Estimated benefit of increased vitamin D status in reducing the economic burden of disease in western Europe

Grant, William B.; Cross, Heide S.; Garland, Cedric F.; Gorham, Edward D.; Moan, Johan Emelian; Peterlik, Meinrad; Porojnicu, Alina Carmen; Reichrath, Jörg; Zittermann, Armin

doi:10.1016/j.pbiomolbio.2009.02.003

Cited by 143 publications

(126 citation statements)

References 139 publications

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“…Higher levels of PTH in summer than in winter months among females in the present study is contradictory to the higher winter-time than summer-time prevalence of secondary hyperparathyroidism shown in past studies [12] [41] [42]. Given that absence of seasonal variation of 25(OH) D levels in our cohort, our findings seem to emphasize the influence of confounding variables, such as weight status, calcium intake and calcium absorption on elevation in PTH levels [17] [27] [36] [43].…”

Section: Discussioncontrasting

confidence: 99%

Is There Any Threshold for Vitamin D That Elevates Parathyroid Hormone

Mert¹,

Tamer²,

Günay³

et al. 2017

OJEMD

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Objective: To evaluate vitamin D status in relation to serum levels for parathyroid hormone (PTH) and corrected calcium among endocrine outpatients. Methods: A total of 760 patients (mean(SD) age: 40.0(12.6) years, 94.6% were females) admitted to our endocrinology outpatient clinic were included and evaluated with respect to patient demographics, serum levels for 25-hydroxyvitamin D (25(OH) D, ng/mL), PTH (pg/mL) and corrected calcium (mg/dL) as well as the vitamin D status. Results: Vitamin D deficiency was determined in 65.0% and elevated PTH levels in 20.3% of patients. iPTH levels were significantly higher in females than in males (58.9(40.4) vs. 45.1(26.2) pg/mL, p = 0.031) and in summer than in winter cases (63.9(47.7) vs. 54.2(32.8) pg/mL, p = 0.002), whereas no difference was found in serum levels for 25(OH) D, corrected calcium and phosphate with respect to gender and season. Significantly higher levels for iPTH were noted in vitamin D deficient patients (60.7(43.9) pg/mL) than in normal (51.1(33.4) pg/mL) and vitamin D insufficient (57.1(26.0) pg/mL) cases (p = 0.03). iPTH levels were correlated positively with age (r = 0.116, p = 0.001) and negatively with corrected calcium (r = −0.097, p = 0.008), P (r = −0.224, p = 0.000) and 25(OH) D (r = −0.134, p = 0.000), whereas no correlation was noted between 25(OH) D and corrected calcium levels. Conclusion: Our findings indicated that vitamin D deficiency in 65.0%, whereas PTH elevation only in 20.3% of endocrine outpatients, despite the significantly negative correlation of PTH to 25(OH) D and significantly higher levels of PTH among vitamin D deficient cases than in vitamin D insufficient and sufficient cases. Gender's and seasonal differences had influence on serum levels for PTH but not on either 25(OH) D or corrected calcium, and no correlation was evident between 25(OH) D and corrected calcium levels.

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Section: Discussioncontrasting

confidence: 99%

Is There Any Threshold for Vitamin D That Elevates Parathyroid Hormone

Mert¹,

Tamer²,

Günay³

et al. 2017

OJEMD

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“…We are of the opinion that our review provides a reasonable rationale to speculate that the link between vitamin D deficiency and mortality is partially driven by vitamin D effects on the myocardium. Besides, it is also important to point out that apart from bone and skeletal health, vitamin D exerts beneficial effects which are relevant for several chronic diseases [2][3][4]106]. Given that vitamin D supplementation is relatively easy, cheap, and safe, we therefore recommend vitamin D supplementation for all vitamin Ddeficient patients with or at high risk for myocardial diseases to maintain 25(OH)D levels of at least 30 ng/mL.…”

Section: Clinical Consequences and Summarymentioning

confidence: 99%

“…Furthermore, it should also be noted that daily, weekly, or monthly dosing regimens can equally raise 25(OH)D levels [110]. Importantly, excessive sun exposure can produce up to 20 000 IU vitamin D per day but even short-term exposure to suberythemal doses of UV-B can effectively treat and prevent vitamin D deficiency [2,106].…”

Section: Clinical Consequences and Summarymentioning

confidence: 99%

Vitamin D deficiency and myocardial diseases

Pilz

Tomaschitz

Drechsler

et al. 2010

Molecular Nutrition Food Res

134

142

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Vitamin D deficiency is common among patients with myocardial diseases because sun-induced vitamin D production in the skin and dietary intake of vitamin D is often insufficient. Knockout mice for the vitamin D receptor develop myocardial hypertrophy and dysfunction. It has also been shown that children with rickets who suffered from severe heart failure could be successfully treated with supplementation of vitamin D plus calcium. In adults, almost all patients with heart failure exhibit reduced 25-hydroxyvitamin D levels, which are used to classify the vitamin D status. In prospective studies, vitamin D deficiency was an independent risk factor for mortality, deaths due to heart failure and sudden cardiac death. Several vitamin D effects on the electrophysiology, contractility, and structure of the heart suggest that vitamin D deficiency might be a causal factor for myocardial diseases. Data from interventional trials, however, are rare and urgently needed to elucidate whether vitamin D supplementation is useful for the treatment of myocardial diseases. In our opinion, the current knowledge of the beneficial effects of vitamin D on myocardial and overall health strongly argue for vitamin D supplementation in all vitamin D-deficient patients with or at high risk for myocardial diseases.

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“…result in a comprehensive reduction in economic burden of disease by 17.7%, or $211 million (Grant et al, 2009). …”

mentioning

confidence: 99%

A vitamin D protocol post‐liver transplantation

Grant

2017

Journal of the American Association of Nurse Practitioners

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Background and purpose Adults with compromised liver function are inherently deficient and especially vulnerable to the consequences of vitamin D deficiency. Consequences of vitamin D deficiency include liver disease progression, infection, and graft failure. A vitamin D supplementation protocol is proposed to systematically optimize serum vitamin D levels according to guidelines in both pre‐ and post‐liver transplanted patients. Methods This quasiexperimental study included a sample of N = 45 post‐liver transplanted patients taking daily cholecalciferol (vitamin D3) 2500 units for 12 weeks, with a pre‐ and post‐lab measure of serum 25‐hydroxyvitamin D levels at a large academic facility. Conclusions Seventy‐eight percent of patients reached minimum guideline levels using the protocol with an average increase of serum vitamin D of 13.8 ng/mL. Long‐term outcomes of clinical significance may include decreased incidence of acute T‐cell‐mediated graft rejection and infections in the immunocompromised patient. Implications for practice Optimizing vitamin D in vulnerable patient populations such as chronic liver disease and the immunosuppressed posttransplanted patient has the potential to curtail complications of vitamin D deficiency. As a result, nurse practitioners employing a vitamin D protocol can create a favorable impact on patient quality of life, safety, and healthcare spending.

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Estimated benefit of increased vitamin D status in reducing the economic burden of disease in western Europe

Cited by 143 publications

References 139 publications

Is There Any Threshold for Vitamin D That Elevates Parathyroid Hormone

Is There Any Threshold for Vitamin D That Elevates Parathyroid Hormone

Vitamin D deficiency and myocardial diseases

A vitamin D protocol post‐liver transplantation

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