Vitamin D

Objective  To determine the effects of menopause on bone-related variables in Indonesian women and to compare them with corresponding data in Caucasian Australian women.Design  A study of bone-related variables in women aged 45–55 years in Jakarta compared with corresponding historical data from Caucasian Australian women.Measurements  Dietary intakes, bone mineral density (BMD) and calcium-related variables in blood and urine.Results  Dietary calcium, phosphorus and protein intakes were significantly lower in the women from Jakarta than in those from Adelaide (all P < 0·001), probably because of lower milk consumption, but energy intake was similar in the two cities. Indonesian women were shorter and lighter than Australian women (P < 0·001) but had a comparable body mass index (BMI). The Indonesians also had a lower spinal BMD than the Australians but this was accounted for by the differences in height and weight between the two populations. The differences in serum and urinary calcium and phosphate and serum alkaline phosphatase across the menopause were comparable in Indonesian and Australian women but creatinine excretion was 25% lower in Jakarta than in Adelaide (P < 0·001) and this was probably sufficient to account for higher ratios of some urinary solutes to urinary creatinine in the Indonesians. Serum 25-hydroxyvitamin D (25OHD) levels were significantly lower (P < 0·001) and serum PTH levels significantly higher (P = 0·0045) in Jakarta than in Adelaide.Conclusions  The differences in bone-related biochemical variables across the menopause were similar in the two populations, but calcium and protein intake and urine creatinine were lower in Indonesian than in Australian women. Serum 25OHD was lower and PTH higher in the Indonesian women, probably because of their darker skin, their practice of avoiding direct sunlight and the heavy atmospheric pollution in Jakarta.

Treatment with anti-resorptive agents over 13 months was associated with for three to fivefold lower bone mineral density changes and 1.5-fold increased risk of incidence fracture in vitamin D insufficient as compared to vitamin D repleted postmenopausal osteoporotic women. Introduction Several drugs were registered for the treatment of osteoporosis on the basis of clinical trials in which vitamin D repletion was a pre-requisite inclusion criteria and vitamin D supplements were used as adjunctive therapy. However, in routine clinical practice these supplements are not consistently recommended. Methods We studied 1515 women with postmenopausal osteoporosis under treatment with anti-resorbing agents (alendronate, risedronate, raloxifene) for 13.1 months with an adherence > 75%. The patients were classified as vitamin D deficient (N=514) or vitamin D repleted (N=1001) according to risk factors (N=1062) or the level of 25(OH) vitamin D [25(OH)D] above or below 50 nmol/l (N=453). Results Vitamin D deficient and vitamin D repleted subjects differed significantly for annualized spine and hip bone mineral density (BMD) changes adjusted for all available confounding factors (type of treatment, age, global calcium intake, baseline BMD values). One hundred fifty one patients suffered from a new incident clinical fracture. The adjusted odds ratio for incident fractures in vitamin D deficient as compared to vitamin D repleted women was 1.77 (1.20 -2.59, 95% CI; p=0.004). Conclusions Optimal vitamin D repletion seems to be necessary to maximize the response to anti-resorbers in terms of both BMD changes and anti-fracture efficacy.

The recent discovery--from a meta-analysis of 18 randomized controlled trials--that supplemental cholecalciferol (vitamin D) significantly reduces all-cause mortality emphasizes the medical, ethical, and legal implications of promptly diagnosing and adequately treating vitamin D deficiency. Not only are such deficiencies common, and probably the rule, vitamin D deficiency is implicated in most of the diseases of civilization. Vitamin D&#39;s final metabolic product is a potent, pleiotropic, repair and maintenance, seco-steroid hormone that targets more than 200 human genes in a wide variety of tissues, meaning it has as many mechanisms of action as genes it targets. One of the most important genes vitamin D up-regulates is for cathelicidin, a naturally occurring broad-spectrum antibiotic. Natural vitamin D levels, those found in humans living in a sun-rich environment, are between 40-70 ng per ml, levels obtained by few modern humans. Assessing serum 25-hydroxy-vitamin D (25(OH)D) i...

This study was undertaken to examine the effects of 12 weeks of skeletal unloading on parameters of calcium homeostasis, calcitropic hormones, bone histology, and biochemical markers of bone turnover in 11 normal subjects (9 men, 2 women; 34 ؎ 11 years of age). Following an ambulatory control evaluation, all subjects underwent 12 weeks of bed rest. An additional metabolic evaluation was performed after 12 days of reambulation. Bone mineral density declined at the spine (؊2.9%, p ‫؍‬ 0.092) and at the hip (؊3.8%, p ‫؍‬ 0.002 for the trochanter). Bed rest prompted a rapid, sustained, significant increase in urinary calcium and phosphorus as well as a significant increase in serum calcium. Urinary calcium increased from a pre-bed rest value of 5.3 mmol/day to values as high as 7.3 mmol/day during bed rest. Immunoreactive parathyroid hormone and serum 1,25dihydroxyvitamin D declined significantly during bed rest, although the mean values remained within normal limits. Significant changes in bone histology included a suppression of osteoblastic surface for cancellous bone (3.1 ؎ 1.3% to 1.9 ؎ 1.5%, p ‫؍‬ 0.0142) and increased bone resorption for both cancellous and cortical bone. Cortical eroded surface increased from 3.5 ؎ 1.1% to 7.3 ؎ 4.0% (p ‫؍‬ 0.018) as did active osteoclastic surface (0.2 ؎ 0.3% to 0.7 ؎ 0.7%, p ‫؍‬ 0.021). Cancellous eroded surface increased from 2.1 ؎ 1.1% to 4.7 ؎ 2.2% (p ‫؍‬ 0.002), while mean active osteoclastic surface doubled (0.2 ؎ 0.2% to 0.4 ؎ 0.3%, p ‫؍‬ 0.020). Serum biochemical markers of bone formation (osteocalcin, bone-specific alkaline phosphatase, and type I procollagen extension peptide) did not change significantly during bed rest. Urinary biochemical markers of bone resorption (hydroxyproline, deoxypyridinoline, and N-telopeptide of type I collagen) as well as a serum marker of bone resorption (type I collagen carboxytelopeptide) all demonstrated significant increases during bed rest which declined toward normal during reambulation. Thus, under the conditions of this study, the human skeleton appears to respond to unloading by a rapid and sustained increase in bone resorption and a more subtle decrease in bone formation. (J Bone Miner Res 1998;13:1594-1601)

Objective: To analyse the current vitamin intake and the contribution of dietary supplements to this intake of 4030 Design: In the GeNuS participants were interviewed comprehensively about their usual diet and supplementation patterns using a modified dietary history. Setting: Population-based nutritional survey. Subjects: A subsample of 4030 persons, aged 18 -79 y, randomly selected from the GNHIES 1998. Results: The contribution of dietary supplements to the vitamin intake reached 5% for vitamin E among men and 6% for vitamin C among women. Among the group of regular users, the contribution to the vitamin E intake is 36% among men and 43% among women. A substantial part of the population does not reach the current recommendations for some vitamins, especially for folate and vitamin E through their diet alone. Among regular supplement users, about one-third for folate and about half for the other vitamins reach the recommended intake only when supplemental intake is considered. Among the regular users of folate supplements, this proportion is about half. Conclusion: If reference values are used as preference intake, a substantial population part improves their vitamin intake by taking supplements regularly. Nevertheless, there are persons who stay below the reference values including supplemental intake or already consume more than 100% of recommendation excluding supplemental intake.

Background: Inadequate photosynthesis or oral intake of Vitamin D are associated with high incidence and mortality rates of breast cancer in ecological and observational studies, but the dose-response relationship in individuals has not been adequately studied. Methods: A literature search for all studies that reported risk by of breast cancer by quantiles of 25(OH)D identified two studies with 1760 individuals. Data were pooled to assess the dose-response association between serum 25(OH)D and risk of breast cancer. Results: The medians of the pooled quintiles of serum 25(OH)D were 6, 18, 29, 37 and 48 ng/ml. Pooled odds ratios for breast cancer from lowest to highest quintile, were 1.00, 0.90, 0.70, 0.70 and 0.50 (p trend < 0.001). According to the pooled analysis, individuals with serum 25(OH)D of approximately 52 ng/ml had 50% lower risk of breast cancer than those with serum <13 ng/ml. This serum level corresponds to intake of 4000 IU/day. This exceeds the National Academy of Sciences upper limit of 2000 IU/day. A 25(OH)D level of 52 ng/ml could be maintained by intake of 2000 IU/day and, when appropriate, about 12 min/day in the sun, equivalent to oral intake of 3000 IU of Vitamin D 3. Conclusions: Intake of 2000 IU/day of Vitamin D 3 , and, when possible, very moderate exposure to sunlight, could raise serum 25(OH)D to 52 ng/ml, a level associated with reduction by 50% in incidence of breast cancer, according to observational studies.

1␣,25-Dihydroxyvitamin D 3 (1,25D3), the active form of vitamin D 3 , is an immunoregulatory hormone with beneficial effects on Th1 cell-mediated inflammatory diseases. Although IL-17-producing CD4 + T helper (Th17) cells have been recently identified as novel effector cells, the immunomodulating effects of 1,25D3 on Th17 cells have not been well defined. We confirmed here that 1,25D3 inhibited the generation of Th17 cells in vitro. Interestingly, 1,25D3 synergistically suppressed the generation of Th17 cells by the combination with all-trans retinoic acid (ATRA). 1,25D3 and ATRA suppressed the development of allergen-induced contact hypersensitivity (CHS) in a mouse ear swelling model. In addition, we found that 1,25D3 and ATRA significantly inhibited the development of human Th17 cells from both naïve and memory human CD4 + T cells. 1,25D3 and ATRA effectively suppressed mRNA expressions of IL-1R1, IL-21R, IL-23R, RORC, and AHR in human T cells. ATRA further suppressed IL-6R, whereas 1,25D3 did not. Finally, we found that 1,25D3 and ATRA remarkably blocked IL-22 as well as IL-17 mRNA expression in human memory CD4 + T cells. Thus, we initially reveal that 1,25D3 and ATRA have synergistic effects on the generation of Th17 cells, suggesting that the combination with ATRA would provide a promising novel therapy for Th17 cell-related immune diseases including skin inflammation.

This review reports on a decade of nutrition research into calcium (Ca) homeostasis in freshwater turtles, including research on non-nutritive factors that are essential for Ca homeostasis [i.e. ontogeny, environmental temperature and humidity, and ultraviolet (UV) light and photoreception]. Recommendations for future research include long-term research programmes in three specific areas: (1) photoreception, UV light and biosynthesis, (2) Ca homeostasis and vitamin and mineral supplementation, and (3) developmental indices, gut transit time (GTT) and energy requirements.

There is accumulating evidence that vitamin D exerts important pathophysiological effects on cardiovascular system. Low vitamin D was associated with increased cardiovascular risk in several reports. We studied the association between vitamin D and arterial stiffness in a random sample of 560 subjects selected from general population. Arterial stiffness was measured as aortic pulse-wave velocity (PWV) using Sphygmocor device. Serum 25-hydroxyvitamin D (25(OH)D) was measured using commercial kits. We found a clear negative trend in aortic PWV among 25(OH)D quartiles. Subjects in the bottom 25(OH)D quartile (o20 ng ml À1) showed the highest aortic PWV (9.04 m s À1), compared with 2nd-4th quartile (8.07 m s À1 , 7.93 m s À1 and 7.70 m s À1 , respectively; P for trend o0.0001). The association between 25(OH)D and aortic PWV remained significant after adjustment for age, gender and other potential confounders; subjects in the first 25(OH)D quartile had adjusted odds ratio 2.04 (1.26-3.30) for having aortic PWV X9 m s À1 (top quartile) in multiple regression. In conclusion, we found a clear significant and independent negative association between 25(OH)D and aortic PWV. Subjects with lowest vitamin D status showed the highest arterial stiffness.

Information on sCD200 (OX-2), 25-Hydroxyvitamin-D(25(OH)D), homocysteine (hcy), eosinophil cationic peptid (ECP), d-dimer (DD), CXCL8, fractional exhale nitric oxide concentrations (FeNO) status all together among patients with allergy in mediterranean region in comparison of climatic conditions have not been well established yet. Blood samples were taken on May and June during the highest air pollination. Hence, this study was undertaken to compare these serum biomolecules’ levels in allergic patients and matched controls, to evaluate disease characteristics. The study participants (n=129) included 25 healthy individuals (controls) and 104 allergic patients. Consecutive patients with allergic disease (Group II,III,IV,V) above the age of 18 years, managed. In the control group there was a significant positive correlation between ECP and BMI. Positive correlations between ECP, IgE and OX-2 were detected in group IV. For group V patients, positive correlations between age and IgE and ...

Purpose. – Corticosteroid induced osteoporosis (CIO) is the most frequent complication of long-term corticosteroid therapy, and the most frequent cause of secondary osteoporosis. New data from biological, epidemiological and therapeutic studies provide basis for optimal management of this bone disease.Main points. – Corticosteroids are responsible for both quantitative and qualitative deleterious effects on bone, through their effect on bone cells, mainly on osteoblasts (with both a decrease in osteoblast activity and an increase in apoptosis). Epidemiological studies have shown an increased risk of fractures related to CIO, even for low doses, and during the first 6 months of treatment. Relative risk is 1.3 and 2.6 for peripheral and vertebral fractures respectively. Bone mineral density, measured by dual-energy X-ray absorptiometry, is decreased at spine and hip; the risk of fracture is higher in CIO as compared to post-menopausal osteoporosis, for a similar bone density. Preventi...

Summary  Vitamin D deficiency is associated with increased fracture risk. The observational study aimed to investigate vitamin D status and supplementation in ambulatory patients. Only 20% of patients had optimal serum 25-hydroxyvitamin D [25(OH)D] levels. Commonly recommended dosages were insufficient to achieve clinically relevant increase of 25(OH)D levels. Higher dosages were safe and effective under clinical practice conditions. Introduction  Vitamin D deficiency

Objectives: To evaluate and compare the effects and safety of high dose intramuscular (IM) or oral cholecalciferol on 25-hydroxyvitamin D [25(OH)D] levels, muscle strength and physical performance in vitamin D deficient/insufficient elderly. Study design: Randomized prospective study. Main outcome measures: 116 ambulatory individuals aged 65 years or older living in a nursing home were evaluated. Eligible patients with 25(OH)D levels <30 ng/ml (n = 66) were randomized to IM or Oral groups according to the administration route of 600,000 IU cholecalciferol. Demographic and descriptive data were collected. Biochemical response was measured at baseline, 6th and 12th weeks. Muscle strength was measured from quadriceps by using a hand-held dynamometer and physical performance was evaluated by short physical performance battery (SPPB) at the beginning and 12th week. Results: Among the screened ambulatory elderly only 5.2% (n = 6) had adequate vitamin D levels. 37.1% (n = 43) were vitamin D deficient and 57.7% (n = 67) were insufficient. After administration of one megadose of vitamin D, mean serum 25(OH)D levels increased significantly at 6th week (32.72 ± 9.0 ng/ml) and at 12th week (52.34 ± 14.2 ng/ml) compared with baseline (11.76 ± 7.6 ng/ml) in IM group (p < 0.0001). In Oral group levels were 47.57 ± 12.7 ng/ml, 42.94 ± 13.4 ng/ml and 14.87 ± 6.9 ng/ml, respectively (p < 0.0001). At 12th week the increase in IM group was significantly higher than Oral group (p = 0.003). At the end of the study period, serum 25(OH)D levels were ≥30 ng/ml in all patients in IM group and in 83.3% of the patients in the Oral group. Quadriceps muscle strength and SPPB total score increased significantly in both groups and SPPB balance subscale score increased only in IM group. Six patients (9.6%) developed hypercalciuria, no significant adverse events were observed. Conclusion: In vitamin D deficient/insufficient elderly, a single megadose of cholecalciferol increased vitamin D levels significantly and the majority of the patients reached optimal levels. Although both administration routes are effective and appear to be safe, IM application is more effective in increasing 25(OH)D levels and balance performance.

To report the vitamin D status in adults from seven European countries and to identify behavioural correlates. In total, 1075 eligible adult men and women from Ireland, Netherlands, Spain, Greece, UK, Poland and Germany, were included in the study. Vitamin D deficiency and insufficiency, defined as 25-hydroxy vitamin D3 (25-OHD3) concentration of &lt;30 and 30-49.9 nmol/L, respectively, were observed in 3.3 and 30.6% of the participants. The highest prevalence of vitamin D deficiency was found in the UK and the lowest in the Netherlands (8.2 vs. 1.1%, P &lt; 0.05). In addition, the prevalence of vitamin D insufficiency was higher in females compared with males (36.6 vs. 22.6%, P &lt; 0.001), in winter compared with summer months (39.3 vs. 25.0%, P &lt; 0.05) and in younger compared with older participants (36.0 vs. 24.4%, P &lt; 0.05). Positive dose-response associations were also observed between 25-OHD3 concentrations and dietary vitamin D intake from foods and supplements, as wel...

Background Vitamin D was used to treat tuberculosis in the pre-antibiotic era, and its metabolites induce antimycobacterial immunity in vitro. Clinical trials investigating the effect of adjunctive vitamin D on sputum culture conversion are absent.

Background: Multiple sclerosis (MS) is a neurological disorder with a highly characteristic disease distribution. Prevalence and incidence in general increase with increasing distance from the equator. Similarly the female to male sex ratio increases with increasing latitude. Multiple possible risk factors have been hypothesised for this epidemiological trend, including human leukocyte antigen allele frequencies, ultraviolet exposure and subsequent vitamin D levels, smoking and Epstein-Barr virus. In this study we undertook a study of medical records across Scotland on an NHS health board level of resolution to examine the epidemiology of MS in this region.

Nutritional rickets remains a public health concern in many areas of the world despite cheap and effective means of preventing the disease. The roles of vitamin D deficiency, low dietary calcium intakes and the interrelationships between the two in the pathogenesis of the disease are discussed. It is now recognized that vitamin D deficiency in the pregnant and lactating mother predisposes to the development of rickets in the breastfed infant, and that cultural and social factors are important in the pathogenesis of the disease during the adolescent growth spurt. Prevention of rickets is dependent on the awareness of the medical profession and the general public of the need to ensure adequate intakes of vitamin D in at-risk populations, and of the importance of increasing dietary intakes of calcium using locally available and inexpensive foods in communities in which dietary calcium deficiency rickets is prevalent.

Australia has one of the highest rates of incidence and mortality due to skin cancer in the world. Exposure to the sun also has a beneficial side. The beneficial effects are relatively low, but they are essential to a person&#39;s well being. It is well known that exposure to small amounts of UV are beneficial for the human body and important in the production of vitamin D3. This investigation will give students the opportunity to measure erythemal UV radiation in full sun and in the shade to determine how this can be potentially beneficial. An important outcome of this investigation will be to illustrate that some exposure to sunlight is necessary for ling-term human health.

Background Low vitamin D status has been associated with short-term (30-day) mortality in hospitalized adults with community-acquired pneumonia (CAP). Data on its prevalence in these patients are scarce, and impact on long-term prognosis is unknown. We examined the prevalence of vitamin D deficiency and inadequacy and their effect on long-term mortality in hospitalized adults with CAP. Methods Secondary follow-up analysis of data from a prospectively recruited (January 2008-January 2011) well-defined cohort of 241 hospital survivors of CAP (Norway, latitude 60°N). Serum 25-hydroxyvitamin D levels, demographic, clinical, and laboratory data were measured within 48 hours of admission. The etiology of CAP was established in 63% of patients through extensive microbiological investigations. Mortality data were obtained from the national Cause of Death Registry. Explanatory strategy and Cox regression models were used to explore the association between vitamin D status and all-cause mortality. Results Median age was 66 years. Eighty-seven (36%) patients were vitamin D deficient (<30 nmol/ L), 81 (34%) were inadequate (30-49 nmol/L), and 73 (30%) were sufficient (50 nmol/L). Seventy-two patients died over a median of 1839 days (range 1-2520 days), corresponding to cumulative 5-year survival rates of 66.2% (95% CI 56.2-76.2%), 77.0% (67.6-86.4%), and 77.8% (67.8-87.8%) for vitamin D deficient, inadequate, and sufficient patients, respectively. After adjusting for confounders (age, chronic obstructive pulmonary disease,

Vitamin D, i.e. 1,25(OH) 2D, is an essential factor, not only of homeostasis of calcium and phosphorus, but also of cell proliferation, differentiation and apoptosis, immune and hormonal regulation, as well as other body processes. Thus, its optimal presence in the body is of exceptional significance for health, both of children, as well as adults and elderly persons. Today, it is known that the lack of vitamin D, besides having negative effects on the skeleton and teeth, also contributes to the development of various malignancies, primarily of the large bowel, prostate and breasts, as well as of autoimmune and allergic diseases, diabetes mellitus type II, arterial hypertension and others. Considered from the biological aspect, physiological requirements in vitamin D are achieved by cutaneous synthesis from 7-dehydrocholesterol during sun exposure, while, except rarely, it is very scarce in food. Having in mind extensive evidence that sun exposure presents a high risk for the develo...

Background: Obesity is associated with vitamin D deficiency, and both are areas of active public health concern. We explored the causality and direction of the relationship between body mass index (BMI) and 25-hydroxyvitamin D [25(OH)D] using genetic markers as instrumental variables (IVs) in bi-directional Mendelian randomization (MR) analysis.

Vitamin D-binding protein (DBP) and albumin (ALB) are abundant serum proteins and both possess high-affinity binding for saturated and unsaturated fatty acids. However, certain differences exist. We surmised that in cases where serum albumin level is low, DBP presumably can act as a transporter of fatty acids. To explore this possibility we synthesized several alkylating derivatives of 14 C-palmitic acid to probe the fatty acid-binding pockets of DBP and ALB. We observed that N-ethyl-5-phenylisooxazolium-3 0 -sulfonate-ester (WRK-ester) of 14 C-palmitic acid specifically labeled DBP; but p-nitrophenyl-and N-hydroxysuccinimidyl-esters failed to do so. However, p-nitrophenyl ester of 14 C-palmitic acid specifically labeled bovine ALB, indicating that the micro-environment of the fatty acid-binding domains of DBP and ALB may be different; and DBP may not replace ALB as a transporter of fatty acids.

The mechanisms that control fibroproliferation and matrix deposition in lung fibrosis remain unclear. We speculate that vitamin D deficiency may contribute to pulmonary fibrosis since vitamin D deficiency has been implicated in several diseases. First, we confirmed the presence of vitamin D receptors (VDRs) in cultured NIH/3T3 and lung fibroblasts. Fibroblasts transfected with a vitamin D response element-reporter construct and exposed to the active vitamin D metabolite, 1,25(OH) 2 D 3 , showed increased promoter activity indicating VDR functionality in these cells. Testing the effects of 1,25(OH) 2 D 3 on fibroblasts treated with transforming growth factor ␤1 (TGF␤1), considered a driver of many fibrotic disorders, we found that 1,25(OH) 2 D 3 inhibited TGF␤1-induced fibroblast proliferation in a dose-dependent fashion. 1,25(OH) 2 D 3 also inhibited TGF␤1 stimulation of ␣-smooth muscle actin expression and polymerization and prevented the upregulation of fibronectin and collagen in TGF␤1-treated fibroblasts. Finally, we examined how 1,25(OH) 2 D 3 affects epithelial-mesenchymal transformation of lung epithelial cells upon exposure to TGF␤1. We showed that the TGF␤1-induced upregulation of mesenchymal cell markers and abnormal expression of epithelial cell markers were blunted by 1,25(OH) 2 D 3 . These observations suggest that under TGF␤1 stimulation, 1,25(OH) 2 D 3 inhibits the pro-fibrotic phenotype of lung fibroblasts and epithelial cells.

Background We conducted a 5-year prospective, observational, controlled study to assess the eVects of tibolone 1.25 mg/day on bone mineral density (BMD) in postmenopausal women with osteopenia or osteoporosis. Methods The subjects were 420 women, an average of 66.4 years old, who had been postmenopausal between 8 and 19 years when enrolled in the study. Of the 420 women enrolled, 346 agreed to take tibolone for 5 years. The 74 who refused tibolone took only calcium/vitamin D supplements and served as the control group. BMD was measured in the lumbar spine and total hip region at baseline and annually by dual-energy X-ray absorptiometry (DXA). Results At the Wrst two follow-up visits, women taking tibolone had a signiWcant increase in BMD at the spine (P < 0.001) and at the hip (P < 0.001) when compared to baseline values and when compared to BMD values for the control group, which decreased from baseline. In the Wnal 3 years of the study, BMD values (spine and hip) continued to decrease in the control group and also tended to decrease in the tibolone group, but at the end of the Wfth year, mean BMD in the tibolone group was still higher than BMD before the start of tibolone treatment (P < 0.05). Calculations showed that if women taking tibolone continued to lose BMD at the same rate as during the Wnal 3 years of the study, after 11 years of tibolone treatment the average patient would have the same BMD as she had when treatment started. Conclusion This 5-year observational study provides evidence that tibolone is eVective in increasing BMD in postmenopausal women with osteopenia and osteoporosis during the Wrst 2 years of treatment, but because BMD starts to decline in the third year, it is vital that postmenopausal women start treatment with tibolone as early as possible, so that bone mineral density levels are kept high as long as possible.

Purpose To investigate the correlation between serum 25-hydroxyvitamin D (25-OH-VD) concentrations and metabolic parameters in obese and non-obese women with polycystic ovary syndrome (PCOS). Methods One hundred women with PCOS were divided into two groups, obese and non-obese, according to their body mass index (BMI). Waist-to-hip ratio (WHR), Ferriman-Gallwey score, homeostasis model assessment of insulin resistance (HOMA-IR), total cholesterol, triglycerides, calcium, 25-OH-VD, LH/FSH, total testosterone, and DHEAS were measured. Results The serum 25-OH-VD mean levels were 56.31% lower in the obese PCOS patients. There was an association of increased HOMA-IR, BMI, WHR, triglycerides, total testosterone, and DHEAS with decreased 25-OH-VD concentrations in the obese PCOS patients. Conclusion Low serum 25-OH-VD concentrations result from the presence of obesity and insulin resistance. However, the dependency between PCOS and hypovitaminosis D is questionable. Hypovitaminosis D should be kept in mind while managing obese women with PCOS.

Vitamin D metabolites are important immune-modulatory hormones and are able to suppress Th2mediated allergic airway disease. Some genetic factors that may contribute to asthma are regulated by vitamin D, such as vitamin D receptor (VDR), human leukocyte antigen genes (HLA), human Toll-like receptors (TLR), matrix metalloproteinases (MMPs), a disintegrin and metalloprotein-33 (ADAM-33), and poly(ADP-ribosyl) polymerase-1 (PARP-1). Vitamin D has also been implicated in asthma through its effects on the obesity, bacillus CalmetteeGuérin (BCG) vaccination and high vitamin D level, vitamin D supplement, checkpoint protein kinase 1 (Chk1), plasminogen activator inhibitor-1 (PAI-1) and gamma delta T cells (gdT). Vitamin D plays a role in asthma and exerts its action through either genomic and/or non-genomic ways.

This is a case report of an 40 years female patient with Scheuermann Kyphosis with a rigid thoracic hyperkyphosis of 90º and compensatory lumbar hyperlordosis of 92º, treated with a single posterior approach, Ponte osteotomy and instrumented posterolateral fusion. There is some discussion about the best surgical approach. Combined approach was classically considered the gold-standard, but recent studies revealed that posterior-only approach allows comparable corrections with less complications rate. Posterior-only approach good results are related with advances in posterior instrumentation combined with posterior column shortening techniques, such Ponte osteotomies. Preoperative planning is essential. Spine instrumentation should extend from proximal end vertebra to sagittal stable vertebra.

Metabolic syndrome poses additional risk for postmenopausal women who are already at risk for osteoporosis. We hypothesized that a nutritional supplement containing anti-inflammatory phytochemicals and essential bone nutrients would produce a favorable bone biomarker profile in postmenopausal women with metabolic syndrome. In this 14-week, randomized trial, 51 women were instructed to consume a modified Mediterranean-style, low-glycemic-load diet and to engage in aerobic exercise. Those in the intervention arm (n = 25) additionally received 200 mg hop rho iso-alpha acids, 100 mg berberine sulfate trihydrate, 500 IU vitamin D 3 , and 500 μg vitamin K 1 twice daily. Forty-five women completed the study. Baseline nutrient intake did not differ between arms. Compared with baseline, the intervention arm exhibited an approximate 25% mean decrease (P b .001) in serum osteocalcin (indicative of bone turnover), whereas the placebo arm exhibited a 21% increase (P = .003). Serum 25-hydroxyvitamin D increased 23% (P = .001) in the intervention arm and decreased 12% (P = .03) in the placebo arm. The between-arm differences for osteocalcin and 25-hydroxyvitamin D were statistically significant. Serum insulin-like growth factor I was statistically increased in both arms, but the between-arm differences were not statistically significant. Subanalysis showed that among those in the highest tertile of baseline insulin-like growth factor I, the intervention arm exhibited a significant increase in amino-terminal propeptide of type I collagen, whereas the placebo arm showed a significant decrease at 14 weeks. Treatment with rho iso-alpha acids, berberine, vitamin D 3 , and vitamin K 1 produced a more favorable bone biomarker profile indicative of healthy bone metabolism in postmenopausal women with metabolic syndrome.

Background: Little is known regarding the health effects of a raw food (RF) vegetarian diet. Methods: We performed a cross-sectional study on 18 volunteers (mean ± SD age, 54.2 ± 11.5 years; male/ female ratio, 11:7) on a RF vegetarian diet for a mean of 3.6 years and a comparison age-and sex-matched group eating typical American diets. We measured body composition, bone mineral content and density, bone turnover markers (C-telopeptide of type I collagen and bone-specific alkaline phosphatase), C-reactive protein, 25-hydroxyvitamin D, insulin-like growth factor 1, and leptin in serum. The RF vegetarians had a mean±SD body mass index (calculated as weight in kilograms divided by the square of height in meters) of 20.5 ± 2.3, compared with 25.4±3.

Objective: To investigate whether abnormalities in serum concentrations of 1,25-dihydroxyvitamin D [1,25(OH) 2 D], 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), calcium, and phosphorus were associated with risk of polycystic ovary syndrome (PCOS) and obesity. The possible correlations of the calciotropic hormones with insulin resistance were also examined. Design: Case-control study. Setting: Department of Genetics, Royan Institute. Patient(s): Eighty-five women with PCOS and 115 control women were recruited. Intervention(s): None. Main Outcome Measure(s): Serum levels of glucose, insulin, total calcium, phosphorus, PTH, 25(OH)D, and 1,25(OH) 2 D were measured in all 200 subjects. Result(s): The presence of PCOS had age-and body mass index (BMI)-independent positive effects on serum phosphorus, PTH, 25(OH)D, and insulin concentrations as well as on insulin resistance. Furthermore, overweight/obese (BMI R25 kg/m 2 ) women with PCOS had significantly decreased levels of 1,25(OH) 2 D and glucose compared with normal-weight (BMI <25 kg/m 2 ) women with PCOS. In women with PCOS, phosphorus was correlated negatively with insulin and insulin resistance and positively with 1,25(OH) 2 D. In addition, in normalweight patients, PTH correlated positively with insulin and insulin resistance. Conclusion(s): It is possible that elevated levels of phosphorus and PTH in women with PCOS, at least in part, through their effects on insulin levels and insulin resistance, are involved in pathogenesis of the syndrome. (Fertil

... d-α-Tocopheryl Polyethylene Glycol-1000 Succinate Enhances the Absorption of Vitamin D in Chronic Cholestatic Liver Disease of Infancy and Childhood. Eric A Argao 1 , James E Heubi 1 , Bruce W Hollis 2 and Reginald C Tsang 3. ... Top of page Abstract. ...

Dental disease is considered as one of the, if not, the most common disorders seen in pet rabbits. This article provides a review of the scientific literature and an overview of the peculiarities of calcium homeostasis in the rabbit in an attempt to draw together current thinking on the cause of dental disease. A complete understanding of the aetiology and pathophysiology of rabbit dental disease is necessary for the veterinary practitioner to establish a proper therapeutic plan, prognosis and ultimately prevention of this common cause of morbidity and mortality in pet rabbits.

Nutrition plays a role in the etiology of osteoporosis. Two of the most important nutrients for bone health are calcium and vitamin D. Plasma 25-hydroxyvitamin D [25-(OH) D] is the most sensitive clinical index of vitamin D status and has been found to be positively related to ...