Is vitamin D status a determining factor for metabolic syndrome? A case-control study

This study was undertaken to assess vitamin D status in nonmenopausal women with metabolic syndrome (MeS) and to evaluate its possible role in inflammation and other components of MeS. A case-control study was conducted during late fall and winter 2009–10. A total of 375 women with waist circumference (WC) ≥88 cm were examined to find 100 who met MeS criteria according to the National Cholesterol Education Program (NCEP)/Adult Treatment Panel (ATP) III criteria (NCEP/ATP III). Of those without MeS, 100 age- and residence area-matched women were selected as a control group. Anthropometric and laboratory evaluations were performed. Waist-to-hip ratio (WHR), body mass index (BMI), homeostatic model of insulin resistance (HOMA-IR) and body fat mass (FM) were also evaluated. Women with MeS had significantly higher BMI, waist circumference (WC) and FM but lower serum osteocalcin than controls. There was no significant difference in serum 25 hydroxyvitamin D (25[OH]D), intact parathyroid hormone (iPTH) or vitamin D status between the two groups. Serum highly sensitive C-reactive protein (hsCRP) concentration was significantly higher in the MeS group, compared to the controls (3.4 ± 3.3 vs 2.0 ± 1.9 mg/L, P < 0.001). The difference remained significant even after controlling for BMI (P = 0.011), WC (P = 0.014) and FM (P = 0.005). When comparison was made only in those subjects with insulin resistance (HOMA-IR > 2.4), hsCRP was still higher in the MeS group (n = 79) than in the control group (n = 61) (P < 0.001). When data were categorized according to vitamin D status, in the MeS group significantly higher plasma glucose concentrations were observed in subjects with vitamin D deficiency compared to those with insufficiency or sufficiency (104.0 ± 11.7, 83.0 ± 11.3 and 83.2 ± 9.9 mg/dL, respectively, P < 0.001). Interestingly, their WC or WHR did not show any significant difference. In stepwise regression analysis, 25(OH)D was the main predictor of both hsCRP and plasma glucose. Vitamin D status may, at least in part, be a determining factor of systemic inflammation and the related metabolic derangements of MeS

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

<p>Abstract</p> <p>Background</p> <p>Endothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.</p> <p>Methods</p> <p>Subjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n₁= 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n₂= 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.</p> <p>Results</p> <p>The intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (<it>P </it>< 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, <it>P </it>= 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, <it>P </it>= 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, <it>P </it>< 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (<it>P </it>= 0.009 and <it>P </it>= 0.005, respectively) but disappeared for E-selectin (<it>P </it>= 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(<it>P </it>= 0.066) and MMP-9 (<it>P </it>= 0.277) but still remained significant for E-selectin (<it>P </it>= 0.011).</p> <p>Conclusions</p> <p>Ameliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.</p> <p>Trial registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01236846">NCT01236846</a></p

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Dimethyl fumarate in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Dimethyl fumarate (DMF) inhibits inflammasome-mediated inflammation and has been proposed as a treatment for patients hospitalised with COVID-19. This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple treatments in patients hospitalised for COVID-19 (NCT04381936, ISRCTN50189673). In this assessment of DMF performed at 27 UK hospitals, adults were randomly allocated (1:1) to either usual standard of care alone or usual standard of care plus DMF. The primary outcome was clinical status on day 5 measured on a seven-point ordinal scale. Secondary outcomes were time to sustained improvement in clinical status, time to discharge, day 5 peripheral blood oxygenation, day 5 C-reactive protein, and improvement in day 10 clinical status. Between 2 March 2021 and 18 November 2021, 713 patients were enroled in the DMF evaluation, of whom 356 were randomly allocated to receive usual care plus DMF, and 357 to usual care alone. 95% of patients received corticosteroids as part of routine care. There was no evidence of a beneficial effect of DMF on clinical status at day 5 (common odds ratio of unfavourable outcome 1.12; 95% CI 0.86-1.47; p = 0.40). There was no significant effect of DMF on any secondary outcome

Vitamin D Status of Tehran Taxi Drivers: How Efficient Is the Occupational Exposure to Sun? A Case-control Study

Background and Objectives: Day-shift taxi drivers have a long duration of direct sun exposure. However, the efficiency of this occupational exposure in vitamin D synthesis has not been addressed yet. The aim of this study was to assess the vitamin D status of taxi drivers in Tehran, and examine vitamin D status association with some anthropometric and circulating biomarkers. Materials and Methods: In a case control study, 53 taxi drivers and 80 apparently healthy subjects from other occupations were enrolled. Questionnaires for demographic data, supplement use, and duration of sun exposure were completed. Weight, height and waist circumference were measured. Blood samples were taken from all participants for complete blood cell count, fasting blood glucose (FBG), lipid profile, and 25-hydroxycholecalciferol (25 (OH)D) measurements. Results: Taxi drivers, as compared to the controls, had significantly higher body mass index (BMI), waist circumference (WC), serum triglycerides (TG), and 25(OH)D concentrations. Moreover, 56.6% of the drivers had more than 2 hours of sun exposure during a day. Conclusions: Despite having higher circulating concentrations of 25(OH)D, the taxi drivers had higher cardiometabolic risk factors. These findings indicate a need for nutritional education for taxi drivers. Keywords: Vitamin D, Driving, Sun exposur

Vitamin D Deficiency is Associated with the Metabolic Syndrome in Subjects with Type 2 Diabetes

Background and Objectives: There is convincing evidence that subjects concomitantly affected by type 2 diabetes (T2D) and metabolic syndrome (MeS) are at greater risk for cardiovascular disease (CVD). Many metabolic derangements in T2D might be attributed to poor vitamin D status. The purpose of this study was to investigate the associations among vitamin D status, MeS and glycemic status in subjects with T2D. Materials and Methods: A total of 101 known cases of T2D (39 males, 62 females) were enrolled in a cross-sectional study by convenient sampling. Serum 25(OH)D3, glycemic markers and lipid profile were assessed. Results: Mean concentration of serum 25(OH)D3 was 42.2±33.8 nmol/L. Prevalence of undesirable vitamin D status (25(OH)D < 50nmol/L) was significantly higher among the subjects with MeS as compared to those without MeS (p=0.020). The subjects with sufficient vitamin D status had 50% lower risk for MeS compared to those who had vitamin D deficiency, and this association remained significant even after additional adjustment for body mass index (BMI), percent of fat mass or waist circumference. Conclusions: Our data showed that firstly higher vitamin D status is inversely associated with fasting glycemia, and secondly serum 25(OH)D3 predicts MeS risk in the subjects with T2D. Demonstrating the association of hypovitaminosis D with disorders of glucose metabolism and higher risk for development of further complications, notably CVD, may lead to a new target for preventive efforts at the population level. Keywords: Vitamin D, Type 2 diabetes, Metabolic syndrome, Cardiovascular diseas

Prevalence of Obesity and Overweight and Its Associated Factors in Urban Adults from West Azerbaijan, Iran: The National Food and Nutritional Surveillance Program (NFNSP)

Background and Objectives: Globally, the prevalence of overweight/obesity is increasing at an alarming rate. According to the World Health Organization (WHO), about 1.9 billion adults worldwide are overweight, and of these, over 600 million are obese. The purpose of this study was to determine the prevalence of overweight and obesity in West Azerbaijan, Iran, in 2014. Materials and Methods: Data were collected as part of the National Food and Nutritional Surveillance Program (NFNSP). A total of 249 men and women aged 20&ndash;60 from West Azerbaijan were included in the survey conducted in 2014. Body height and weight were measured with light clothing and no footwear after overnight fasting. Results: Mean age of the participants was 38.5 &plusmn;7.8 yrs. Mean BMI was 28.0&plusmn;4.9 kg/m2 (men: 26.8&plusmn;4.2 vs. women: 29.0&plusmn;5.3, p<0.001). The prevalence of overweight and obesity was 36.5% (men: 38.6 % vs. women: 34.8%, p: 0.439) and 33.3% (men: 25.4 vs. women: 40.0 %, p: 0.016), respectively. Women were more likely to be overweight or obese than males (P=0.038). Multiple logistic regression revealed that gender (women vs. men) (OR, 2.05; CI, 1.15-3.65; p,0.014) and age (OR, 1.06; CI, 1.01-1.1; p,0.004) increased the risk of becoming overweight or obese. Women who were housewives were five times more at risk of becoming overweight or obese (OR: 4.93; CI: 1.9-12.3; p<0.001) even after adjusting for age and educational level. Conclusions: The high prevalence of weight problems in West Azerbaijan is a serious health concern, especially in women. The lifestyle of housewives is a potential risk factor for weight gain in women. Keywords: Obesity, Prevalence, Azerbaijan, Adult