There is discordance in the vitamin D literature between correlational studies, which show an association between higher vitamin D exposure and good health, and randomized controlled trials of vitamin D supplementation, which are inconclusive. I test the theory that this discordance is due to false assumptions about how vitamin D affects human health. I use the method of systematic review and meta-analysis—accepting only experimental studies that supplement with the animal version of vitamin D, D3, not D2 or vitamin D metabolites or analogues, as well as accepting only studies with daily rather than less-frequent but larger doses—to show that daily vitamin D3 supplementation has a statistically-significant beneficial effect on blood pressure and markers of diabetes. Using nationally-representative correlational data, I also demonstrate that the health disparities in blood pressure, if not diabetes, will be eliminated only with new health policies dedicated to health education on the vast nutritional difference in vitamin D status between black and white Americans. As a part of this dissertation, I also developed an online multi-user web application to facilitate systematic reviews and meta-analyses.

Despite numerous studies have demonstrated an association of type 2 diabetes mellitus (T2DM) and osteoporosis, the underlying mechanism connecting these two conditions remains elusive. Clinically, combined calcium and vitamin D supplement is the commonest osteoporosis therapy; however, recent studies have suggested an increase in cardiovascular risks associated with calcium plus vitamin D supplementation. Therefore, an alternative strategy in treating osteoporosis patients with T2DM is urgently needed. In this study, we hypothesized that combined administration of menaquinone-4 (vitamin K₂, biologically active form of vitamin K) and 1α,25-dihydroxyvitamin D₃ (vitamin D₃, biologically active form of vitamin D) as a novel therapy in treating osteoporosis of T2DM patients. Anabolic effect of vitamin K₂ and vitamin D₃, alone or in combination, was assessed on primary osteoblasts harvested from the iliac crests of C57BL/KsJ lean (db⁺/m⁺) and obese/diabetic (db⁺/db⁺, leptin receptor-deficient) mice. Furthermore, the underlying cellular mechanism was also investigated. Serum undercarboxylated osteocalcin (an indication of vitamin K₂ level) level was higher whereas vitamin D₃ level was lower in db⁺/db⁺ mice, and sections of the iliac crests of db⁺/db⁺ mice illustrated extensive porous structures filled with enlarged adipocytes compared with db⁺/m⁺ mice. Lower levels of bone anabolic markers and bone formation transcription factors (osteocalcin, Runx2, Dlx5, ATF4, type I collagen, OSX, alkaline phosphatase (ALP) activity, p-Smad1/5/8 and p-ERK1/2) were observed in the osteoblasts of db⁺/db⁺ mice. Acute vitamin D₃ (10 nM) application elicited a more sustained and greater magnitude of increase of [Ca²⁺]ᵢ in osteoblasts of db⁺/m⁺ mice when compared with db⁺/db⁺ mice. A significantly higher level of calcium deposits in osteoblasts was observed in db⁺/m⁺ mice when compared to db⁺/db⁺ mice. Co-administration of vitamin K₂ (10 nM) and vitamin D₃ (10 nM) caused an enhancement of calcium deposits in osteoblasts in both strains of mice. Vitamins K₂ and D₃ co-administration time-dependently (7, 14 and 21 days) increased the levels of bone anabolic markers and transcription factors for bone formation, with a greater magnitude of increase observed in osteoblasts of db⁺/db⁺ mice. Suppressed expression of calcium-sensing receptor (CaSR), F-actin, V-ATPase, vitamin D receptor (VDR) and pregnane X receptor (PXR) observed in osteoblasts of db⁺/db⁺ mice were partially reversed by combined vitamins treatment. Moreover, combined vitamins K₂ plus D₃ treatment significantly enhanced migration and the appearance of surface microvilli and ruffles of osteoblasts of db⁺/db⁺ mice. Effects of combined vitamins K₂ plus D₃ treatment observed in osteoblasts of db⁺/db⁺ and db⁺/m⁺ mice were eradicated by warfarin (20 µM, a vitamin K epoxide reductase inhibitor). Thus, our results illustrate that vitamins K₂ plus D₃ supplementation is a novel therapeutic strategy in treating osteoporosis of T2DM patients. / 儘管大量研究已證明第二類型糖尿病和骨質疏鬆症的關聯，連接這兩個病症的基本機制仍然是難以捉摸的。在臨床上，鈣和維生素D的綜合補充劑是最常見的骨質疏鬆症治療，然而最近的研究卻表明服用鈣和維生素D的綜合補充劑會增加患者的心血管風險，因此急切需要尋找可以給予同時患有骨質疏鬆症和第二類型糖尿病患者的替代治療。在本研究中，我們假設甲萘醌-4（維生素K₂，維生素K生物活性形式）和1α，25 - 二羥基維生素D₃（維生素D₃，維生素D的生物活性形式）可以嘗試在同時患有骨質疏鬆症和第二類型糖尿病患者身上作為一種革新的療法。本研究從C57BL/KsJ瘦削/非糖尿病 (db⁺/m⁺) 的小鼠和肥胖/帶有第二類型糖尿病基因 (db⁺/db⁺) 兼有瘦素受體缺陷的小鼠的髂嵴原始成骨細胞上對維生素K₂和維生素D₃單獨或組合使用的合成代謝作用進行了評估。此外，我們也對該成骨細胞的底層機制進行了一系列的研究。 / 在肥胖/帶有第二類型糖尿病基因的小鼠血清內低羧骨鈣素水平（維生素K₂水平的指標）較高而維生素D水平較低，另外，它們的髂嵴的部分與瘦削/非糖尿病的小鼠相比，呈現出比較廣泛的多孔結構並填滿了擴大的脂肪細胞。從肥胖/帶有第二類型糖尿病基因的小鼠的成骨細胞中，可以觀察到它們的骨合成代謝的標誌物和骨骼形成的轉錄因子 (骨鈣蛋白，Runx2，Dlx5，ATF4，第一類型骨膠原，OSX，鹼性磷酸酶 (ALP) 活性，p-Smad1/5/8和p-ERK1/2) 的水平比較低。急性維生素D₃ (10 nM) 的應用在瘦削/非糖尿病小鼠的成骨細胞比起在肥胖/帶有第二類型糖尿病基因的小鼠的成骨細胞引起更持續和更大幅度的細胞內鈣變化增加。在瘦削/非糖尿病小鼠的成骨細胞中比起在肥胖/帶有第二類型糖尿病基因的小鼠的成骨細胞有顯著較高的鈣沉積形成。維生素K₂ (10 nM) 和維生素D₃ (10 nM) 的綜合藥在兩種小鼠的成骨細胞中可以有效地增強鈣沉積的形成。維生素K₂和維生素D₃的綜合藥對增加骨合成代謝的標誌物和骨形成轉錄因子的水平有時間依賴性 (7，14和21日)，療程越長至21日，在肥胖/帶有第二類型糖尿病基因小鼠的成骨細胞中有更大的幅度的增加。合併維生素治療能部分有效地逆轉在肥胖/帶有第二類型糖尿病基因小鼠的成骨細胞中被抑制表達的鈣敏感受體 (CASR)，F-肌動蛋白，V-ATP酶，維生素D受體 (VDR) 和孕烷X受體 (PXR)。此外，結合維生素K₂加維生素D₃治療顯著增強了肥胖/帶有第二類型糖尿病基因小鼠的成骨細胞的細胞遷移和增加了成骨細胞表面外觀的微絨毛和褶皺。在瘦削/非糖尿病小鼠的成骨細胞及肥胖/帶有第二類型糖尿病基因的小鼠的成骨細胞上結合維生素K₂加維生素D₃的治療效果被華法林 (20 μM，維生素K環氧化物還原酶抑製劑) 根除。因此，我們的結果証明了維生素K₂加維生素D₃補充劑的結合使用可有效地作為治療第二類型糖尿病患者並患有骨質疏鬆症的一種新的治療策略。 / Poon, Chui Wa Christina. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2014.n5203 / Includes bibliographical references (leaves 135-151). / Abstracts also in Chinese. / Title from PDF title page (viewed on 26, October, 2016). / Detailed summary in vernacular field only. / Detailed summary in vernacular field only.

Wong Kit Sum. / Includes bibliographical references / Thesis (M.Ph.)--Chinese University of Hong Kong, 1985

Acute respiratory infections (ARI) are a major global cause of morbidity and mortality. Vitamin D deficiency has been reported to associate with susceptibility to ARI and with greater severity and poorer control of asthma and chronic obstructive pulmonary disease (COPD). Clinical trials of vitamin D for the prevention of ARI have yielded heterogeneous results, with some showing protection and others not. This may reflect variation in the frequency of genetic variants influencing response to vitamin D supplementation in different populations. The impact that genetic variation in the vitamin D pathway has on vitamin D status, disease phenotype and response to vitamin D supplementation in prevention of ARI has not been comprehensively investigated. Methods: I conducted: 1. A systematic review and meta-analysis of clinical studies which have investigated vitamin D as a potential therapy for ARI; 2. Three cross-sectional studies (in n=297 adult asthma patients, n=278 COPD patients, and n=272 older adults) to investigate potential environmental determinants (lifestyle and anthropometric) and genetic determinants (35 single nucleotide polymorphisms [SNP] in 11 vitamin D related genes) of serum 25-hydroxyvitamin D concentration (25[OH]D) and clinical phenotype; 3. Three prospective studies investigating the influence of genetic variation in the vitamin D pathway on a) susceptibility to ARI (main effects analysis) and b) efficacy of vitamin D supplementation for the prevention of ARI (interaction analysis). Results: My systematic review identified consistent reports of an inverse association between vitamin D status and risk of ARI in observational studies, and heterogeneous reports from clinical trials. My cross-sectional studies identified a range of classical environmental factors which predict vitamin D status in the three study populations, but did not identify any genetic variants in the vitamin D pathway that associate with vitamin D status. I identified an association between vitamin D deficiency and decreased lung function in COPD patients, but no associations between vitamin D deficiency and asthma phenotype. Finally, my analysis identified a haplotype of 5 single nucleotide polymorphisms in the vitamin D receptor (VDR) gene which significantly modify the effect of vitamin D supplementation on risk of upper respiratory infection in COPD patients. Conclusions: I identified environmental determinants that predict 25(OH)D concentrations in all three study populations, but only found an association between vitamin D deficiency and disease severity in COPD patients. Furthermore, I identified a haplotype in VDR which modifies the effect of vitamin D supplementation in COPD patients to result in a significantly reduced risk of ARI.

Typescript (photocopy). / Digitized by Kansas Correctional Industries

Made available in DSpace on 2014-06-11T19:31:00Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-07-11Bitstream added on 2014-06-13T20:41:03Z : No. of bitstreams: 1 khalil_oak_dr_araiq_parcial.pdf: 122903 bytes, checksum: 87266cce24ee42f91603bd596a620467 (MD5) Bitstreams deleted on 2015-07-02T12:36:14Z: khalil_oak_dr_araiq_parcial.pdf,. Added 1 bitstream(s) on 2015-07-02T12:37:34Z : No. of bitstreams: 1 000690213_20400528.pdf: 122681 bytes, checksum: c32b117b1b8d8496aaf7f3e5de89fbf4 (MD5) / Universidade Estadual Paulista (UNESP) / O excesso na geração de espécies reativas como os radicais livres pode resultar num desequilíbrio que, embora benéfico em casos específicos como no combate a microrganismos patógenos, está implicado na etiologia de diversas patologias crônicas e com o envelhecimento precoce. Muitos pesquisadores indicam o uso de antioxidantes como potenciais para a prevenção destas patologias e inclusive, algumas pesquisas com antioxidantes como a curcumina estão em etapas finais do desenvolvimento de novos medicamentos. Embora atividades biológicas como a antimicrobiana e antioxidante sejam bastante exploradas para várias substâncias, há um grande potencial para a investigação em relação às atividades de duas ou mais substâncias associadas. O ácido ascórbico, por exemplo, possui algumas atividades biológicas semelhantes às da curcumina, entretanto seu uso e custo são mais acessíveis. Deste modo, há perspectivas para investigações sobre os efeitos resultantes da associação entre a curcumina e o ácido ascórbico em relação a algumas atividades biológicas, com destaque para a curcumina. Assim, este trabalho objetivou determinar os efeitos resultantes desta associação em relação ao perfil de atividades antimicrobiana, antioxidante, hemolítica e na estabilidade da curcumina. Foram utilizadas metodologias de análise de atividade antioxidante como os ensaios de ação scavenger do DPPH·, ABTS·+, O2 ·-, HOCl e também por análise do sistema oxidativo catalisado por peroxidase. Em relação às análises celulares e antimicrobianas, foi determinada a toxicidade sobre eritrócitos e a atividade em relação à Sthaphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans e Candida krusei. A estabilidade da curcumina foi determinada por espectrofotometria... / The excessive generation of reactive species such as free radicals can result in an imbalance which is implicated in the etiology of various chronic diseases and premature aging, although it is beneficial in specific cases, such as in against microbial pathogens. Many researchers suggest the antioxidants usage to prevent these diseases. Some researches about curcumin and others antioxidants are even in final stages of developing new medicines. Although some biological activities are fully explored for various substances, there is great potential of research about the activities of two or more associated substances. Ascorbic acid, for example, has some biological activities similar to those of curcumin, but its use and cost are more accessible. Thus, there are prospects for research on the effects of the association between these molecules, especially curcumin, in relation to some biological activities. This study aimed to determine the effects of this association on antioxidant, antimicrobial and hemolytic activities of curcumin. Since this association can prevent the oxidative degradation of curcumin, it was also aimed to analyze the effects of ascorbic acid on the curcumin stability. Antioxidant activities were evaluated through DPPH , ABTS +, O2 - and HOCl scavenging assays and guaiacol oxidation catalyzed by peroxidase. Regarding the cellular and microbial analysis, the toxicity was determined on erythrocytes and the antimicrobial activity was studied to Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Candida albicans and Candida krusei. The stability of curcumin was determined spectrophotometrically. The combination resulted in a increase in antioxidant activity of curcumin against DPPH , ABTS + and HOCl. We were unable to determine the effect of the association against... (Complete abstract click electronic access below)

Morbus Fabry ist eine multisystemische Erkrankung, die zahlreiche Komplikationen mit sich bringt. Eine verminderte Aktivität des Enzyms α-Galactosidase führt zu einer Anreicherung von Globotriaosylceramiden in verschiedenen Organen und Geweben. Betroffene Patienten entwickeln häufig eine linksventrikuläre Hypertrophie und eine renale Fibrose. Wegen Hitzeintoleranz und Hypohidrosis vermeiden Patienten häufig eine Sonnenexposition. Wir stellten die Hypothese auf, dass ein Vitamin D-Mangel an der Ausprägung einer Fabry-kardiomyopathie beteiligt ist. In dieser Querschnittstudie wurde der Einfluss des Vitamin D-Status auf die typischerweise auftretenden Komplikationen der Erkrankung an 111 Patienten mit gesichertem Morbus Fabry vor Beginn einer Enzymersatztherapie untersucht. Dafür bestimmten wir das 25(OH)D und teilten die Patienten anhand dieser Werte in drei Gruppen ein: Vitamin D-defizient (25(OH)D<15 ng/ml), Vitamin D-insuffizient (25(OH)D 15-30 ng/ml und Vitamin Dsuffizient (25(OH)D >30 ng/ml). Es erfolgten Magnetresonanztomographie- und echokardiographische Untersuchungen zur Bestimmung der linksventrikulären Masse und einer möglichen Kardiomyopathie. In Querschnittsanalysen wurden Assoziationen zwischen auftretenden klinischen Symptomen und dem Vitamin D-Status durch lineare bzw. binäre logistische Regressionsanalysen bestimmt und nach Alter, Geschlecht, BMI und Jahreszeit der Messung adjustiert. Die Patienten waren im Durchschnitt 40,1±12,5 Jahre alt (42% männlich) und hatten einen durchschnittlichen 25(OH)D-Wert von 23,5±11,4 ng/ml. Patienten der defizienten 25(OH)D-Gruppe hatten ein adjustiertes 6-fach erhöhtes Risiko für eine hypertrophe Kardiomyopathie verglichen mit der suffizienten Kontrollgruppe (p=0,04). Die durchschnittliche linksventrikuläre Masse unterschied sich signifikant: 170±75 g in der defizienten, 154±60 g in der insuffizienten und 128±58 g in der suffizienten Gruppe (p=0,01). Mit dem Schweregrad der Vitamin D-Defizienz stieg der Median einer vorhandenen Proteinurie sowie die Prävalenz von Hitzeintoleranz, Ödemen, Cornea verticillata, Diarrhoen und dem Bedarf einer Schmerzmedikation. Unsere Studie hat gezeigt, dass Patienten mit niedrigen Vitamin D-Werten gehäuft an Komplikationen leiden.75 Dazu gehören die progressive Fabry-Nephropathie, hypertrophe Kardiomyopathie und die Krankheit typischerweise begleitende klinische Symptome. Zum jetzigen Zeitpunkt können wir allerdings eine Vitamin D-Therapie, basierend auf unseren Daten noch nicht grundsätzlich empfehlen obwohl eine Vitamin D-Supplementierung über Vitamin D angereicherte Nahrungsmittel im Allgemeinen empfohlen wird. Unsere Ergebnisse sind bisher nur Beobachtungen und können einen kausalen Zusammenhang nicht beweisen. / Patients with Fabry disease frequently develop left ventricular (LV) hypertrophy and renal fibrosis. Due to heat intolerance and an inability to sweat, patients tend to avoid exposure to sunlight. We hypothesized that subsequent vitamin D deficiency may contribute to Fabry cardiomyopathy. This study investigated the vitamin D status and its association with LV mass and adverse clinical symptoms in patients with Fabry disease. 25-hydroxyvitamin D (25[OH]D) was measured in 111 patients who were genetically proven to have Fabry disease. LV mass and cardiomyopathy were assessed by magnetic resonance imaging and echocardiography. In cross-sectional analyses, associations with adverse clinical outcomes were determined by linear and binary logistic regression analyses, respectively, and were adjusted for age, sex, BMI and season. Patients had a mean age of 40 ± 13 years (42 % males), and a mean 25(OH)D of 23.5 ± 11.4 ng/ml. Those with overt vitamin D deficiency (25[OH]D ≤ 15 ng/ml) had an adjusted six fold higher risk of cardiomyopathy, compared to those with sufficient 25(OH)D levels >30 ng/ml (p = 0.04). The mean LV mass was distinctively different with 170 ± 75 g in deficient, 154 ± 60 g in moderately deficient and 128 ± 58 g in vitamin D sufficient patients (p = 0.01). With increasing severity of vitamin D deficiency, the median levels of proteinuria increased, as well as the prevalences of depression, edema, cornea verticillata and the need for medical pain therapy. In conclusion, vitamin D deficiency was strongly associated with cardiomyopathy and adverse clinical symptoms in patients with Fabry disease. Whether vitamin D supplementation improves complications of Fabry disease, requires a randomized controlled trial.

No description available.

This thesis describes an investigation of the effects of vitamin A deficiency on gut function, The central hypothesis to be tested was that acute vitamin A deficiency affects glucose uptake from the small intestine- The hypothesis was tested using a system involving perfusion of isolated segments of the small intestine in the anaesthetized rat. The system was used to study effects on glucose uptake under steady-state conditions. In the initial part of the study, experiments were diverted towards setting up the system for measuring steady-state uptake, and determining the relative contributions of active uptake and diffusion. Phenol red was found to be a reliable non-absorbable marker for determining net water movement. Phlorizin, generally at 1 mmol/L, was used as a competitive (reversible) inhibitor of active uptake. It is difficult however to confirm complete inhibition of active uptake by phlorizin because of the limited solubility of the inhibitor. The kinetics of glucose uptake f ram intra-luminal maltose were found to be, in general, not significantly different from those applying to the uptake of glucose from an equivalent glucose solution. Maltase activity in the perfused gut segment was found to be sufficient to hydrolyse most of the maltose (80 per cent or more) in the solution being perfused, a much greater proportion than was absorbed. Glucose absorptive capacity, measured on an intestinal dry weight basis, was greatest in the duodenum and progressively less in the jejunum and ileum. The rate of water uptake f ran the gut was increased by the presence of glucose in the lumen, and was linked to glucose uptake as shown by the inhibition of water uptake by phlorizin. Uptake of glucose by solvent drag was demonstrated by showing an increased rate of glucose uptake when the rate of water uptake was increased by perfusing a solution of reduced osmotic pressure. In the experiment a low intra-luminal glucose concentration was used to preclude net uptake by diffusion and active uptake was blocked with phlorizin. This process was further investigated using streptozotocin-diabetic rats in which the diabetes establishes a hyperosomotic blood with hyperglycaemia. Uptake by solvent drag was more obvious in diabetic animals. A back-diffusion (exsorption) of glucose from the tissues to the lumen was also shown; the rate being proportional to plasma glucose concentration. Vitamin A deficiency was established in weanling rats after 6-7 weeks feeding on a diet based on wheat starch, coconut oil, and casein washed with hot ethanol, together with vitamins and minerals. The vitamin A deficiency led to classic eye signs and was reversed by the addition to the diet of retinoic acid (5 g/g diet). Vitamin A deficiency decreased intestinal mucus production (dry weight) but had no detectable effect on the histology of the villous epithelium as shown under the light microscope. Using perfusion experiments it was shown that vitamin A deficiency had no significant effect on the rate of active uptake of glucose, but that deficiency increased the rate of passive uptake.

Thesis (M.S.)--Pennsylvania State University, 1972. / Includes bibliographical references.