Vitamin D Status Research Articles

Withdrawal or reduction of the dietary vitamin premix on bone parameters of broiler chickens in two rearing systems

This study was conducted to compare the withdrawal or reduction of the vitamin premix (VP) from broiler diets at between days 29 and 42 of age on the characteristics of leg bones of the broilers in a battery cage (Trial 1) and a floor (Trial 2) rearing system. Seven experimental diets were formulated, based on wheat and barley, and consisted of four replicates per treatment. The metatarsus bone was used for measuring biomechanical bone characteristics, and alkaline phosphatase (ALP) activity and calcium concentrations blood serum to assess vitamin D3 status. The results of the first trial showed that there were no significant differences in body weight, strength of metatarsus bone and contents of ash, Ca and P in the toe with reduction or withdrawal of the vitamin premix from the diets during days 29 - 35. However, after 36 - 42 days there were significant differences for these parameters between the treatment without the vitamin premix (T1) and the other treatments. At 29 - 35 days and 36 - 42 days there were significant differences for ALP activity between T1 and the other treatments. The results of Trial 2 showed that the reduction in the vitamin premix and withdrawal at d 29 did not impair body weight, bone parameters and blood concentrations during the final growth period of the broilers. Finally, the results of the present study indicate that in the battery cage system it is possible to reduce the level of the dietary vitamin premix during the finisher period, but withdrawal can negatively affect body weight and bone parameters of broiler chickens, while in the floor system it is possible to withdrawal VP from broilers’ finisher diets. Keywords: Alkaline phosphatase, ash, broilers, calcium, bone strength

Low vitamin D levels are related to left ventricular concentric remodelling in men of different ethnic groups with varying cardiovascular risk

South Asians (SA) and African-Caribbean (AfC) people are prominent minorities in Britain and North America. SA have a higher incidence and earlier onset of coronary heart disease (CHD) while AfC have lower rates of CHD despite higher blood pressures, stroke incidence and probably heart failure. Traditional risk factors only partially account for these differences [1,2]. Vitamin-D deficiency is more common among AfC and SA compared to Europeans, probably due to melanised skin [3]. Mounting evidence on the relationship between vitamin-D deficiency and adverse cardiovascular outcomes [4] raises the question whether ethnic differences in outcomes may be explained by vitamin-D status.

Vitamin D status and skeletal health in black men starting androgen deprivation therapy for prostate cancer.

e15139 Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with increased incidence of osteoporosis and fractures. However, much of this information is in Caucasian men. Our aim was to evaluate the prevalence low 25-hydroxyvitamin-D levels and low bone mass in black men starting ADT. Methods: A chart-based retrospective review was conducted on all patients diagnosed with PCa and were deemed appropriate to start ADT in a tertiary care center between September 2007 and July 2010. Baseline data were collected on vitamin-D status and bone mineral density (BMD). Vitamin-D sufficiency was defined as levels ≥30 ng/ml, insufficiency as <30ng/ml and deficiency as ≤20ng/ml. Osteopenia was defined when T scores were between -1 to -2.5 and osteoporosis when T scores ≤ -2.5. Results: A total of 113 black men had evaluable data (mean age 68.9±9.0; range 45-92). At baseline, mean vitamin-D levels were 20.8±9.0 ng/ml (range 4.0-43.0), lumbar Spine T-score was -0.37±1.46 (range -4.20-3.34;) and femoral neck T-score was -0.94±1.04 (range -3.00-1.50). A total of 49.4% of our patients were vitamin-D deficient (13.5±4.6), 33.7% had insufficiency (24.5±3.1) and 16.9% had sufficient vitamin-D levels ( 34.7±4.3). 59.3% of patients had normal BMD, 31.5% had osteopenia and 9.3% had osteoporosis. Conclusions: A significant proportion of black men starting ADT have low Vitamin-D levels and low bone mass. These observations should be taken into account when starting ADT in black men.

Bone turnover markers, glucose and lipid metabolism in relation to atherosclerosis in type-2 diabetic patients: a longitudinal study

Background: Bone metabolism is affected by risk factors of atherosclerosis and hyperglycemia induced low bone turnover with osteoblastic dysfunction. Limited information is available on the relationship between bone turnover markers (BTMs) and atherosclerosis or its related risk factors in patients with Type-2 diabetes mellitus (T2DM). Methods: A total of 135 patients (men=62; women=73) (age≥50 years) with poorly controlled T2DM [indicated by haemoglobin-A1c (HbA1c)] were followed-up over 12 months during glycemic control evaluation. Each patient (at baseline and visits on 3, 6, 9 and 12 months) provided fasting blood sample and second-void morning urine samples for the measurements of BTMs [serum osteocalcin (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 Nterminal propeptide (s-PINP), crosslinked C-terminal telopeptide of type 1 collagen (sCTX), tartarate-resistance acid phosphatase isoform 5b (s-TRACP-5b) and urinary Ntelopeptide of type 1 collagen (u-NTX)]. Various hormones, HbA1c; lipids, glucose and creatinine were measured. Bone mineral density was determined at baseline visit and at 12-month visit. Also, the plaque score (PS) was calculated. Results: Multiple regression analysis showed that changes in s-OC were negatively correlated with HbA1c (r=-0.46, Pb0.001). Baseline s-OC levels were negatively correlated with changes in triglyceride levels (r=-0.37, Pb0.001) and positively with high-density lipoprotein-cholesterol (HDL-c) (r=0.44, Pb0.001). Changes in s-OC correlated positively with baseline PS (r=0.49, Pb0.001) and negatively with changes in PS (r=-0.41, Pb0.001) independent of other potential atherosclerosis risk factors. Conclusions: Association between s-OC with glucose, lipid metabolic indicators and PS independently of other atherosclerosis-related risk factors in patients with T2DM. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared. doi:10.1016/j.bone.2012.02.442 PP254 Volumetric bone mineral density (vbmd) at tibia site and vitamin d status in premenopausal south asian and caucasian women O.A. Hakim⁎, A. Darling, K. Hart, J.L. Berry, S. Lanham-New Nutrition, University of Surrey, Guildford, UK Vitamin D Research Group, University of Manchester, Manchester, UK Abstract: Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were collected for vitamin D analysis. SA women were significantly shorter (pb0.001), and slightly heavier than C women; Therefore SA had significantly higher BMI (pb0.05) than C women. SA women had significantly lower 25(OH)D concentration than C women (pb0.001) with mean values of 31.53[16.32] and 80.91[20.08] (nmol/l) respectively. SA women had significantly smaller bone size and higher vBMD than C women (pb0.05) for total, trabecular, and cortical bone at the 4% site. SA women had significantly lower total vBMD at 14% site (pb0.05) and the 38% site (pb0.01) than Caucasians. SA had significantly lower cortical density at site 14% than Caucasians (pb0.05).This was also lower at the 38% site but this was not statistically significant. There was a trend for a negative association between 25(OH)D and total area, trabecular area, and cortical area at the 4% site in the Asian group only (p=0.06). There was no correlation between 25(OH)D and vBMD at any site in either ethnic group. Our finding of differences in vBMD at the tibia for SA and C premenopausal women is novel and now requires further investigation. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared.

Habitual calcium intake and vitamin D status during adulthood through estrogen deficiency have few interactions on calcium kinetics and bone

Eating patterns do not change as rapidly as the physiological changes that accompany the menopause. As such, habitual nutrition status may strongly affect post menopausal bone health in the general population. To test how dietary calcium (Ca) and vitamin D (VD) interact to influence bone during the menopause, we studied 70 female Sprague Dawley rats from young adulthood through ovariectomy (OVX)‐induced estrogen deficiency. Weanling rats were housed in a UV‐free environment and fed an AIN93G diet with 0.4% Ca and 100 IU VD/kg diet for 5 weeks. At 8 weeks of age, rats were randomized to AIN93M diets containing 0.2 or 1.0% Ca and 50, 100, or 1000 IU VD/kg diet. OVX was performed at 12 weeks of age. At 24–28 weeks of age, Ca kinetics was performed with a 45Ca tracer (oral Ca dose: 15 mg) up to 48 hours. Kinetics was modeled using WinSAAM software. A Ca and VD interaction was seen in the soft tissue compartment, but each nutrient independently increased endogenous Ca secretion. Bone formation was not affected by either nutrient. However, rats on the 1% Ca diet had lower fractional Ca absorption, higher net Ca absorption and higher bone balance due to reduced bone resorption, regardless of VD intake. Habitual Ca intake and VD status during adulthood throughout estrogen deficiency have few interactions on Ca kinetics and bone. Rather, Ca intake may be more influential to benefit bone than VD status at levels relevant to the general population.

Hope and challenge: The importance of ultraviolet (UV) radiation for cutaneous Vitamin D synthesis and skin cancer

Solar ultraviolet (UV)-radiation is the most important environmental risk factor for the development of non-melanoma skin cancer (most importantly basal and squamous cell carcinomas), that represent the most common malignancies in Caucasian populations. To prevent these malignancies, public health campaigns were developed to improve the awareness of the general population of the role of UV-radiation. The requirements of vitamin D is mainly achieved by UV-B-induced cutaneous photosynthesis, and the vitamin D-mediated positive effects of UV-radiation were not always adequately considered in these campaigns; a strict “no sun policy” might lead to vitamin D-deficiency. This dilemma represents a serious problem in many populations, for an association of vitamin D-deficiency and multiple independent diseases has been convincingly demonstrated. It is crucial that guidelines for UV-exposure (e.g. in skin cancer prevention campaigns) consider these facts and give recommendations how to prevent vitamin D-deficiency. In this review, we analyze the present literature to help developing well-balanced guidelines on UV-protection that ensure an adequate vitamin D-status without increasing the risk to develop UV-induced skin cancer.

25-Hydroxy vitamin-D, obesity, and associated variables as predictors of breast cancer risk and tamoxifen benefit in NSABP-P1

Observational studies suggest that host factors are associated with breast cancer risk. The influence of obesity, vitamin-D status, insulin resistance, inflammation, and elevated adipocytokines in women at high risk of breast cancer is unknown. The NSABP-P1 trial population was used for a nested case–control study. Cases were drawn from those who developed invasive breast cancer and controls selected from unaffected participants (≤4 per case) matched for age, race, 5 year Gail score, and geographic location of clinical center as a surrogate for latitude. Fasting serum banked at trial enrolment was assayed for 25-hydroxy vitamin-D (25OHD), insulin, leptin (adipocytokine), and C-reactive protein (CRP, marker of inflammation). Logistic regression was used to test for associations between study variables and the risk of invasive breast cancer. Two hundred and thirty-one cases were matched with 856 controls. Mean age was 54, and 49% were premenopausal. There were negative correlations for 25OHD with body mass index (BMI), insulin, CRP, and leptin. BMI ≥ 25 kg/m2 was associated with higher breast cancer risk (odds ratio [OR] 1.45, p = 0.02) and tamoxifen treatment was associated with lower risk (OR = 0.44, p < 0.001). Suboptimal 25OHD (<72 nmol/l) did not influence breast cancer risk (OR = 1.06, p = 0.76). When evaluated as continuous variables, 25OHD, insulin, CRP, and leptin levels were not associated with breast cancer risk (all p > 0.34). In this high risk population, higher BMI was associated with a greater breast cancer risk. Serum levels of 25OHD, insulin, CRP, and leptin were not independent predictors of either breast cancer risk or tamoxifen benefit.Electronic supplementary materialThe online version of this article (doi:10.1007/s10549-012-2012-x) contains supplementary material, which is available to authorized users.

A Deficiência de vitamina d está associada com níveis aumentados de il-17 e tnfα em pacientes com insuficiência cardíaca crônica

Recent studies revealed a strong association between vitamin D (VD) status and chronic heart failure (CHF). It is now commonly considered that proinflammatory immune response underlies CHF development. Since VD expresses anti-inflammatory properties, we investigated its impact on cytokines implicated in CHF, such as TNFα and IL-17, in patients suffering from CHF. Blood was obtained from forty patients with CHF secondary to hypertension and/or coronary heart disease. VD status, IL-17 and TNFα levels were assessed using 25-hydroxy VD3 EIA and cytokine ELISAs. Clinical assessment and echocardiography was also performed. Elderly patients with CHF in Nis (Southeast Europe, latitude 43ºN) exhibited 25-hydroxy VD3 levels below normal. Our data identified that patients with CHF secondary to hypertension have significantly lower 25-hydroxy VD3, increased TNFα and IL-17A levels in comparison to donors with CHF secondary to coronary disease. This study reveals that even in regions with a lot of sunny days VD deficiency represents a concerning issue. Data suggest that impaired VD status contributes to high IL-17 and TNFα levels and thereby may support CHF development.

Seasonal Variation in Vitamin D3 Levels Is Paralleled by Changes in the Peripheral Blood Human T Cell Compartment

It is well-recognized that vitamin D3 has immune-modulatory properties and that the variation in ultraviolet (UV) exposure affects vitamin D3 status. Here, we investigated if and to what extent seasonality of vitamin D3 levels are associated with changes in T cell numbers and phenotypes. Every three months during the course of the entire year, human PBMC and whole blood from 15 healthy subjects were sampled and analyzed using flow cytometry. We observed that elevated serum 25(OH)D3 and 1,25(OH)2D3 levels in summer were associated with a higher number of peripheral CD4+ and CD8+ T cells. In addition, an increase in naïve CD4+CD45RA+ T cells with a reciprocal drop in memory CD4+CD45RO+ T cells was observed. The increase in CD4+CD45RA+ T cell count was a result of heightened proliferative capacity rather than recent thymic emigration of T cells. The percentage of Treg dropped in summer, but not the absolute Treg numbers. Notably, in the Treg population, the levels of forkhead box protein 3 (Foxp3) expression were increased in summer. Skin, gut and lymphoid tissue homing potential was increased during summer as well, exemplified by increased CCR4, CCR6, CLA, CCR9 and CCR7 levels. Also, in summer, CD4+ and CD8+ T cells revealed a reduced capacity to produce pro-inflammatory cytokines. In conclusion, seasonal variation in vitamin D3 status in vivo throughout the year is associated with changes in the human peripheral T cell compartment and may as such explain some of the seasonal variation in immune status which has been observed previously. Given that the current observations are limited to healthy adult males, larger population-based studies would be useful to validate these findings.

The Hydroxylation of Vitamin D on C25 in Thyrotoxicosis The Role of the Activity of Microsomal Liver Enzymes

Vitamin D3 after its entrance in the organism undergoes hydroxylation on C-25 carbon atom by the action of microsomal liver enzymes giving the metabolite 25 hydroxyvitamin D3 (25OHD3). The function of microsomal liver enzymes is influenced in some specified states by hormones or drugs. It has approved that thyroxin is a potent stimulator of these enzymes while allopurinol suppresses their function. The aim of this issue is to examine 25OHD3 plasma levels in thyrotoxic subjects and in those pretreated with allopurinol on the base of the afford mentioned data. In a first phase 25OHD3 plasma levels were estimated in thyrotoxic subjects against euthytoid healthy controls. In a second phase lmg vitamin D3 was injected intravenously (i.v.) in thyrotoxic subjects and in healthy euthyroid controls. 25OHD3 plasma levels were measured before and in post injection period in six hours intervals for 48 hours. In a third phase a couple of subjects one thyrotoxic and one euthyroid healthy control pretreated both with allopurinol injected lmg of vitamin D3 i.v. In all studied subjects 25OHD3 plasma levels were measured before and in post injection period in six hours intervals for 48 hours. The pre and post injection 25OHD3 plasma levels measured the size of activity of liver enzyme responsible for bioactivation of vitamin D3. In the first phase was indicated that 25OHD3 plasma levels were lower in thyrotoxic subjects comparing with that of euthyroid healthy controls (p 3 in thyrotoxic subjects was 2,5 to 8 times faster comparing with euthyroid healthy controls. In the third phase was shown that allopurinol decreases the activity of liver enzymes function as regard the bioactivation of vitamin D3. The bioactivation of vitamin D3 is accelerated in thyrotoxicosis compared with that in euthyroid state. This phenomenon produces low 25OHD3 plasma levels in thyrotoxic subjects which initially may be normal or slightly increased depended from the vitamin D3 status in the thyrotoxic subjects. By continuous stimulatory action of increased thyroid hormones on liver enzymes the 25OHD3 plasma levels earlier or later decline in levels of hypo-or avitaminosis D3. The previously described biological events may explain the decreased intestinal calcium absorption of vitamin D3 and the osteomalacic component found in a percentage of thyrotoxic bone histology. For the blocking effects of allopurinol on liver enzymes function and possibly of other pharmaceutical products in relation to vitamin D3 bioactivation, available data are still lacking.

Dietary Vitamin D and Vitamin D Receptor Level Modulate Epithelial Cell Proliferation and Apoptosis in the Prostate

Low vitamin D (VD) status may increase prostate cancer risk but experimental evidence for this relationship is modest. We tested whether low VD status or VD receptor (VDR) deletion influences prostate epithelial cell (PEC) biology using intact mice, castrated mice, or castrated mice treated with testosterone propionate (TP, 2.5 mg/kg BW). PEC proliferation (Ki-67 staining) and apoptosis (TUNEL method) were determined in the anterior prostate (AP). In study 1, wild-type (WT) and TgAPT(121) mice (a model of prostate intraepithelial neoplasia) were fed diets with 25, 200 (reference diet), or 10,000 IU VD/kg diet (as vitamin D(3)) prior to castration/repletion. Serum 25 hydroxyvitamin D levels were 26, 78, and 237 nmol/L in the three diet groups, respectively. Castration reduced proliferation and increased apoptosis in the AP while TP reversed these effects. Low VD diet increased proliferation in WT (+82%) and TgAPT(121) (+24%) mice while it suppressed apoptosis in WT (-29%) and TgAPT(121) (-37%) mice. This diet also increased the severity of prostate intraepithelial neoplastic lesions in the AP of intact TgAPT(121) mice. In study 2, mice with PEC-specific VDR deletion (PEC VDR KO) were examined after castration/repletion. TUNEL staining was 60% lower in castrated PEC VDR KO mice compared with castrated WT mice. In castrated mice given TP, Ki-67 staining was 2-fold higher in PEC VDR KO compared with WT mice. Our data show that low diet VDR or VDR deletion provide a prostate environment that is permissive to early procarcinogenic events that enhance prostate cancer risk.

Does vitamin D during pregnancy impact offspring growth and bone?

During pregnancy, maternal and fetal Ca demands are met through increased intestinal Ca absorption. Increased Ca absorption may be more dependent on oestrogen's up-regulation of Ca transport genes than on vitamin D status. Numerous studies, however, have found that severe vitamin D deficiency with secondary hyperparathyroidism during pregnancy leads to abnormal Ca homoeostasis in the neonate. Some, but not all, studies of maternal vitamin D supplementation during pregnancy find a greater birth weight among infants of mothers with adequate vitamin D status. Observational studies find a higher incidence of small-for-gestational age (SGA) infants among mothers who are vitamin D deficient, but this effect may be modified by genetics. In addition, the effect of vitamin D status on SGA may not be linear, with increased occurrence of SGA at high maternal 25-hydroxyvitamin D (25-OHD) concentrations. Some studies, but not all, also have found that maternal vitamin D status is associated with growth trajectory during the first year of life, although the findings are contradictory. There are recent studies that suggest maternal 25-OHD, or surrogates of vitamin D status, are associated with growth and bone mass later in childhood. These results are not consistent, and blinded randomised trials of vitamin D supplementation during pregnancy with long-term follow-up are needed to determine the benefits, and possible risks, of maternal vitamin D status on offspring growth and bone development. The possibility of adverse outcomes with higher maternal 25-OHD concentrations should be considered and investigated in all ongoing and future studies.

Opposite effects of pravastatin and atorvastatin on insulin sensitivity in the rat: Role of vitamin D metabolites

ObjectiveRecent studies indicate that pravastatin improves whereas other statins impair glucose homeostasis in humans, but the underlying mechanisms are not clear. We examined the effect of pravastatin and atorvastatin on insulin sensitivity in a rat model. MethodsPravastatin (40mg/kg/day) or atorvastatin (20mg/kg/day) were administered for 3 weeks and insulin sensitivity was assessed by measuring fasting plasma insulin, HOMA-IR, non-esterified fatty acids (NEFA) and glycerol levels, as well as by the hyperinsulinemic euglycemic clamp. ResultsPravastatin had no effect on fasting insulin and HOMA-IR but significantly reduced plasma NEFA and glycerol levels and increased glucose infusion rate (GIR) during the hyperinsulinemic clamp. Increase in GIR induced by pravastatin was not abolished by NO synthase inhibitor, l-NAME, indicating that this effect did not result from the improvement of endothelial function. Atorvastatin increased fasting insulin, HOM-IR, NEFA and glycerol levels as well as reduced GIR. Statins had no effect on leptin, HMW adiponectin, resistin, visfatin, interleukin-6 and TNF-α. Pravastatin increased plasma concentrations of 25-hydroxy- and 1,25-dyhydroxyvitamin D3 (25-OH-D3 and 1,25-(OH)2-D3), and its effect on insulin sensitivity was mimicked by exogenous 1,25-(OH)2-D3. Atorvastatin reduced plasma 25-OH-D3 but had no effect on 1,25-(OH)2-D3. Decrease in insulin sensitivity induced by atorvastatin was not corrected by supplementation of vitamin D3 despite normalization of plasma 25-OH-D3 level. ConclusionsPravastatin and atorvastatin have opposite effects on insulin sensitivity and vitamin D3 status. Pravastatin-induced increase in insulin sensitivity is mediated by elevation of 1,25-(OH)2-D3. In contrast, atorvastatin-induced decrease in insulin sensitivity is independent of lowering 25-OH-D3.

The prevalence of metabolic risk factors in black men with prostate cancer undergoing consideration for androgen-deprivation therapy.

e15082 Background: Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with endocrine complications such as osteoporosis, weight gain, diabetes and dyslipidemia. However, in previous studies, the patient population has been predominantly white. The aim of this study was to examine relevant baseline characteristics, associated with the above-mentioned complications, in a predominantly black population presenting with prostate cancer for consideration of ADT. The information gained will help us to further risk stratify this population in regards to the possible complications of ADT. Methods: A chart-based retrospective review was conducted on all patients diagnosed with PCa presenting to one provider in an urban hospital between September 2007 and July 2010 who were being considered for ADT. Baseline data were collected on body mass index (BMI), Vitamin-D status, bone mineral density (BMD), lipid profile and diabetes status. Overweight and obesity were classified as BMI≥25 and BMI≥30, respectively, Vitamin-D sufficiency as ≥30 ng/ml, osteopenia as T scores between -1 to -2.5 and osteoporosis as T scores ≤ -2.5. Results: A total of 180 patients had sufficient data of which 71.1%, (n=128 patients, mean age 68.0 years; range 45-93) were black. Their origin was from 16 countries with 44.9 % being African Americans and 55.1% immigrants. At baseline, average BMI was 28.1±5.9 SD (range 15.4-58.5; n=104) with 42.3% of patients being overweight and an additional 31.7% obese. Mean Vitamin-D levels were 21.1±9.7 SD (range 4.0-48.0; n=93) and 80.7% of patients were Vitamin-D insufficient. Osteopenia and osteoporosis were present in 46.8% and 6.4%, respectively. Dyslipidemia was present in 40.6% of patients and 28.1% had diabetes. Conclusions: A large proportion of black men with PCa presenting for consideration of ADT are either overweight or obese at baseline. The prevalence of Vitamin-D insufficiency, low BMD, dyslipidemia and diabetes is also remarkably high. These data should be helpful for physicians considering ADT in this population.

Cross-sectional study of bone metabolism with nutrition in adult classical phenylketonuric patients diagnosed by neonatal screening

The mechanism underlying the development of osteopenia or osteoporosis in longstanding phenylketonuria (PKU) remains to be clarified. We investigated the details of bone metabolism in 21 female and 13 male classical PKU patients aged 20-35 years. Vitamin D (VD), parathyroid hormone (PTH), bone turnover markers, and daily nutrient intake were examined. The patients had lower daily energy and protein intake than did the age-matched controls (22 women, 14 men), but their respective fat, VD, and calcium intake did not differ. Serum 1,25-dihydroxy VD and 25-hydroxy VD levels in female and male patient groups were significantly higher and lower than those in respective control groups (females, P < 0.001; males, P < 0.05 and P < 0.01, respectively). Serum intact PTH levels were significantly higher in the female patient group (P < 0.05). Urinary calcium levels in the patient groups were significantly higher than those of the control subjects (females, P < 0.001; males, P < 0.05). Bone resorption markers were significantly higher in patients than in controls, although bone formation markers were not different. Patient serum levels of osteoprotegerin-inhibiting bone resorption were significantly lower (females, P < 0.001; males, P < 0.01). None of the bone parameters correlated significantly with serum phenylalanine or nutrient intake. PKU patients exhibited lower VD status and more rapid bone resorption despite normal calcium-VD intakes.

Análisis comparativo del estado nutricional de vitamina D y de los hábitos de exposición solar de las participantes españolas (adolescentes y de edad avanzada) del Estudio de los Cinco Países (Proyecto OPTIFORD)

Introduction: Vitamin D deficiency is known to be very common in adolescent girls and elderly women. Aim: To analyze vitamin D status, vitamin D intake and solar exposure of Spanish participants in The Five Countries Study of Optiford Project. Methods: Questionnaires approved and validated of lifestyle and food consumption frequency applied. The biochemical analysis of 25-hidroxivitamin D and PTH and the evaluation of the solar exposure (dosymeter UV VioSpor) were carried out. Results: The average solar exposure of adolescent girls (1,519 J/m2) was double than elderly women (740 J/m2). The vitamin D status of adolescent girls in summer and winter was better than elderly women. Conclusions: Solar exposure habits are different between the two age groups. This fact, jointly to the lower body’s capacity to synthesize Vitamin D through exposure to the sun in the elderly, may justify the worse vitamin D status in this age group.

Regulation of cytokine responses by seasonality of vitamin D status in healthy individuals

The immune modulating capacity of vitamin D(3) is well-recognized. Ultra-violet (UV) exposure determines production of vitamin D(3) in vivo and varies through the course of the year, especially in temperate regions. However, it is not known whether the human innate immune response differs due to seasonality. To validate the seasonal effects of vitamin D(3) , the effect of 1,25(OH)(2) D(3) on peripheral blood mononuclear cells (PBMC) cytokine response was first determined in vitro. 1,25(OH)(2) D(3) decreased interleukin (IL)-6 and tumour necrosis factor (TNF)-α release by PBMC stimulated with tripalmitoyl-S-glycerylcysteine (Pam3Cys) or lipopolysaccharide (LPS). Subsequently, ex-vivo stimulation studies were performed in 15 healthy volunteers through the course of the four seasons of the year. PBMC were isolated and stimulated with Toll-like receptor (TLR)-2 and TLR-4 ligands Pam3Cys and LPS, respectively. Circulating concentrations of 25(OH)D(3) and 1,25(OH)(2) D(3) were higher during summer (P<0·05) and a down-regulation of TLR-4-mediated IL-1β, IL-6, TNF-α, interferon (IFN)-γ and IL-10 production in summer was observed compared to winter (P<0·05). The variation in cytokine response upon TLR-2 (Pam3Cys) stimulation was moderate throughout the four seasons. The repressed cytokine production during the summer months could be explained partly by the reduced cell-membrane expression of TLRs. Physiological variation in vitamin D(3) status through the four seasons of the year can lead to alteration in the innate immune responses. Elevated vitamin D(3) level in vivo is associated with down-regulation of cytokine response through diminished surface expression of pattern recognition receptors.

Impact of artificial sunlight therapy on the progress of non-alcoholic fatty liver disease in rats

Non-alcoholic steatohepatitis (NASH) is recognized as the most severe form of non-alcoholic fatty liver disease, with likely progression to liver cirrhosis and hepatocellular carcinoma. However, there is no unified standard for diagnosis and therapeutics. This study aimed to characterize lipid transfer/metabolic proteins as non-invasive diagnostic markers, and to evaluate the therapeutic effects of phototherapy on the progression of NASH in rats. Lewis rats given a choline-deficient and iron-supplemented l-amino acid-defined (CDAA) diet and Zucker fa/fa rats were used as a diet-induced and an obesity-related NASH models, respectively, with or without phototherapy. Serum apolipoprotein E and low molecular weight-adiponectin levels were gradually reduced and reached the lowest level at fatty liver/NASH stage both in CDAA diet-induced NASH model and in genetically obese model. Total-adiponectin levels were dramatically elevated after NASH was established in CDAA diet-induced NASH model. Phototherapy ameliorated hepatocyte apoptosis, inflammation, fibrosis, and insulin/leptin resistance caused by CDAA diet with alteration of the levels of lipid transfer/metabolic proteins and elevation of the circulating active form of vitamin D(3). Vitamin D(3) supplementation ameliorated NASH progression in CDAA diet-induced NASH model. However, phototherapy failed to ameliorate the obesity and steatosis, suggesting that phototherapy may possess anti-inflammatory/fibrotic activity rather than anti-obesity/steatotic activity. These results suggest that serum lipid transfer/metabolic proteins and vitamin D(3) status may be effective biomarkers for non-invasive diagnosis of NASH progression, and that phototherapy may be a good complementary therapy for NASH because of its regulation of lipid transfer/metabolic proteins and vitamin D(3).

Effect of different dress style on vitamin D level in healthy young Orthodox and ultra-Orthodox students in Israel

Ultra-orthodox Jewish lifestyle, which encourages modest dress and indoor scholarly activity, represents a risk factor for vitamin-D deficiency. Our study in healthy young males from higher education religious institutions located in the same geographical area showed frequent and severe vitamin D deficiency, strongly correlated with the degree of sun exposure. However, PTH level was usually normal. Ultra-orthodox Jewish lifestyle encourages modest dress and indoor scholarly activity. As such, it represents a risk factor for vitamin-D deficiency, a worldwide problem previously underestimated in sunny countries. Our aim was to characterize the vitamin-D status of religious Jewish males according to sun exposure and outdoor activity, and study the correlation between serum 25-hydroxyvitamin D (25(OH) D) and PTH level. Seventy-four young adult males were recruited from three Jewish higher education institutions (Yeshiva) in Jerusalem. Yeshiva-A ultra-Orthodox students (aged 20.1 ± 0.6) wear traditional clothing, live in dormitories and stay mostly indoor. Yeshiva-B ultra-Orthodox students (aged 33.0 ± 4.2) dress similarly but have regular outdoor activities. Yeshiva-C religious students (aged 19 ± 2.0) participate in a mixed army/Yeshiva program. Weekly outdoor activity time and degree of sun exposure were estimated by questionnaire. 25(OH)D was 8.9 ± 3.6, 10.2 ± 5.7 and 21.7 ± 10.4ng/ml (mean ± SD) in Yeshiva A, B and C. 25(OH)D was correlated with degree of sun exposure (r = 0.54, p < 0.0001) and inversely correlated with PTH (r = -0.3, p = 0.01). Levels below 20 ng/ml were considered as vitamin D deficiency. PTH was normal in 87% of vitamin D-deficient subjects from Yeshiva-A and Yeshiva-C (mean age 20), compared to 52% of Yeshiva-B students (mean age 33). Bone mineral density studied in a random subset (n = 14) of vitamin D-deficient subjects showed Z-scores of -1.5 ± 1.0, -1.8 ± 0.8, -2.1 ± 0.4 in femoral neck, spine and radius. Severe vitamin-D deficiency is extremely prevalent in ultra-Orthodox males. Despite rare secondary hyperparathyroidism, they represent an important previously unrecognized high-risk group for metabolic bone disease.

Tooth Resorption and Vitamin D3Status in Cats Fed Premium Dry Diets

It has been suggested that tooth resorption (TR) in cats is associated with vitamin D3 status. The purpose of this study was to evaluate any correlation between serum 25-OH-D concentrations and the prevalence of TR. The healthy adult domestic cats (n=64) of this study had been fed similar premium dry-expanded foods throughout their lives. Serum 25-OH-D was measured, and cats received a single, complete periodontal examination, with periodontal probing of each tooth and exploration of the tooth surface using a dental explorer A complete set of 10 dental radiographs was taken for each cat. There were 168 TRs diagnosed in 40 of 64 cats (85 were Type 1 TR and 83 were Type 2). The mean serum 25-OH-D concentration was 187.7 +/- 87.3 nmol/L. The mean serum 25-OH-D in cats with one or more TR was 164.2 +/- 78.8 nmol/L, compared with 226.8 +/- 88.2 nmol/L for those without TR (p = 0.14). The mean serum 25-OH-D in the 13 cats with >5 TR was 131.2 +/- 49.5 nmol/L, which was significantly less than in cats with no TR (p < 0.05). There was no relationship between TR type and serum 25-OH-D. There was no effect of age or sex on serum 25-OH-D. On the contrary, variations in serum 25-OH-D were observed according to the studied breeds. There was no relationship between TR type and serum 25-OH-D. TR prevalence was greater in cats with lower serum 25-OH-D concentrations. In conclusion, the hypothesis that higher serum 25-OH-D concentrations are associated with a higher prevalence of TR is not supported by this study.