A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency

This review looks at the critical role of vitamin D in improving barrier function, production of antimicrobial peptides including cathelicidin and some defensins, and immune modulation. The function of vitamin D in the innate immune system and in the epithelial cells of the oral cavity, lung, gastrointestinal system, genito‐urinary system, skin and surface of the eye is discussed. Clinical conditions are reviewed where vitamin D may play a role in the prevention of infections or where it may be used as primary or adjuvant treatment for viral, bacterial and fungal infections. Several conditions such as tuberculosis, psoriasis, eczema, Crohn's disease, chest infections, wound infections, influenza, urinary tract infections, eye infections and wound healing may benefit from adequate circulating 25(OH)D as substrate. Clinical diseases are presented in which optimization of 25(OH)D levels may benefit or cause harm according to present day knowledge. The safety of using larger doses of vitamin D in various clinical settings is discussed.     

Epidemiology of vitamin D insufficiency and deficiency in a population in a sunny country: Geospatial meta-analysis in Brazil

Studies conducted among populations of tropical countries have reported high prevalences of vitamin D deficiency and insufficiency. Information resulting from meta-analyses on the spatial distribution of vitamin D deficiency and insufficiency in tropical countries is still rare. The aim of this review was investigated the prevalence of vitamin D deficiency and insufficiency among the Brazilian population. Observational studies were searched in eight electronically databases. Additionally, theses and dissertations and abstracts were screened. Details on study design, methods, population, mean and data on serum concentrations of vitamin D in different age groups in Brazil were extracted. Data were pooled using a random-effects model and choropleth maps were created based on the geopolitical regions of the country. 72 published paper met the inclusion criteria. The mean vitamin D concentration among the Brazilian population between 2000 and 2017 of 67.65 nmol/L (95% CI: 65.91, 69.38 nmol/L).The prevalences of vitamin D deficiency and insufficiency were 28.16% (95% CI: 23.90, 32.40) and 45.26% (95% CI: 35.82, 54.71), respectively, for the Brazilian population. The highest prevalence of deficiency were observed in the southern and southeastern regions and the highest occurrence of vitamin D insufficiency was among the populations of the southeastern and northeastern regions. Finally, there are high prevalence of inadequate vitamin D concentrations among the population, regardless of age group in Brazil. The development of vitamin D food fortification policies in needs to be cautious and carefully planned.     

Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D

Purpose

To determine the possible association between serum vitamin D levels and dry eye symptoms, and the impact of an oral vitamin D supplement.

Associations between inflammatory bowel diseases and vitamin D

Inflammatory Bowel Diseases (IBD) are increasing sharply, and the common medications are not effective for most patients. Vitamin D (VD) has been considerate to reduce inflammatory processes and may be helpful in IBD. The aim of this review was to perform an update on the potential role of VD in the IBD. We performed a search for articles associating VD and IBD published in MEDLINE-PubMed and EMBASE. The focused question used for the search was “What is the association between Inflammatory Bowel Disease and Vitamin D?” The exclusion criteria for this search were studies not in English, editorials, case reports, or poster presentations. VD prevents the inflammatory process such as negatively interfering with the release of Interleukin (IL)-1, IL-6, and Tumour Necrosis Factor-α; enhancing the function of the intestinal epithelial barrier; decreasing the occurrence of apoptosis; stimulating Toll-Like Receptor-4; inducing the production of an antimicrobial peptide in Paneth cells. Furthermore, deficiency of VD is related to the severity of the symptoms and increased the risk of cancer and surgery. In conclusion, VD shows a potential role in the management of IBD, the supplementation is inexpensive, safe, and leads to improvement of the quality of life.     

Production of novel vitamin D3 loaded lipid nanocapsules for milk fortification

Lipid nanoparticles are carriers to improve stability, solubility, and efficacy of bioactive compounds. In this paper, novel vitamin D₃ loaded lipid nanocapsules (LNC) were produced by phase inversion method. The produced nanocapsules were characterised by particle size, polydispersity index, zeta potential, encapsulation efficiency, and encapsulation load. LNC showed sizes in the range of 31.43 to 36.66 nm. Optimum LNC formulation was selected for further analysis (such as morphological study, analysis of chemical structure, release study, and sensory evaluation). Transmission electron microscopy revealed that particles had approximately spherical shape. The Fourier transform infrared spectra indicated that no adverse reactions occurred between vitamin D₃ and lipid nanocapsules. About 9.6% of vitamin released in gastric simulated solution (pH: 1.2), which indicated that LNC can protect vitamin against acidic conditions. Sensory evaluation revealed the potential application of produced vitamin D₃ loaded LNC for development of fortified milk.     

液相色谱-质谱联用法同时测定保健食品中维生素D3和维生素K1的含量

目的 建立液质串联法同时测定维生素D3和维生素K1的含量。方法 样品经过前处理, 5mmol/L甲酸铵甲醇为流动相, 等度洗脱, 经C18色谱柱（4.6 mm×150 mm,2.6 μm）分离, 并于相应条件下进行检测。结果 维生素D3在浓度0.05461~0.5461μg/mL之间呈现良好的线性关系, r=0.9990, 平均回收率为92.15%~98.99%, 相对标准偏差为2.4%;维生素K1在浓度0.1337~1.3370 μg/mL之间呈现良好的线性关系, r=0.9990, 平均回收率在94.15%~101.01%之间, 相对标准偏差为2.2%。结论 该方法能同时测定维生素D3和维生素K1含量, 耗时短、操作简便、准确、重现性好,可在实验室推广。     

Lifestyle genomics and the metabolic syndrome: A review of genetic variants that influence response to diet and exercise interventions

Metabolic syndrome (MetS) comprises a cluster of risk factors that includes central obesity, dyslipidemia, impaired glucose homeostasis and hypertension. Individuals with MetS have elevated risk of type 2 diabetes and cardiovascular disease; thus placing significant burdens on social and healthcare systems. Lifestyle interventions (comprised of diet, exercise or a combination of both) are routinely recommended as the first line of treatment for MetS. Only a proportion of people respond, and it has been assumed that psychological and social aspects primarily account for these differences. However, the etiology of MetS is multifactorial and stems, in part, on a person's genetic make-up. Numerous single nucleotide polymorphisms (SNPs) are associated with the various components of MetS, and several of these SNPs have been shown to modify a person's response to lifestyle interventions. Consequently, genetic variants can influence the extent to which a person responds to changes in diet and/or exercise. The goal of this review is to highlight SNPs reported to influence the magnitude of change in body weight, dyslipidemia, glucose homeostasis and blood pressure during lifestyle interventions aimed at improving MetS components. Knowledge regarding these genetic variants and their ability to modulate a person's response will provide additional context for improving the effectiveness of personalized lifestyle interventions that aim to reduce the risks associated with MetS.     

A comparison of the effect of supplementation and sunlight exposure on serum vitamin D and parathyroid hormone: A systematic review and meta-analysis

Abstract

Background: Supplementation and getting sunlight exposure are two treatments for vitamin D deficiency. However, studies reported conteroversial findings regarding the efficacy of these two methods.

Objective: To compare the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and parathyroid hormone (PTH).

Methods: A computer-based literature search through PubMed, Scopus and Google scholar search engines was conducted until April 2019 to find clinical trials which compared the effect of oral vitamin D supplementation with sunlight exposure on serum vitamin D and PTH. Means for serum 25-hydroxy vitamin D3 (25(OH) D3) and PTH concentration were extracted. A subgroup analysis was used to detect potential sources of inter-study heterogeneity. Mean differences (MD) were analyzed using a random-effects model (the DerSimonian-Laird approach).

Results: A total of seven papers were included in the meta-analysis. Pooled analysis showed that vitamin D supplementation significantly elevated levels of serum 25(OH) D3 in comparison with sunlight exposure (MD: 8.56nmol/l, 95%CI: 4.15, 12.97, T² = 40.32%, H² = 9.45%, P for heterogeneity p?<?0.001). Also, the difference between the effect of vitamin D supplementation and sun exposure was lower in studies which used UVB radiation compared with studies which applied direct sunlight (MD: 11.65?nmol/l, 95%CI: 7.02, 16.28; P for between subgroup heterogeneity = 0.001).

Conclusion: Vitamin D supplementation was more effective than sun exposure at increasing serum 25(OH) D3. The difference between efficacy of vitamin D supplementation and sun exposure was lower in studies which used long-term sun exposure or applied UVB treatment instead of direct sunlight.     

Effect of calcium and vitamin D2 fortification on quality characteristics of dahi

Two levels (500 and 600 ppm) of calcium (calcium phosphate and calcium citrate) along with vitamin D₂ (600 IU/L) were fortified in milk for dahi preparation. pH, water‐holding capacity and syneresis of fortified dahi were not affected significantly (P > 0.05). However, acetaldehyde content decreased and setting time increased upon fortification. Microbial count significantly (P < 0.05) decreased in calcium phosphate‐fortified dahi, whereas no difference was observed in calcium citrate‐fortified dahi. Firmness and viscosity decreased in calcium phosphate‐fortified dahi, whereas it increased in calcium citrate‐fortified dahi as compared to control. All dahi samples showed good sensory acceptability.     

Relationship between vitamin D and gestational diabetes in overweight or obese pregnant women may be mediated by adiponectin

Scope

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.

Methods and results

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.

Conclusion

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.