, two studies, mean difference 17.66 (95% confidence interval 10.59 to 24.74); at three months, one study, mean difference 11.61 (95% confidence interval 4.77 to 18.45); and at six months, one study, mean difference 19.74 (95% confidence interval 13.48 to 26.00). At one month fat-soluble vitamin E significantly improved serum vitamin E levels compared with control: one month, two studies, mean difference 13.59 (95% CI 9.52 to 17.66). The findings at three months were imprecise; one study; mean difference 6.40 (95% CI -1.45 to 14.25).None of the studies report the review's primary outcomes of vitamin E total lipid ratio or the incidence of vitamin E-specific deficiency disorders, or the secondary outcomes lung function or quality of life. Only one study, comparing water-soluble vitamin E with placebo, reported the secondary outcome of growth and nutritional status (weight), but the results are uncertain due to imprecision around the effect estimate.There was limited detail about randomisation and blinding in the included studies which compromises the quality of the evidence base for the review. The heterogeneous mix of the formulations with differing biovailabilities among these studies also limits the generalisability of the data to the wider cystic fibrosis population. Vitamin E supplementation led to an improvement in vitamin E levels in people with cystic fibrosis, although the studies may have been at risk of bias. No data on other outcomes of interest were available to allow conclusions about any other benefits of this therapy.In future, larger studies are needed, especially in people already being treated with enteric-coated pancreatic enzymes and supplemented with vitamin E, to look at more specific outcome measures such as vitamin E status, lung function and nutritional status. Future studies could also look at the optimal dose of vitamin E required to achieve maximal clinical effectiveness.

Vitamin D: Can fish food–based solutions be used for reduction of vitamin D deficiency in Poland?

ObjectiveThe multitude of diseases promoted by vitamin D deficiency makes providing the human organism with a constant and sufficiently high supply of this compound a high priority. The aim of this study was to verify the extent to which fish present in the Polish diet can satisfy the body's requirement for this compound. The obtained data would help to evaluate whether a diet rich in fish may be a solution for vitamin D deficiency. MethodsCholecalciferol and ergocalciferol in muscle tissues of fish species popular in the Polish market were determined by means of high-performance liquid chromatography. Based on these updated data, and on data regarding fish consumption, it was possible to assess the level of vitamin D intake provided by fish consumption. ResultsThis study proved that some of the investigated species of fish are a good source of vitamin D3. Among wild fish, Baltic salmon and herring contained the highest amount of cholecalciferol. Surprisingly, the highest content of this compound was observed in lean tilapia, farmed in China. Ergocalciferol also was found in the studied fish samples. ConclusionAnalysis of vitamin D content in various fish species indicated that the disproportion between requirement and supply seems too vast to enable eradication of vitamin D deficiency by fish food–based solutions. Still, increasing fish consumption or changing consumption patterns could be beneficial and result in noticeable improvements in vitamin D status.

Prevalence of vitamin D deficiency and insufficiency in Bulgarian patients with chronic Hepatitis C viral infection

Aims. The present pilot study aimed to determine vitamin D status in Bulgarian patients with chronic HCV infection in respect to the severity of liver disease and response to interferon-ribavirin therapy. Methods. The study encompassed 296 patients: 161 males (54.4%) aged 42.08 ± 14.87 years, 135 females (45.6%) aged 45.72 ± 14.34 years, 86.5% of them infected with HCV genotype 1. Total 25-hydroxyvitamin-D (25OHD) was determined by liquid chromatography/tandem-mass spectrometric detection. Results. The median 25OHD level of the studied cohort was 50.40 nmol/L (range: 29.6–71.05). 25OHD deficient (< 25 nmol/L) were 16% of patients, 33% showed profound insufficiency (25–50 nmol/L), another 33% were in the range 50–80 nmol/L (mild insufficiency), the rest 18% were 25OHD sufficient. Significantly lower 25OHD levels were registered in cases with advanced fibrosis compared to those with mild or absent fibrosis (37.10 nmol/L vs. 53.00 nmol/L, respectively, p < 0.05). This association remained unchanged by seasonal variations in 25OHD levels. Inverse relationship was found between 25OHD and HCV-RNA (p < 0.01). Patients with sustained virological response to therapy had significantly higher 25OHD levels, compared to patients who failed to achieve viral eradication (56.90 nmol/L vs. 45.00 nmol/L, p = 0.012). Conclusion. More than 80% of HCV-infected patients were vitamin D-deficient and -insufficient. The inverse relationship between 25OHD levels and viral load, liver fibrosis and treatment outcomes supports the hypothesis that improvement of vitamin D status may have considerable potential to amend the host defense against HCV infection and response to therapy.

Modifiable factors of vitamin D status among a Brazilian osteoporotic population attended a public outpatient clinic.

Objectives To evaluate the serum 25-hydroxyvitamin D [25(OH)D] concentration in Brazilian osteoporotic patients and the modifiable factors of vitamin D status in this population. Subjects and methods In a cross-sectional study, 363 community-dwelling patients who sought specialized medical care were evaluated between autumn and spring in São Paulo, Brazil. Serum levels of 25(OH)D and parathormone (PTH), biochemical and anthropometric measurements, and bone density scans were obtained. The group was assessed using two questionnaires: one questionnaire covered lifestyle and dietary habits, skin phototype, sun exposure, medical conditions, and levels of vitamin D supplementation (cholecalciferol); the other questionnaire assessed health-related quality-of-life. Logistic regression and a decision tree were used to assess the association between the variables and the adequacy of vitamin D status. Results The mean age of the overall sample was 67.9 ± 8.6 years, and the mean 25(OH)D concentration was 24.8 ng/mL. The prevalence of inadequate vitamin D status was high (73.3%), although 81.5% of the subjects were receiving cholecalciferol (mean dose of 8,169 IU/week). 25(OH)D was positively correlated with femoral neck bone mineral density and negatively correlated with PTH. In the multivariate analysis, the dose of cholecalciferol, engagement in physical activity and the month of the year (September) were associated with improvement in vitamin D status. Conclusions In this osteoporotic population, vitamin D supplementation of 7,000 IU/week is not enough to reach the desired 25(OH)D concentration (≥ 30 ng/mL). Engagement in physical activity and the month of the year are modifiable factors of the vitamin D status in this population.

A 6-month "self-monitoring" lifestyle modification with increased sunlight exposure modestly improves vitamin D status, lipid profile and glycemic status in overweight and obese Saudi adults with varying glycemic levels.

BackgroundThe over-all age-adjusted prevalence of diabetes mellitus type 2 (DMT2) in Saudi Arabia is unprecedented at 31%. Aggressive measures should be done to curb down increasing incidence. In this prospective 6-month study we aim to determine whether a self-monitoring, life-style modification program that includes increased sunlight exposure confer improvement in vitamin D status and health benefits among adult Saudi overweight and obese patients with varying glycemic status.MethodsA total of 150 overweight and obese Saudi adults with varying glycemic status aged 30–60 years were included in this study. They were divided into 3 groups (Non-DMT2, Pre-diabetes and DMT2). Baseline anthropometrics and blood glucose were taken at baseline and after 6 months. Fasting blood sugar, lipid profile, calcium, albumin and phosphate were measured routinely. Serum 25(OH) vitamin D was measured using standard assays. Within the time period they were instructed to reduce total intake of fat, increased fiber intake and increase sun exposure.ResultsIn all groups there was a significant improvement in vitamin D levels as well as serum triglycerides, LDL- and total cholesterol. However, a significant increase in serum glucose levels was noted in the non-DMT2 group, and a significant decrease in HDL-cholesterol in both non-DMT2 and pre-diabetes group. In the pre-diabetes group, 53.2% were able to normalize their fasting blood levels after 6 months, with 8.5% reaching the DMT2 stage and 38.3% remaining pre-diabetic. In all groups there was a significant increase in the prevalence of hypertension.ConclusionImproving vitamin D status with modest lifestyle modifications over a short-period translates to improvement in lipid profile except HDL-cholesterol among overweight and obese Saudi adults, but not BMI and blood pressure. Findings of the present study merit further investigation as to whether full vitamin D status correction can delay or prevent onset of DMT2.

Matrix metalloproteinase-10 and microvascular complications of type 1 diabetes: might vitamin D status be relevant?

To the Editor: Inflammation, with excessive production of matrix metalloproteinase (MMP)-9 in unstable plaque, has a major role in the progression of macrovascular disease, including the development of acute events [1]. In a recent issue of Diabetologia, Toni et al [2] report increased circulating MMP-10 in association with increased microvascular disease risks in type 1 diabetes; this finding is in line with the earlier observations, and, as the authors suggest, provides a potential therapeutic target for reducing microvascular disease risks. Vitamin D repletion is associated with reductions in macrovascular disease risks and, although causation remains unproven, plausible mechanisms exist [3]. Increased circulating MMP-9, inversely correlated with severity of vitamin D insufficiency, was reduced by ∼70% in response to modest improvement in vitamin D repletion in healthy South Asians [4], and circulating MMP-9 increased with reduction in vitamin D status in submariners after an 85 day submerged patrol [5]. Furthermore, MMP-10 formation, increased in peripheral blood mononuclear cells by exposure to Mycobacterium tuberculosis, was inhibited by activated vitamin D [6]. It would, therefore, be useful if Toni and colleagues could examine serum 25-hydroxyvitamin D concentrations in the participants in this study as a potential independent predictor for MMP-10 and microvascular complications, since lower vitamin D status has been found to be associated with increases in the prevalence of both diabetic retinopathy and diabetic nephropathy in a study of patients with type 2 diabetes [7]. If there is such an association, then the potential for reduction in circulating MMP-10 by correction of vitamin D deficiency should be examined early in the search for pharmacological agents to lower MMP-10 production in diabetes, since modest vitamin D supplementation might prove to be a particularly cost-effective way of reducing the problems of diabetic complications.

The role of vitamin D in regulating the iron-hepcidin-ferroportin axis in monocytes

Chronic kidney disease affects 40% of adults aged 65 and older. Anemia of CKD is present in 30% of patients with CKD and is associated with increased cardiovascular risk, decreased quality of life, and increased mortality. Hepcidin-25 (hepcidin), the key iron regulating hormone, prevents iron egress from macrophages and thus prevents normal recycling of the iron needed to support erythropoiesis. Hepcidin levels are increased in adults and children with CKD. Vitamin D insufficiency is highly prevalent in CKD and is associated with erythropoietin hyporesponsiveness. Recently, hepcidin levels were found to be inversely correlated with vitamin D status in CKD. The aim of this study was to investigate the role of vitamin D in the regulation of hepcidin expression in vitro and in vivo. This study reports that 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), the hormonally active form of vitamin D, is associated with decreased hepcidin and increased ferroportin expression in lipopolysaccharide (LPS) stimulated THP-1 cells. 1,25(OH)2D3 also resulted in a dose-dependent decrease in pro-hepcidin cytokines, IL-6 and IL-1β, release in vitro. Further, we show that high-dose vitamin D therapy impacts systemic hepcidin levels in subjects with early stage CKD. These data suggest that improvement in vitamin D status is associated with lower systemic concentrations of hepcidin in subjects with CKD. In conclusion, vitamin D regulates the hepcidin-ferroportin axis in macrophages which may facilitate iron egress. Improvement in vitamin D status in patients with CKD may reduce systemic hepcidin levels and may ameliorate anemia of CKD.

Effects of Micronutrient Supplementation on Concentrations of Vitamins and Minerals, Inflammation and Cardiovascular Risk Factors

There is growing interest in the role of micronutrients (essential trace elements and vitamins) in the optimization of health, and prevention and treatment of diseases. As multivitamin –multimineral supplementation (MVMM) is the most commonly reported supplement, it is important to study the health benefits associated with regular intake. We investigated the use of a particular MVMM supplement, developed by the Pure North Foundation, on blood chemistry parameters and lipid profiles, along with the inflammation marker C - reactive protein, in 100 steel company workers over a one year period of supplementation. According to our study, participants with lower levels of vitamins D, B2, and C before supplementation tended to show higher levels of inflammation. Vitamin D levels correlated with a variety of lipid profile parameters. Analysis of the data after one year of supplementation demonstrated that participants with blood vitamin D concentrations above 30 ng/ml showed decreases in triglycerides, cholesterol to HDL ratio, and improvement of HDL levels. In addition, higher vitamin C levels were associated with lower triglyceride and VLDL levels. Blood concentrations of vitamin C, D, and E increased substantially as a result of supplementation, but coenzyme Q10 levels, lutein, lycopene, and vitamin A levels were not greatly affected. Furthermore, looking into the distinction between smokers and non-smokers, our data indicate that improvements in antioxidant levels during MVMM supplementation are less dramatic in smokers. After one year supplementation, smokers had lower plasma antioxidant concentrations than nonsmokers. The greatest differences were found with lycopene, lutein, and vitamin A, while improvements in vitamin C, vitamin D and vitamin E were practically the same for both groups. Smokers had less improvement of the health score in comparison with non-smokers. For all participants, half year and one year of supplementation eliminated very low health scores, and increased the number of people with high scores.

The effects of spending time outdoors in daylight on the psychosocial wellbeing of older people and family carers: a comprehensive systematic review protocol

Review question/objective The overall objective of this research is to undertake a systematic review of the effects of spending time outdoors in daylight on the psychosocial wellbeing of older adults and family carers. The specific objectives to be addressed are: Which aspects of psychosocial wellbeing are affected by spending time outdoors in daylight in older adults and family carers? To what extent is spending time outdoors in the daylight effective for improving aspects of psychosocial wellbeing in older adults and family carers? Inclusion criteria Types of participants This review will consider studies that include all older adults aged 55 years or more, including those living in a community setting or a residential aged care facility. In addition, this review will consider family carers, who are defined as unpaid relatives or friends of an older person, who help that individual with their activities of daily living. No further inclusion criteria will be applied. Types of intervention(s)/phenomena of interest The intervention or phenomenon of interest is spending time outdoors in daylight. ‘Outdoors in daylight’ is a broad term that encompasses all outdoor environments where participants are exposed, directly or indirectly, to daylight in a natural setting while participating in any type of outdoor activity. For our review, the definition of outdoor activity is simply ‘being outdoors’ in order to capture all types of engagement with outdoor environments. Studies will be excluded if they utilise artificial ‘bright’ light sources or modify the indoor environment to improve light exposure. An absence of activity or indoors activity with no exposure to daylight will be used as a comparator. Types of outcomes This review will consider studies that include objective and/ or subjective measures of the following outcomes: Older adults: • psychosocial well-being: o behavioural disturbances; o cognition; o mood levels; o quality of life; o satisfaction with service provision; and o social interaction. Family carer health: o carer satisfaction; and o carer stress.

Vitamin D Insufficiency/Deficiency in HIV-Infected Inner City Youth

High prevalence of vitamin D deficiency among HIV-infected individuals has been reported in many studies. Increasing evidence for vitamin D's role in innate and cell-mediated immunity suggests that vitamin D insufficiency or deficiency is worrisome particularly for HIV-infected individuals who are already at increased risk of infection. It is unknown whether vitamin D deficiency and supplementation will have any effects on HIV infection, including CD4 counts/CD4% and HIV plasma RNA. Serum vitamin D levels, 25-hydroxyvitamin D (25-(OH)D), were obtained from 160 HIV-infected youth, aged 2 to 26 years as part of routine care. The HIV plasma RNA and CD4 counts were compared between patients with normal vitamin D and vitamin D insufficiency/deficiency. Individuals whose vitamin D level was ≤35 ng/mL received vitamin D3 supplementation. We compared the HIV plasma RNA, absolute CD4 counts, and CD4% in pre- and post-vitamin D supplementation. Categorical comparisons between the groups were examined using a nonparametric Fisher exact test, while continuous variables, pre- and post-vitamin D supplementation, were examined using a parametric paired samples t test. The majority (152 of 160; 95%) of our patients were African American. Only 8 (5%) of 160 had normal vitamin D. Of the 160 patients with HIV, 37 (23.1%) had vitamin D insufficiency (25-(OH)D level between 21 and 35 ng/mL) and 11 of 160 (71.9%) had vitamin D deficiency (25-(OH)D level ≤20 ng/mL). Absolute CD4 counts averaged lower in patients who have severe vitamin D deficiency (25-(OH)D ≤10 ng/mL; mean 574.41 ± 306.17 cells/mm(3)) compared to those who had higher vitamin D level (mean 701.15 ± 444.19 cells/mm(3)). The CD4% were also lower (mean 25.12% ± 12.5%) in those who have severe vitamin D deficiency compared to those whose vitamin D level was ≥11 ng/mL (mean 29.47% ± 11.62%). The HIV plasma RNA was similar in all the groups. Our patients who were prescribed tenofovir (TDF) and/or efavirenz (EFV) did not have different vitamin D levels than patients who were prescribed other antiretroviral (ARV) medications. Only 60 (39.5%) of the 152 patients who received vitamin D supplement showed improvement in vitamin D level. Of the 60 patients, 10 (16.7%) had normalized vitamin D level (25-(OH)D level > 35 ng/mL). We did not see any significant change in the absolute CD4 counts or CD4%. A higher prevalence of vitamin D insufficiency/deficiency was found in our study compared to the previous large cohorts. However, patients who were prescribed TDF/EFV did not have lower vitamin D levels. Inadequate sunlight exposure in temperate latitudes and the cloud effect of the Great Lakes as well as large number of African American participants who live in the inner city area with poverty and poor diet may combine to explain these results. The effect of ARV medications on vitamin D may be washed out by the numerous other factors affecting vitamin D in our patients. Severe vitamin D deficiency seemed to be related to lower CD4 counts and CD4% but not related to HIV plasma RNA. Vitamin D supplementation did not increase CD4 counts/CD4% in our study.

Influence of Vitamin D Status and Vitamin D3 Supplementation on Genome Wide Expression of White Blood Cells: A Randomized Double-Blind Clinical Trial

BackgroundAlthough there have been numerous observations of vitamin D deficiency and its links to chronic diseases, no studies have reported on how vitamin D status and vitamin D3 supplementation affects broad gene expression in humans. The objective of this study was to determine the effect of vitamin D status and subsequent vitamin D supplementation on broad gene expression in healthy adults. (Trial registration: ClinicalTrials.gov NCT01696409).Methods and FindingsA randomized, double-blind, single center pilot trial was conducted for comparing vitamin D supplementation with either 400 IUs (n = 3) or 2000 IUs (n = 5) vitamin D3 daily for 2 months on broad gene expression in the white blood cells collected from 8 healthy adults in the winter. Microarrays of the 16 buffy coats from eight subjects passed the quality control filters and normalized with the RMA method. Vitamin D3 supplementation that improved serum 25-hydroxyvitamin D concentrations was associated with at least a 1.5 fold alteration in the expression of 291 genes. There was a significant difference in the expression of 66 genes between subjects at baseline with vitamin D deficiency (25(OH)D<20 ng/ml) and subjects with a 25(OH)D>20 ng/ml. After vitamin D3 supplementation gene expression of these 66 genes was similar for both groups. Seventeen vitamin D-regulated genes with new candidate vitamin D response elements including TRIM27, CD83, COPB2, YRNA and CETN3 which have been shown to be important for transcriptional regulation, immune function, response to stress and DNA repair were identified.Conclusion/SignificanceOur data suggest that any improvement in vitamin D status will significantly affect expression of genes that have a wide variety of biologic functions of more than 160 pathways linked to cancer, autoimmune disorders and cardiovascular disease with have been associated with vitamin D deficiency. This study reveals for the first time molecular finger prints that help explain the nonskeletal health benefits of vitamin D.Trial RegistrationClinicalTrials.gov NCT01696409

Regular Consumption of Both Vitamin D– and Calcium- and Vitamin D–Fortified Yogurt Drink Is Equally Accompanied by Lowered Blood Lipoprotein (a) and Elevated Apoprotein A1 in Subjects with Type 2 Diabetes: A Randomized Clinical Trial

Objective: Cardiovascular disease (CVD) is the major morbidity and cause of death in diabetic subjects. Observational studies have shown the association of low vitamin D status with poor glycemic control, atherogenic lipid profile, and CVD. However, the possible link between circulating 25-hydroxycholecalciferol and apoproteins (Apo A1 and B) and the atherogenic lipoprotein (a) [Lp(a)] has not been documented to date. Methods: Ninety subjects with type 2 diabetes (T2D) aged 30–60 years from both sexes were randomly allocated to one of the 3 groups to receive 2 bottles a day of either (1) plain doogh (PD; containing 150 mg calcium and no detectable vitamin D/250 mL); (2) vitamin D–fortified doogh (DD; containing 150 mg calcium and 500 IU vitamin D/250 mL); or (3) calcium- and vitamin D–fortified doogh (CDD; containing 250 mg calcium and 500 IU vitamin D/250 mL) for 12 weeks. Anthropometric, dietary, and laboratory assessments, including Apo A1, Apo B, and Lp(a), were done. Results: Improvement of vitamin D status in DD and CDD groups, compared to PD, resulted in a significant increase in Apo A1 (mean changes 0.22 ± 0.38, 0.20 ± 0.27 and 0.01 ± 0.35 g/L, respectively, p = 0.047) and a significant decrease in serum Lp(a) (mean changes −0.08 ± 0.30, −0.08 ± 0.31, and 0.14 ± 0.25 μmol/L, respectively, p = 0.011). There was no significant difference between DD and CDD groups. Serum Apo B did not change significantly in any of the groups. Conclusions: Significant amelioration of serum Apo A1 and Lp(a) following improvement of vitamin D status in T2D subjects may have preventive implications against long-term diabetic complications, notably CVD. This trial was registered at ClinicalTrials.gov as NTC01229891.

Antioxidant Activity, Vitamin C Content and Growth of Chinese Kale in Response to High Humus Seedling Media and Beneficial Microorganisms

Nutritional values (antioxidant activity and vitamin C content), growth and nutrient uptake of Chinese kale seedlings in response to high humus seedling media and beneficial microorganisms were evaluated in the screenhouse. Selected seedling media (SSM) were mixed with each of the three selected isolates (Azospirillum sp., Beijerinckia sp. and actinomycetes) and various percentages of leonardite. The results showed that SSM with actinomycetes plus 15% leonardite produced the highest shoot and root dry weight of Chinese kale seedling and all these values were significantly higher than the control. This treatment also produced the highest nutrient uptake (N, P, K, Ca and Mg). Furthermore, this treatment produced the highest vitamin C content (33.08 and 44.66 µg/ml) and antioxidant activity (1.9285 and 4.733 µmol trolox/g) at both the seedling stage (20 days after inoculation, or 20 DAI) and harvest time (40 days after inoculation, or 40 DAI), respectively. For Chinese kale, application of SSM with actinomycetes plus 15% leonardite not only improved plant growth and nutrient uptake but also increased nutritional values (antioxidant activity and vitamin C content) at both a seedling and at harvest. SSM with Beijerinckia sp. and 10% leonardite provided the second highest values of vitamin C content and antioxidant activity, also exceeding the control. Our results demonstrated that the improvement of vitamin C content and antioxidant activity of Chinese kale by bioorganic inputs in the production system is of interest and could lead to better consumer health.

Long-Term Bone Density Evaluation in Cerebrotendinous Xanthomatosis: Evidence of Improvement after Chenodeoxycholic Acid Treatment

Cerebrotendinous xanthomatosis (CTX) is known to be associated with osteoporosis and a higher incidence of bone fractures. However, the underlying pathogenesis is still unknown, and the effects of long-term replacement therapy with chenodeoxycholic acid (CDCA) on bone mineral density (BMD) have not been fully investigated. We studied 11 CTX patients aged 13-43years. We performed dual-energy X-ray absorptiometry and assessed serum cholestanol and 25-hydroxyvitamin D (25-OHD) concentrations both at the time of diagnosis and after long-term treatment with CDCA. At baseline, we found low BMD in nine patients, cholestanol elevation in all subjects, and 25-OHD decrease in nine. After a mean follow-up time of 30months (range 24-36), no substantial clinical changes including bone fractures occurred; and we detected a significant increase of both planar and volumetric BMD as well as normalization of plasma cholestanol levels and increase of serum 25-OHD. Densitometric improvement following CDCA introduction was not correlated to changes of biochemical parameters. Our study confirms the presence of low bone mass in CTX and demonstrates that long-term CDCA treatment increases bone mineral content. In this respect, improvement of vitamin D intestinal absorption secondary to bile acid restoration could play an important role. Moreover, our data strongly suggest the utility of periodic bone density evaluation in CTX patients.

Improvement of vitamin E quality and quantity in tobacco and lettuce by chloroplast genetic engineering.

Vitamin E (tocopherol: Toc) is an important lipid-soluble antioxidant synthesized in chloroplasts. Among the 8 isoforms of vitamin E, α-Toc has the highest activity in humans. To generate transgenic plants with enhanced vitamin E activity, we applied a chloroplast transformation technique. Three types of the transplastomic tobacco plants (pTTC, pTTMT and pTTC-TMT) carrying the Toc cyclase (TC) or γ-Toc methyltransferase (γ-TMT) gene and the TC plus γ-TMT genes as an operon in the plastid genome, respectively, were generated. There was a significant increase in total levels of Toc due to an increase in γ-Toc in the pTTC plants. Compared to the wild-type plants, Toc composition was altered in the pTTMT plants. In the pTTC-TMT plants, total Toc levels increased and α-Toc was a major Toc isoform. Furthermore, to use chloroplast transformation to produce α-Toc-rich vegetable, TC-overexpressing transplastomic lettuce plants (pLTC) were generated. Total Toc levels and vitamin E activity increased in the pLTC plants compared with the wild-type lettuce plants. These findings indicated that chloroplast genetic engineering is useful to improve vitamin E quality and quantity in plants.

Improvement of vitamin D status resulted in amelioration of biomarkers of systemic inflammation in the subjects with type 2 diabetes

Both vitamin D deficiency and inflammation have been linked to cardiovascular disease, the major cause of death in diabetes. In this study, the effects of daily intake of vitamin D-fortified yoghourt drink (doogh) on systemic inflammatory biomarkers in subjects with type 2 diabetes (T2D) were investigated. In this 12-week randomized controlled trial, T2D subjects received either plain doogh (PD; containing 170 mg calcium and no detectable vitamin D/250 mL, n(1) = 50) or vitamin D3-fortified doogh (FD; containing 170 mg calcium and 500 IU/250 mL, n(2) = 50) twice a day. Glycemic status, body fat mass and systemic inflammatory biomarkers including serum highly sensitive C-reactive protein (hsCRP), serum amyloid A (SAA), interleukin(IL)-2, IL-6, IL-10 and tumour necrosis factor (TNF)-α were evaluated at the beginning and after the intervention. Data were expressed as either mean ± SD or median (interquartile range) whenever they had either normal or non-normal distribution, respectively. In the patients receiving the vitamin D fortified drink, compared with those receiving the unfortified drink, a significant increase in serum 25(OH)D was accompanied by significant changes in TNF-α (-57.9 (-264.6) versus +106.3 (683.2), p = 0.044), IL-6 (-6.3 (-69.2), p = 0.002), hsCRP (-0.39 (-1.50) versus +0.8 (1.52), p < 0.001), SAA (-14.2 ± 44.5 versus +5.6 ± 37.5 mg/L, p = 0.022) and IL-10 (+38.7 ± 157.0 versus -51.9 ± 165.2 ng/L, p = 0.013). The between-group differences of hsCRP, SAA and IL-6 changes remained significant even after controlling for changes quantitative insulin check index (p < 0.001, p < 0.001 and p = 0.009, respectively). Improvement of vitamin D status of T2D subjects resulted in amelioration of the systemic inflammatory markers. This may have preventive implications against cardiovascular disease and other diabetic complications.

Vitamin D3 supplementation to improve fatigue in patients with advanced cancer.

9097 Background: Fatigue is one of the most common symptoms of patients diagnosed with cancer. Vitamin D deficiency has been associated with an increased risk of mortality in oncology patients. We conducted a prospective vitamin D (cholecalciferol) supplementation study to analyse the response to oral D3 supplementation on fatigue in this population of chemo-naïve patients. Methods: Eligibility critera included life expectancy ≥ 6 months, ECOG PS 0-3, low serum 25-hydroxyvitamin D3 at the time of diagnosis (using cutoff value of 32 ng/mL), and normal serum calcium level. Cancer related fatigue was measured with the Functional Assessment of Cancer Therapy Fatigue module (FACT-F). Patients were randomized to receive oral supplementation with 2,000 IU of Vitamin D3 daily for 3 months with standard cancer treatment or to continue standard treatment without vit D3 supplementation. Primary endpoint was changes in the FACT-F scale. Secondary endpoints was improvement of vitamin D serum levels and safety. Results: 69 vit D deficient patients enrolled in the this study between November 2009 and November 2011 returned a baseline FACT-F. The mean serum 25(OH)D levels were 18.7 ng/ml (SD = 7.4) at baseline. Patients in experimental arm showed marked improvement from baseline in fatigue (p&lt;0.05) and vitamin D serum levels after 3 months (p&lt;0.001). There were significant difference in fatigue score in patients with experimental arm and control arm after 3 months of treatment (p&lt; 0.001). Conclusions: Vitamin D supplementation resulted in a significant increase in Fatigue score and serum 25(OH)D levels in vitamin D deficient patients. Fatigue improve rapidly but remain worse in control arm. The safety profile of vitamin D in combination with chemotherapy or BSC was acceptable. [Table: see text]

Cord-Blood Vitamin D Levels and Risk of Recurrent Wheezing, Effect of Sleep-Disordered Breathing on Blood Pressure in Children, and Long-Term Impact of Bronchopulmonary Dysplasia

Recent studies have suggested a strong inverse correlation between maternal intake of vitamin D during pregnancy and the risk of recurrent wheezing in children (2). However, the relationship between cord-blood levels of 25(OH)D and childhood wheezing is unknown. To address this issue, the New Zealand Asthma Cohort did a prospective trial in which the cord-blood levels of 25(OH)D in 922 apparently healthy children were examined and correlated with outcomes, which included parental history of respiratory infection at 3 months of age, wheezing at 15 months of age and annually thereafter till 5 years, and incident asthma diagnosed by 5 years of age. Effects of various potential confounders were assessed using multivariate logistic regression models, thereby increasing the validity of findings. Eighty-nine percent of the children completed the study. The median cord-blood level of 25(OH)Dwas 44 nmol/L.After adjusting for the birth season, 25(OH)D had an inverse association with risk of respiratory infection at 3 months of age (odds ratio, 1 for.75 nmol/L, 1.39 for 25–74 nmol/L, and 2.16 for ,25 nmol/L, with 95% confidence interval). Similarly, 25(OH)D had an inverse linear association with risk of wheezing at 15 months, 3 years, and 5 years of age (all P , 0.05). Every 10-nmol/L increase in cord-blood 25(OH)D lowered cumulative risk of wheeze by the age of 5 years (odds ratio, 0.95). In all models, cord-blood 25(OH)D levels were not associated with either atopic or nonatopic asthma (all P . 0.2). These results were unchanged after adjustment for more than 12 potential confounders. In light of growing literature on the role of vitamin D in innate immunity, this study indicates that improvement in vitamin D status in pregnant women may provide a simple, safe, and inexpensive way to reduce the respiratory infections that often trigger wheezing in early childhood (3). Indistinctiveness of the primary outcomes is the potential limitation of the study, as it was based on parental survey rather than actual medical examination. Further randomized controlled trials are needed to evaluate the outcome of vitamin D supplementation during pregnancy and early childhood on respiratory outcomes and follow-up in late childhood and adulthood to better define this relationship.

Improvement of Vitamin D Status via Daily Intake of Fortified Yogurt Drink Either with or without Extra Calcium Ameliorates Systemic Inflammatory Biomarkers, including Adipokines, in the Subjects with Type 2 Diabetes

Systemic inflammation is thought to have a central role in diabetic long-term complications. The aim of this study was to investigate the effects of vitamin D either with or without extra calcium on certain inflammatory biomarkers in the subjects with type 2 diabetes (T2D). This was a double-blind, randomized, controlled trial conducted over 12 wk in 90 T2D subjects aged 30-60 yr from both sexes. Subjects were randomly allocated to one of three groups to receive two 250-ml bottles a day of plain Persian yogurt drink or doogh (PD, containing 150 mg calcium and no detectable vitamin D(3)/250 ml), vitamin D-fortified doogh (DD, containing 500 IU vitamin D(3) and 150 mg calcium/250 ml), or calcium + vitamin D(3)-fortified doogh (CDD, containing 500 IU vitamin D(3) and 250 mg calcium/250 ml). The changes in inflammatory markers were evaluated. Compared to the baseline values, highly sensitive C-reactive protein, IL-1β, IL-6, fibrinogen, and retinol binding protein-4 concentrations significantly decreased in both the DD and CDD groups. Although the decrement in highly sensitive C-reactive protein and fibrinogen was more in CDD compared to DD (-4.0 ± 8.5 vs. -1.3 ± 2.8 mg/liter, and -0.40 ± 0.74 and -0.20 ± 0.52 mg/liter, respectively), the differences were not significant. There was a significant increase in serum adiponectin in both the DD and CDD groups (51.3 ± 65.3 vs. 57.1 ± 33.8 μg/liter; P < 0.05). Mean adiponectin changes in CDD were significantly higher than in PD (P = 0.021). Daily intake of vitamin D-fortified doogh improved inflammatory markers in T2D subjects, and extra calcium conferred additional benefit only for the antiinflammatory adipokine, i.e. adiponectin.