Effects Of Long-term Vitamin Research Articles

6928 Vitamin D excess in a patient with hypoparathyroidism after parathyroidectomy

Abstract Disclosure: Z. Zavgorodneva: None. A. Barsegian: None. F. Zhang: None. Introduction. We describe a case of a patient with mild persistent hypoparathyroidism after parathyroidectomy with autotransplantation, which was indicated for ESRD-related secondary hyperparathyroidism. The patient presented with nonspecific complaints and was found to have a high Vitamin D level after long-term moderate-dose Vitamin D supplementation. Case report. A 71-year-old male with a past medical history of end-stage renal disease (ESRD) undergoing hemodialysis for the past 18 years, as well as a history of parathyroidectomy with autoimplantation of parathyroid glands in the forearm in 2010 due to severe secondary hyperparathyroidism, presented to the hospital complaining of generalized weakness and lower extremity cramps that had been ongoing for a few weeks. Further investigations did not reveal evidence of infectious processes. A review of medications indicated the absence of statins among his outpatient medications. No focal neurological deficits or objective signs of muscle weakness were identified. Laboratory findings showed no significant metabolic derangements or haematological abnormalities. Inflammatory markers and creatine phosphokinase were within normal ranges. As part of the workup for generalized subjective weakness and ESRD, Vitamin D levels were checked, revealing a result of of120 ng/mL. The patient reported taking over-the-counter 2000 IU of Vitamin D twice daily for the past six years despite having a normal level of Vitamin D checked five years prior to admission. Calcium supplements were initiated in the postoperative period and continue to be administered at a dose of 600 mg daily. Analysis of the PTH-calcium axis demonstrated persistent mild hypoparathyroidism with hypocalcemia since the time of the surgery. However, there was an observed tendency for calcium levels to improve, especially in the last six years. Vitamin D supplement was discontinued, and the patient was subsequently discharged home with the continuation of physical therapy. Discussion. Explaining the origin of the high level of Vitamin D in this patient poses a challenge. There is limited data in the literature regarding the long-term effects of vitamin D use when the initial Vitamin D levels are normal. Additionally, there are numerous abstracts suggesting significantly higher doses of Vitamin D received for up to 6 years without any evident biochemical or clinical consequences. Moreover, the typical consequences of Vitamin D toxicity, such as hypercalcemia, can not be present in patients who underwent parathyroidectomy. Therefore, it is possible to consider that the severe generalized subjective weakness may be a sign of Vitamin D toxicity itself. Presentation: 6/1/2024

Can Vitamin D Levels Alter the Effectiveness of Short-Term Facelift Interventions?

Facelifting is increasingly popular among the population. It exceeded the limits of post-traumatic facia-reconstruction. Both the demand and the methods available are getting increasingly diverse. The minimally invasive technique revolutionized the facelift, although it took some time to completely comprehend the mechanics. The roles of vitamin D in numerous physiological processes in which it is involved have mostly been elucidated in the last decade. Our hypothesis is based on one of these roles, that is, vitamin D intervenes in changing the type of collagen by changing its location; therefore, collagen will have a supporting role for the subcutaneous tissue. A group of 156 patients with different facelifting methods was followed: 93 minimally invasive (NC), 49 classical surgery (C) and 14 with the combined technique (NC + C). The change in the subcutaneous tissue was monitored by an elastograph. The level of vitamin D was monitored in order to assess the immediate and long-term effects of vitamin D on the progression of subcutaneous fibrosis. It was proven that an optimal level of vitamin D has a beneficial effect in maintaining the volume of subcutaneous tissue in patients from the NC and NC + C groups, the best results being in the NC + C group. An increase in the subcutaneous volume was recorded, which leads to a decrease in elasticity (statistical significance p < 0.05) and the lowering of the subcutaneous tissue, and an increased amount of lowering corresponds to a lowering of vitamin D levels.

The Long-Term Effect of Vitamin D Supplementation on Quality of Life in Persistent (Perennial) Allergic Rhinitis Patients.

Vitamin D is one of the thoroughly studied risk factors in the pathogenesis of allergic rhinitis (AR). Low serum level of vitamin D is well documented in the urban population of India. The supplementation policy of vitamin D is not uniform among practitioners. The study aims to assess the impact of vitamin D deficiency on AR & long-term quality of life in perennial AR patients with low vitamin D levels after its supplementation in the urban population.The policy for evaluation of serum level of vitamin D & its supplementation in deficit patients in AR is not uniform in our hospital. The data was extracted from the hospital records & the patients came to OPD in the year 2018-2019. Inclusion criteria were the clinical diagnosis (ARIA guideline) of the perennial form of AR where vitamin D assessment was performed before prescribing treatment & the patients received a complete course of vitamin D as per the recommendation followed in our Institute. The patients received oral antihistaminic & topical steroids based nasal spray and were clubbed together as a control group whereas, in the study group, the patients were pooled together who received vitamin D supplementation along with oral antihistaminic & topical steroids based nasal spray. Pre-treatment & post-treatment (at 8weeks, 6months, and 12months) SNOT-22 scores were obtained from the records. The data were analyzed statistically using repeated measures ANOVA test. The study showed a significant decrease in the SNOT-22 score in both Groups in comparison to pre-treatment scores, but post-treatment group comparison was not found statistically significant at each point of comparison. The scores were found on the lower side in the study group at the initial two evaluation points whereas it was higher at the third point of evaluation. This study showed the additional therapeutic effect of vitamin D supplementation as an adjunct in the treatment of perennial AR patients but the effectiveness of the treatment does not last forever so maintenance therapy is required especially in areas following the Indian lifestyle.

Short- and Long-Term Effects of Vitamin D Treatment on Bacillus Calmette-Guerin-Induced Depressive-Like Behavior in Mice.

PurposeDepression is one of the most common psychological disorders. The nutritional etiology of the depression proposes that vitamin D may play a significant role in the pathogenesis of depression. Further, vitamin D deficiency has been found to aggravate depression in animals. Therefore, vitamin D treatment might be a potential therapeutic aid in depression management. This study aimed to explore the antidepressant effects of vitamin D in a Bacillus Calmette-Guerin (BCG)-induced depression model.MethodsThirty-six mice were randomly assigned to short-term and long-term experimental groups. In each group, mice were randomly subcategorized into three subgroups: 1. control (received vehicle), 2. BCG (received BCG [107 CFU/mouse]), and 3. BCG + vitamin D (received vitamin D [60.000 IU/kg] before BCG [107 CFU/mouse] inoculation). After completion of the two experimental periods (3 days for the short-term group and 2 weeks for the long-term group), the mice underwent three behavioral tests: locomotor activity, the forced swimming test (FST), and the tail suspension test (TST).ResultsLocomotor activity did not significantly differ among the subgroups in either the long-term or short-term groups. In the short-term group, the total immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. However, in the TST, no significant difference was found between the vitamin D-treated group and the BCG group. In the long-term group, the immobility time on the FST was decreased in the vitamin D-treated group compared to the BCG group. Similarly, the total immobility time on the TST was also significantly lower in the vitamin D-treated mice than in the BCG-treated mice.ConclusionVitamin D is useful in the management of depressive behavior. The potential role of vitamin D in the etiology of depression should be investigated in future work.

Vitamin D Supplementation and Change in Objectively Measured Physical Performance

Change in usual gait speed (GS) was a prespecified secondary outcome in STURDY and additional physical performance measures were also assessed. Over 12 months, gait speed declined slightly in both the 200IU/d (control) and the intervention groups receiving 1000 or more IU/d, with identical declines in both groups. However, at month 24 GS declined 0.09 m/s from baseline in controls and 0.03 m/s in the intervention group (p=0.03). Subgroup analyses of persons receiving just 1000IU/d throughout the trial compared to controls did not reach significance (p=0.07). Neither SPPB, balance, chair stand tests, or 6-minute walk test showed differences between controls and intervention at any follow-up point. The timed up and go (TUG) test showed a significantly greater improvement in the intervention group at 2 months (p=0.004) but not 12 or 24 months (p=0.17 and 0.79, respectively). Effects of long-term vitamin D supplementation on physical functioning remain unclear.

Alterations in oxidative metabolism in liver of female rats: Effects of long-term vitamin A deficiency

Background: The latest estimate by 5 UN agencies is that 821 million people globally are undernourished, which puts them at risk of vitamin and other nutrient deficiencies. Vitamin A deficiency remains a widespread public health problem among women and children in the developing world the role of vitamin A and its active metabolites in pathways involved in antioxidant protection and in the inhibition of important pathways that promote oxidative stress. Objectives: Determine if vitamin A deficiency could influence oxidative metabolism in 6-month-old female wistar rats. Materials and Methods: Determine the concentration of carbonyl proteins, as a marker of protein oxidation; TBARS, as a lipoperoxidation marker; and nitrotyrosine as a marker of oxidative stress dependent on nitric oxide. Quantify the expression of CAT, SOD, eNOS and iNOS in the liver and wistar rats deficient in vitamin A for 6 months. Results: An increase in the concentration of carbonyl protein and nitrotyrosine in the liver tissue deficient in vitamin A is observed. The expression of SOD, eNOS and iNOS decreased in the group with a private diet of vitamin A. From the regression analysis a positive correlation was established between hepatic retinoic acid levels and gene expression of eNOS, iNOS and SOD. A positive correlation between serum retinoic acid levels and gene expression of eNOS and iNOS was also observed. Conclusions: It is possible to ratify the relationship between the development of stress and vitamin A levels; improving the understanding of hepatic metabolism and its response to the absence of this vitamin.

Alterations in oxidative metabolism in liver of female rats: Effects of long-term vitamin A deficiency

Alterations in oxidative metabolism in liver of female rats: Effects of long-term vitamin A deficiency

Effects of long-term vitamin D and n-3 fatty acid supplementation on inflammatory and cardiac biomarkers in patients with type 2 diabetes: secondary analyses from a randomised controlled trial.

Interventions that reduce inflammation may delay progression of microvascular and macrovascular complications in diabetes. We examined the effects of vitamin D3 and/or n-3 fatty acid supplementation vs placebo on 5year changes in serum inflammatory and cardiac biomarkers in adults with type 2 diabetes. This study reports pre-specified secondary outcomes of the Vitamin D and Omega-3 Trial to Prevent and Treat Diabetic Kidney Disease, in which 1312 US adults with type 2 diabetes and without known cardiovascular disease, malignancy, or end-stage kidney disease were randomised using computer-generated random numbers in blocks of eight to vitamin D3 (2000IU/day) vs placebo and n-3 fatty acids (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]; 1g/day) vs placebo in a 2 × 2 factorial design. Participants, examiners, and researchers assessing outcomes were blinded to intervention assignment. We measured serum IL-6, high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) at baseline and after 2 and 5years. A total of 333 participants were randomised to vitamin D3 and placebo n-3 fatty acids, 289 to n-3 fatty acids and placebo vitamin D3, 370 to vitamin D3 and n-3 fatty acids, and 320 to 2 placebos; 989 (75%) and 934 (71%) participants returned blood samples at 2 and 5years, respectively. Participants had a mean age of 67.6years (46% women). Overall, baseline geometric means of IL-6, hsCRP and NT-proBNP were 1.2pg/ml, 1.9mg/l and 262ng/l, respectively. After 5years, mean IL-6 and hsCRP remained within 6% of their baseline values while mean NT-proBNP increased by 55% overall. Compared with placebo, participants assigned to vitamin D3 had a 1.24-fold greater increase in NT-proBNP over 5years (95% CI 1.09, 1.41; p = 0.003), while IL-6 and hsCRP did not have a significant difference in change. Comparing n-3 fatty acids with placebo, there was no significant difference in change in IL-6, hsCRP or NT-proBNP. No heterogeneity was observed in subgroup analyses accounting for baseline eGFR, urine albumin to creatinine ratio, initial biomarker concentration, 25-hydroxyvitamin D level or EPA+DHA index. Among adults with type 2 diabetes, supplementation with vitamin D3 or n-3 fatty acids did not reduce IL-6, hsCRP or NT-proBNP over 5years. ClinicalTrials.gov NCT01684722 FUNDING: The study was funded by grant R01DK088762 from the National Institute of Diabetes and Digestive and Kidney Diseases. Graphical abstract.

1061-P: Effects of Long-Term Vitamin D and Omega-3 Fatty Acid Supplementation on Inflammatory and Cardiac Biomarkers in Patients with Type 2 Diabetes

Background: Immune system activation contributes to the development of microvascular and macrovascular complications in diabetes. Identifying interventions that reduce inflammation may delay progression of diabetes complications. Methods: This study reports pre-specified secondary outcomes of the Vitamin D and Omega-3 Trial to Prevent and Treat Diabetic Kidney Disease, in which 1,312 adults with type 2 diabetes were randomized to vitamin D3 (2000 IU/d) versus placebo and omega-3 fatty acids (EPA+DHA;1g/d) versus placebo in a 2x2 factorial design. We measured serum interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) at baseline and after two and five years, then used linear mixed models to test treatment effects. Results: Participants were on average 67.6 years old (46% women). Overall, baseline geometric means of IL-6, hsCRP, and NT-proBNP were 1.2 pg/mL, 1.9 mg/L, and 262 pg/mL, respectively. After five years, mean IL-6 and hsCRP remained within 5% of their baseline values while mean NT-proBNP increased by 56% in the full population. Compared with placebo, participants assigned to vitamin D3 had a larger increase in NT-proBNP over time (ratio of change compared with placebo at five years 1.25; 95%CI 1.09-1.43; p=0.005), while there was no significant difference in change in IL-6 (ratio 0.97; 95%CI 0.80-1.18) or hsCRP (ratio 0.90; 95%CI 0.79-1.02). Comparing omega-3 fatty acids to placebo, there was no significant difference in change in IL-6 (ratio 1.11; 95%CI 0.92-1.34), hsCRP (ratio 0.88; 95%CI 0.77-1.00), or NT-proBNP (ratio 1.03; 95%CI 0.90-1.17) at five years. No heterogeneity was observed in subgroup analyses accounting for pre-specified clinical and demographic features. Conclusions: Among adults with type 2 diabetes, supplementation with vitamin D3 or omega-3 fatty acids did not reduce IL-6, hsCRP, or NT-proBNP long-term. Disclosure C. Limonte: None. L. Zelnick: None. A. Hoofnagle: None. R. Thadhani: None. M. Melamed: Other Relationship; Self; American Board of Internal Medicine, ICON plc. J. Ruzinski: None. I. Lee: None. H. Sesso: None. J.E. Buring: Advisory Panel; Spouse/Partner; Pharmavite. J.E. Manson: None. I. de Boer: Advisory Panel; Self; Boehringer Ingelheim International GmbH. Consultant; Self; George Clinical, Goldfinch Bio, Ironwood Pharmaceuticals. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK088762); National Institutes of Health (U01CA138962, R01CA138962)

Long-Term Effects of Vitamin D Supplementation in Obese Children During Integrated Weight-Loss Programme-A Double Blind Randomized Placebo-Controlled Trial.

Background: Vitamin D was studied in regards to its possible impact on body mass reduction and metabolic changes in adults and children with obesity yet there were no studies assessing the impact of vitamin D supplementation during a weight management program in children and adolescence. The aim of our study was to assess the influence of 26 weeks of vitamin D supplementation in overweight and obese children undergoing an integrated 12–months’ long weight loss program on body mass reduction, body composition and bone mineral density. Methods: A double–blind randomized placebo–controlled trial. Vitamin D deficient patients (<30 ng/ml level of vitamin D) aged 6–14, participating in multidisciplinary weight management program were randomly allocated to receiving vitamin D (1200 IU) or placebo for the first 26 weeks of the intervention. Results: Out of the 152 qualified patients, 109 (72%) completed a full cycle of four visits scheduled in the program. There were no difference in the level of BMI (body mass index) change – both raw BMI and BMI centiles. Although the reduction of BMI centiles was greater in the vitamin D vs. placebo group (−4.28 ± 8.43 vs. −2.53 ± 6.10) the difference was not statistically significant (p = 0.319). Similarly the reduction in fat mass—assessed both using bioimpedance and DEXa was achieved, yet the differences between the groups were not statistically significant. Conclusions: Our study ads substantial results to support the thesis on no effect of vitamin D supplementation on body weight reduction in children and adolescents with vitamin D insufficiency undergoing a weight management program.

The effect of vitamin D supplementation on the glycemic control of pre-diabetic Qatari patients in a randomized control trial

BackgroundVitamin D deficiency is associated with indicators of pre-diabetes including, insulin resistance, β-cell dysfunction and elevated plasma glucose with controversial findings from current trials. This study aims to investigate the long-term effect of vitamin D on glucose metabolism and insulin sensitivity in pre-diabetic and highly vitamin-deficient subjects.MethodsOne hundred thirty-two participants were randomized to 30,000 IU vitamin D weekly for 6 months. Participants underwent oral glucose tolerance test (OGTT) at 3-month intervals to determine the change in plasma glucose concentration at 2 h after 75 g OGTT (2hPCG). Secondary measurements included glycated hemoglobin, fasting plasma glucose and insulin, post-prandial insulin, indices of insulin sensitivity (HOMA-IR, Matsuda Index), β-cell function (HOMA-β, glucose and insulin area under the curve (AUC), disposition and insulinogenic indices), and lipid profile.ResultsA total of 57 (vitamin D) and 75 (placebo) subjects completed the study. Mean baseline serum 25(OH) D levels were 17.0 ng/ml and 14.9 ng/ml for placebo and vitamin D group, respectively. No significant differences were observed for 2hPC glucose or insulin sensitivity indices between groups. HOMA-β significantly decreased in the vitamin D group, while area under curve for glucose and insulin showed a significant reduction in β-cell function in both groups. Additionally, HOMA-β was found to be significantly different between control and treatment group and significance persisted after adjusting for confounding factors.ConclusionVitamin D supplementation in a pre-diabetic and severely vitamin-deficient population had no effect on glucose tolerance or insulin sensitivity. The observed reduction in β-cell function in both placebo and vitamin D groups could be attributed to factors other than supplementation.Trial registrationNCT02098980, 28/03/2014 (www.clinicaltrials.gov).

The Effect of Vitamin D Supplementation in Patients with Acute Traumatic Brain Injury

To investigate the acute and long-term effects of vitamin D supplementation on the recovery of patients with traumatic brain injury (TBI). A retrospective study was conducted involving 345 patients with TBI who visited a single trauma center. Vitamin D serum levels were measured without supplementation at admission, 1 month, and 3 months post-TBI (control group) from August to December 2016. From January 2017, vitamin D supplementation was provided to patients with TBI with low vitamin D serum levels at admission (supplement group). The outcomes were investigated by assessing performance function (Extended Glasgow Outcome Scale) and cognitive function (Mini-Mental Status Examination, and Clinical Dementia Rating) at 1 week and 3 months post-TBI. The mean vitamin D serum level in patients with TBI at admission was 13.62 ± 9.01 ng/mL. The level significantly increased from 14.03 ± 8.68 ng/mL at admission to 37.42 ± 12.57 ng/mL at 3 months post TBI in the supplement group (P < 0.001). The cognitive outcomes (Mini-Mental Status Examination/Clinical Dementia Rating, P= 0.042/P= 0.044) and GOS-E score (total TBI, P=0.003; mild-to-moderate TBI, P= 0.002) significantly improved from the first week to 3 months post TBI in the patients with vitamin D supplementation. Administration of vitamin D supplements in mild-to-moderate TBI patients with significant vitamin D deficiency during the acute phase of the injury may improve long-term performance and cognitive outcomes. Therefore, the treatment strategies should be individually planned for the patients with TBI based on their baseline vitamin D level.

MANAGEMENT OF ENDOCRINE DISEASE: Therapeutics of Vitamin D.

The central role of vitamin D in bone health is well recognized. However, controversies regarding its clinical application remain. We therefore aimed to review the definition of hypovitaminosis D, the skeletal and extra-skeletal effects of vitamin D and the available therapeutic modalities. Narrative and systematic literature review. An international working group that reviewed the current evidence linking bone and extra-skeletal health and vitamin D therapy to identify knowledge gaps for future research. Findings from observational studies and randomized controlled trials (RCTs) in vitamin D deficiency are discordant, with findings of RCTs being largely negative. This may be due to reverse causality with the illness itself contributing to low vitamin D levels. The results of many RCTs have also been inconsistent. However, overall evidence from RCTs shows vitamin D reduces fractures (when administered with calcium) in the institutionalized elderly. Although controversial, vitamin D reduces acute respiratory tract infections (if not given as bolus monthly or annual doses) and may reduce falls in those with the lowest serum 25-hydroxyvitamin D (25OHD) levels. However, despite large ongoing RCTs with 21 000–26 000 participants not recruiting based on baseline 25OHD levels, they will contain a large subset of participants with vitamin D deficiency and are adequately powered to meet their primary end-points. The effects of long-term vitamin D supplementation on non-skeletal outcomes, such as type 2 diabetes mellitus (T2DM), cancer and cardiovascular disease (CVD) and the optimal dose and serum 25OHD level that balances extra-skeletal benefits (T2DM) vs risks (e.g. CVD), may soon be determined by data from large RCTs.

Vitamin D as a Regulator of Adipocyte Differentiation Effects in vivo and in vitro

The age-associated adiposity and the effect of long-term vitamin D was studied in vitamin D deficient rats. In in vivo experiments, the influence of a 9 months of vitamin D treatment (weekly oral gavage with 0.125 mg vitamin D3 (5000 IU)/100g body weight) on the adipocyte precursors from the omental adipose tissue was examinated. In in vitro experiment, rat adipose-derived mesenchymal stromal/stem cells (ASCs) were induced to differentiate into adipocytes in the presence or absence of 25(OH)D3 (0.25, 25, and 2500 nmol/L). ASCs derived from vitamin D-treated animals showed an increase adipogenic potential as compared to vitamin D-deficient rats. The addition of 25(OH)D3 inhibits the adipocyte differentiation and lipid deposition in a dose dependent manner.

Long-term effects of vitamin d supplementation and maintaining vitamin d sufficiency on knee osteoarthritis over 5 years

Purpose: Epidemiological studies suggest that vitamin D deficiency is associated with knee symptom and structural progression of knee osteoarthritis (OA). However, randomised controlled trials (RCTs) failed to demonstrate a significant effect of vitamin D supplementation on OA, probably due to selecting OA participants with and without vitamin D deficiency, short duration of the studies and a large proportion of participants in the placebo group reaching vitamin D sufficiency (61.3% of patients in the placebo group achieved a serum 25-hydroxyvitamin D [25(OH)D] level of > 60 nmol/l at 3 months of a clinical trial). We conducted the Vitamin D Effect on Osteoarthritis (VIDEO) clinical trial by selecting knee OA participants with vitamin D insufficiency and reported that there was no significant effect of vitamin D supplementation over 2 years on cartilage volume loss and knee pain assessed using the WOMAC scale. However, there was a significant reduction in knee pain evaluated by VAS knee pain scale, an improvement in physical function and a decrease in joint effusion-synovitis volume and bone marrow oedema compared to the placebo group. We aimed to describe the effect of vitamin D supplementation for 2 years on knee symptoms compared to placebo after 3 years of cessation of treatment, and to examine whether those maintaining sufficient serum vitamin D levels over 5 years had reduced knee symptoms compared with those who did not maintain adequate vitamin D levels over 5 years in patients with knee OA. Methods: Participants with symptomatic knee OA and low 25(OH)D (12.5-60 nmol/l) were enrolled in the VIDEO clinical trial. Participants were randomly assigned to receive monthly treatment with oral vitamin D3 (50,000 IU; n = 209) or an identical placebo (n = 204) for 2 years. 172 participants who enrolled in the study from Hobart were followed up after 3 years (5 years from baseline) of the cessation of the treatment to assess knee symptoms and vitamin D levels. Participants with serum 25(OH)D measurements at month 0, 3, 24 and 60 and were included in the post-hoc analyses. The incidence of total knee replacement was recorded and they were excluded from the symptom analyses. Participants were classified as maintaining sufficient vitamin D group if they maintained serum 25(OH)D >50 nmol/l at month 3, 24 and 60 (n = 79), and not maintaining sufficient vitamin D group (25[OH]D ≤50 nmol/l at month 3, 24 and 60, n = 62). Knee symptoms were assessed at baseline, 3, 6, 12, 24 and 60 months using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The level of 25(OH)D dropped in the vitamin D group (from 87.0 nmol/l to 53.3 nmol/l) over 3 years after the cessation of the treatment. Placebo group slightly increased the vitamin D level (53.3 nmol/l to 61.7 nmol/l) over 3 years. Knee pain increased from the end of the study (2nd year) to 5 years of follow-up in the treatment (81.8 to 91.7) and placebo (75.8 to 101.1) groups. 16.7% of the participants in vitamin D and 18.5% of the participants in placebo group underwent total knee replacement surgery. There were no significant differences in WOMAC pain, stiffness or dysfunction scores and total knee replacement surgery rates or change in symptom between Vitamin D and placebo groups after 3 years of cessation of the supplementation. However, participants who maintained adequate vitamin D levels over 5 years had significantly less WOMAC knee pain (β: −38.4, 95% CI: −69.2, −7.7) and physical dysfunction (β: −98.5, 95% CI: −193.8, −3.1) than participants with vitamin D deficiency over 5 years in multivariable analyses after adjusting for age, sex and BMI.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Conclusions: Vitamin D supplementation over 2 years did not result in significant differences in change in knee symptom score over 5 years compared to placebo. However, knee OA patients maintaining sufficient serum vitamin D levels over long-term had more improvement in knee pain and physical function than those who did not maintain adequate vitamin D levels, suggesting a beneficial effect of maintaining sufficient serum vitamin D for knee OA.

The effect of vitamin D supplementation on thyroid autoantibody levels in the treatment of autoimmune thyroiditis: a systematic review and a meta-analysis.

Although observational studies suggested that vitamin D plays a role in autoimmune thyroiditis (AIT), intervention trials yielded inconsistent findings. We therefore conducted a systematic review and a meta-analysis to evaluate the effects of Vitamin D on decreasing autoantibodies in patients with AIT. We identified all studies that assessed the changes of TPO-Ab and Tg-Ab in patients with AIT under the treatment of vitamin D from PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang, and VIP Database. Six randomized controlled trials (RCTs) were included in this systematic review representing a total of 344 patients with AIT. The results showed that Vitamin D supplementation significantly dropped TPO-Ab titers [three studies, random effects standardized mean difference (SMD): -1.11, 95% CI -1.52 to -0.70, P < 0.01] at six months, but not at no more than 3 months [random effects SMD: -0.12, 95% CI: -0.69 to 0.44, P = 0.67]. As compared with control group, participants who received vitamin D supplementation demonstrated significantly lower Tg-Ab [random effects SMD: -0.55, 95% CI: -1.05 to -0.04, P = 0.033]. In addition, no serious adverse effect was reported. The current evidence suggests that vitamin D supplementation could decrease serum TPO-Ab and Tg-Ab titers of patients with AIT in the short-term (about six months). More high quality studies are needed to further confirm the effects, especially the long-term effects of Vitamin D supplementation on thyroid autoantibodies levels in the treatment of AIT.

Long-term effects of vitamin D supplementation in vitamin D deficient obese children participating in an integrated weight-loss programme (a double-blind placebo-controlled study) \u2013 rationale for the study design

BackgroundObesity is associated not only with an array of metabolic disorders (e.g. insulin resistance, hiperinsulinemia, impaired tolerance of glucose, lipid disorders) but also skeletal and joint abnormalities. Recently, a pleiotropic role of vitamin D has been emphasized. Obese children frequently present with vitamin D deficiency, and greater fat mass is associated with lower serum concentration of this vitamin. Although some evidence suggests that weight loss may affect vitamin D status, this issue has not been studied extensively thus far. The aim of a double-blind placebo-controlled study is to assess long-term health effects of vitamin D supplementation in vitamin D deficient obese children participating in an integrated weight-loss programme.MethodsA randomized double-blind, placebo-controlled trial analysing the effects of vitamin D3 supplementation in overweight or obese vitamin D deficient (<30 ng/ml) children participating in an integrated weight-loss programme. Children are randomized to receive either vitamin D (1200 IU) or placebo for 26 weeks. Primary endpoints include changes in BMI (body mass index), body composition and bone mineral density at the end of the study period, and secondary endpoints – the changes in laboratory parameter reflecting liver and kidney function (transaminases, creatinine) and glucose homeostasis (glucose and insulin levels during oral glucose tolerance test).DiscussionThe effects of vitamin D supplementation in obese individuals, especially children, subjected to a weight-loss program are still poorly understood. Considering physiological processes associated with puberty and adolescent growth, we speculate that supplementation may enhance weight reduction and prevent bone loss in obese children deficient in this vitamin.Trial registrationNCT 02828228; Trial registration date: 8 Jun 2016; Registered in: ClinicalTrials.gov. The trial was registered retrospectively.

Effects of Long-Term Vitamin D Supplementation on Regression and Metabolic Status of Cervical Intraepithelial Neoplasia: a Randomized, Double-Blind, Placebo-Controlled Trial.

We are not aware of any study examining the effects of long term vitamin D administration on regression and metabolic status of patients with cervical intraepithelial neoplasia grade 1 (CIN1). This study was performed to evaluate the effects of long-term vitamin D administration on regression and metabolic status of patients with CIN1. This randomized, double-blind, placebo-controlled trial was performed among 58 women diagnosed with CIN1. CIN1 diagnosis was performed based on specific diagnostic procedures of biopsy, pathological diagnosis, and colposcopy. Patients were randomly allocated into two groups to take 50,000IU vitamin D3 supplements (n=29) or placebo (n=29) every 2weeks for 6months. Fasting blood samples were taken at the beginning of the study and end-of-trial to measure related markers. After 6months of vitamin D administration, greater percentage of women in the vitamin D group had regressed CIN1 (84.6 vs. 53.8%, P=0.01) than those in the placebo group. Long-term vitamin D supplementation increased serum-25(OH) vitamin D levels in the intervention group compared to the placebo group (+12.3±11.4 vs. -0.1±3.7ng/mL, P<0.001). In addition, vitamin D intake led to significant decreases in serum insulin levels (-5.3±7.3 vs. +2.4±5.9 μIU/mL, P<0.001), homeostasis model of assessment-insulin resistance (-1.2±1.6 vs. +0.5±1.2, P<0.001), homeostatic model assessment-Beta cell function (P=0.005) and a significant elevation in quantitative insulin sensitivity check index (+0.03±0.04 vs. -0.007±0.02, P<0.001) compared with the placebo group. Additionally, significant increases in plasma nitric oxide (NO) (+15.5±10.3 vs. +4.0±13.4μmol/L, P=0.001), total antioxidant capacity (TAC) (P=0.04), total glutathione (GSH) (+11.8±153.5 vs. -294.2±595.1μmol/L, P=0.01) and a significant reduction in plasma malondialdehyde (MDA) levels (-0.8±1.0 vs. -0.03±1.4μmol/L, P=0.03) were observed following the administration of vitamin D supplements compared with the placebo group. In conclusion, vitamin D3 administration for 6months among women with CIN1 resulted in its regression and had beneficial effects on markers of insulin metabolism, plasma NO, TAC, GSH and MDA levels. Clinical trial registration number www.irct.ir : IRCT201412065623N30.

Functionality of High-Density Lipoprotein as Antiatherosclerotic Therapeutic Target.

A great majority of the morbidity and mortality worldwide can still be attributed to cardiovascular diseases, such as ischemic (coronary) heart disease, angina pectoris, and myocardial and cerebral infarction. Atherosclerosis, narrowing of the arteries because of arterial cholesterol deposition in macrophage foam cells, is the driving force behind the cardiovascular disease pathology. Water-soluble protein/lipid complexes called lipoproteins mediate the transport of cholesterol and other lipoid substances through the blood compartment. Relatively high levels of cholesterol associated with apolipoprotein B–containing low-density lipoprotein (LDL) particles predispose human subjects to the development of atherosclerosis and, thereby, increase the risk for cardiovascular disease.1,2 Apolipoprotein B–containing lipoproteins are, therefore, generally regarded as being proatherogenic factors. Cholesterol ester–rich high-density lipoprotein (HDL) particles use apolipoprotein A1 (apoA1) as their primary protein component. In sharp contrast to LDL, HDL is considered a potent anti-atherogenic agent. This notion is based on the fact that, in the general population, a strong inverse correlation exists between plasma levels of HDL cholesterol and the risk of cardiovascular disease.1 Of note, this inverse association seems to be independent of the level of cholesterol associated with proatherogenic LDL particles. As such, increasing plasma levels of HDL cholesterol has long been regarded a promising alternative therapy to supplement classical statin–based LDL cholesterol–lowering strategies that are able to reduce cardiovascular disease by only ≈30%.3 However, over the last decade, the enthusiasm for HDL as an interesting therapeutic target has been challenged by the HDL hypothesis critics because genetic association studies have excluded HDL cholesterol levels as determinants for cardiovascular disease risk.2,4 Furthermore, several therapeutic HDL-targeting approaches have proven insufficient to secure benefit for cardiovascular disease patients. Niacin is the most effective drug available in the clinic to raise plasma HDL cholesterol levels. Despite the fact that niacin is …

Effect of long-term vitamin E and selenium supplementation on urine F2-isoprostanes, a biomarker of oxidative stress

BackgroundCigarette smoking generates reactive oxidant species and contributes to systemic oxidative stress, which plays a role in the pathophysiology of chronic diseases. Nutrients with antioxidant properties, including vitamin E and selenium, are proposed to reduce systemic oxidative burden and thus to mitigate the negative health effects of reactive oxidant species. ObjectiveOur objective was to determine whether long-term supplementation with vitamin E and/or selenium reduces oxidative stress in smokers, as measured by urine 8-iso-prostaglandin F2-alpha (8-iso-PGF2α). DesignWe measured urine 8-iso-PGF2α with competitive enzyme linked immunoassay (ELISA) in 312 male current smokers after 36 months of intervention in a randomized placebo-controlled trial of vitamin E (400IU/d all rac-α-tocopheryl acetate) and/or selenium (200µg/d L-selenomethionine). We used linear regression to estimate the effect of intervention on urine 8-iso-PGF2α, with adjustments for age and race. ResultsCompared to placebo, vitamin E alone lowered urine 8-iso-PGF2α by 21% (p=0.02); there was no effect of combined vitamin E and selenium (intervention arm lower by 9%; p=0.37) or selenium alone (intervention arm higher by 8%; p=0.52). ConclusionsLong-term vitamin E supplementation decreases urine 8-iso-PGF2α among male cigarette smokers, but we observed little to no evidence for an effect of selenium supplementation, alone or combined with vitamin E.