Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub‐analysis

Zhang, Y.; Shan, Guojin; Zhang, Y.-X.; Cao, Shoujin; Zhu, Sai-Nan; Li, H.-J.; Ma, Ding; Wang, D.-X.

doi:10.1111/aas.13116

Cited by 19 publications

(8 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Additionally, VD 3 is synthesized in the skin as the biologically active VD form by exposure to the ultraviolet radiation from the sun (Gallagher et al., 2019). The marker for VD status is circulating 25(OH)D in the blood which is correlated with disease prevention and regulation of physiological functions (Abdel‐Rehim, El‐Tahan, El‐Tarawy, Shehata, & Kamel, 2019; Di Somma et al., 2017; Goncalves et al., 2014; Hoseini, Damirchi, & Babaei, 2017; Hu et al., 2019; Morello et al., 2018; Wintermeyer et al., 2016; Zhang et al., 2018). However, most people are not getting enough VD, attributed to insufficient sun exposure, disease occurrence, and insufficient dietary intake due to the presence of VD in only some limited foods such as eggs, liver, mushrooms, and oily fish (Calvo & Whiting, 2013; Manoy et al., 2017; Tracy et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications

Lamsen

Wang

D’Souza

et al. 2020

Journal of Food Science

View full text Add to dashboard Cite

Delivery of vitamin D3 (VD3) in foods should exhibit desirable physicochemical characteristics and improves absorption. In this study, gum arabic (GA) was investigated as a VD3 carrier to encapsulate VD3. VD3 dissolved in 5 mL ethanol corresponding to 0.3 to 6.0% mass of GA, was blended in 5.0% w/v GA solution, followed by freeze drying. The encapsulation efficiency decreased while loading capacity increased with an increased amount of VD3. At the highest VD3 level, the loading capacity (3.47%) was the highest, and the encapsulation efficiency (61.24%) was satisfactory, and the treatment was further studied. The magnitude of negative zeta‐potential increased from 3.1 to 31.0 mV at pH 2.0 to 7.4. During the 100‐day storage at 3 °C of capsules reconstituted at pH 2.0 to 7.4, the hydrodynamic diameter decreased at all pH conditions, most evident for reduction to 81.3 nm at pH 7.4, and no precipitation was observed, indicating the significance of steric repulsion on capsule stability. Bioaccessibility of VD3 in capsules (95.76%) was significantly higher than the nonencapsulated VD3 (68.98%). The in vivo pharmacokinetic study in Sprague–Dawley rats after a single‐dose of 300 µg VD3 showed the area‐under‐curve of serum 25(OHD) level in 48 hr of the encapsulation treatment was 4.32‐fold of the nonencapsulated VD3 and more than twice higher than the VD3‐GA physical mixture. During 2‐week supplementation of 60 µg VD3/d, rats receiving capsules or physical mixture had 25(OH)D levels of at least 81 ng/mL higher than that of the nonencapsulated VD3 group. The studied encapsulation system holds great potential as a value‐added ingredient to supplement VD3 in beverages with a wide pH range. Practical Application The findings of this study demonstrated the improved dispersion stability and absorption of vitamin D3 after encapsulation in gum arabic. The capsules exhibited good dispersion stability across a pH range between 2.0 and 7.4, showing potential application in beverages. Furthermore, the enhanced absorption of VD3 after encapsulation highlights the nutritional benefits of the studied encapsulation system.

show abstract

Section: Introductionmentioning

confidence: 99%

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications

Lamsen

Wang

D’Souza

et al. 2020

Journal of Food Science

View full text Add to dashboard Cite

show abstract

“…Unfortunately, previous studies dealt with the relation between HVD and POCD were deficient. However, the obtained results go in hand with Zhang et al [50] who documented that after adjusting for confounding factors, preoperative VD deficiency was associated with an increased risk of POCD. In trial to explore the association between HVD and disturbed CF, Annweiler et al [51] suggested an association between HVD and dysfunction of the frontal-subcortical neuronal circuits, particularly the dorsolateral circuit in patients with disturbed CF and HVD.…”

Section: Discussionmentioning

confidence: 68%

Preoperative Hypovitaminosis D Can Predict Development of Postoperative Cognitive Dysfunction

Salem

2019

JAICM

View full text Add to dashboard Cite

Objectives: Preoperative estimation of serum 25OH-vitamin D (25OHD) level in patients undergoing surgical procedures extending for >60min under sevoflurane anesthesia and correlate these levels with frequency of postoperative (PO) cognitive dysfunction (POCD).Patients & Methods: 254 patients; 127 Kuwaiti (Group A) and 127 Egyptian patients (Group B) were evaluated clinically and gave blood samples for ELISA estimation of serum 25OHD. Vitamin D sufficiency status was defined as sufficient (≥75nmol/L), insufficient (50-75nmol/L) and deficient (<50nmol/L) level. Cognitive function was assessed preoperatively, 48-hr, 1-wk and 2-wk PO using the Digit span (DS) test. Anesthetic was induced using propofol, fentanyl and rocuronium, and was maintained with sevoflurane, fentanyl and rocuronium with continuous non-invasive hemodynamic monitoring. Study outcome included the frequency and severity of hypovitaminosis D (HVD) and POCD in studied patients.Results: Only 31 patients (12.2%) had sufficient VD level with significant difference in favor of Group B. All surgeries were conducted uneventfully within mean operative time of 154.4±37min and mean blood loss of 415±158ml. Median preoperative DS score was 6, at 48-hr, 1-wk and 2-wk PO, 153, 124 and 95 patients, respectively had score of <6. Preoperative serum 25OHD level showed negative significant correlation with age and BMI, and positive significant correlation with male gender and duration of education. Median PO score on DS testing showed positive significant correlation with serum 25OHD, especially in Kuwaiti patients. Statistical analyses defined preoperative low serum 25OHD as significant specific predictor for POCD. Conclusion:POCD is a common incident event among patients underwent major surgeries consuming long operative time under sevoflurane anesthesia. Old age, high BMI, duration and severity of surgery are co-factors for POCD. Preoperative HVD has a pronounced effect and correlated with these precipitating factors and could be used as independent significant predictor for POCD.

show abstract

“…The incidence of DNR varies from 5% to 60% in patients after major noncardiac surgery and is highly related with patients poor outcome such as increased complications and mortality. [ 29 – 33 ] Accurate diagnosis is the key point to prevent and treat DNR. [ 1 , 2 ] The main gap between DNR diagnosis and clinical practice includes lack of standard criteria and cross-cultural consideration of instruments.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of DNR in elderly patients after major noncardiac surgery was about 25%. [ 29 ] The width of confidence interval was set at 0.2 and statistical significance at 0.05. Assumed both the sensitivity and specificity were at 90%, 138 patients and 82 patients were required for sensitivity and specificity analysis respectively.…”

Section: Methodsmentioning

confidence: 99%

The sensitivity and specificity of statistical rules for diagnosing delayed neurocognitive recovery with Montreal cognitive assessment in elderly surgical patients

Wang

et al. 2020

Medicine

View full text Add to dashboard Cite

Delayed neurocognitive recovery (DNR) is common in elderly patients after major noncardiac surgery. This study was designed to investigate the best statistical rule in diagnosing DNR with the Montreal cognitive assessment (MoCA) in elderly surgical patients. This was a cohort study. One hundred seventy-five elderly (60 years or over) patients who were scheduled to undergo major noncardiac surgery were enrolled. A battery of neuropsychological tests and the MoCA were employed to test cognitive function at the day before and on fifth day after surgery. Fifty-three age- and education-matched nonsurgical control subjects completed cognitive assessment with the same instruments at the same time interval. The definition of the international study of postoperative cognitive dysfunction (ISPOCD 1) was adopted as the standard reference for diagnosing DNR. With the MoCA, the following rules were used to diagnose DNR: the cut-off point of ≤26; the 1 standard deviation decline from baseline; the 2 scores decline from baseline; and the Z score of ≥1.96. The sensitivity and specificity as well as the area under receiver operating characteristic curve for the above rules in diagnosis of DNR were calculated. The incidence of DNR was 13.1% (23/175) according to the ISPOCD1 definition. When compared with the standard reference, the 2 scores rule showed the best combination of sensitivity (82.6%, 95% confidence interval [CI] 67.1%–98.1%) and specificity (82.2%, 95% CI 76.2%–88.3%); it also had the largest area under receiver operating characteristic curve (0.824, 95% CI 0.728–0.921, P < .001). The cut-off point rule showed high sensitivity (95.7%) and low specificity (37.5%), whereas the 1 standard deviation and the Z score rules showed low sensitivity (47.8% and 21.7%, respectively) and high specificity (93.4% and 97.3%, respectively). Compared with the ISPOCD1 definition, the 2 scores rule with MoCA had the best combination of sensitivity and specificity to diagnose DNR.

show abstract

Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub‐analysis

Abstract: Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.

Cited by 19 publications

References 38 publications

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications

Preoperative Hypovitaminosis D Can Predict Development of Postoperative Cognitive Dysfunction

The sensitivity and specificity of statistical rules for diagnosing delayed neurocognitive recovery with Montreal cognitive assessment in elderly surgical patients

Contact Info

Product

Resources

About

Preoperative vitamin D deficiency increases the risk of postoperative cognitive dysfunction: a predefined exploratory sub‐analysis

Abstract: Vitamin D deficiency is prevalent in elderly patients undergoing major cancer surgery and increases the risk of early POCD development. Whether prophylactic vitamin D supplementation can reduce POCD in the elderly deserves further study.

Cited by 19 publications

References 38 publications

Encapsulation of vitamin D3 in gum arabic to enhance bioavailability and stability for beverage applications

Encapsulation of vitamin D3 in gum arabic to enhance bioavailability and stability for beverage applications

Preoperative Hypovitaminosis D Can Predict Development of Postoperative Cognitive Dysfunction

The sensitivity and specificity of statistical rules for diagnosing delayed neurocognitive recovery with Montreal cognitive assessment in elderly surgical patients

Contact Info

Product

Resources

About

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications

Encapsulation of vitamin D₃ in gum arabic to enhance bioavailability and stability for beverage applications