Vitamin D supplementation in primary hyperparathyroidism: effects on 1,25(OH)2 vitamin D and FGF23 levels.

PURPOSE: In patients with Primary Hyperparathyroidism (PHPT) vitamin D deficiency has been associated with more severe presentations. Our aim was to investigate the effects of Vitamin D supplementation on mineral homeostasis and related hormones in individuals with and without PHPT. METHODS: Individuals with and without PHPT (CTRL) received 14,000 IU/week of oral vitamin D3 for 12 weeks. At baseline and endpoint, blood samples were collected to measure 1,25(OH)2vitamin D (1,25(OH)2D), intact Fibroblast Growth Factor 23 (FGF23), 25OHD, Parathormone, and other biochemical markers. The 1,25(OH)2D measurement was performed using liquid chromatography and mass spectrometry (LC-MS/MS). RESULTS: 70 PHPT patients and 75 CTRL were included, and 55 PHPT and 64 CTRL completed the 12-week protocol. After the intervention, there were significant increases in the FGF23 levels (PHPT: 47.9 ± 27.1 to 76.3 ± 33.3; CTRL: 40.5 ± 13.9 to 59.8 ± 19.8 pg/mL, p < 0.001), and significant decreases in 1,25(OH)2D levels (PHPT: 94.8 ± 34.6 to 68.9 ± 25.3; CTRL: 68.7 ± 23.5 to 56.4 ± 20.7 pg/mL, p < 0.001). The reduction of 1,25(OH)2D was inversely associated with the increase of FGF23 in both the PHPT (r = -0.302, p = 0.028) and CTRL (r = -0.278, p = 0.027). No changes in plasmatic or uninary calcium concentrations were observed in both groups. CONCLUSION: The weekly administration of 14,000 IU of Vitamin D3 was safe and efficient to increase in 25OHD levels in both groups. However, a paradoxical decrease in 1,25(OH)2D levels measured by LC-MS/MS was associated with a significant increase in FGF23 levels in both groups. This phenomenon might represent a defense against hypercalcemia after vitamin D supplementation and paves the way for new studies in this regard.

What is known about the effects of vitamin D in neuropsychiatric lupus?

Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.

What is known about the effects of vitamin D in neuropsychiatric lupus?

Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect several organs and systems. The central and/or peripheral nervous system can suffer from complications known as neuropsychiatric lupus (NPSLE). Studies have associated the manifestations of SLE or NPSLE with vitamin D deficiency. It has been shown that hypovitaminosis D can lead to cognition deficits and cerebral hypoperfusion in patients with NPSLE. In this review article, we will address the main features related to vitamin D supplementation or serum vitamin D levels with neuropsychiatric manifestations, either in patients or in animal models of NPSLE.

Vitamin D3 supplementation had no benefits in patients with metabolic syndrome and vitamin D deficiency: A pilot study.

BACKGROUND: Vitamin D deficiency has been observed in individuals with metabolic syndrome (MetS). This study evaluated the effects of vitamin D supplementation in patients with MetS and vitamin D deficiency. METHODS: Vitamin D3 supplementation was performed in patients with MetS and 25(OH)D levels ≤20 ng/mL arranged in two phases. The first phase corresponded to 50,000 IU/week for eight weeks, and the second phase was 7000 IU/week for twelve weeks. RESULTS: The 20-week intervention resulted in an increment of 14.3 ng/mL of 25(OH)D. HbA1c showed a reduction of 0.69% (95% CI [-1.16, -0.21], p = 0.005); however, the triglycerides, HDL-cholesterol, fasting blood glucose, blood pressure, and waist circumference were not responsive to supplementation. CONCLUSION: Vitamin D3 supplementation did not favor the MetS components.

Suplementación efectiva de vitamina D en pacientes con fractura tibial / Effective vitamin D supplementation in patients with tibial fracture

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.

OBJETIVOS Determinar la prevalencia de déficit de vitamina D, así como evaluar la seguridad y efectividad de un nuevo método de carga con colecalciferol en pacientes adultos con fractura de tibia. MATERIALES Y MÉTODOS Se reclutaron a 56 pacientes consecutivos con edades entre 18 y 65 años con fractura de tibia ingresados en nuestro hospital durante 1 año. Se determinó el nivel de 25-hidroxivitamina D ([25(OH)-D]) al ingreso y tras suplementación con 100.000 UI semanales de colecalciferol, durante 3 o 5 semanas, en casos de insuficiencia ([25(OH)-D] entre 20 ng/mL y 29,9 ng/mL) o deficiencia ([25(OH)-D] < 20 ng/mL), respectivamente. Se determinó la prevalencia de hipovitaminosis D, el porcentaje de normalización de [25(OH)-D], y los efectos adversos. RESULTADOS Se evaluaron 56 pacientes; 98,2% presentó hipovitaminosis D, y 28 (73,7%) y 10 (26,3%) presentaron déficit e insuficiencia, respectivamente. Tras la suplementación, 92,1% alcanzaron niveles [25(OH)-D] normales. Ningún paciente presentó efectos adversos. DISCUSIÓN La prevalencia de deficiencia de vitamina D en nuestra población fue mayor a la reportada en la literatura. Comprobamos que un esquema de suplementación en altas dosis de vitamina D es seguro, y más efectivo que los previamente recomendados. Este esquema de suplementación puede ser implementado en futuros estudios randomizados. CONCLUSIÓN La prevalencia de hipovitaminosis D en pacientes adultos chilenos con fractura de tibia fue alta (98,2%). El esquema de suplementación con vitamina D propuesto fue efectivo y seguro.

Vitamin D Supplementation and Its Relationship with Loss of Visceral Adiposity.

PURPOSE: An inverse relationship between vitamin D (VD) nutritional status and obesity is frequent, and the distribution of body fat is an important aspect to assess the risks of obesity-related metabolic dysfunction. The purpose of the study was to evaluate the relationship between serum VD concentrations and body fat reduction after 12 months of bariatric surgery, using two different vitamin D3 (VD3) supplementation protocols. MATERIAL AND METHODS: A randomized controlled trial consisted of 41 patients divided into G1 (800 IU/day) and G2 (1800 IU/day) according to the VD3 supplementation. At baseline (T0) and follow-up (T1), 25(OH)D, waist circumference (WC), visceral adiposity index (VAI), body adiposity index (BAI), and waist/height ratio (WHtR) were evaluated. RESULTS: In T0, the mean of 25(OH)D was lower in G2 compared to that in G1 (22.6 vs 23.6 ng/mL; p = 0.000). At T1, it had a significant increase in G2 (32.1 vs 29.9 ng/mL; p = 0.000), with 60% sufficiency. A significant negative correlation was observed between VAI, BAI, and WHtR with 25(OH)D in G2 (r = - 0.746, p = 0.024; r = - 0.411, p = 0.036; r = - 0.441, p = 0.032) after surgery. Higher mean changes from baseline of visceral fat loss, represented by VAI, were observed in G2 (176.2 ± 149.0-75.5 ± 55.0, p = 0.000). CONCLUSION: Patients submitted to the 1800 IU/day protocol, 12 months after the surgical procedure, had a higher percentage of sufficient vitamin D levels compared to those submitted to the 800 IU/day protocol. Additionally, higher dose supplementation promoted a significant improvement in VAI.

Effect of supplementation with 5,000 IU of vitamin D on the glycemic profile of women with gestational diabetes mellitus.

OBJECTIVES: The frequency of GDM and vitamin D insufficiency in Mexico is high. Vitamin D supplementation in GDM patients has shown favorable but non-homogeneous results regarding improvement of glycemic profile. The aim of the study was to assess the effects of supplementing with 5,000 IU of vitamin D on the glycemic profile of women with GDM. METHODS: A randomized clinical trial was conducted on women with GDM who received 5,000 IU of vitamin D (n=27) or a placebo (n=27) for eight weeks. Changes in vitamin D levels and metabolic parameters before and after the intervention were analyzed. RESULTS: Vitamin D vs. placebo: 25-OHD (32 vs. 26 ng/mL, p=0.006), HbA1c (6.0 vs. 6.1%, p=0.29), glucose (99 vs. 87 mg/dL, p=0.29), insulin (14 vs. 13 µIU/mL, p=0.79), HOMA-IR (3.6 vs. 2.6, p=0.55), QUICKI (0.31 vs. 0.33, p=0.55). CONCLUSIONS: Supplementation with 5,000 IU of vitamin D for eight weeks had no significant effect on the glycemic profile.

Vitamin D supplementation in inflammatory bowel disease: a narrative review. / Suplementación con vitamina D en enfermedad inflamatoria intestinal: una revisión narrativa.

Inflammatory bowel disease is a chronic disorder characterized by exacerbation and remission periods, and its worldwide incidence has increased in recent decades. Vitamin D is involved in immune regulation and improves barrier functions and intestinal microbiota. Studies have observed that high vitamin D levels decrease relapses and improve the clinical course of inflammatory bowel disease. The objective of this review was to analyze the evidence on vitamin D supplementation in adult patients with inflammatory bowel disease. Among inactive patients, the studies administrating less than 2000 international units per day of vitamin D did not find any beneficial effects. However, those supplementing 2000 international units of vitamin D per day increased serum levels and reduced disease activity. In patients with active disease, doses between 5000 to 10 000 international units per day reduced symptomatology. This review showed that vitamin D supplementation above 2000 international units per day among inactive patients with inflammatory bowel disease, and between 5000 to 10 000 international units per day among those in the active stage, shows potential benefits on the disease.

La enfermedad inflamatoria intestinal es un trastorno crónico caracterizado por presentar episodios de exacerbación y remisión, cuya incidencia mundial se ha incrementado en las últimas décadas. La vitamina D está implicada en la regulación inmunológica, mejora las funciones de la barrera y la microbiota intestinal. Estudios han observado que niveles altos de esta vitamina disminuye la incidencia de recidivas y mejora la evolución clínica de la enfermedad. El objetivo de esta revisión fue analizar la evidencia sobre la suplementación de vitamina D en pacientes adultos con enfermedad inflamatoria intestinal. Los estudios que administraron dosis menores a 2000 unidades internacionales al día de vitamina D en pacientes ambulatorios, no presentaron efectos beneficios. Por el contrario, los que suplementan niveles de 2000 unidades internacionales al día incrementaron los niveles séricos de esta vitamina y redujo la actividad de la enfermedad. En el caso de los sujetos con enfermedad activa, dosis de 5000 a 10 000 unidades internacionales al día redujeron la sintomatología clínica. Esta revisión apreció que la suplementación con vitamina D sobre 2000 unidades internacionales al día, en pacientes con enfermedad inflamatoria intestinal en etapa inactiva y entre 5000 a 10 000 unidades internacionales al día en etapa activa, muestra efectos positivos en el cuadro clínico de la patología.

[Vitamin D and respiratory allergy: state of the art]. / Vitamina D y alergia respiratoria: estado del arte.

An increasing number of studies are analyzing the relationship between serum vitamin D levels and the development of sensitization and allergic diseases in genetically predisposed individuals, as well as the impact of vitamin D supplementation. This article reviews the literature on this subject. Clinical trials, meta-analyses and systematic reviews consulted in PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane and manual resources were included, with the keywords: vitamin D, 25 hydroxyvitamin D, cholecalciferol, asthma, rhinitis, allergy, 25-OH-D, 1,25 hydroxyvitamin D, supplementation. The results show a positive linear trend, however, differ. We should keep in mind that in the studies there is heterogeneity of population groups and associated factors, which may modify such studies. It is necessary to increase research to clarify this relationship and to have successful interventions from the patient's approach to the strengthening of pharmacological and immunological treatment of allergic patients with these diseases.

Cada vez son más los trabajos que analizan la relación de los niveles séricos de vitamina D y el desarrollo de sensibilizaciones y enfermedades alérgicas en los individuos con predisposición genética, así como el impacto de su suplementación. El presente artículo efectúa una revisión de la literatura acerca de este tema. Se incluyeron ensayos clínicos, metaanálisis y revisiones sistemáticas consultadas en PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane y recursos manuales, con las palabras clave: vitamina D, 25 hidroxivitamina D, colecalciferol, asma, rinitis, alergia, 25-OH-D, 1,25 hidroxivitamina D, suplementación. Los resultados muestran una tendencia lineal positiva; sin embargo, algunos difieren. Debemos tener en mente que en los estudios existe heterogeneidad de los grupos poblacionales y los factores asociados, lo que puede modificarlos. Es necesario incrementar las investigaciones para clarificar esta relación y tener intervenciones exitosas desde el abordaje del paciente hasta el fortalecimiento del tratamiento farmacológico e inmunológico de los pacientes alérgicos con estas enfermedades.

Vitamina d, sus acciones "no clásicas" y su utilidad en la pandemia del covid-19 / Vitamin d, its "non-classic" actions and it utility in the covid-19 pandemic

RESUMEN El descubrimiento de que la síntesis de 1,25 vitamina D no fue solo renal, la enzima 1 alfa hidroxilasa se encuentra en numerosos tejidos del organismo, además de la evidencia de que la asociación entre el déficit de vitamina D y la presencia de enfermedades no óseas (cáncer, esclerosis múltiple, enfermedades autoinmunes, etc.) nos ofrece la posibilidad de intentar prevenir estas afecciones. Los estudios de suplementación contra placebo no han dado resultados positivos para algunas afecciones, aunque algunos de esos trials se realizaron en población "suficiente" y no "deficiente" de vitamina D. Sin embargo, otros metaanálisis han demostrado prevención en los grupos suplementados con déficit para algunas patologías (infecciones respiratorias, prediabetes). Además, existe evidencia de efecto antiviral de la misma. La acción antiinfecciosa e inmunomoduladora que ejerce y su efecto sobre el sistema renina angiotensina, estimulando la enzima convertidora de angiotensina 2 (que es el receptor virus del SARS-CoV), permiten sospechar, actualmente, que con niveles elevados podría ser más difícil, o menos grave, la infección por COVID-19. La suplementación con vitamina D es conveniente para prevenir enfermedades en sujetos con déficit, pero en medio de la grave pandemia 2020 administrarla, aún sin tener un dosaje previo en las poblaciones de mayor riesgo, podría disminuir la chance de esta enfermedad.

ABSTRACT The discovery that the synthesis of 1-25-vitamin D is not only renal and that the enzyme 1 alpha hydroxylase is found in numerous tissues of the body, together with the evidence of the association between vitamin D deficiency and the presence of non-bone diseases (cancer, multiple sclerosis, autoimmune diseases, etc.), gives us the possibility of trying to prevent these conditions. Placebo-controlled supplementation studies have not provided positive results for certain conditions, but some of these trials have been carried out on populations with "sufficient" and not "deficient" vitamin D levels. However, other meta-analyses have shown prevention of some conditions (respiratory infections, prediabetes) in groups of patients with deficiencies who were given supplements. There is also evidence of antiviral effect of vitamin D. Its anti-infective and immunomodulatory action and its effect upon the renin-angiotensin system, stimulating the angiotensin-converting enzyme 2 (the SARS-CoV virus receptor), nowadays allow us to think that, in high levels, COVID-19 infection could be less likely or serious. Vitamin D supplementation is adequate for preventing diseases in patients with deficiencies; administering vitamin D within the 2020 pandemic, even without having tested it in high-risk populations, could diminish the incidence of this disease.

Effects of vitamin D supplementation on fasting glucose, dyslipidemia, blood pressure, and abdominal obesity among patients with metabolic syndrome: a protocol for systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Vitamin D deficiency can play a role in extraskeletal functions that are involved with a set of risk factors associated with metabolic syndrome (MetS). The purpose of this review is to investigate the impact of vitamin D supplementation on fasting glucose, dyslipidemia, blood pressure, and abdominal obesity among patients with MetS. METHODS: EMBASE, Medline, Web of Science, Lilacs, the Cochrane Central Register of Controlled Trials, clinicaltrials.gov databases, and grey literature will be systematically searched for randomized controlled trials (RCTs) of vitamin D supplementation compared with placebo, through December 2020. We will include in the study patients with MetS diagnosed by the criteria set forth by the National Cholesterol Education Program Adult Treatment Panel III or the International Diabetes Federation. The effect of oral vitamin D supplementation on lipid profile improvement (triglycerides, high-density lipoprotein cholesterol-HDL-C) is this review's primary outcome. The systematic review will be performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study screening, data extraction, and quality assessment will be fulfilled by two independent reviewers according to the Cochrane Risk of Bias tool (RoB 2.0). The results of the systematic review will be provided according to the type of intervention, characteristics of the target population, the methods of measurement of vitamin D, the calculated vitamin D concentrations, types of biological samples, and types of outcomes. Meta-analyses will be conducted where appropriate. The Cochran's Q test and the I2-heterogeneity test will be used to assess the presence of heterogeneity and whether the fixed or the random-effects model would be appropriate for combining study results using the inverse variance method or the DerSimonian-Lair method, respectively. Publication bias will be evaluated using funnel plots and Egger's and Begg's tests. The strength of the evidence will be assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). DISCUSSION: This systematic review will assess the effects of vitamin D supplementation on fasting glucose and triglyceride levels, waist circumference and mean blood pressure, and HDL-C among individuals with MetS. These findings may assist with decision-making within a clinical setting. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42019123212.

The Potential Protective Role of Vitamin D Supplementation on HIV-1 Infection.

HIV infection remains a global and public health issue with the incidence increasing in some countries. Despite the fact that combination antiretroviral therapy (cART) has decreased mortality and increased the life expectancy of HIV-infected individuals, non-AIDS conditions, mainly those associated with a persistent inflammatory state, have emerged as important causes of morbidity, and mortality despite effective antiviral therapy. One of the most common comorbidities in HIV-1 patients is Vitamin D (VitD) insufficiency, as VitD is a hormone that, in addition to its physiological role in mineral metabolism, has pleiotropic effects on immune regulation. Several reports have shown that VitD levels decrease during HIV disease progression and correlate with decreased survival rates, highlighting the importance of VitD supplementation during infection. An extensive review of 29 clinical studies of VitD supplementation in HIV-infected patients showed that regardless of cART, when VitD levels were increased to normal ranges, there was a decrease in inflammation, markers associated with bone turnover, and the risk of secondary hyperparathyroidism while the anti-bacterial response was increased. Additionally, in 3 of 7 studies, VitD supplementation led to an increase in CD4+ T cell count, although its effect on viral load was inconclusive since most patients were on cART. Similarly, previous evidence from our laboratory has shown that VitD can reduce the infection of CD4+ T cells in vitro. The effect of VitD supplementation on other HIV-associated conditions, such as cardiovascular diseases, dyslipidemia or hypertension, warrants further exploration. Currently, the available evidence suggests that there is a potential role for VitD supplementation in people living with HIV-1, however, comprehensive studies are required to define an adequate supplementation protocol for these individuals.

Glycemic Variability and Insulin Needs in Patients with Type 1 Diabetes Mellitus Supplemented with Vitamin D: A Pilot Study Using Continuous Glucose Monitoring System.

BACKGROUND: Recent studies suggest that glycemic variability could influence the risk of complications in Type 1 Diabetes Mellitus (T1DM). There are no data about the action of Vitamin D (VD) on glycemic variability. Our pilot study aims to evaluate glycemic variability and insulin needs in patients with T1DM supplemented with VD. METHODS: 22 Patients received doses of 4000 and 10000 IU/day of cholecalciferol for 12 weeks, according to the patient's baseline VD levels and underwent continuous glucose monitoring system. RESULTS: Correlations were found between percentage variation (Δ) of glycemia standard deviation (ΔSDG), calculated using continuous glucose monitoring, with Δ of basal (r = 0.6; p <0.01) and total insulin dose (r = 0.6; p <0.01). Correlations between VD status after supplementation and Δ of prandial (r = 0.5; p <0.05) and total insulin dose (r = 0.4; p <0.05) were found, suggesting that the dose of insulin needed by patients is lower when VD status is better. We divided patients in two subgroups: SDG improved (subgroup 1; N = 12 (55%)) and SDG worsened (subgroup 2; N = 10 (45%)). Group 1, compared to subgroup 2, required a lower insulin dose (Δbasal insulin dose = -8.0 vs. 6.3%; p <0.05) and had a lower frequency of hypoglycemia (27% vs. 64%, hypoglycemias/days evaluated; p <0.01). CONCLUSION: Our study suggests a relation between VD supplementation, improved glycemic variability, lower insulin needs and lower frequency of hypoglycemia in patients with T1DM.

Albuminuria Reduction after High Dose of Vitamin D in Patients with Type 1 Diabetes Mellitus: A Pilot Study.

BACKGROUND: Some studies suggest an association between diabetic kidney disease (DKD) and vitamin D (VD), but there is no data about the effect of high dose of VD on DKD in type 1 diabetes mellitus (T1DM). Our pilot study aims to evaluate albuminuria reduction in patients with T1DM supplemented with high dose of VD. METHODS: 22 patients received doses of 4,000 and 10,000 IU/day of cholecalciferol for 12 weeks according to patient's previous VD levels. They were submitted to continuous glucose monitoring system, 24 hours ambulatory blood pressure monitoring and urine albumin-to-creatinine ratio before and after VD supplementation. RESULTS: There was a reduction of DKD prevalence at the end of the study (68 vs 32%; p = 0.05), with no changes on insulin doses, glycated hemoglobin, glycemic variability and blood pressure values. A correlation between percentage variation of VD levels (ΔVD) and albuminuria at the end of the study was presented (r = -0.5; p < 0.05). Among T1DM patients with DKD at the beginning of the study, 8/13 (62%) had their DKD stage improved, while the other five ones (38%) showed no changes (p < 0.05). CONCLUSION: Our pilot study suggests an association between VD high dose supplementation, lower prevalence and improvement in stages of DKD in T1DM.

Calcium plus vitamin D supplementation during pregnancy interacts with polymorphisms in the promoter region of the VDR gene to affect postpartum bone mass of Brazilian adolescent mothers: A randomized controlled trial.

OBJECTIVE: We investigated whether calcium plus vitamin D supplementation interacts with polymorphisms in the VDR gene promoter region to affect changes on maternal bone mass from 5 to 20 wk postpartum in Brazilian adolescent mothers. METHODS: Pregnant adolescents (14-19 y) randomly received calcium plus cholecalciferol (600 mg/d + 200 IU/d, n = 30) or placebo (n = 26) from 26 wk of pregnancy until parturition. Bone mineral content (BMC), bone area (BA), and bone mineral density (BMD) at total body, lumbar spine, total hip, and femoral neck were evaluated at 5 and 20 wk postpartum. Serum 25-hydroxyvitamin D (25[OH]D) and parathyroid hormone concentrations were measured. Real-time polymerase chain reaction was used for genotyping rs7139166 (1521 pb G > C) and rs4516035 (1012 pb A > G). Interactions between supplementation and polymorphisms were adjusted for significant covariates. RESULTS: Changes in serum 25(OH)D from pregnancy to postpartum differed between supplemented and placebo groups for mothers carrying 1521 GG/1012 AA genotypes (P = 0.004). Only in the placebo group, mothers carrying 1521 GG/1012 AA had greater reduction in total BMD z score, femoral neck BMC, and BMD from 5 to 20 wk postpartum compared with those with 1521 GC/1012 AG (P < 0.05). In the placebo group, total hip BA decreased from 5 to 20 wk postpartum in adolescents with 1521 GG/1012 AA, but increased in those with 1521 GC/1012 AG (P < 0.05), in contrast to the supplemented group. CONCLUSION: Calcium plus vitamin D supplementation during pregnancy interacted with polymorphisms in the VDR gene promoter region affecting postpartum bone loss. The increased supply of calcium and vitamin D appeared to minimize postpartum bone loss particularly in adolescents with 1521 GG/1012 AA.

Healthier Lipid Profiles with Vitamin D Supplementation in a Pilot Study in Argentinean Children of Two Ethnicities.

OBJECTIVE: to explore changes in lipid levels in two groups of children of different ethnicities who were able to access vitamin D supplementation versus those who were not. METHODS: A prospective one-year study evaluated 87 San Antonio de los Cobres (SAC) Indigenous and 36 Buenos Aires (BA) urban schoolchildren aged 9.7 + 2.1 years between October 2013 and October 2014. SAC children included 70 (80.5%) treated with 100,000 IU/year of vitamin D and 17 (19.5%) untreated; and BA children included 25 (69,5%) treated and 11(30.5%) untreated. BMI, lipids, and 25-hydroxyvitamin D (25(OH)D) concentrations were measured at baseline and after one year. RESULTS: There was a significantly lower prevalence of overweight/obesity in SAC (n = 7; 8%) versus BA (n = 7; 36.4%) children. There was a significant association between changes in (25(OH)D) and changes in HDL-C levels in SAC (r0.44;p < 0.01) and in BA (r0.34;p < 0.05). Multiple linear regression analyses showed that changes in (25(OH)D ) were significantly associated with changes in HDL-C in SAC (Beta = 0.55, p = 0.02; R20.11) and BA children (Beta = 0.42, p = 0.04; R2 0.21) adjusted for age, gender, and BMI. Furthermore, multiple logistic regression analysis showed that children in the treated group had a likelihood six times greater of having HDL-C >40 mg/dL than the untreated group, adjusted for age, gender, and BMI (OR 6.3: CI 2.0 - 19.8; p < 0.01). CONCLUSION: These results suggest that children who had received vitamin D supplementation had significantly higher vitamin D status and HDL-C, as compared with non-supplemented children in both communities.

Calcium Plus Vitamin D Supplementation During the Third Trimester of Pregnancy in Adolescents Accustomed to Low Calcium Diets Does Not Affect Infant Bone Mass at Early Lactation in a Randomized Controlled Trial.

BACKGROUND: Pregnancy and lactation in adolescents with low calcium intake may impair fetal growth and infant bone mass. OBJECTIVE: We investigated the effects of calcium plus vitamin D supplementation during pregnancy in Brazilian adolescent mothers consuming low calcium diets (∼600 mg/d) on fetal biometry and infant bone mass, and the relation between infant and maternal bone mass during early lactation. METHODS: Infants of mothers who received calcium (600 mg/d) plus cholecalciferol (200 IU/d) supplementation (n = 30) or placebo (n = 26) from 26 wk of gestation until parturition were studied. Fetal biometric measurements at 23 and 36 wk of gestation were obtained from medical records. Infant anthropometric and total body bone measurements [bone mineral content (BMC), bone area (BA), and bone mineral density (BMD)] at 5 wk postpartum were assessed by dual-energy X-ray absorptiometry. Maternal BMD z scores for total body, lumbar spine, total hip, and femoral neck at 5 wk postpartum were obtained. Group comparisons were adjusted for significant covariates. RESULTS: Maternal mean serum 25-hydroxyvitamin D was 59 nmol/L at baseline in both groups. No differences in fetal measurements at 36 wk of gestation were observed between the groups, except for body weight and its increment from 23 to 36 wk, which were higher in the supplemented group (6.8%, P = 0.014 and 10.5%, P = 0.07, respectively). Infant BMC (61.1 ± 21.7 g), BA (167 ± 79 cm(2)), and BMD (0.385 ± 0.069 g/cm(2)) did not significantly differ between the groups. In the placebo group, infant BMC and BA were negatively correlated with maternal BMD z scores for total body (r = -0.40 and r = -0.47; P < 0.05) and hip (r = -0.41 and r = -0.46; P < 0.05). In contrast, no correlations were observed in the supplemented group. CONCLUSIONS: Calcium and vitamin D supplementation of the adolescents studied resulted in higher fetal body weight at 36 wk of gestation and had no effect on infant bone mass at 5 wk postpartum. Because correlations between maternal and infant bone mass were evident only in the placebo group, infant bone mass appeared to be more dependent on maternal skeletal mass when calcium intake was low. This trial was registered at clinicaltrials.gov as NCT01732328.

The effect of vitamin D supplementation on serum lipids in postmenopausal women with diabetes: A randomized controlled trial.

BACKGROUND & AIMS: Dyslipidemia is a risk factor for cardiovascular disease that has become an increasing public health problem. Dyslipidemia is especially relevant in vulnerable populations such as postmenopausal women. Low serum levels of 25-hydroxyvitamin D have been associated with an unfavourable lipid profile. Due to contradictory findings from intervention trials, we investigated the effect of vitamin D supplementation on serum lipids in postmenopausal women with type 2 diabetes. METHODS: A total of 104 postmenopausal women with type 2 diabetes were randomly assigned in a double-blind manner to 1 of 2 groups taking a daily tablet for 6 months: a group consuming 4000 IU tablets of a vitamin D supplement (vitamin D group n = 52) or a group consuming placebo tablets (placebo group n = 52). RESULTS: The study was completed by 99 participants. However, as the analysis was based on an intention-to-treat approach, all 104 women were included in the final analysis. In the vitamin D group mean serum levels of 25(OH)D3 improved significantly at the end of the follow-up period (+25.5 nmol/L; P = <0.001). Our findings revealed no significant changes in low density lipoproteins, high density lipoproteins and total cholesterol concentrations, but did identify a greater decrease in serum triglycerides in the vitamin D group. The average effect of supplementation on the treated group was -34.24 mg/dL (P = 0.021), while the average treatment effect was -31.8 mg/dL (P = 0.023). CONCLUSIONS: Our results suggest that supplementation with vitamin D (4000 IU/d) may have a beneficial effect on serum triglyceride levels without otherwise affecting levels of other lipids. TRIAL REGISTRATION: clinicaltrial.gov; identifier NCT01019642.