25-hydroxyvitamin-d-2 and Cardiovascular-Diseases

The Institute of Medicine (IOM) report on dietary reference intakes (DRI) for vitamin D is reviewed, along with its implications.. Evidence-based reviews were completed; the IOM committee conducted its own literature search, an open public workshop, and two open sessions, and maintained a public web site for stakeholder input. The consensus report of the 14 scientists on the committee was reviewed by a panel of experts.. Only bone health could be used as an indicator for DRI development. Evidence for extraskeletal outcomes was inadequate, inconsistent, or insufficient to develop DRI. The recommended dietary allowance was found to be 600 IU/d for ages 1-70 yr, corresponding on average to a serum 25-hydroxyvitamin D (25OHD) level of at least 50 nmol/liter (20 ng/ml), and 800 IU/d for those older than 70 yr. Comparison with current levels of 25OHD in the National Health and Nutrition Examination Survey population survey revealed that the vitamin D intake in the United States and Canada is adequate. An upper limit was set at 4000 IU/d for adults, corresponding to an average serum 25OHD level of 125 nmol/liter (50 ng/ml).. Previous reports of an epidemic of vitamin D deficiency in North America were based on an overestimation of adequacy. Population screening with serum 25OHD is therefore not warranted. Current laboratory reference ranges for serum 25OHD are overestimated and should be revised. Practice guidelines to treat disease should not be applied to the healthy American population where use of the DRI is appropriate.

Topics: 25-Hydroxyvitamin D 2; Accidental Falls; Aged; Bone and Bones; Calcium, Dietary; Cardiovascular Diseases; Diabetes Mellitus, Type 2; Diet; Diet Surveys; Dietary Supplements; Health Status; Humans; Metabolic Syndrome; Neoplasms; North America; Nutrition Policy; Public Health; Reference Values; Sunlight; United States; Vitamin D; Vitamin D Deficiency

The hypothesis that vitamin D is inversely associated with multiple health outcomes has been studied in the Harvard cohorts, including the Nurses' Health Study I (n=121,700 female nurses aged 37-64 at baseline in 1984), Nurses' Health Study II (n=116,671 female nurses aged 27-44 years at baseline in 1991), Health Professionals Follow-up Study (n=51,529 male health professionals aged 40-75 years at baseline in 1986), and Physicians' Health Study (n=22 071 male physicians aged 40-84 years at baseline in 1982). These studies assessed vitamin D through circulating 25-hydroxyvitamin D, dietary and supplemental intake, predicted 25-hydroxyvitamin D, and vitamin D receptor polymorphisms. This review summarizes studies of vitamin D and various endpoints considered in these cohorts, including risk of cardiovascular disease, hypertension, elevated plasma C-peptide, various cancers, bone fractures, and multiple sclerosis. Based on the multiple observed benefits of vitamin D, this article postulates recommendations for vitamin D intake in the US population for reduced incidence of multiple health outcomes.

Topics: 25-Hydroxyvitamin D 2; Adult; Calcifediol; Cardiovascular Diseases; Cohort Studies; Diet; Dietary Supplements; Female; Fractures, Bone; Health Surveys; Humans; Male; Multiple Sclerosis; Neoplasms; Nutrition Policy; Nutritional Requirements; Polymorphism, Genetic; Receptors, Calcitriol; Vitamin D; Vitamin D Deficiency

To investigate the effect of short-term vitamin D supplementation on cardiometabolic outcomes among individuals with an elevated risk of diabetes.. In a double-blind placebo-controlled randomized trial, 340 adults who had an elevated risk of type 2 diabetes (non-diabetic hyperglycaemia or positive diabetes risk score) were randomized to either placebo, 100,000 IU vitamin D2 (ergocalciferol) or 100,000 IU vitamin D3 (cholecalciferol), orally administered monthly for 4 months. The primary outcome was change in glycated haemoglobin (HbA1c) between baseline and 4 months, adjusted for baseline. Secondary outcomes included: blood pressure; lipid levels; apolipoprotein levels; C-reactive protein levels; pulse wave velocity (PWV); anthropometric measures; and safety of the supplementation.. The mean [standard deviation (s.d.)] 25-hydroxyvitamin D [25(OH)D]2 concentration increased from 5.2 (4.1) to 53.9 (18.5) nmol/l in the D2 group, and the mean (s.d.) 25(OH)D3 concentration increased from 45.8 (22.6) to 83.8 (22.7) nmol/l in the D3 group. There was no effect of vitamin D supplementation on HbA1c: D2 versus placebo: -0.05% [95% confidence interval (CI) -0.11, 0.02] or -0.51 mmol/mol (95% CI -1.16, 0.14; p = 0.13); D3 versus placebo: 0.02% (95% CI -0.04, 0.08) or 0.19 mmol/mol (95% CI -0.46, 0.83; p = 0.57). There were no clinically meaningful effects on secondary outcomes, except PWV [D2 versus placebo: -0.68 m/s (95% CI -1.31, -0.05); D3 versus placebo -0.73 m/s (95% CI -1.42, -0.03)]. No important safety issues were identified.. Short-term supplementation with vitamin D2 or D3 had no effect on HbA1c. The modest reduction in PWV with both D2 and D3 relative to placebo suggests that vitamin D supplementation has a beneficial effect on arterial stiffness.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Calcifediol; Cardiovascular Diseases; Cholecalciferol; Cohort Studies; Diabetes Mellitus, Type 2; Dietary Supplements; Double-Blind Method; England; Ergocalciferols; Feasibility Studies; Female; Follow-Up Studies; Glycated Hemoglobin; Humans; Male; Middle Aged; Pulse Wave Analysis; Risk; Vascular Stiffness

Low levels of 25-hydroxyvitamin D (25(OH)VitD) have been recognized as an emerging cardiovascular disease (CVD) risk factor. Statins are reported to increase 25(OH)VitD concentration. Animal studies suggest that ezetimibe is a moderate inhibitor of intestinal 25(OH)VitD absorption, but its effect in humans is unknown.. To investigate whether combined treatment with simvastatin/ezetimibe 10/10 mg would increase 25(OH)VitD levels compared to simvastatin 40 mg monotherapy in patients with primary hypercholesterolemia.. In a Prospective Randomized Open-label Blinded End point study, 50 patients with primary hypercholesterolemia received either simvastatin/ezetimibe 10/10 mg (n = 25) or simvastatin 40 mg (n = 25) daily for 3 months. The primary end point was between-group difference in the change of serum 25(OH)VitD levels.. Simvastatin/ezetimibe 10/10 mg was associated with a 36.7% increase in 25(OH)VitD serum levels (from 6.8 to 9.3 ng/mL, P = .000), while simvastatin 40 mg was associated with a 79.1% increase (from 6.7 to 12.0 ng/mL, P = .008). The increase in 25(OH)VitD levels in the simvastatin 40 mg group was significantly greater compared to that in the simvastatin/ezetimibe 10/10 mg group (P = .04). Both groups exhibited similar reductions in low-density lipoprotein cholesterol (LDL-C) levels.. For similar LDL-C lowering simvastatin 40 mg is associated with greater increase in 25(OH)VitD compared to simvastatin/ezetimibe 10/10 mg. Whether this difference is relevant in terms of CVD risk reduction is unknown.

Topics: 25-Hydroxyvitamin D 2; Aged; Anticholesteremic Agents; Azetidines; Calcifediol; Cardiovascular Diseases; Drug Combinations; Ezetimibe, Simvastatin Drug Combination; Female; Gastrointestinal Agents; Greece; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypercholesterolemia; Male; Membrane Proteins; Membrane Transport Modulators; Membrane Transport Proteins; Middle Aged; Risk; Simvastatin; Up-Regulation; Vitamin D Deficiency

Low levels of 25(OH) vitamin D [25(OH)VitD] have been recognized as a new cardiovascular disease (CVD) risk factor. Statins seem to increase 25(OH)VitD concentration.. To investigate whether combined treatment with the usual dose of rosuvastatin plus fenofibrate or omega-3 fatty acids would increase 25(OH)VitD levels compared with the high-dose rosuvastatin monotherapy in participants with mixed dislipidemia.. We randomly allocated 60 patients with mixed dyslipidemia (low-density lipoprotein cholesterol: >160 mg/dL plus triglycerides: >200 mg/dL) to receive rosuvastatin 40 mg (n = 22), rosuvastatin 10 mg plus fenofibrate 200 mg (n = 21), or rosuvastatin 10 mg plus omega-3 fatty acids 2 g (n = 17) daily for 3 months. Our primary end point was changes in the levels of serum 25(OH)VitD.. Rosuvastatin monotherapy was associated with a 53% increase in 25(OH)VitD (from 14.6 [1.0-38.0] to 17.8 [5.3-49.6] ng/mL; P = .000). Rosuvastatin plus micronized fenofibrate and rosuvastatin plus omega-3 fatty acids were associated with increases of 64% (from 14.1 [1.0-48.0] to 18.4 [6.7-52.4] ng/mL, P = .001) and 61% (from 10.4 [6.6-38.4] to 14.0 [9.6-37.6] ng/mL, P = .04), respectively. The changes in 25(OH)VitD after treatment were comparable in the 3 groups.. High-dose rosuvastatin monotherapy and the usual dose of rosuvastatin plus fenofibrate or omega-3 fatty acids are associated with significant and similar increases in the 25(OH)VitD levels. This increase may be relevant in terms of CVD risk prevention.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Calcifediol; Cardiovascular Diseases; Combined Modality Therapy; Dietary Supplements; Drug Therapy, Combination; Dyslipidemias; Fatty Acids, Omega-3; Female; Fenofibrate; Fluorobenzenes; Greece; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Male; Middle Aged; Pyrimidines; Risk Factors; Rosuvastatin Calcium; Sulfonamides

Vitamin D has a potential role in protecting against cardiovascular disease (CVD). Serum 25-hydroxyvitamin D (25D) is the most widely used indicator of vitamin D status in the human body. 25D is estimated as total of 25-hydroxyvitamin D2 (25D2) and 25-hydroxyvitamin D3 (25D3). However, the presence of 3-epi-25-hydroxyvitamin D3 (3epi25D3) can affect 25D measurement. In this research a novel validated UPLC-MS/MS technique was developed to measure three vitamin D metabolites, 25D2, 25D3 and 3epi25D3 in human plasma. A liquid-liquid extraction using hexane was applied for isolation of the analytes from the samples. A chromatographic separation was achieved in a Kinetex F5 analytical column with isocratic elution (water and methanol with 0.1% methanoic acid, 20:80 v/v). Mass spectrometry detection of the metabolites was performed in a triple-quadruple tandem mass spectrometer under positive ion mode. Concentrations of the analytes were estimated in plasma samples of 54 patients. Validation parameters of the UPLC-MS/MS method, including linearity, precision, accuracy, and stability, fulfilled the requirements for bioanalytical assays. The deficient concentration of 25D (<20 ng/mL) was stated in over 60% of patients. 3epi25D3 was present in 78% of samples and its relative amount ranged from 0 to 54.1% of 25D concentration. The analysis of 25D2, 25D3 and 3epi25D3 by the validated UPLC-MS/MS method in plasma of patients with CVD permitted the classification of the patients with insufficient levels of 25D. 3epi25D3 might be relevant in the classification of vitamin D status.

Topics: 25-Hydroxyvitamin D 2; Aged; Cardiovascular Diseases; Chromatography, High Pressure Liquid; Female; Humans; Hydroxycholecalciferols; Limit of Detection; Linear Models; Male; Middle Aged; Reproducibility of Results; Tandem Mass Spectrometry

Celiac disease (CD) is an autoimmune disorder characterized by damage to the intestinal mucosa and nutrient malabsorption in severe cases. However, it remains unclear whether nutrient deficiencies and other adverse health effects are prevalent in individuals with positive CD serology identified through screening studies.. The objective was to determine whether biomarkers of cardiometabolic health and nutritional status differ between those with positive and negative CD serology identified in a screening study of Canadian adults.. Participants ( n=2832) were from the Toronto Nutrigenomics and Health Study and the Toronto Healthy Diet Study. Individuals were screened for CD-specific anti-tissue transglutaminase autoantibodies. Lipid profiles as well as concentrations of six carotenoids (α-carotene, β-carotene, β-cryptoxanthin, lutein, lycopene, and zeaxanthin), three tocopherols (α-tocopherol, δ-tocopherol, and γ-tocopherol), retinol, ascorbic acid, and 25-hydroxyvitamin D were cross-sectionally compared between those with positive and negative CD serology using general linear mixed models.. Individuals with positive CD serology ( n=23) had significantly lower levels of HDL-cholesterol ( p=0.008) and apolipoprotein-AI ( p=0.02), a higher ratio of total cholesterol to HDL-cholesterol ( p=0.006), and a higher apolipoprotein-B/AI ratio ( p=0.03) than those with negative CD serology. Positive CD serology was also associated with significantly lower concentrations of retinol ( p=0.006) in fully adjusted models. Those with positive CD serology had lower serum 25-hydroxyvitamin D in unadjusted models ( p=0.01), but not in fully adjusted models ( p=0.08).. Individuals with undiagnosed CD may have unfavorable lipid profiles and be at elevated risk for inadequacy of certain fat-soluble vitamins, but not widespread nutrient deficiencies.

Topics: 25-Hydroxyvitamin D 2; Adult; Asymptomatic Diseases; Autoantibodies; Biomarkers; Calcifediol; Cardiovascular Diseases; Celiac Disease; Cross-Sectional Studies; Female; Humans; Male; Malnutrition; Mass Screening; Nutritional Status; Ontario; Risk; Severity of Illness Index; Transglutaminases; Vitamin A; Vitamin A Deficiency; Vitamin D Deficiency

Maternal vitamin D deficiency has been implicated in adverse pregnancy outcomes. However, the association between vitamin D and inflammation, particularly adipokines, remains unexplored in pregnancy.. In 102 overweight or obese pregnant women at high-risk of gestational diabetes mellitus (GDM), we investigated relationships between maternal 25-hydroxyvitamin D (25(OH)D) concentrations at 12-15 wk gestation (baseline) and serum lipids, inflammatory markers, novel adipokines (omentin-1, visfatin, high molecular weight (HMW) adiponectin), and subsequent pregnancy outcomes (GDM, preeclampsia, preterm birth [PTB]). After adjustment for maternal factors (age, BMI, parity, ethnicity, and smoking status), baseline 25(OH)D concentrations were inversely associated with total cholesterol and triglycerides, and positively associated with HMW-adiponectin. Higher baseline 25(OH)D concentrations were associated with decreased fasting and 1-h post-OGTT glucose and reduced risk of GDM at 26-28 wk, as well as with longer gestation and reduced risk of PTB upon additional adjustment for caesarean section. Adding HMW-adiponectin to the multivariable models attenuated most associations, and HMW-adiponectin was a significant predictor in the models.. Our findings suggest that lower maternal 25(OH)D concentrations in overweight/obese pregnant women at high-risk of GDM are associated with increased cardiometabolic risks during pregnancy and adverse pregnancy outcomes, and that these associations may be mediated by HMW-adiponectin.

Topics: 25-Hydroxyvitamin D 2; Adiponectin; Adult; Biomarkers; Body Mass Index; Calcifediol; Cardiovascular Diseases; Cohort Studies; Cross-Sectional Studies; Diabetes, Gestational; Female; Hospitals, Teaching; Humans; Maternal Nutritional Physiological Phenomena; Molecular Weight; Obesity; Overweight; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Pregnancy Trimester, Second; Risk; Victoria; Vitamin D Deficiency

To assess the prevalence of vitamin D insufficiency and deficiency and its association with cardiometabolic risk factors, controlled by adiposity, in a representative sample of prepubescent children.. Cross-sectional population-based study. Body composition was evaluated by dual-energy X-ray absorptiometry. Anthropometric measures and blood pressure were performed. Laboratory analyses were performed to determine the levels of vitamin D (25-hydroxyitamin D; 25(OH)D), glucose, insulin, serum lipids and intact parathyroid hormone. Dietary intake was assessed by three 24 h recalls.. Viçosa, Minas Gerais, Brazil, 2015.. Representative sample of 378 children aged 8 and 9 years from urban schools.. Inadequate serum concentrations of 25(OH)D were diagnosed in more than half of the children and none of them met the recommended vitamin D intake. After adjusting for confounding factors in the multiple regression analysis, lower prevalence of insulin resistance and hypertriacylglycerolaemia was found in children with serum 25(OH)D levels ≥75 nmol/l (prevalence ratio=0·25; 95 % CI 0·08, 0·85) and ≥50 nmol/l (prevalence ratio=0·61; 95 % CI 0·37, 0·99), respectively. However, after adjusting for different indicators of adiposity, insulin resistance remained independently associated and the association with hypertriacylglycerolaemia was lost after adjusting for central adiposity. The prevalence of vitamin D insufficiency/deficiency was associated with the number of cardiometabolic alterations in children.. The study results showed that prevalence of vitamin D insufficiency/deficiency was high among the children and insulin resistance was the main cardiometabolic alteration associated with this condition, even in a tropical climate country such as Brazil.

Topics: 25-Hydroxyvitamin D 2; Adiposity; Biomarkers; Brazil; Calcifediol; Cardiovascular Diseases; Child; Child Nutritional Physiological Phenomena; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Female; Humans; Insulin Resistance; Male; Nutritional Status; Poisson Distribution; Prevalence; Risk Factors; Severity of Illness Index; Urban Health; Vitamin D Deficiency

To investigate the possible association between vitamin D deficiency and cardiovascular autonomic neuropathy in people with diabetes.. A total of 113 people with Type 1 or Type 2 diabetes [mean (interquartile range) diabetes duration 22.0 (12-31) years, mean (sd) age 56.2 (13.0) years, 58% men] underwent vitamin D (D2 and D3) assessment, and were screened for cardiovascular autonomic neuropathy using three cardiovascular reflex tests [heart rate response to deep breathing (E/I ratio), to standing (30/15 ratio) and to the Valsalva manoeuvre] and assessment of 5-min resting heart rate and heart rate variability indices.. We found an inverse U-shaped association between serum vitamin D level and E/I ratio, 30/15 ratio and three heart rate variability indices (P < 0.05). Vitamin D level was non-linearly associated with cardiovascular autonomic neuropathy diagnosis (P < 0.05 adjusted for age and sex). Linear regression models showed that an increase in vitamin D level from 25 to 50 nmol/l was associated with an increase of 3.9% (95% CI 0.1;7.9) in E/I ratio and 4.8% (95% CI 4.7;9.3) in 30/15 ratio. Conversely, an increase from 125 to 150 nmol/l in vitamin D level was associated with a decrease of 2.6% (95% CI -5.8;0.1) and 4.1% (95% CI -5.8;-0.5) in the respective outcome measures.. High and low vitamin D levels were associated with cardiovascular autonomic neuropathy in people with diabetes. Future studies should explore this association and the efficacy of treating dysvitaminosis D to prevent cardiovascular autonomic neuropathy.

Topics: 25-Hydroxyvitamin D 2; Aged; Autonomic Nervous System Diseases; Biomarkers; Calcifediol; Cardiovascular Diseases; Cohort Studies; Denmark; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Diabetic Angiopathies; Diabetic Cardiomyopathies; Diabetic Neuropathies; Dietary Supplements; Female; Humans; Male; Middle Aged; Prevalence; Severity of Illness Index; Vitamin D; Vitamin D Deficiency

To examine cross-sectional relationships between plasma vitamin D and cardiometabolic risk factors in young adults.. Data were collected from interviews, physical examinations and biomarker measurements. Total plasma 25-hydroxyvitamin D (25(OH)D) was measured using LC-tandem MS. Associations between 25(OH)D and cardiometabolic risk factors were modelled using weighted linear regression with robust estimates of standard errors.. Individuals born in Jerusalem during 1974-1976.. Participants of the Jerusalem Perinatal Study (n 1204) interviewed and examined at age 32 years. Participants were oversampled for low and high birth weight and for maternal pre-pregnancy obesity.. Mean total 25(OH)D concentration among participants was 21·7 (sd 8·9) ng/ml. Among males, 25(OH)D was associated with homeostatic model assessment of insulin resistance (natural log-transformed, β=-0·011, P=0·004) after adjustment for BMI. However, these associations were not present among females (P for sex interaction=0·005).. We found evidence for inverse associations of 25(OH)D with markers of insulin resistance among males, but not females, in a healthy, young adult Caucasian population. Prospective studies and studies conducted on other populations investigating sex-specific effects of vitamin D on cardiometabolic risk factors are warranted.

Topics: 25-Hydroxyvitamin D 2; Adult; Biomarkers; Body Mass Index; Calcifediol; Cardiovascular Diseases; Cohort Studies; Cross-Sectional Studies; Female; Humans; Hyperglycemia; Hyperinsulinism; Hyperlipidemias; Insulin Resistance; Israel; Longitudinal Studies; Male; Metabolic Syndrome; Overweight; Risk Factors; Sex Factors; Vitamin D Deficiency

Vitamin D deficiency has been associated with increased risk for cardiovascular (CV) disease, but the possible effects of Vitamin D on cardiac structure and function are not well characterized.. The correlation between 25-hydroxyvitamin D levels and metabolic and cardiac echocardiographic parameters was studied in ARTEMIS study population including 831diabetic and 659 non-diabetic patients with stable coronary artery disease (CAD). Low levels of Vitamin D were associated with high BMI (p < 0.001), high total and LDL cholesterol and triglyceride levels (p < 0.001 for all) in both diabetics and non-diabetics. Among non-diabetic patients, low Vitamin D was also associated independently with elevated systolic and diastolic blood pressure (p < 0.005). Low Vitamin D levels were independently associated with reduced left ventricular (LV) ejection fraction (p < 0.005) and increased left atrial diameter (p < 0.03) measured by cardiac ultrasound by 2-dimensional echo. In the non-diabetic group, low Vitamin D levels were associated with impaired LV filling (high E/E') (p < 0.03) and low E/A mitral flow pattern measured by Doppler echocardiography (p < 0.05). Among diabetics, low Vitamin D levels were also related to increased LV end-systolic diameter (p < 0.05) and right ventricular diameter (p < 0.005). The association between LV diastolic filling (E/E') and Vitamin D levels was significant (p < 0.01) after adjustment for the commonly recognized risk factors of diastolic dysfunction in linear regression analysis.. Low Vitamin D is associated with several major cardiovascular risk factors and cardiac structural changes including impaired systolic and diastolic function, which together may explain the association of low Vitamin D to worse cardiovascular outcome.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Aged, 80 and over; Calcifediol; Cardiovascular Diseases; Cohort Studies; Coronary Artery Disease; Echocardiography, Doppler; Female; Finland; Heart; Heart Atria; Heart Ventricles; Humans; Male; Middle Aged; Nutritional Status; Organ Size; Prevalence; Risk Factors; Stroke Volume; Ventricular Dysfunction, Left; Vitamin D Deficiency

Low circulating levels of total vitamin D [25(OH)D] and 25(OH)D3 have been associated with vascular complications in few studies on individuals with type 1 diabetes. However, these measures are affected by UV light exposure. Circulating 25(OH)D2, however, solely represents dietary intake of vitamin D2, but its association with complications of diabetes is currently unknown. We investigated the associations between 25(OH)D2 and 25(OH)D3 and the prevalence of albuminuria, retinopathy and cardiovascular disease (CVD) in individuals with type 1 diabetes.. We measured circulating 25(OH)D2 and 25(OH)D3 in 532 individuals (40 ± 10 years old, 51 % men) with type 1 diabetes who participated in the EURODIAB Prospective Complications Study. Cross-sectional associations of 25(OH)D2 and 25(OH)D3 with albuminuria, retinopathy and CVD were assessed with multiple logistic regression analyses adjusted for age, sex, season, BMI, smoking, HbA1c, total-HDL-cholesterol-ratio, systolic blood pressure, antihypertensive medication, eGFR, physical activity, alcohol intake, albuminuria, retinopathy and CVD, as appropriate.. Fully adjusted models revealed that 1 nmol/L higher 25(OH)D2 and 10 nmol/L higher 25(OH)D3 were associated with lower prevalence of macroalbuminuria with ORs (95 % CI) of 0.56 (0.43;0.74) and 0.82 (0.72;0.94), respectively. These vitamin D species were not independently associated with microalbuminuria, non-proliferative and proliferative retinopathy or CVD.. In individuals with type 1 diabetes, both higher 25(OH)D2 and 25(OH)D3 are associated with a lower prevalence of macroalbuminuria, but not of retinopathy and CVD. Prospective studies are needed to further examine the associations between 25(OH)D2 and 25(OH)D3 and the development of microvascular complications and CVD in type 1 diabetes.

Topics: 25-Hydroxyvitamin D 2; Adult; Albuminuria; Calcifediol; Cardiovascular Diseases; Cohort Studies; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Diabetic Angiopathies; Diabetic Retinopathy; Female; Humans; Logistic Models; Male; Middle Aged; Prospective Studies; Risk Factors; Vitamin D Deficiency

Studies of the associations of circulating total 25-hydroxyvitamin D (25(OH)D) with cardiovascular disease risk factors in adults have reported inconsistent findings. We aimed to compare prospective associations of two analogues of childhood 25(OH)D (25(OH)D2 and 25(OH)D3) with cardiovascular risk factors measured in adolescence.. We examined associations of childhood (ages 7-12 years) 25(OH)D2 and 25-25(OH)D3 with a range of cardiovascular risk factors (blood pressure, fasting lipids, glucose, insulin and C-reactive protein (CRP)) determined in adolescence (mean age 15.4 years). Data were from 2470 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC), a prospective population-based cohort. After adjustments for age, gender, socioeconomic position and BMI, there were no associations of 25(OH)D2 with cardiovascular risk factors. There was a positive association of season-adjusted (and unadjusted) 25(OH)D3 with high-density lipoprotein cholesterol (HDL-C) (mean change per doubling of 25(OH)D3: 0.03 mmol/l; 95% confidence interval (CI): 0.001 to 0.05, p = 0.02) and an inverse association with fasting insulin (relative difference of -4.59% per doubling; 95% CI: -8.37 to -0.59, p = 0.03). Participants with total 25(OH)D concentration <50 nmol/l had 0.04 mmol/l lower HDL-C (95% CI: -0.07 to -0.01) and 5.54% higher fasting insulin (95% CI: 0.82 to 10.47) compared with participants with total 25(OH)D ≥72 nmol/l.. In the first prospective study of children/adolescents, we have shown that higher 25(OH)D3 concentrations in childhood are associated with higher levels of HDL-C and lower fasting insulin in adolescence.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Age Factors; Biomarkers; Calcifediol; Cardiovascular Diseases; Child; Cholesterol, HDL; England; Female; Humans; Insulin; Longitudinal Studies; Male; Prospective Studies; Risk Assessment; Risk Factors; Vitamin D Deficiency

Recent studies in critically ill populations have suggested both adrenal insufficiency (AI) and vitamin D deficiency to be associated with worse clinical outcome. There are multiple mechanisms through which these pleiotropic hormones might synergistically influence critical illness.. The aim of the study was to investigate potential relationships between vitamin D status, adrenal status, and cardiovascular dysfunction in critically ill children.. We conducted a secondary analysis of data from a prospective cohort study.. The study was conducted on 319 children admitted to 6 Canadian tertiary-care pediatric intensive care units.. Vitamin D status was determined through total 25-hydroxyvitamin D (25OHD) levels. AI was defined as a cortisol increment under 9 μg/dL after low-dose cosyntropin. Clinically significant cardiovascular dysfunction was defined as catecholamine requirement during pediatric intensive care unit admission.. Using 3 different thresholds to define vitamin D deficiency, no association was found between vitamin D status and AI. Furthermore, linear regression failed to identify a relationship between 25OHD and baseline or post-cosyntropin cortisol. However, the association between AI and cardiovascular dysfunction was influenced by vitamin D status; compared to children with 25OHD above 30 nmol/L, AI in the vitamin D-deficient group was associated with significantly higher odds of catecholamine use (odds ratio, 5.29 vs 1.63; P = .046).. We did not find evidence of a direct association between vitamin D status and critical illness-related AI. However, our results do suggest that vitamin D deficiency exacerbates the effect of AI on cardiovascular stability in critically ill children.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Adrenal Cortex; Adrenal Insufficiency; Calcifediol; Canada; Cardiovascular Diseases; Cardiovascular System; Catecholamines; Child; Child, Preschool; Cohort Studies; Cosyntropin; Hormones; Humans; Hydrocortisone; Infant; Intensive Care Units, Pediatric; Nutritional Status; Prospective Studies; Tertiary Care Centers; Vitamin D Deficiency

In various populations, vitamin D deficiency is associated with chronic diseases and mortality. We examined the association between concentration of circulating 25-hydroxyvitamin D [25(OH)D], a marker of vitamin D status, and all-cause as well as cause-specific mortality.. The study included 3404 participants of the general adult Swiss population, who were recruited between November 1988 and June 1989 and followed-up until the end of 2008. Circulating 25(OH)D was measured by protein-bound assay. Cox proportional hazards regression was used to examine the association between 25(OH)D concentration and all-cause and cause-specific mortality adjusting for sex, age, season, diet, nationality, blood pressure, and smoking status. Per 10 ng/mL increase in 25(OH)D concentration, all-cause mortality decreased by 20% (HR = 0.83; 95% CI 0.74-0.92). 25(OH)D concentration was inversely associated with cardiovascular mortality in women (HR = 0.68, 95% CI 0.46-1.00 per 10 ng/mL increase), but not in men (HR = 0.97; 95% CI 0.77-1.23). In contrast, 25(OH)D concentration was inversely associated with cancer mortality in men (HR = 0.72, 95% CI 0.57-0.91 per 10 ng/mL increase), but not in women (HR = 1.14, 95% CI 0.93-1.39). Multivariate adjustment only slightly modified the 25(OH)D-mortality association.. 25(OH)D was similarly inversely related to all-cause mortality in men and women. However, we observed opposite effects in women and men with respect to cardiovascular and cancer mortality.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Aging; Calcifediol; Cardiovascular Diseases; Cohort Studies; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Middle Aged; Mortality; Neoplasms; Proportional Hazards Models; Risk Factors; Sex Characteristics; Switzerland; Vitamin D Deficiency

Several studies suggested that low serum concentrations of 25-hydroxyvitamin D (25(OH)D) are associated with an increased risk of cardiovascular disease (CVD). However, the evidence is still inconclusive, mostly based on CVD mortality and studies with single 25(OH)D measurements.. We aimed to assess the association of 25(OH)D with fatal and nonfatal CVD in the same study population, using repeated 25(OH)D measurements and competing risks analysis.. This was a population-based cohort study (ESTHER study, baseline 2000-2002). Follow-up data, including survival status, were collected after 2, 5, and 8 years. The response rate for survival was 99.9%.. Participants were recruited during a health screening examination by their general practitioners. 25(OH)D was measured in blood samples collected at baseline and the 5-year follow-up visit.. A total of 9949 men and women, aged 50 to 74 years at baseline, with sufficient knowledge of the German language and resident in the German state of Saarland were included in the study.. Outcomes included CVD, coronary heart disease (CHD), and stroke, in total and differentiated into fatal and nonfatal events.. Overall, 854 study participants had a nonfatal and 176 a fatal CVD event during 8 years of follow-up. Comparing subjects with 25(OH)D levels below 30 nmol/L and above 50 nmol/L resulted in a hazard ratio of 1.27 (95% confidence interval = 1.05-1.54) for total CVD and 1.62 (95% confidence interval = 1.07-2.48) for fatal CVD in a model adjusted for important potential confounders. No significant association for nonfatal CVD was observed. In dose-response analysis, we observed an increased cardiovascular risk at 25(OH)D levels below 75 nmol/L. Results for CHD and stroke were comparable to the results obtained for the composite outcome CVD.. Our results support evidence that low 25(OH)D levels are associated with moderately increased risk of CVD and indicate that the observed association is much stronger for fatal than for nonfatal events.

Topics: 25-Hydroxyvitamin D 2; Aged; Calcifediol; Cardiovascular Diseases; Cohort Studies; Coronary Disease; Female; Follow-Up Studies; Germany; Humans; Incidence; Male; Middle Aged; Models, Biological; Risk Assessment; Risk Factors; Severity of Illness Index; Stroke; Survival Analysis; Vitamin D Deficiency

Vitamin D, estimated glomerular filtration rate (eGFR) and parathyroid hormone (PTH) are related to cardiovascular disease risk. We examined the associations between the levels of 25-hydroxyvitamin D (25-D) and 1,25-dihydroxyvitamin D (1,25-D) and both eGFR and PTH.. Cross-sectional population-based study in Kuopio, Eastern Finland.. A total of 909 men without known chronic kidney disease (CKD) and not receiving antidiabetic medication, aged from 45 to 73 years, were included in the study. Main outcome measures. Fasting levels of 25-D, 1,25-D, creatinine and PTH were measured, and an oral glucose tolerance test (OGTT) was performed.. High levels of 25-D were associated with low levels of eGFR and PTH (β = -0.17, P = 9 × 10(-7) and β = -0.28, P = 6 × 10(-17) , respectively, adjusted for age, body mass index and levels of calcium, phosphorus and glucose in a 2-h OGTT, and also for either eGFR or PTH). By contrast, high 1,25-D levels were associated with high levels of eGFR and PTH (β = 0.17, P = 2 × 10(-6) and β = 0.19, P = 5 × 10(-8) , respectively, adjusted as mentioned earlier and additionally for 25-D). Eighteen per cent of men in the highest 25-D quartile were in the lowest 1,25-D quartile and also had a lower eGFR than men with high levels of both 25-D and 1,25-D (P = 4 × 10(-5) ). Finally, 15% of men in the lowest 25-D quartile were in the highest 1,25-D quartile and also had higher PTH levels than men with low levels of both 25-D and 1,25-D (P = 2 × 10(-3) ).. Our findings suggest that both eGFR and PTH are significantly associated with vitamin D metabolism in men without known CKD.

Topics: 25-Hydroxyvitamin D 2; Aged; Algorithms; Analysis of Variance; Biomarkers; Cardiovascular Diseases; Creatinine; Cross-Sectional Studies; Finland; Glomerular Filtration Rate; Glucose Tolerance Test; Humans; Kidney Failure, Chronic; Male; Middle Aged; Multivariate Analysis; Parathyroid Hormone; Regression Analysis; Risk Factors; Sampling Studies; Surveys and Questionnaires; Vitamin D; Vitamins

Topics: 25-Hydroxyvitamin D 2; Cardiovascular Diseases; Glomerular Filtration Rate; Humans; Kidney Failure, Chronic; Male; Parathyroid Hormone; Vitamin D; Vitamins

Studies in adults have reported associations of low circulating total 25-hydroxyvitamin D with increased cardiovascular disease and risk factors. Evidence of associations in children, however, is limited, and it is unknown whether associations with risk factors differ for each 25-hydroxyvitamin D analog [25-hydroxyvitamin D(2) (25[OH]D(2)) and 25-hydroxyvitamin D(2) (25[OH]D(3))].. The objective of the study was to compare associations of 25(OH)D(2) and 25(OH)D(3) with cardiovascular risk factors in children.. The design of the study was a cross-sectional study of 4274 children (mean age 9.9 yr) from the Avon Longitudinal Study of Parents and Children.. The main outcomes included blood pressure, lipids [triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C)], apolipoproteins (Apo-A1 and Apo-B), adiponectin, leptin, C-reactive protein, and IL-6.. In confounder-adjusted models, 25(OH)D(2) was inversely associated with Apo-A1 (change per doubling of exposure: -0.74 mg/dl; 95% confidence interval -0.14, -0.04) and triglycerides (relative percentage change per doubling of exposure: -1.64%; -3.27, 0.01) and positively associated with C-reactive protein (8.42%; 3.40, 13.58) and IL-6 (5.75%; 1.83, 9.25). 25(OH)D(3) was positively associated with HDL-C (0.04 mmol/liter; 0.02, 0.06), Apo-A1 (1.96 mg/dl; 0.65, 3.24), and adiponectin (0.47 μg/ml; 0.15, 0.79). There was statistical evidence that associations of 25(OH)D(2) and 25(OH)D(3) with HDL-C, Apo-A1, and IL-6 differed from each other (all P values for differences ≤0.02).. Higher circulating 25(OH)D(3) was associated with cardioprotective levels of HDL-C, Apo-A1, and adiponectin in children. Associations of 25(OH)D(2) with cardiovascular risk factors were in mixed directions. It is necessary to see whether these associations are replicated in large prospective studies.

Topics: 25-Hydroxyvitamin D 2; Adiponectin; Apolipoproteins; Blood Pressure; C-Reactive Protein; Calcifediol; Cardiovascular Diseases; Child; Cross-Sectional Studies; Female; Humans; Interleukin-6; Leptin; Lipids; Male; Risk Factors

Metabolic consequences of vitamin D deficiency have become a recent research focus. Maternal vitamin D status is thought to influence musculoskeletal health in children, but its relation with offspring metabolic risk is not known.. We aimed to examine the association between maternal vitamin D status and anthropometric variables, body composition, and cardiovascular risk markers in Indian children.. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured at 28-32 wk gestation in 568 women who delivered at Holdsworth Memorial Hospital, Mysore, India. Anthropometric variables, glucose and insulin concentrations, blood pressure, and fasting lipid concentrations were measured in the offspring at 5 and 9.5 y of age. Muscle-grip strength was measured by using a hand-held dynamometer at age 9.5 y. Arm-muscle area was calculated as a measure of muscle mass. Fasting insulin resistance was calculated by using the homeostasis model assessment equation.. Sixty-seven percent of women had vitamin D deficiency [serum 25(OH)D concentration <50 nmol/L]. At ages 5 and 9.5 y, children born to vitamin D-deficient mothers had smaller arm-muscle area in comparison with children born to mothers without deficiency (P < 0.05). There was no difference in grip strength between offspring of women with and without vitamin D deficiency. At 9.5 y, children of vitamin D-deficient mothers had higher fasting insulin resistance than did children of nondeficient women (P = 0.04). There were no associations between maternal vitamin D status and other offspring risk factors at either age.. Intrauterine exposure to low 25(OH)D concentrations is associated with less muscle mass and higher insulin resistance in children.

Topics: 25-Hydroxyvitamin D 2; Adult; Body Composition; Body Weights and Measures; Cardiovascular Diseases; Child; Child Development; Child, Preschool; Cohort Studies; Female; Humans; India; Insulin Resistance; Male; Maternal Nutritional Physiological Phenomena; Muscle Strength; Nutritional Status; Pregnancy; Pregnancy Trimester, Third; Risk Factors; Vitamin D Deficiency

To explore associations between vitamin D and cardiovascular disease risk factors in young European adults.. This was a cross-sectional analysis of serum 25-hydroxyvitamin D [s25(OH)D], intact parathyroid hormone (iPTH) and biomarkers of cardiovascular disease risk in 195 healthy 20- to 40-year-olds (109 women) with a BMI between 27.5 and 32.5 from Iceland (64° N; n = 82), Ireland (51° N; n = 37) and Spain (42° N; n = 76) during mid-late winter.. The median s25(OH)D was 52.8 nmol/l (IQR 38.1-69.9) or 21.1 ng/ml (IQR 15.2-28.0) with a latitude-dependent gradient (p ≤ 0.0001): Iceland, 41.7 nmol/l (IQR 32.7-54.2) or 16.7 ng/ml (IQR 13.1-21.7); Ireland, 52.9 nmol/l (IQR 35.3-68.6) or 21.2 ng/ml (IQR 14.1-27.4), and Spain, 67.1 nmol/l (IQR 47.1-87.1) or 26.8 ng/ml (IQR 18.8-34.8). Eleven percent of Icelandic participants had s25(OH)D concentrations <25 nmol/l (10 ng/ml) and 66% of Icelandic, 43% of Irish, and 30% of Spanish volunteers had concentrations <50 nmol/l (20 ng/ml), respectively. Overall, 17% met 3 or more of the NCEP/ATP III criteria for cardio-metabolic syndrome (MetS). Participants in the lowest third of s25(OH)D [≤ 42.5 nmol/l (17 ng/ml)] were more likely to have MetS (OR 2.49, p = 0.045) and elevated TAG (OR 3.46, p = 0.019). Individuals with iPTH concentrations in the lowest third [2.34 pmol/l (22.2 pg/ml)] were more likely to have elevated fasting TAG (OR 4.17, p = 0.039), insulin (OR 3.15, p = 0.029) and HOMA-IR (OR 2.15, p = 0.031), and they were less likely to have elevated IL-6 (OR 0.24, p = 0.003).. There were interactions between s25(OH)D, iPTH and cardio-metabolic risk factors which, given the increasing prevalence of overweight and obesity and a low vitamin D status among adults, require randomised controlled vitamin D intervention studies in overweight persons.

Topics: 25-Hydroxyvitamin D 2; Adult; Calcifediol; Cardiovascular Diseases; Cross-Sectional Studies; Female; Humans; Hypertriglyceridemia; Iceland; Insulin Resistance; Interleukin-6; Ireland; Male; Metabolic Syndrome; Nutritional Status; Overweight; Parathyroid Hormone; Prevalence; Risk Factors; Seasons; Spain; Vitamin D Deficiency; Young Adult

The health and nutritional status (anthropometry, and blood and urine biochemistry) of 44 Dutch apparently healthy vegetarians, aged 65-97 years, refraining from meat, fish, and poultry consumption, was assessed for insight into long-term consequences of ovo-lacto- or lacto-vegetarianism. The results indicate that in comparison to omnivorous elderly the vegetarian elderly (especially men) have aged successfully with respect to cardiovascular risk factors. In contrast, vegetarian elderly are at a higher risk for a marginal iron, zinc, and vitamin B12 status. Although several vegetarian elderly showed low levels of 25-hydroxyvitamin D in plasma and many had low values of 24-hr urine volume (per kg body weight), these values are not likely the result of a vegetarian diet per se. It is concluded that, although some nutrition-related risks are prevalent among vegetarian elderly, these risks can probably be prevented by lifestyle changes.

Topics: 25-Hydroxyvitamin D 2; Aged; Aged, 80 and over; Anemia, Hypochromic; Anthropometry; Cardiovascular Diseases; Diet, Vegetarian; Drinking; Female; Ferritins; Humans; Male; Nutritional Status; Risk Factors; Urine; Vitamin B 12 Deficiency; Zinc