Vitamin D

Calcidiol and prostate cancer. Tuohimaa P, Golovko O, Kalueff A, Nazarova N, Qiao S, Syvälä H, Talonpoika R, Lou YR. J Steroid Biochem Mol Biol. 2005 Feb;93(2-5):183-90. Epub 2005 Jan 22. Review. PMID: 15860261

Vitamin D deficiency and bone health in healthy adults in Finland: could this be a concern in other parts of Europe? Lamberg-Allardt CJ, Outila TA, Kärkkainen MU, Rita HJ, Valsta LM. J Bone Miner Res. 2001 Nov;16(11):2066-73. PMID: 11697803 Low vitamin D status was prevalent in these young adults in northern Europe in winter, although the vitamin D intake met the recommendation. This probably is not a local problem for northern Europe, because the natural sources of vitamin D are scarce and fortification is not very common in Europe, and with the exception of the southern part of Europe, sunshine is not very abundant in this part of the world. Thus, the results of this study indicate that more attention should be focused on vitamin D status and the sources of vitamin D in these countries.

A high prevalence of hypovitaminosis D in Finnish medical in- and outpatients. Kauppinen-Mäkelin R, Tähtelä R, Löyttyniemi E, Kärkkäinen J, Välimäki MJ. J Intern Med. 2001 Jun;249(6):559-63. PMID: 11422663 DOI: 10.1046/j.1365-2796.2001.00847.x CONCLUSION: Hypovitaminosis D is very common amongst Finnish in- and outpatients in both sexes, causing secondary hyperparathyroidism in females. More extensive studies are warranted to elucidate the vitamin D status of the Finnish population.

An international comparison of serum 25-hydroxyvitamin D measurements. Lips P, Chapuy MC, Dawson-Hughes B, Pols HA, Holick MF. Osteoporos Int. 1999;9(5):394-7. PMID: 10550457 DOI: 10.1007/s001980050162 The results show that 25(OH)D values from different laboratories can not be assumed to be comparable unless a careful cross-calibration has been performed.

Healthy elderly French women living at home have secondary hyperparathyroidism and high bone turnover in winter. EPIDOS Study Group. Chapuy MC, Schott AM, Garnero P, Hans D, Delmas PD, Meunier PJ. J Clin Endocrinol Metab. 1996 Mar;81(3):1129-33. PMID: 8772587 These results show that vitamin D status of a French aged population in good health and living at home depends mainly on lifestyle. Like institutionalized women, old women living at home exhibit clear evidence of senile hyperparathyroidism in the winter, secondary in part to a reduced 25OHD level and associated with biological signs of increased bone turnover. The maintenance of PTH within the normal range for healthy adults by vitamin D and calcium treatment might constitute an approach for the prevention of bone loss in the entire

Vitamin D3 and calcium to prevent hip fractures in the elderly women. Chapuy MC, Arlot ME, Duboeuf F, Brun J, Crouzet B, Arnaud S, Delmas PD, Meunier PJ. N Engl J Med. 1992 Dec 3;327(23):1637-42. PMID: 1331788 CONCLUSIONS. Supplementation with vitamin D3 and calcium reduces the risk of hip fractures and other nonvertebral fractures among elderly women.

Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Outila TA, Kärkkäinen MU, Lamberg-Allardt CJ. Am J Clin Nutr. 2001 Aug;74(2):206-10. PMID: 11470722 Conclusion: A large percentage of adolescent females have low vitamin D status during the winter in Finland, which seems to have negative effects on bone health.

Prostate cancer risk and prediagnostic serum 25-hydroxyvitamin D levels (Finland). Ahonen MH, Tenkanen L, Teppo L, Hakama M, Tuohimaa P. Cancer Causes Control. 2000 Oct;11(9):847-52. PMID: 11075874 DOI: 10.1023/A:1008923802001 CONCLUSIONS: We conclude that low levels of 25-VD associated with an increased risk for subsequent earlier exposure and more aggressive development of prostate cancer, especially before the andropause.

David Feldman, MD, professor of medicine at Stanford, explores the biological action of Vitamin D beyond its widely understood role in the information and maintenance of bone. Emerging therapeutic uses of the vitamin include the prevention and treatment of breast, prostate and colon cancer, chronic kidney disease and arthritis, among other conditions.

Low serum 25-hydroxyvitamin D concentrations and secondary hyperparathyroidism in middle-aged white strict vegetarians. Lamberg-Allardt C, Kärkkäinen M, Seppänen R, Biström H. Am J Clin Nutr. 1993 Nov;58(5):684-9. PMID: 8237875 In conclusion, white strict vegetarians are at risk of vitamin D deficiency, at least in the winter, primarily because of a low dietary vitamin D intake, despite a normal sunlight exposure in summer. Low serum 25(OH)D concentrations are accompanied by high S-iPTH concentrations, which also are affected by a low calcium intake. The effect of these changes on bone health remains to be evaluated.

Differences in vitamin D status between countries in young adults and the elderly. McKenna MJ. Am J Med. 1992 Jul;93(1):69-77. PMID: 1385673 PURPOSE: To compare vitamin D status between countries in young adults and in the elderly. MATERIALS AND METHODS: Reports on vitamin D status (as assessed by serum 25-hydroxyvitamin D) from 1971 to 1990 were reviewed. Studies were grouped according to geographic regions: North America (including Canada and the United States); Scandinavia (including Denmark, Finland, Norway, and Sweden); and Central and Western Europe (including Belgium, France, Germany, Ireland, The Netherlands, Switzerland, and the United Kingdom). RESULTS: Vitamin D status varies with the season in young adults and in the elderly, and is lower during the winter in Europe than in both North America and Scandinavia. Oral vitamin D intake is lower in Europe than in both North America and Scandinavia. Hypovitaminosis D and related abnormalities in bone chemistry are most common in elderly residents in Europe but are reported in all elderly populations. CONCLUSIONS: The vitamin D status in young adults and the elderly varies widely with the country of residence. Adequate exposure to summer sunlight is the essential means to ample supply, but oral intake augmented by both fortification and supplementation is necessary to maintain baseline stores. All countries should adopt a fortification policy. It seems likely that the elderly would benefit additionally from a daily supplement of 10 micrograms of vitamin D.

Teenage girls and elderly women living in northern Europe have low winter vitamin D status. Andersen R, Mølgaard C, Skovgaard LT, Brot C, Cashman KD, Chabros E, Charzewska J, Flynn A, Jakobsen J, Kärkkäinen M, Kiely M, Lamberg-Allardt C, Moreiras O, Natri AM, O'brien M, Rogalska-Niedzwiedz M, Ovesen L. Eur J Clin Nutr. 2005 Apr;59(4):533-41. PMID: 15714215 doi:10.1038/sj.ejcn.1602108 CONCLUSION: Vitamin D status is low in northern Europe during winter. More than one-third of the adolescent girls have vitamin D status below 25 nmol/l and almost all are below 50 nmol/l. Two-thirds of the elderly community-dwelling women have vitamin D status below 50 nmol/l. Use of vitamin D supplements is a significant positive determinant for S-25OHD for both girls and women (P = 0.001). SPONSORSHIP: The European Fifth Framework Programme (Contract No. QLK1-CT-2000-00623)

Association of low 25-hydroxyvitamin D concentrations with elevated parathyroid hormone concentrations and low cortical bone density in early pubertal and prepubertal Finnish girls. Cheng S, Tylavsky F, Kröger H, Kärkkäinen M, Lyytikäinen A, Koistinen A, Mahonen A, Alen M, Halleen J, Väänänen K, Lamberg-Allardt C. Am J Clin Nutr. 2003 Sep;78(3):485-92. Erratum in: Am J Clin Nutr. 2006 Jan;83(1):174. PMID: 12936933 CONCLUSIONS: Vitamin D-deficient girls have low cortical BMD and high iPTH concentrations, which are consistent with secondary hyperparathyroidism. A low vitamin D concentration accompanied by high bone resorption (TRAP 5b) may limit the accretion of bone mass in young girls.

Prevalence and Associations of 25-Hydroxyvitamin D Deficiency in US Children: NHANES 2001-2004. Kumar J, Muntner P, Kaskel FJ, Hailpern SM, Melamed ML. Pediatrics. 2009 Aug 3. [Epub ahead of print] PMID: 19661054 CONCLUSIONS: 25(OH)D deficiency is common in the general US pediatric population and is associated with adverse cardiovascular risks.

Breastfeeding does not protect against urinary tract infection in the first 3 months of life, but vitamin D supplementation increases the risk by 76%. Katikaneni R, Ponnapakkam T, Ponnapakkam A, Gensure R. Clin Pediatr (Phila). 2009 Sep;48(7):750-5. Epub 2009 Mar 4. PMID: 19264720 DOI: 10.1177/0009922809332588 The relative risk of UTI with breastfeeding versus formula feeding was 1.03 (0.58-1.82), and any breastfeeding versus no breastfeeding was 0.92 (0.58-1.45). Vitamin D supplementation increased the UTI risk, with a relative risk of 1.76 (1.07-2.91, P < .05). However, only formula-fed infants showed an increased risk of UTI after vitamin D supplementation.

Association between serum 25(OH)D concentrations and bone stress fractures in Finnish young men. Ruohola JP, Laaksi I, Ylikomi T, Haataja R, Mattila VM, Sahi T, Tuohimaa P, Pihlajamäki H. J Bone Miner Res. 2006 Sep;21(9):1483-8. doi: 10.1359/jbmr.060607 Conclusions: A lower level of serum 25(OH)D concentration may be a generally predisposing element for bone stress fractures. Considering the obvious need of additional vitamin D in prevention of stress fractures, the effects of vitamin D fortification of foods and supplementation will be subjects of interest for future research PMID: 16939407

Calcium and vitamin d supplementation decreases incidence of stress fractures in female navy recruits. Lappe J, Cullen D, Haynatzki G, Recker R, Ahlf R, Thompson K. J Bone Miner Res. 2008 May;23(5):741-9. PMID: 18433305 doi: 10.1359/jbmr.080102 Conclusions: Generalizing the findings to the population of 14,416 women who entered basic training at the Great Lakes during the 24 mo of recruitment, calcium and vitamin D supplementation for the entire cohort would have prevented 187 persons from fracturing. Such a decrease in SFx would be associated with a significant decrease in morbidity and financial costs.

Stress fractures in the Israeli defense forces from 1995 to 1996. Givon U, Friedman E, Reiner A, Vered I, Finestone A, Shemer J. Clin Orthop Relat Res. 2000 Apr;(373):227-32. PMID: 10810481 Serum levels of bone specific alkaline phosphatase and osteocalcin were elevated in patients with high grade stress fractures compared with control subjects with no symptoms: 37.6 versus 26.2 units/L, and 10.8 versus 8.8 ng/mL, respectively. Levels of 25-hydroxy vitamin D were lower in patients with high grade stress fractures (25.3 ng/mL) than in control subjects (29.8 ng/mL). This study revealed that several parameters can distinguish soldiers with high grade stress fractures, but their predictive value and precise pathogenetic role remain unclear.

Fatigue fractures in military conscripts : A study on risk factors, diagnostics and long-term consequences Ruohola, Juha-Petri University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Orthopaedics and Traumatology, Helsinki University Central Hospital Centre of Military Medicine, Helsinki 2007-03-09 Doctoral dissertation (article-based) It seems likely that low vitamin D levels are related to fatigue fractures, and that an increasing trend exists between TRACP-5b bone resorption marker elevation and fatigue fracture incidence. Though seldom detected by plain radiography, fatigue fractures often underlie unclear lower leg stress-related pain occurring in the distal parts of the tibia. Femoral neck fatigue fractures, when displaced, lead to long-term morbidity in a high percentage of patients, whereas, when non-displaced, they do not predispose patients to subsequent adverse complications. Importantly, an educational intervention can diminish the incidence of fracture displacement by enhancing awareness and providing instructions for earlier diagnosis of fatigue fractures

Serum 25-hydroxyvitamin D status of vegetarians, partial vegetarians, and nonvegetarians: the Adventist Health Study-2. Chan J, Jaceldo-Siegl K, Fraser GE. Am J Clin Nutr. 2009 May;89(5):1686S-1692S. Epub 2009 Apr 1. PMID: 19339396 Conclusions: s25(OH)D concentrations were not associated with vegetarian status. Other factors, such as vitamin D supplementation, degree of skin pigmentation, and amount and intensity of sun exposure have greater influence on s25(OH)D than does diet.