Vitamin D3 Supplementation Research Articles

Efficacy of high-dose vitamin D supplementation vs. solifenacin or standard urotherapy for overactive bladder dry in children: a secondary analysis of a randomized clinical trial.

To investigate the efficacy of high-dose vitamin D supplementation (VDS) plus standard urotherapy (SU) in managing pediatric overactive bladder dry (OAB-dry), specifically in children with (1) vitamin D levels between 20 and 35 ng/mL and (2) heightened baseline symptom severity. In this secondary analysis of a randomized controlled trial, eligible children (n = 303) were assigned to 8 weeks of VDS + SU group, solifenacin (SOL) + SU group, or SU alone group. The primary outcome was voiding frequency; secondary outcomes included urgency, nocturia, quality of life (QoL), pediatric lower urinary tract symptoms scores, and patient satisfaction. Among 303 participants, 197 (65%) had vitamin D levels between 20 and 35 ng/mL, and 119 (39%) exhibited heightened baseline symptom severity. In both subgroups, VDS + SU resulted in significantly greater improvements in voiding frequency compared to SOL + SU and SU alone. In the vitamin D subgroup (20-35 ng/mL), the median difference in voids/day between VDS + SU and SOL + SU was 2.0 (95% CI, 1.0 to 3.0; P = 0.003) and 3.2 compared to SU alone (P < 0.001). In the heightened symptom subgroup, the median difference was 3.0 (95% CI, 2.0 to 4.0; P < 0.001) vs. SOL + SU and 5.0 (95% CI, 4.0 to 6.0; P < 0.001) vs. SU alone. The VDS + SU group generally outperformed the other groups in various secondary outcome measures. High-dose VDS plus SU has significant therapeutic benefit in children with OAB-dry in those with vitamin D levels between 20 and 35 ng/mL and with more severe symptoms, compared to SOL + SU or SU alone.

Vitamin D supplementation decrease asthma exacerbations in children: a systematic review and meta-analysis of randomized controlled trials

Background Observational studies have linked low vitamin D (VD) levels to increased asthma attacks in children. Subsequent meta-analyses of adults and children revealed that VD treatment might benefit asthmatic patients by reducing the incidence of exacerbations. Therefore, this review aims to analyze the effects of VD supplementation in reducing asthma exacerbations in children. Methods Published reports from PubMed, Cochrane, and Google Scholar were systematically searched until April 2023. The study protocol was registered in the PROSPERO database CRD42023411796. Randomized controlled trial studies were included in this review. Meta-analysis was performed using Cochrane RevMan 5.1 and presented with 95% confidence intervals (CIs). Results Ten relevant studies enrolled 1243 asthmatic children (631 children receiving vitamin D3 supplementation, 612 children receiving placebo) were included in this review. Our pooled analysis found that VD supplementation had a significant effect on lowering the total number of asthma exacerbations (RR 0.62; 95% CI: 0.44, 0.87; p = 0.01). Subgroup analysis revealed that a daily dose of VD given based on standard daily dose recommendation had a significant improvement on asthma exacerbations [(RR 0.41; 95% CI: 0,18, 0,92; p = 0.03). Conclusions Vitamin D supplementation can lower the occurrence of exacerbations in children with asthma, along with the improvement of FEV1.

Efficacy of Vitamin-D supplementation in improving the prognosis of H-type hypertension in elderly patients

Objective: To investigate the correlation between 25-hydroxyvitamin D and H-type hypertension in elderly patients, and to observe the clinical efficacy of vitamin D supplementation in those patients. Methods: This was a retrospective study. One hundred and twenty elderly hypertensive patients treated at The Affiliated Hospital of Hebei University from June 2022 to June 2023 were randomly divided into Group-A (n=60) with hypertension and elevated homocysteine (Hcy) levels (H-type hypertension), and Group-B(n=60) with hypertension and normal Hcy levels. Blood levels of 25-hydroxyvitamin D and 24 hours ambulatory blood pressure were assessed in both groups of patients upon admission, with the correlation analysis performed simultaneously. The therapeutic effects were compared between the two groups. Results: Through Pearson correlation analysis, there were negative correlations of serum 25-hydroxyvitamin D levels with 24 hours SSD, 24 hours DSD, dnSBP, and nDBP(all p&lt;0.05). After 12 weeks of treatment, the treatment group had higher 25-hydroxyvitamin D levels and lower 24 hours SBP, 24h DBP, dSBP, dDBP, nSBP, nDBP levels than those of the control group(p&lt;0.05). After treatment, the treatment group had lower blood Hcy, IMT, TC, TG, and LDL-C levels(p&lt;0.05), and higher HDL-C levels(p&lt;0.05) than those of the control group. Conclusion: Serum 25-hydroxyvitamin D levels in elderly patients with H-type hypertension have negative correlations with 24 hours SSD, 24 hours DSD, dnSBP, and nDBP. Oral vitamin D supplementation for H-type hypertensive patients exhibits significant therapeutic effects, with improvements in 24 hours ambulatory blood pressure monitoring results, blood lipid levels, IMT, and blood Hcy levels after treatment. doi: https://doi.org/10.12669/pjms.40.10.8464 How to cite this: Zang S, Zhao Q, Xiao N, Liu S. Efficacy of Vitamin-D supplementation in improving the prognosis of H-type hypertension in elderly patients. Pak J Med Sci. 2024;40(10):2379-2383. doi: https://doi.org/10.12669/pjms.40.10.8464 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effect of dietary calcium and vitamin D supplements on plasma bone turnover biomarkers, bone mineralization, bone strength, and lameness score in gilts.

This study investigated the impact of calcium (Ca) and vitamin D supplements on bone metabolism, bone measurement, lameness, and selection rate in gilts fed five dietary treatments. Two Ca levels (6.85/6.42 [adequate; ACa] or 8.99/8.56 [high; HCa] g/kg) were combined with either 856 IU/kg vitamin D3 (Danish feeding standards; adequate; AD3) or 50 μg/kg 25-hydroxyvitamin D3 (high; HHyD) to create ACaAD3, HCaAD3, ACaHHyD, and HCaHHyD diets. The values 6.85/6.42 and 8.99/8.56g/kg correspond to adequate and high Ca supply for gilts weighing 32 to 100 and 100 to 180kg body weight (BW), respectively. The fifth diet was a combination of HCa and 2,000 IU/kg vitamin D3 (high; HD3) to create HCaHD3. Two hundred gilts were phase fed the dietary treatments from 32 to 100 and 100 to 180kg BW until they were slaughtered, either at 100 or 180kg BW. The gilts were weighed fortnightly, and plasma and urine samples were collected at 100 and 180kg BW. At slaughter, the 2nd and 3rd metacarpal bones were collected for bone parameters measurements. Lameness and selection rate were assessed within the last 7 d at 100 and 180kg BW. Dietary treatments did not affect gilts' growth performance and plasma concentration of Ca, but urinary concentration of Ca was greater in HCa-supplemented gilts at both 100 (P = 0.003) and 180 (P = 0.05) kg BW. Plasma concentration of vitamin D3 (P < 0.001) and 25-hydroxyvitamin D3 (P < 0.001) showed dose-dependent responses at both 100 and 180kg BW. Bone-specific alkaline phosphatase was greater (P = 0.02) in the plasma sample collected at 180kg BW in gilts fed the HCaHD3 diet and tended to be greater in gilts fed the ACaAD3 diet (P = 0.06). The bone ash content (P = 0.02) was greater in gilts fed the HCaAD3 diet and slaughtered at 100kg BW compared with gilts fed the ACaAD3 and ACaHHyD diets. However, bone weight, length, thickness, dry matter, and mineral content did not differ among the dietary treatments at both 100 and 180kg BW (P > 0.05). Neither lameness nor selection rate was affected by the dietary treatments. The average daily gain of gilts weighing 32 to 100 and 100 to 180kg BW showed a positive correlation with bone strength (r = 0.37; P < 0.001) and bone ash content (r = 0.24; P = 0.02), respectively. In conclusion, higher Ca and vitamin D3 supplementation slightly increased bone ash content but had no effect on lameness or selection rate of the gilts compared to those fed according to the Danish nutrient standards.

Effects of vitamin D supplementation on serum 25(OH)D3 levels and neurobehavioral development in premature infants after birth

This study explored the factors influencing serum 25(OH)D3 levels and the effects of Vitamin D deficiency (VDD) and VD supplementation on 25(OH)D3 levels and neuropsychobehavioral development in premature infants, to provide a theoretical basis for improving their prognosis. Physical examination, neuropsychobehavioral development and serum 25(OH)D3 levels were assessed regularly in 158 preterm infants supplemented with VD formulation. 25(OH)D3 levels were analyzed at 3, 6, 9, 12, and 18 months after birth. The Gesell neuropsychological development test was conducted at 6, 9, 12, and 18 months after birth to obtain the developmental quotient (DQ). Based on the serum 25(OH)D3 levels at 42 days of age, the infants were divided into VDD and non-VDD groups. Preterm infants in the VDD group were supplemented with more VD until their 25(OH)D3 levels were normal, and were divided into sustained VDD (SVDD) and corrected VDD (CVDD) groups according to serum 25(OH)D3 levels at 3 months of age. Appropriate statistical methods were chosen to compare differences in 25(OH)D3 and DQ between or among different groups, screen for the factors influencing 25(OH)D3 levels in preterm infants at 42 days of age, and analyze the relationship between 25(OH)D3 and DQ. The 25(OH)D3 levels of preterm infants at 42 days of age were positively correlated with VD supplementation during pregnancy, and before 42 days after birth (P < 0.05). The 25(OH)D3 levels in preterm infants at 42 days and 3 months of age were positively correlated with the DQ levels at 6, 9, 12, and 18 months of age (P < 0.05). The DQ level in the VDD group, especially SVDD group, was lower than that in CVDD and non-VDD groups at the same time point (P < 0.05). This research thus demonstrates that VD supplementations during pregnancy and after birth is a major factor affecting 25(OH)D3 levels in premature infants. Early VDD and SVDD can affect their neuropsychobehavioral development, and effective VD supplementation can gradually correct VDD and mitigate this influence.

Bleeding vs Thrombosis: Treatment Strategy for Women Having Large Uterine Fibroids and DVT

Large uterine fibroids (UFs) are clonal neoplasms of the uterus that form during the mid and late-aged women. Such women generally consume oral contraceptive pills, tranexamic acid, or NSAIDS to manage heavy menstrual bleeding (HMB) and associated complications while waiting for a conclusive procedure or avoiding hysterectomy. The procoagulant effect of these medicinal agents can result in venous stasis of the lower limbs, leading to deep vein thrombosis (DVT), a challenging complication with HMB. We examine the complicated state of heavy bleeding with thrombosis and explore better management options. It has been seen that women with hypothyroidism have an increased risk of getting DVT due to an alteration in the coagulation system. These incidences are mostly associated with higher uterine weight, which is related to the extrinsic compression of the inferior vena cava. In such cases, the occurrence of postoperative thrombosis is riskier if hysterectomy/myomectomy is the only option. Utilization of appropriate anticoagulants with modification of the steroid-hormone system using hormone agonists or antagonists (e.g., levonorgestrel intrauterine system, high-dose progestin-only therapy, danazol, aromatase inhibitors, Vitamin-D supplements or selective estrogen receptor modulators) could be an effective technique, but adverse consequences of continued use should be monitored. More research is needed into the basic biology associated with the role of growth factors and genetic alterations in these malignancies. The development of new leiomyomas following conservative therapy is also a significant issue.

Effect of weekly high-dose vitamin D3 supplementation on the association between circulatory FGF-23 and A1c levels in people with vitamin D deficiency: A randomized controlled 10-week follow-up trial

Effect of weekly high-dose vitamin D3 supplementation on the association between circulatory FGF-23 and A1c levels in people with vitamin D deficiency: A randomized controlled 10-week follow-up trial

Cardiometabolic factors and vitamin D deficiency in pediatric patients with chronic kidney disease.

Patients with chronic kidney disease (CKD) are at increased risk for cardiovascular disease. Up to 80% of patients with CKD may exhibit inadequate vitamin D (VD) levels, which have been linked to the presence of cardiometabolic factors (CFs) in the adult population. However, research on this association in the pediatric population is limited. To analyze the effects of 25-hydroxyvitamin D3 (25-[OH]D) levels and status on the presence of CFs in children receiving kidney replacement therapy (KRT). This cross-sectional study included pediatric patients receiving KRT, aged 8-17 years, who were receiving hemodialysis or peritoneal dialysis from January 2021 to March 2024. We conducted anthropometric measurements, blood pressure assessments, and glucose, 25-(OH)D, and lipid profiling for all participants. The daily dose of cholecalciferol supplementation, as well as other medications affecting bone and lipid metabolism and antihypertensive drugs, were documented. Statistical analyses were performed using Student's t-tests and chi-square tests to compare the CFs between groups with and without VD deficiency. The study involved 156 patients with an average age of 12.9 years and a mean serum VD level of 22.5 ng/dL. Patients with VD deficiency presented higher levels of total cholesterol and diastolic blood pressure (p < 0.05). No statistically significant differences were found in other biochemical profile variables or in the frequency of cardiometabolic factors. Vitamin D deficiency seems to increase the risk of dyslipidemia and uncontrolled hypertension in children and adolescents with end-stage CKD.

6970 Severe Symptomatic Hypophosphatemia After Intravenous Iron Therapy: An Under-recognized Adverse Reaction

Abstract Disclosure: A. Morvant: None. O. Olajide: None. Introduction: Iron deficiency is a common condition that is often treated with intravenous preparations of iron supplementation. It has been documented in the literature that ferric carboxymaltose is the form of intravenous iron supplementation that is associated with the highest incidence of hypophosphatemia, when compared to other formulations of intravenous iron therapy. This case highlights a severe case of hypophosphatemia after ferric carboxymaltose therapy that led to multiple hospitalizations and required several months of oral and intravenous phosphorus repletion. Clinical Case A 36-year-old woman presented to the ED with severe diffuse arthralgias, generalized muscle weakness, and fatigue. Laboratory analysis revealed the following: phosphorus 1.2 mg/dL (2.3-4.7 mg/dL), 25-hydroxyvitamin D 13 ng/mL (25-80 ng/mL), parathyroid hormone 220 pg/mL (16-77 pg/mL), and calcium 8.5 mg/dL (8.4-10.5 mg/dL). She was admitted and started on intravenous and oral phosphorus repletion as well as oral ergocalciferol. She was subsequently discharged home on oral phosphorus and ergocalciferol supplementation, with a phosphorus level of 1.8 mg/dL. She was readmitted one day later with persistent arthralgias, myalgias, and severe fatigue, and found to have a phosphorus level of 1.1 mg/dL. Additional laboratory studies revealed the following: FGF23 41 pg/mL (&amp;lt;59 pg/mL) and 24-hour urine phosphorus 2191 mg/24hr (400-1300 mg/24hr). The patient notably had a history of chronic severe iron deficiency anemia due to menorrhagia and had been treated with intravenous iron sucrose infusions 7 months prior to her presentation. Due to adverse reactions to iron sucrose, this was switched to ferric carboxymaltose, and she had received two doses; one month and two weeks prior to her initial presentation. She was treated again with intravenous and oral phosphorus repletion and ergocalciferol and discharged after two weeks on oral phosphorus and ergocalciferol as well as thrice-weekly intravenous phosphorus infusions in the outpatient setting. She continued intravenous phosphorus infusions for about three months, and this was subsequently discontinued without recurrent hypophosphatemia. She is currently on low doses of oral phosphorus with normophosphatemia. Conclusion: Intravenous ferric carboxymaltose therapy can lead to severe and long-lasting, treatment-resistant hypophosphatemia due to increased urinary phosphate excretion. An increased awareness about this is needed by clinicians in treating patients who receive ferric carboxymaltose and monitoring phosphorous levels is crucial.

Effect of cholecalciferol supplementation on PTH and increasing the glomerular filtration rate in kidney transplant patients at King Faisal Specialist Hospital and Research Center

The association between oral cholecalciferol and GFR has been identified in various renal transplant populations around the globe. This study aimed to evaluate the effect of oral cholecalciferol supplementation on the GFR and serum PTH levels, with other parameters in the Saudi kidney transplant population. A retrospective observational study was conducted on a cohort of 174 kidney recipients who underwent transplantation and had serum 25-Hydroxy VD level tests performed (2018-2022) at King Faisal Specialist Hospital and Research Center in Jeddah, KSA. Generalized and linear mixed effects regression models were conducted. The percentage of GFR &gt;60 (25.86% vs 78.16%, P&lt;.0001) and VD insufficiency (&lt; 30 ng/mL) (36.21% vs 6.90%, P&lt;.0001) were significantly different between pre-&amp; post-transplant periods, respectively. After adjustment, significant changes were found in post-transplant GFR, hemoglobin levels, serum creatinine levels, blood urea nitrogen levels, hematocrit levels, PTH levels, and VD 25-Hydroxy from the baseline. Calciferol 1000/2000 IU and 50,000 IU (P&lt;.0001) were significantly more effective in increasing the odds of having GFR &gt;60 as compared to other supplements (P=0.75). VD supplementations may be particularly beneficial in improving kidney function in kidney transplant patients, as this contributes to normalizing GFR levels and creatinine levels and reducing PTH levels.

Effect of Vitamin D3 on Uterine Morphology and Insulin Signaling in a Polycystic Ovary Syndrome (PCOS) Rat Model

Abstract Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age leading to infertility. Besides reproductive and hormonal disturbances, PCOS is often characterized by vitamin D3 (VD) deficiency. This study aimed to determine the effect of VD on uterine histoarchitecture, the biochemical composition of gland secretions, and the insulin signal transduction pathway using a PCOS rat model. The experiment was conducted on four animal groups (n=8/group): control (C), VD supplemented (VD; 500 IU/day), letrozole-treated (PCOS; 1 mg/kg body weight), and VD-treated PCOS (PCOS+VD) group. Herein, VD supplementation did not improve histomorphometric parameters in the PCOS uterus, whereas clearly influenced sugar composition in uterine gland secretions, restoring their content to that observed in the C group. Furthermore, we found that VD can reduce peripheral and local uterine insulin resistance developed in the PCOS rats via activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway and subsequent glucose metabolism in the uterus. To sum up, the present results suggest a possible beneficial role of VD supplementation for the maintenance of uterus functions in PCOS rats.

Overview of Dietary Supplements Use: A Narrative Review

Abstract: Dietary supplements are ingestible nutrient products used in individuals’ diets to meet their adequate intake of nutrients required for general health purposes. This review aims to explore the impact of using dietary supplements in relation to communicable and non-communicable diseases, as well as some adverse effects caused by dietary supplements. Findings indicated that vitamin D supplements can aid in recovery from flu and COVID-19. Folic acid can reduce stroke incidents among adults with hypertension. Moreover, vitamin C or calcium intake is significantly associated with lowering diabetes risk. Advantageous effects have been reported of high doses of vitamin C against breast cancer. Moreover, frequent consumption of vitamin E reduced the risk of chronic lung diseases by 10%. In conclusion, the present review confirms the beneficial health effects of dietary supplement consumption and suggests further investigations for a better understanding of their mechanisms in the prevention and treatment of communicable and non-communicable diseases.

Effects of native vitamin D supplementation on vitamin D status and body composition after sleeve gastrectomy: A retrospective study in Japanese patients

IntroductionThe effect of vitamin D status after bariatric surgery on postoperative skeletal muscle condition has not been adequately studied. MethodsClinical data from 83 patients (median age 44 years, BMI 40.4 kg/m2) who underwent sleeve gastrectomy (SG) were collected from medical records and analyzed retrospectively. Of the 83 patients, 37 who received continuous guidance on native vitamin D3 supplementation from before to 12 months after surgery were defined as the vitamin D supplementation (VDS) group, and 46 patients who did not receive such guidance as the control group. Native vitamin D3 supplement was provided by a dietitian at preoperative and postoperative visits. The supplementation dose was prescribed at 3000 IU/day after SG. ResultsIn VDS group, blood 25-hydroxyvitamin D (25OHD) level increased significantly from 18.5 at baseline to 29.7 ng/mL at 3 months after surgery and plateaued, while 25OHD level remained low in the control group. In the analysis that included both groups, change in 25OHD level from baseline to 12 months after surgery correlated significantly with mean vitamin D intake (r = 0.596, p < 0.001) and 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass (r = 0.469, p < 0.05). Multiple regression analysis identified change in 25OHD level and mean exercise time as significant factors independently associated with 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass. ConclusionVitamin D3 supplementation after SG is useful for improving vitamin D status that may be associated with prevention of postoperative lower limb skeletal muscle mass loss.

The Effect of Vitamin D Supplementation with or without Calcium on Vitamin D Epimer and Metabolites.

A possible role of vitamin D epimers and metabolites in the measurement and response to treatment of vitamin D has been reported recently. Furthermore, the influence of underlying vitamin D receptor (VDR) genetic polymorphisms which have been linked to diseases such as obesity remains unclear. We therefore aimed to examine the influence of vitamin D3 and calcium supplements on vitamin D epimer and metabolite concentrations in subjects with and those without vitamin D receptor (VDR) gene polymorphisms. A total of 277 participants who were part of a randomized intervention trial of vitamin D3 and calcium or a placebo for 6 months had clinical and anthropometric assessments. Blood samples were taken for measurements of vitamin D, epimers and metabolites of vitamin D, four vitamin D receptor gene polymorphism SNPs, namely, BsmI, FokI, TaqI, and ApaI, metabolic and inflammatory markers, and related biochemical variables. Repeated-measures analysis of variance was used to assess the between-group difference in cumulative changes in vitamin D epimers and metabolites at 6 months after adjusting for the presence of the 4 VDR genotypes and allele gene polymorphisms. Overall, 277 participants, with a mean (±SD) age of 41 ± 12 and 204 (74%) of whom were female, were included in the study. We found no statistically significant differences in vitamin D metabolites or (epimers) between male and females or younger subjects compared to those over 40 years of age except in 7C4 BL (p < 0.05). There was a statistically significant difference in 1,25(OH)2D3 concentrations between subjects with and those without genotypes AG and the allele G SNP2_Taql VDR gene polymorphism. Vitamin D3 concentrations were also significantly lower in subjects with the CC SNP3_Apal gene polymorphism compared to those without the CC SNP3 gene. No statistically significant effects were seen on vitamin D epimers and metabolites concentration in response to supplements before or after adjusting for the presence of the 4 VDR genotypes and allele gene polymorphisms. The CC SNP3 gene had statistically significant influence on vitamin D3 levels. Vitamin D and/or calcium supplements, however, had no effects on vitamin D epimer and metabolite concentration before or after adjusting for the presence of the 4 VDR genotypes and alleles.

Effects of vitamin D supplementation on cardiac biomarkers: Results from the STURDY trial

ObjectivesIn observational studies, older adults with low serum vitamin D levels are at higher risk of cardiovascular disease (CVD), but randomized trials have failed to demonstrate reduction in CVD risk from vitamin D supplementation, possibly because the doses of vitamin D supplements tested were too low. Our objective was to determine if higher doses of vitamin D supplementation reduce high-sensitivity cardiac troponin (hs-cTnI) and N-terminal pro-b-type natriuretic peptide (NT-proBNP), markers of subclinical CVD. MethodsThe Study to Understand Fall Reduction and Vitamin D in You (STURDY) was a double-blind, randomized, response-adaptive trial that tested the effects of 4 doses of vitamin D3 supplementation (200, 1000, 2000, 4000 IU/day) on fall risk among older adults with low serum 25-hydroxyvitamin D concentrations (10–29 ng/mL). Hs-cTnI and NT-proBNP levels were measured at baseline, 3-, 12-, and 24-month follow-up visits. For this ancillary study, we used data from the original trial and compared participants by treatment group: low-dose (200 IU/day) or high-dose (1000+ IU/day). The effects of vitamin D dose on biomarkers were assessed via mixed effects tobit models. ResultsAmong 688 participants (mean age of 76.5) hs-cTnI increased in both the low- and high-dose groups by 5.2 % and 7.0 %, respectively; likewise, NT-proBNP increased by 11.3 % and 9.3 %, respectively. Compared to the low-dose, high-dose vitamin D supplementation did not affect hs-cTnI (1.6 %-difference; 95 % CI: -5.3, 8.9) or NT-proBNP (-1.8 %-difference; 95 % CI: -9.3, 6.3). ConclusionsCompared to low-dose vitamin D supplementation, doses ≥1,000 IU/ day did not affect markers of subclinical CVD in older adults with low serum vitamin D levels.

Metabolic phenotypes and vitamin D response in the critically ill: A metabolomic cohort study

Background & AimsAlthough vitamin D deficiency is common in critically ill patients, randomized controlled trials fail to demonstrate benefits of supplementation. We aimed to identify distinct vitamin D3 responsive metabolic phenotypes prior to trial intervention of high-dose vitamin D3 by applying machine learning clustering method to metabolomics data from the Correction of Vitamin D Deficiency in Critically Ill Patients (VITdAL-ICU) trial. MethodsIn the randomized, placebo-controlled VITdAL-ICU trial, critically ill adults received placebo or high-dose vitamin D3. To distinguish vitamin D3 responsive metabolic phenotypes prior to intervention, we implemented consensus clustering with partitioning around medoids algorithm to the plasma metabolome data before randomization. Individual metabolite differences were determined utilizing linear mixed-effects regression models stratified for metabolomic phenotypes with false discovery rate adjustment. The association between vitamin D3 supplementation and 180-day mortality was evaluated in each metabolic phenotype, applying multivariable logistic regression analysis. ResultsIn 453 critically ill adults, the study identified 4 distinct metabolic phenotypes (clusters A. N=134; B. N=123; C. N=92; D. N=104). We found differential metabolic pathway patterns in the four clusters. Specifically, branched chain amino acid catabolic metabolites, long-chain acylcarnitines and diacylglycerol species are significantly increased in a specific metabolic phenotype (cluster D) following high-dose vitamin D3. Further, in cluster D high-dose vitamin D3 supplementation had a significantly lower adjusted odds of 180-day mortality after controlling age, sex, Simplified Acute Physiology Score II, admission diagnosis, and baseline 25-hydroxyvitamin D (OR 0.28 (95%CI, 0.09–0.89); P=0.03). In metabotype A, B, and C, high-dose vitamin D3 supplementation was not significantly associated with lower 180-day mortality following multivariable adjustment. ConclusionIn this post-hoc cohort study of the VITdAL-ICU trial, the clustering analysis of plasma metabolome data identified biologically distinct metabolic phenotypes. Among clusters, we found the different associations between high-dose vitamin D3 supplementation and specific metabolite pathways as well as 180-day mortality. Our findings facilitate further research to validate metabolic phenotype-targeted strategies for critical illness treatments.

Changes in bone density and microarchitecture following treatment of Graves' disease and the effects of vitamin D supplementation. A randomized clinical trial.

Vitamin D is important to skeletal health and ensuring a replete vitamin D status is recommended. In thyrotoxicosis, bone turnover is increased and bone mass density (BMD) reduced. We examined whether vitamin D supplementation improves bone recovery in thyrotoxicosis caused by Graves' disease (GD). Using a double-blinded design, hyperthyroid patients with GD were randomized to vitamin D3 70µg/day (2800IU) or similar placebo as add-on to antithyroid drugs (ATD). At baseline and 9months, we measured BMD and bone architecture using DXA and high resolution peripheral quantitative computerized tomography. Bone turnover markers (BTM) were measured at 3months also. Effect of vitamin D versus placebo and the response to ATD treatment were analyzed using linear mixed modelling. Eighty-six GD patients were included (age 41 ± 14years, 86% females). Compared to placebo, vitamin D3 did not improve BMD or microarchitecture. In response to ATD, BMD increased in the hip by 2% (95%CI: 1-4%). Cortical porosity decreased in tibia (- 7% [95%CI: - 12 to - 2%]) and radius [- 14% [95%CI: - 24 to - 3%]), and trabecular thickness increased (tibia (5% [95%CI: 2 - 9%]) and radius (4% [95%CI: 1-7%]). Changes in BTM, but not thyroid hormones, were associated with changes in BMD by DXA and with changes in the cortical compartment. In newly diagnosed GD, 9months of high dose vitamin D3 supplementation does not offer benefit by improving skeletal health. Treatment of thyrotoxicosis is associated with the recovery of BMD and microarchitecture. NCT02384668.

Cholecalciferol effect on oxidative stress and novel predictors of inflammation in hemodialysis patients: a prospective randomized trial

BackgroundEmerging evidence links vitamin D deficiency to oxidative stress (OS) and inflammation, posing ongoing risks to cardiovascular outcomes in hemodialysis (HD) patients. Despite this, current data are lacking regarding the optimal approach or schedule for administering vitamin D in this population. This study investigated the effectiveness of oral weekly versus oral monthly cholecalciferol supplementation on 25-hydroxy vitamin D (25(OH)D) levels, oxidative stress, inflammatory indicators, and secondary hyperparathyroidism in HD population. HD patients (N = 50) were randomly allocated to Group A (oral weekly 50,000 IU cholecalciferol) or Group B (oral monthly 200,000 IU cholecalciferol) for a 3 months duration. Serum levels of 25(OH)D, malondialdehyde (MDA), superoxide dismutase (SOD), high sensitivity C-reactive protein (HsCRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and intact parathyroid hormone (iPTH) were assessed at baseline and upon completion of the study.ResultsA notable increase in serum 25(OH)D levels observed in both groups, with Group A showing a notably greater increase (p = 0.003). Group A demonstrated significant reductions in serum MDA and increases in SOD, along with declines in hsCRP and NLR levels, which were not observed in Group B. Moreover, Group A exhibited a greater drop in iPTH (ΔiPTH = − 30 pg/mL vs. − 3 pg/mL) compared to Group B. Clinicaltrial.gov: NCT05460338, registered 13/07/2022.ConclusionsWeekly oral 50,000 IU cholecalciferol supplementation emerges as a tolerable, safe and effective approach for restoring vitamin D levels in HD patients, while concurrently mitigating inflammation, OS, and secondary hyperparathyroidism. This finding suggests that the more frequent the administration of oral cholecalciferol, the higher the efficiency observed.

Recovery Supplementation Strategies Applied to Elite Soccer Players

Purpose of review: During soccer seasons, athletes have canned a 48 number of matches. Therefore, recovery supplementation strategies that optimize recovery and/or reduce the damage caused by the number of matches during a season are important to help elite football players in their state of recovery. This way, the purpose of this review is to provide a holistic view of the mainly recovery supplements and their effects on elite soccer players recovery, based on what the literature recommends decreasing the oxidative stress, muscle damage and help them in the status recovery. Recent findings: Vitamin C e vitamin E in co-administration (500 mg vitamin C with 1200 IU vitamin E per day), 6 g per day of glutamine supplementation, and 60 mL drinks per day of Turmeric Original Shot (1400 mg curcumin combined with 10 mg of piperine), were able to decrease oxidative stress and lower rates of injury. 1000 mg magnesium citrate twice a day and 5000 IU (international units) cholecalciferol supplement daily were improving the recovery status. Coenzyme Q10 100 mg twice daily and omega 3 (550 mg DHA and 550 mg EPA) proven a reduction in the levels of the muscle-damage marker. Summary: Recovery supplements should include the vitamin's C, E, and D, besides that glutamine, magnesium, and turmeric with piperine to be able supplements to help the elite soccer players recovery, decreasing oxidative stress and rates of injury.

The effect of vitamin D3 and omega-3 combination, taken orally, on triglycerides, lining of intestine, and the biodiversity of gut microbiota in healthy rats.

The gut microbiota plays a key role in host health. An intake of omega-3 and vitamin D3 in a separate manner is vital for maintaining good health of gut microbiota and controlling some illness manifestations. The aim of this study is to investigate the potential change in biodiversity of the gut microbiome in healthy rats supplemented with vitamin D3, omega-3 alone and their combination and to reflect onto the triglyceride levels in serum and fecal samples. Using the 16S rRNA gene Miseq Illumina NGS, and monitoring triglyceride levels in serum and fecal samples coupled with several clinical parameters, we examined the effect of orally taken combination of omega-3 and vitamin D3 alongside the separate intake of supplements on gut microbiota in 24 healthy white Wistar rats for six weeks. The study findings showed that combination treatment encouraged the growth of opportunistic Clostridia class during day 21 and 42 of treatment by 7.7 and 7.4 folds, respectively, exhibited incomplete absorption levels for both supplements when used concomitantly, demonstrated a damaging effect on the gut intestinal lining wall thickness (126 µm) when compared to control group (158 µm), increasing lumen diameter (400 µm), and showed higher triglyceride level in fecal samples. These findings indicate that omega-3 and vitamin D3 supplements as combination intake reveal unfavorable effects, thus, it is advised to conduct further in-depth studies to clarify the presence or absence of any chemical interaction between both supplements' molecules and to investigate based on human model to attain a superior perspective.