The correlation of cardiovascular risk factors and angiographic findings with serum vitamin D levels in patients undergoing coronary angiography

Background: Studies regarding correlation of various conventional risks factors for Coronary Artery Disease (CAD) are many. Keeping in mind the scarcity of studies regarding Vit-D Deficiency (VDD), a new risk factor in CAD, present study was conducted to correlate Vit-D level with conventional risk factors and Coronary Angiography (CAG).Methods: Hundred adult patients admitted to Medicine and Cardiology undergoing CAG with suspected or established CAD were kept in study. Patients having renal, hepatic, parathyroid disease, osteomalacia and patients taking drugs interfering with Vitamin D (Vit-D) metabolism were excluded. After detailed history and thorough clinical examination, routine investigations and 25-(OH) D level was estimated. Subsequently patients underwent CAG. Statistical analysis by Mann Whitey test and Chi-square Test was done and inference was drawn.Results: 100 patients in different age groups had hypertension (HTN) in 53, diabetics mellitus (DM) 39, dyslipidemia 62, smokers 38 and family history of CAD 19. CAG showed normal coronaries in 4, Single Vessel Disease (SVD) in 30, double vessel diseases (DVD) 43 and triple vessel disease (TVD) 22. Vit-D level <20ng/ml i.e. Vit-D deficiency (VDD) in 68, 20-30ng/ml i.e. Vit-D insufficiency (VDI) in 22 and >30ng/ml (normal) in 10. VDD was profound in 51-60 and 61-70 years age groups. Statistical correlation of VDD was not significant with conventional risk factors, but statistically significant correlation of VDD was observed with dyslipidemia and CAG findings in our study.Conclusions: Like earlier studies we observed significant correlation of Vit-D levels with CAD. Though dyslipidemia was significantly correlated with VDD, correlation of other conventional risk factors like age, sex, HTN, DM, smoking and family history was not found. We conclude from this study presence of significant association of VDD with severe CAD. DVD and TVD by CAG were common with low Vit-D levels.

Valores de 25-hidroxivitamina D (25-OH D3) en hombres con baja masa ósea / Values of 25 -hydroxyvitamin D (25 - OH D3) in men with low bone mass

Para mantener un esqueleto sano y mineralizado es de importancia crítica tener una fuente adecuada de vitamina D, que puede conseguirse mediante la exposición solar o la dieta. Se ha observado un aumento de la prevalencia del déficit de Vitamina D que se ha extendido a distintos grupos de edad y diferentes regiones, y ha alcanzado proporciones epidémicas. Estudios recientes han demostrado la importancia de la Vitamina D en la función neuromuscular y su déficit se ha relacionado con alteraciones funcionales y riesgo de caídas en ancianos. La vitamina D es esencial para la absorción normal del calcio en el intestino y tiene un papel fundamental en la mineralización del hueso. Objetivo: Determinar los valores de 25-hidroxivitamina D (25-OH D3) en hombres con baja masa ósea. Materiales y métodos: Se estudiaron sujetos masculinos con baja masa ósea que acudieron a la Unidad de Investigación UNILIME-UC Hospital Universitario "Dr. Ángel Larralde" entre Junio a Diciembre 2015, la muestra quedó constituida por 47 sujetos con criterios de inclusión (> 60 años con baja masa ósea (osteopenia-osteoporosis) por densitometría ósea (DEXA), en ausencia de enfermedades que determinan hipovitaminosis. A los mismos se les midió calcio sérico y 25 -hidroxivitamina D ( 25 -OH D3) este último se determinó por inmmuno ensayo (OCTEIA 25 -hidroxi vitamina D. IDS.UK). Se tomaron muestras de sangre venosa en ayuno, se congelaron a -70 °C y se midió por duplicado en el mismo tiempo. Los resultados se analizaron con programa SPSS.20 para Windows, utilizando técnicas de análisis descriptivos y para la significancía estadística, el coeficiente correlación de Pearson. Resultados: Se estudiaron 47 hombres con un promedio de edad de 66,28± 5,17 años, con valores promedio de calcio sérico de 8,88±0.38 mg/dl y con baja masa osea por DEXA a nivel de cuello de fémur (CF) de 0,870 g/cm3 con T score -1.5 y a nivel de columna lumbar L1-L4 de 0,917 g/cm3 con T score -1.8. Valores promedio de Vitamina D (25-OH D3) de 28,72±5,33 ng/ml (valor mínimo 18 ng/ml y valor máximo 39,60 ng/ml), observando un 38,30% (n=18) con valores inferiores de 30 ng/dl; de los cuales el 23,5% (n=11) presentaron valores entre 20 - 30 ng/ml catalogados como sujetos con deficit relativo de 25-OH D3 y un 14,8% (n=7) con valores inferiores a 20 ng/ml catalogados como sujetos con insuficiencia de 25-OH D3. Al correlacionar los valores de 25-OH D3 con la edad se observó una relación estadisticamente significativa (p<0,05), no asi con los niveles de calcio sérico (p=0.2), con DEXA CF (p=0.18) y con DEXA L1- L4 (p= -0,15). Conclusiones: La prevalencia de la disminución de vitamina D (25-OH D3) está sobrestimada, sobre todo en los paises tropicales donde se supone que contamos con uno de los principales factores que influyen en mantener dichos valores como es la exposición solar. En este estudio se observa una alta prevalencia de ipoavitaminosis (deficiencia e insuficiencia) de Vitamina D (38,3%). Por lo cual recomendamos se considere (AU)

To maintain a healthy mineralized skeleton is critically important to have an adequate supply of vitamin D, which can be achieved by sun exposure or diet. There has been an increase in the prevalence of vitamin D deficiency that has spread to different age groups and different regions, and has reached epidemic proportions. Recent studies have shown the importance of vitamin D in the neuromuscular function, and its deficit has been associated with functional alterations and risk of falls in the elderly. Vitamin D is essential for normal calcium absorption in the intestine and plays a key role in bone mineralization. Objective: To determine the values of 25 -hydroxyvitamin D (25 - OH D3) in men with low bone mass. Methods: Male patients with low bone mass who came to the Research Unit UNILIME -UC University Hospital " Angel Larralde" were studied from June to Diciemnbre 2015; the sample consisted of 47 subjects with theses inclusion criteria. >60 years with low bone mass (osteopenia - (osteoporosis) by bone densitometry (DEXA ) in the absence of diseases that determine hipovitaminosis. Serum calcium and 25 hydroxyvitamin D (25 -OH D3 ) were measured by enzymeinmmunoassay (25 -hydroxy vitamin D. OCTEIA IDS.UK ) venous blood samples in fasting state , frozen at - 70° C and measured in duplicate at the same time. the results were analyzed with SPSS.20 program for Windows, using descriptive analysis techniques and statistical significance the Pearson correlation coefficient. Results: the average age was 66.28 ± 5.17 years (minimum value of 61 years and maximum 71 years ), with average values of serum calcium of 8.88 ± 0.38 mg / dl and low bone mass by DEXA level Femur neck ( CF ) of 0.870 g / cm3 with Tscore -1.5 and level L1- L4 lumbar spine of 0.917 g / cm3 with Tscore -1.8. average Vitamin D values (25 - OHD3) of 28.72 ± 5.33 ng / ml (minimum value of 18 ng/ ml and maximum value 39.60 ng / ml), observing a 38.30 % (n = 18) with values lower than 30 ng / dl ; of which 23.5 % (n = 11) showed values between 20 to 30 ng / ml classified as subjects with relative deficit of 25 - OH D3 and 14.8 % (n = 7) with values lower than 20 ng / ml classified as failure subjects with 25 - OH D3. By correlating the values of 25 - OH D3 with age A statistically significant relationship (p < 0.05) was observed, but not with serum calcium levels (p = 0.2) with DEXA CF (p = 0.18) and with DEXA L1 -L4 (p = -0.15). Conclusions: Decrease of the prevalence of vitamin D (25 - OHD3) is overestimated, especially in tropical countries where sun exposure happens. In this study a high prevalence of Vit D hypovitaminosis (deficiencyand insufficiency) Vitamin D (38.3 %) was found. Therefore we recommend the determination of serum Vitamin D is considered in male subjects over 60 years and which have low bone mass(AU)

Effect of vitamin D on ACE2 and vitamin D receptor expression in rats with LPS-induced acute lung injury / 中华急诊医学杂志

Objective To observe the effect of vitamin D on angiotensin converting enzyme 2 (ACE2) and vitamin D receptor (VDR) expression in Wister rat models of acute lung injury (ALI) induced by using lipopolysaccharide (LPS).Methods The rat models of ALI induced by LPS were established by intravenous injection of LPS via tail vein.Thirty Wistar rats were randomly (random number) divided into 6 groups:normal control group,LPS group,calcitriol (25 μg/kg) group,LPS + calcitriol 1 μg/kg group,LPS + calcitriol 5 μg/kg group and LPS + calcitriol 25 μg/kg group.The changes of general condition,lung pathology,lung wet/dry weight ratio and changes of VDR mRNA and ACE2 mRNA expressions and protein levels of VDR and ACE2 in rats were observed.Results The clinical manifestations (rapid shallow breathing;listlessness;the oral and nose hemorrhage) in LPS group were obvious,and the clinical manifestations and pathological changes of lung tissues in the LPS + calcitriol groups were significantly milder than those in LPS group.The expressions of VDR mRNA and ACE2 mRNA in LPS group was significantly lower than those in normal control group and calcitriol group (P ＜ 0.05).The expressions of VDR mRNA and ACE2 mRNA in LPS + calcitriol groups were significantly higher than those in LPS group (P ＜ 0.05),and lower than those in normal control group significantly (P ＜ 0.05).Meanwhile,among LPS + calcitriol groups,there was no significant difference in expression of VDR mRNA (P ＞ 0.05) and there was significant difference in ACE2 mRNA expression (P ＜ 0.05).Conclusions Calcitriol can increase the expressions of VDR mRNA and ACE2 mRNA and protein levels of VDR and ACE2 in rat models of LPS-induced ALI,thus suggesting the increased expressions of ACE2 mRNA and VDR mRNA playing a role in protection against the development of ALI.

Effect of consumption of fatty acids, calcium, Vitamin D and boron with regular physical activity on bone mechanical properties and corresponding metabolic hormones in rats.

The consumption of fatty acids, nutrients, and regular physical activity, individually influence bone mechanical properties in rats. To investigate their effects in combination, male rats were divided into the seven groups: G1: regular food and drinking water; G2: same as Gr.1 + physical activity (Whole body vibration; WBV); G3: same as Gr.2 + Calcium, Vit. D, Boron; G4: same as Gr.3 + canola oil; G5: same as Gr.3 + sunflower oil; G6: same as Gr.3 + mix of sunflower oil and canola oil; and G7: same as Gr.3 + coconut oil; and treated for 8 weeks. Analysis between the control with the groups 2 and 3 revealed that vibration in the G2 increased the body weight (P= 0.04), with no other major difference in plasma and bone indices. Comparison between the control with the G4-G7 (the oil groups) revealed that the rats in the G5 had a lower body weight (15 % less) and a significant increase in plasma levels of Estradiol in the G7 was noted. In addition, levels of Testosterone in the G4 and G7, and Free Testosterone in the G7 had a remarkable increase. Similar trend was observed for plasma levels of Vit. D in the G4 and G5. The stiffness and the breaking strength of the femur in the G7, and the breaking strength of the lumbar in the G7 compared to the control and the G4 and G5 was significantly higher and tended to increase in comparison to the G6. Better and stronger measurements observed for coconut oil is warranted to further study its effect on biomechanical properties of bones.

Expression of receptors of Vitamin D and cytokines in osteoclasts differentiated by M-CSF and ODF / 대한치주과학회지

The primary cause of tooth loss after 30 years of age is periodontal disease. Destruction of alveolar bone by periodontal disease is done by bone resorbing activity of osteoclasts. Understanding differentiation and activation mechanism of osteoclasts is essential for controling periodontal disease. The purpose of this study is to identify the possible effects of Vitamin D and cytokines affecting osteoclasts and its precursor cells. Four to six week-old mice were killed and humerus, radius, tibia and femur were removed aseptically and washed two times with Hank's solution containing penicillin-streptomycin and then soft tissue were removed. Bone marrow cells were collected by 22 gauge needle. Cells were cultured in Hank's solution containing 1 mg/ml type II collagenase, 0.05% trypsin, 4mM EDTA. Supernatant solution was removed 5 times after 15 minutes of digestion with above mentioned enzyme solution, and remained bone particles were maintained in alpha-MEM for 15 minutes and 4degrees C temperature. Bone particles were agitated for 1 minute and supernatant solution containing osteoclast precursor cells were filtrated with cell stainer. These separated osteoclast precursor cells were dispensed with 100-mm culture dish by 1x10(7) cells unit and cultured in alpha-MEM containing 20 ng/ml recombinant human M-CSF, 30 ng/ml recombinant human soluble osteoclast differentiation factor and 10% fetal calf serum for 2 and 7 days. Total RNA of osteoclast precursor cells were extracted using RNeasy kit. One microgram of total RNA was reverse transcribed in 42degrees C for 30 minutes using SuperScriptII reverse transcriptase. Expression of transcribed receptors of each hormone and cytokine were traced with 1 microliter of cDNA solution by PCR amplification. Vitamin D receptor was found in cells cultured for 7 days. TNF-alphareceptor was found in cells cultured for 2 days and amount of receptors were increased by 7 days. IL-1 type I receptor was not found in cells cultured 2 and 7 days. But, IL-1 receptor type II was found in cells cultured for 2 days. TGF-alpha,betatype I receptor was found in cells cultured 2 and 7 days, and amount of receptors were increased by 7 days of culture. These results implies Vitamin D and cytokines can affect osteoclasts directly, and affecting period in differentiation cycle of osteoclasts is different by Vitamin D and cytokines.

The effect of Vitamin D(3)addition on bone mineral density in postmenopausal hormone replacement / 대한산부인과학회잡지

OBJECTIVE: To determine the effect of the addition of Vit. D3 (1,25-Dihydroxychole calciferol D3) to the conventional postmenopausal hormone replacement therapy on bone mineral density(BMD) DESIGN: A 2-year retrospective , randomized study Setting : Department of Obstetrics and Gynecology of Catholic university hospital Patients : 388 postmenopausal women were recruited and divided into 5 groups according to treatment regimen; A: conjugated estrogens only treated group(n=146), B : conjugated estrogens and progesterone treated group(n=103), C : conjugated estrogens and Vit.D3 treated group (n=36), D : conjugated estrogens, progesterone and Vit.D3 treated group (n=41), E : control group (n=60). METHODS: The bone mineral density of the lumbar spines and femoral neck were determined by dual-energy X-ray absorptiometry(DEXA) every 2 years. STATISTICS: The difference between before and after treatment was determined by paired t-test. The comparison among the groups were determined by one way ANOVA test and student's t-test. RESULTS: The addition of progesterone to estrogen showed insignificant increase in the lumbar and femoral neck BMD. The addition of Vit. D3 compared with conventional hormone replacement therapy insignificantly influened bone density in women with initially normal BMD, but definitely increase in women with initially osteopenic and osteoporotic BMD of femoral neck rather than lumar spine(p<0.05). CONCLUSIONS: The use of Vit. D3 combined with postmenopausal estrogen replacement effects the increase of BMD in low bone density than normal bone density, especially femoral neck.

The Effect of Steroid Therapy on Growth and Bone Density in Children with Nephrotic Syndrome

PURPOSE: Long-term steroid therapy for various glomerular disorders in children has been known to decrease serum Vit D3 level and develop osteomalacia. The aim of this study was to observe the effect of long-term steroid therapy on growth and bone density in children with nephrotic syndrome. METHODS: Bone density of 17 steroid-treated nephrotic syndrome was compared with that of 17 similar aged healthy children by biochemical measurement, bone age and bone mineral density. Serum Vit D3, calcium, phosphorus and alkaline phosphatase were measured and bone mineral content was measured in the lumbar vertebra by dual energy X-ray absorptiometry (HOLOGIC QDR 2000 X-Ray Bone densitometer). RESULTS: There was no significant difference in height ,weight and bone age between the two groups. The mean bone density was significantly lower in children receiving steroid (0.58 +/- 0.04g/cm2) than in the control group (0.65 +/- 0.07g/cm2) (P<0.001). There was no significant correlation between duration of steroid therapy and decrement of bone density. Serum Vit D3 level was significantly lower in the group receiving steroid (16.7 +/- 6.1pg/ml) than in the control group (31.0 +/- 5.8pg/ml) (P<0.001). CONCLUSION: we conclude that alternate-day steroid therapy doesn't affect growth but may lead to decrement of serum Vit D3 level and bone mineral density in children with nephrotic syndrome.