Assessment of vitamin D nutritional and hormonal status: What to measure and how to do it

Objectives: To study the prevalence of hypovitaminosis D, the effect of vitamin D supplementation on serum 25-hydroxyvitamin D [S-25(OH)D], and the intakes of vitamin D and calcium in Finnish 9-to 15-year-old athletic and nonathletic girls. Design: 1-year follow-up study (February 1997-March 1998 with three months of vitamin D supplementation (10 mgad) from October to January. Setting: Turku University Central Hospital, Finland. Subjects: 191 female volunteers aged 9 ± 15 y (131 athletes and 60 controls). Methods: Vitamin D and calcium intakes were estimated by a four-day food recording and a semi-quantitative food frequency questionnaire (FFQ). S-25(OH)D was followed by radioimmunoassay (RIA). Results: At baseline the mean S-25(OH)D concentration was 33.9 nmolal among all girls. In winter severe hypovitaminosis D (S-25(OH)D`20 nmolal) occurred in 13.4% of the participants and in 67.7% S-25(OH)D was below 37.5 nmolal. By the next summer the mean S-25(OH)D concentration was 62.9 nmolal and in 1.6% of the subjects it was below 37.5 nmolal. The prevalence of severe hypovitaminosis D was not signi®cantly reduced by three months of vitamin D (10 mgad) supplementation. At baseline, the mean intake of vitamin D was 2.9 mgad by food recording and 4.3 mgad by FFQ. The mean calcium intake was 1256 mgad and 1580 mgad, respectively. The intakes of vitamin D and calcium remained unchanged during the follow-up period. The athletes consumed more calcium than nonathletic controls, whereas the intake of vitamin D was quite similar among both groups. The vitamin D intake by FFQ correlated with the S-25(OH)D concentration in wintertime (r 0.28, P`0.01). Conclusion: Hypovitaminosis D is fairly common in growing Finnish girls in the wintertime, and three months of vitamin D supplementation with 10 mgad was insuf®cient in preventing hypovitaminosis D. The daily dietary vitamin D intake was insuf®cient (`5 mgad) in the majority of participants, while the calcium intake was usually suf®cient.

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“…The serum concentration of 25(OH)D is the most sensitive clinical marker of subject's vitamin D status (Hollis, 1996).…”

Section: Discussionmentioning

confidence: 99%

Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls

Lehtonen-Veromaa

Möttönen

Irjala³

et al. 1999

Eur J Clin Nutr

188

131

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“…Eingöngu kom fram marktaek fylgni við CRP en ekki HDL eða BMI. 17 Það er þvert á það sem aðrar rannsóknir hafa sýnt um neikvaett samband á milli D-vítamíns og BMI, 18,19 sem er talið vera vegna aukinnar bindingar D-vítamíns í fituvef. 16 Kelishadi og fleiri könnuðu tengsl milli D-vítamínskorts og áhaettu-þátta hjartasjúkdóma hjá of feitum börnum og unglingum með því að gefa þeim stóra skammta af D-vítamíni á 12 vikna tímabili og fann út að gjöf D-vítamíns dró úr insúlínviðnámi og laekkaði þrí- glýseríð.…”

Section: Umraeðaunclassified

Tengsl D-vítamíns og áhættuþátta hjarta- og æðasjúkdóma meðal íslenskra barna

Hannesdóttir¹,

Hrafnkelsson²,

Jóhannsson³

et al. 2017

LBL

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InngangurMikilvaegi D-vítamíns fyrir þróun heilbrigðra beina og eðlilegra kalkgilda hefur verið þekkt í langan tíma en á síðustu árum hefur komið í ljós að D-vítamín gegnir einnig mikilvaegu hlutverki í ýmsum öðrum líffaerakerfum. Þannig virðist D-vítamín stjórna seytingu kalkvakahormóns, 1 hafa áhrif á renín-angíótensín-aldosterón kerfið 2 og ennfremur hefur D-vítamín bein áhrif á hjartavöðva og aeðaþel.3 Skortur á D-vítamíni hefur verið tengdur við háþrýsting, hjartadrep, heilablóðfall og aðra hjarta-og aeða-sjúkdóma, svo sem sykursýki, hjartabilun og aeðakölkun. 4 Þversniðsrannsóknir hafa sýnt fram á að lágt gildi D-vítamíns í blóði er tengt auknum líkum á áföllum vegna hjarta-og aeða-sjúkdóma. 5,6 Ekki er nákvaemlega vitað á hvern hátt D-vítamín hefur þessi áhrif. Nýlegar rannsóknir benda til þess að D-vítamín-skortur geti verið sjálfstaeður áhaettuþáttur fyrir hjarta-og aeða-sjúkdóma. Þannig hafa Giovannucci og félagar fundið út að fullorðnir karlmenn sem eru með laegra gildi 25-hýdroxývítamín D en 37,5 nmól/L voru 2,4 sinnum líklegri til að fá hjartadrep en þeir Tilgangur: Að kanna tengsl á milli D-vítamíngilda í blóði og þekktra áhaettu þátta fyrir hjarta-og aeðasjúkdómum meðal heilbrigðra íslenskra barna og jafnframt að kanna þessi tengsl óháð líkamsþyngdarstuðli (BMI). Efniviður/aðferðir: Metin voru tengsl milli styrks 25-hydroxyvítamín D í blóði, líkamsþyngdarstuðuls og sjö áhaettuþátta hjarta-og aeðasjúkdóma (háþrýstings, heildarkólesteróls, HDL, LDL, þríglýceríðs, blóðsykurs og styrks insulíns í blóði). Þátttakendur voru 7 ára skólabörn í 6 grunnskól-um Reykjavíkur, haustið 2006. Það er öfugt samband á milli 25(OH)D og kalkvakahormóns, Dvítamínskortur leiðir til ofstarfsemi kalkvaka (hyperparathyroidism) með haerra gildi kalkvakahormóns. Afleiðingar þessa geta á að minnsta kosti þrennan hátt leitt til aukinnar áhaettu á hjarta-og aeðasjúkdómum: Í fyrsta lagi með auknu insúlínviðnámi og truflun á starfsemi beta-frumna í briskirtli sem leiðir til efnaskiptavillu og sykursýki. Í öðru lagi með því að virkja renín-angíótensín-kerfið og á þann hátt valda haekkuðum blóðþrýstingi sem aftur leið-ir til þykknunar á hjartavöðva. Í þriðja lagi með örvun á bólgum baeði almennt en ekki síst í aeðum. 11-13Aðalmarkmið þessarar rannsóknar var að kanna tengsl á milli 25(OH)D og þessara þekktu áhaettuþátta fyrir hjarta-og aeðasjúk-dómum (HDL, LDL, kólesteróls, blóðþrýstings, blóðsykurs, HbA1c og serum insúlíns) meðal heilbrigðra barna og jafnframt að kanna þessi tengsl óháð líkamsþyngdarstuðli.

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“…The concentration of 1,25-dihydroxyvitamin D, the biological active form of vitamin D, will usually be normal or even slightly elevated in vitamin D deficiency, and therefore provides no information with respect to nutritional status (Hollis, 1996;Parfitt, 1998). Blood concentration of native vitamin D reflects recent intake of vitamin D and=or exposure to sunlight, and therefore may vary greatly over a short time in an individual.…”

Section: Vitamin Dmentioning

confidence: 99%

The use of biomarkers in multicentric studies with particular consideration of iodine, sodium, iron, folate and vitamin D

Ovesen

Boeing

2002

Eur J Clin Nutr

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Objective: To determine which biomarkers should be used in a European monitoring system to assess intake of iodine, sodium, iron, folate and vitamin D. These nutrients are relevant for human health but difficult to assess in the diet in a comparable way among countries. Results: Iodine and sodium are mainly excreted in urine. Mean population intakes of iodine and sodium can be estimated by casual urine samples. However, habitual individual intake assessments require multiple 24 h urine collections. Serum ferritin is a sensitive test of iron status (mobilizable storage iron) and continues to be the leading single determination for individual iron status, but with serum transferrin receptor as a promising alternative because it is more specific than ferritin. Erythrocyte folate and homocysteine in blood are markers of folate status which are able to discriminate between normal status and levels of insufficiency in an individual. Serum 25-hydroxyvitamin D is a good marker for vitamin D deficiency in the individual, and can distinguish between overt deficiency and marginal deficiency, especially if combined with serum parathyroid hormone. Conclusions: Specific and sensitive markers for the dietary intake of iodine, sodium, iron, folate and vitamin D are available, which have the advantage of being more accurate than intake estimations derived from dietary surveys. However, the use of biomarkers also has disadvantages such as extra burden in terms of logistics, budget and ethical approval, and can moreover reduce the participation rate. More basic data for the validity of cross-country comparisons are needed and ideas in terms of study design and sampling frame.

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Assessment of vitamin D nutritional and hormonal status: What to measure and how to do it

Cited by 176 publications

References 1 publication

Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls

Vitamin D intake is low and hypovitaminosis D common in healthy 9− to 15-year-old Finnish girls

Tengsl D-vítamíns og áhættuþátta hjarta- og æðasjúkdóma meðal íslenskra barna

The use of biomarkers in multicentric studies with particular consideration of iodine, sodium, iron, folate and vitamin D

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