Effect of Vitamin D Supplementation on Psoriasis Severity in Patients With Lower-Range Serum 25-Hydroxyvitamin D Levels A Randomized Clinical Trial

Importance - Topical vitamin D analogues are routine treatment for psoriasis, but the effect of oral supplementation has not been established. Objective - To examine the effect of vitamin D supplementation on psoriasis severity throughout the winter. Design, Setting, and Participants - This randomized, double-blind placebo-controlled clinical trial with 2 parallel groups was performed through 2 winter seasons (2017 to 2018 and 2018 to 2019). Randomization was computer generated. All participants, health care clinicians, and outcome assessors were masked to group assignment. Each participant was followed for 4 months. The presented analyses were conducted in May 2022. The trial was conducted at the clinical research unit of the University Hospital of North Norway (Tromsø; Norway). Adults from the general population in Tromsø with active plaque psoriasis and 25-hydroxyvitamin D (25[OH]D) levels of less than 24 ng/mL (to convert to nmol/L, multiply by 2.496) were included. Intervention - Vitamin D (cholecalciferol, 100 000 IU, loading dose, followed by 20 000 IU/week) or placebo for 4 months. Main outcomes and Measures - Psoriasis Area Severity Index (PASI) (primary outcome), Physician Global Assessment, self-administered PASI, and Dermatology Life Quality Index scores (secondary outcomes). Results - A total of 122 participants (46 women [37.7%]; mean [SD] age, 53.6 [10.0] years; mean [SD] PASI score, 3.1 [2.0]; mean [SD] serum 25(OH)D, 14.9 [3.9] ng/mL) were included. Of these, 60 (49.2%) were randomized to the vitamin D group and 62 (50.8%) to the placebo group. A total of 120 participants (59 vitamin D [49.2%]/61 placebo [51.8%]) completed the study. By completion, mean (SD) 25(OH)D levels were 29.7 (5.2) ng/mL (vitamin D) and 12.0 (3.8) ng/mL (placebo). There was no significant difference in change in PASI score between the groups (adjusted difference, 0.11; 95% CI, −0.23 to 0.45). There was no significant difference in change in Physician Global Assessment score (adjusted odds ratio, 0.66; 95% CI, 0.27-1.63), self-administered PASI (adjusted difference, −0.60; 95% CI, −1.76 to 0.55) or Dermatology Life Quality Index (adjusted difference, −0.86; 95% CI, −1.9 to 0.19) between the groups. No adverse effects of the intervention were registered. Conclusion and Relevance - The results of this randomized clinical trial showed that vitamin D supplementation did not affect psoriasis severity. Low baseline severity scores may explain the lack of measurable effect. Levels of 25(OH)D in the intervention group increased to a less-than-expected degree based on previous experimental data from the same source population, and this may have affected the results

Krafttak for kysttorsken - Kunnskap for stedstilpasset gjenoppbygging av bestander, naturtyper og økosystem i Færder- og Ytre Hvaler nasjonalparker

Ytre Oslofjord har en unik kystnatur av svært stor verdi for både fastboende og tilreisende. Færder- og Ytre Hvaler nasjonalparker ligger side om side ytterst i fjorden, og skal sikre naturverdiene for kommende generasjoner. Nasjonalparkene har utformet egne forvaltningsplaner og -mål, som gjenspeiler et ønske om å legge best mulig til rette for at fiskearter, fugler, planter og insekter skal fortsette å trives innenfor parkenes grenser. Generelle mål for naturverdiene er at de skal opprettholdes med god økologisk funksjon, og et høyt biologisk mangfold.publishedVersio

Extreme wave statistics of long-crested irregular waves over a shoal

We report laboratory experiments of long-crested irregular water surface waves propagating over a shoal. For a sufficiently shallow shoal we find that the surface elevation can have a local maximum of skewness and kurtosis above the shallower part of the shoal close to the edge on the incoming side, and a local minimum of skewness over the downward slope on the lee side of the shoal. We find that the horizontal fluid velocity can have a local maximum and minimum of skewness at the same locations as those for the surface elevation. However, the kurtosis of the horizontal fluid velocity can have a local maximum over the downward slope on the lee side of the shoal, different from the location of the maximum of kurtosis of the surface elevation

The Tromsø Study: Fit Futures: a study of Norwegian adolescents' lifestyle and bone health

Summary: Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density levels (BMD) and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD. Purpose: Norway has one of the highest reported incidences of osteoporotic fractures. Maximization of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors. Methods: All first year upper secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90% of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual x-ray absorptiometry. Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models. Results: In girls mean BMD (SD) was 1.060 (0.124), 1.066 (0.123) and 1.142 (0.077) g/cm² at the total hip, femoral neck and total body respectively. In boys corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age In girls, height and self-reported intensive physical activity of more than four hours a week and early sexual maturation were positively associated with BMD at both femoral sites (p<0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p<0.038), whereas early stages of sexual maturation and smoking was negatively (p<0.047) related to BMD. Conclusions: Despite the heavy fracture burden, Norwegian adolescents´ BMD levels are higher than agematched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training

Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: the Tromso Study, Fit Futures

Background Positive association between body weight and bone mass is well established, and the concept of body mass index (BMI) is associated with higher areal bone mineral density (aBMD) and reduced fracture risk. BMI, that comprises both fat mass (FM) and lean mass (LM) may contribute to peak bone mass achievement in different ways. This study explored the influence of body composition in terms of total body LM and FM on hip aBMD-values in adolescence. Methods In 2010/2011, 93% of the region’s first-year upper-secondary school students (15–17 years old) in Tromsø, Norway attended the Tromsø Study, Fit Futures. Areal BMD at femoral neck (aBMDFN) and total hip (aBMDTH) (g/cm2), total body LM and FM (g) were measured by dual energy X-ray absorptiometry (DXA). Height and weight were measured, and BMI calculated. Lifestyle variables were collected by self-administered questionnaires and interviews, including questions on time spent on leisure time physical activity. Stratified analyses of covariance and regression models included 395 girls and 363 boys. Crude results were adjusted for age, height, sexual maturation, physical activity levels, vitamin D levels, calcium intake, alcohol consumption and smoking habits. Results Unadjusted distribution indicated higher aBMD-levels at higher LM-levels in both genders (p &lt; 0.001), but higher aBMD at higher FM-levels were found only in girls (p &lt; 0.018). After multiple adjustments, aBMDFN-levels in girls were associated by 0.053 g/cm2 and 0.032 g/cm2 per standard deviation (SD) change in LM and FM (p &lt; 0.001). Corresponding values in boys were 0.072 and 0.025 (p &lt; 0.001). The high LM groups accounted for the highest aBMD-levels, while aBMD-levels at the LM/FM-combinations indicated different patterns in girls compared to boys. The adjusted odds ratio (95% CI) for low levels of aBMDFN was 6.6 (3.4,13.0) in boys, compared to 2.8 (1.6,4.9) in girls per SD lower LM. Conclusions LM and FM should be regarded as strong predictors for bone mass and hence bone strength in adolescents. A gender specific difference indicated that high lean mass is of crucial importance prominently in boys. In adolescents with low lean mass, especially in girls, high fat mass may partially ameliorate the effect of deficient lean mass levels

Leptotrichia amnionii, an Emerging Pathogen of the Female Urogenital Tract▿

Leptotrichia amnionii, a recently described, very fastidious, gram-negative anaerobic bacterium, is an opportunistic pathogen of the female urogenital tract. We report a case of second-trimester abortion in a patient with chorioamnionitis and L. amnionii bacteremia and a case of renal abscess in a female 5 weeks postpartum

Combined hormonal contraceptives and vitamin D metabolism in adolescent girls

Objective: Combined hormonal contraceptive (CHC) use has been associated with higher total 25-hydroxyvitamin D (25(OH)D) levels. Here, we investigate the relation between CHC use and vitamin D metabolism to elucidate its clinical interpretation. Methods: The cross-sectional Fit Futures 1 included 1038 adolescents. Here, a subgroup of 182 girls with available 25(OH)D, 1,25-dihydroxyvitamin D (1,25(OH)2D), 24,25-dihydroxyvitamin D (24,25(OH)2D), vitamin D-binding protein (DBP) and measured free 25(OH)D levels, in addition to parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23), was investigated. Vitamin D metabolites were compared between girls using (CHC+) and not using CHC (CHC−). Further, the predictability of CHC on 25(OH)D levels was assessed in a multiple regression model including lifestyle factors. The ratios 1,25(OH)2D/25(OH)D and 24,25(OH)2D/25(OH)D (vitamin D metabolite ratio (VMR)) in relation to 25(OH)D were presented in scatterplots. Results: CHC+ (n  = 64; 35% of the girls) had higher 25(OH)D levels (mean ± s.d., 60.3 ± 22.2) nmol/L) than CHC- (n  = 118; 41.8 ± 19.3 nmol/L), P -values <0.01. The differences in 25(OH)D levels between CHC+ and CHC− were attenuated but remained significant after the adjustment of lifestyle factors. CHC+ also had higher levels of 1,25(OH)2D, 24,25(OH)2D, DBP and calcium than CHC−, whereas 1,25(OH)2D/25(OH)D, PTH, FGF23 and albumin were significantly lower. Free 25(OH)D and VMR did not statistically differ, and both ratios appeared similar in relation to 25(OH)D, irrespective of CHC status. Conclusion: This confirms a clinical impact of CHC on vitamin D levels in adolescents. Our observations are likely due to an increased DBP-concentration, whereas the free 25(OH)D appears unaltered

Bone mineral density is associated with vitamin D related rs6013897 and estrogen receptor polymorphism rs4870044: The Tromsø study

<div><p>Background</p><p>Bone mineral density (BMD) is determined by bone remodeling processes regulated by endocrine, autocrine and genetic mechanisms. Thus, some studies have reported that BMD is associated with single nucleotide polymorphisms (SNPs) associated with vitamin D receptor (<i>VDR</i>), serum 25(OH)D levels and estrogen receptor 1 (<i>ESR1</i>), but without consensus. Therefore, we aimed to map and compare the risk genotypes for forearm and total hip low BMD.</p><p>Methods and findings</p><p>Data were derived from a population-based study in northern Norway; the Tromsø Study. Distal forearm BMD was measured with a single x-ray absorptiometric device, while total hip BMD was measured with a dual-energy x-ray absorptiometric device. There were 7,317 and 4,082 successful analyses of distal forearm and total hip BMD, respectively, and at least one SNP of interest. We evaluated plausible BMD modulating factors and associations of BMD and SNPs related to vitamin D metabolism (<i>FokI</i>, <i>Cdx2</i>, <i>BsmI</i>, rs2298850, rs10741657, rs3794060, rs6013897), <i>ApaI-BsmI-TaqI</i> haplotypes and <i>ESR1</i> SNP rs4870044.</p><p>Results</p><p>Age, BMI, physical activity and smoking were significantly associated with BMD. In a linear regression model with adjustment for age and gender and with the major homozygote as reference, rs6013897 had a standardized beta coefficient (<i>β</i>) of –0.031 (<i>P</i> = 0.024) for total hip BMD. <i>β</i> for <i>ESR1</i> SNP rs4870044 was –0.016 (<i>P</i> = 0.036) for forearm BMD and –0.034 (<i>P</i> = 0.015) for total hip BMD. The other SNPs nor serum 25(OH)D were significantly associated with BMD.</p><p>Conclusions</p><p>Both forearm and total hip BMD were associated with ESR1 SNP rs4870044. Of the vitamin D–related genes, only <i>CYP24A1</i> gene rs6013897 was associated with total hip BMD, but the association was weak and needs confirmation in other studies. Serum 25(OH)D was not associated with BMD in our population, probably due to the generally sufficient vitamin D levels in the population.</p></div