BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom * epidemiologie etiologie diagnóza MeSH
- nádory kůže * etiologie komplikace MeSH
- nedostatek vitaminu D * komplikace epidemiologie MeSH
- retrospektivní studie MeSH
- sekundární malignity * epidemiologie etiologie MeSH
- vitamin D škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Cystická fibróza (CF) je geneticky podmíněné onemocnění, které vede k postižení především plic a slinivky břišní, ale také řady dalších orgánových systémů včetně kostí a kosterní svaloviny. Osteoporóza, tedy snížená denzita kostního minerálu a současně zvýšený výskyt zlomenin, se u jedinců s CF vyskytuje až ve 28 % a má komplexní etiologii. Je častější u nemocných s vyšším věkem, podvýživou, těžšími klinickými projevy a zhoršenými plicními funkcemi. Tyto faktory vedou také ke snížené svalové síle respiračních i kosterních svalů a k nedostatečným sérovým koncentracím 25-hydroxyvitaminu D (25-OHD), ukazatele zásob vitaminu D v těle a jednoho z hlavních regulátorů kostního metabolismu. Substituce cholekalciferolem vede ke zvýšení 25-OHD jen u části jedinců s CF. Moderní léčba modulátory CFTR (cystic fibrosis transmembrane conductance regulator) kanálu vede ke zlepšení plicních funkcí a nutričního stavu a podle několika recentních pilotních studií má také pravděpodobně pozitivní vliv na denzitu kostního minerálu a sérové koncentrace 25-OHD. Nové randomizované kontrolované studie ověří efekt substituce vitaminu D na denzitu kostního minerálu a koncentrace 25-OHD a objasní vliv CFTR modulátorů na muskuloskeletální komplikace CF. Korespondující autor: MUDr. Kvido Malaska V Úvalu 84 150 00 Praha 5 kvido.malaska@fnmotol.cz
Cystic fibrosis (CF) is a genetically determined disease that primarily affects lungs and pancreas, but also a number of other organ systems, including bones and skeletal muscles. Osteoporosis, i.e. reduced bone mineral density, together with an increased incidence of fractures, occurs in up to 28 % of individuals with CF and has a complex etiology. Osteoporosis is more common in older individuals, individuals with malnutrition, more severe clinical manifestations and impaired lung functions. Some of these factors also cause reduced muscle strength of respiratory and skeletal muscles and insufficient serum concentrations of 25-hydroxyvitamin D (25-OHD), an indicator of vitamin D reserves in the body and one of the main regulators of bone metabolism. Substitution with cholecalciferol increases the concentration of 25-OHD only in some individuals with CF. Modern treatment with CFTR (cystic fibrosis transmembrane conductance regulator) modulators leads to improvement of lung functions and nutritional status and, according to several recent pilot studies, probably has a positive effect on bone density and serum 25-OHD concentrations. New randomized controlled trials will verify the effect of vitamin D substitution on bone density and 25-OHD concentrations and clarify the effect of CFTR modulators on musculoskeletal complications.
BACKGROUND/OBJECTIVE: Optimal vitamin D levels are required for bone health and proper functionality of the nervous, musculoskeletal and immune systems. The objective of this study was to assess the efficacy and safety profiles of new weekly calcifediol formulations with the potential to improve adherence and outcome. METHODS: A Phase II-III, double-blind, randomized, multicentre trial (EudraCT 2020-001099-14 and NCT04735926). Subjects were randomized 2:2:1 to calcifediol 75 μg, 100 μg and placebo. 25(OH)D levels were measured at 4, 16, 24, 32 and 52 weeks. The main outcome was the percentage of subjects who achieved a response defined as 25(OH)D levels ≥20 ng/mL and/or ≥30 ng/mL at week 16. RESULTS: 398 subjects (51.1 ± 15.96 years, 74.2% females, 98.7% Caucasian) with plasma 25(OH)D levels between 10 and 20 ng/mL were randomized. A total of 376 subjects completed 16 weeks of treatment, and 355 subjects completed the study. Six patients withdrew due to an adverse event, all unrelated to treatment. At week 16, 93.6% and 74.4% of subjects receiving calcifediol 75 μg achieved response levels of ≥20 ng/mL and ≥30 ng/mL, respectively. The calcifediol 100 μg group showed 98.7% and 89.9% of responders for ≥20 ng/mL and ≥30 ng/mL, respectively. Both calcifediol groups showed superiority over placebo at each response level at all time points analyzed (p < 0.0001). Calcifediol treatments increased 25(OH)D levels from baseline to week 24 and remained stable thereafter. The frequency of treatment-emergent adverse events was balanced between groups. CONCLUSIONS: New weekly calcifediol 75 and 100 μg formulations showed an effective and sustained response with a good long-term safety profile.
- MeSH
- dospělí MeSH
- dvojitá slepá metoda MeSH
- kalcifediol * krev aplikace a dávkování MeSH
- lidé středního věku MeSH
- lidé MeSH
- nedostatek vitaminu D * farmakoterapie krev MeSH
- potravní doplňky MeSH
- senioři MeSH
- vitamin D krev analogy a deriváty aplikace a dávkování MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze II MeSH
- klinické zkoušky, fáze III MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
BACKGROUND: An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE: This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS: Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS: Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS: This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.
As of the 7th of July 2024, 775,754,322 confirmed cases of COVID-19, including 7,053,902 deaths worldwide, had been reported to the WHO (World Health Organization). Nevertheless, untill the 15th of July 2024, a total of 13,578,710,228 vaccine doses had been administered, with almost no country spared from COVID-19 attacks. The pathophysiology of this virus is complicated, and several symptoms require a deep understanding of the actual mechanisms. It is unclear why some patients develop severe symptoms while others do not, although literature suggests a role for vitamin D. Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms. The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood. VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality. Recent studies suggest that vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and outcomes of COVID-19, especially in the infections caused by Delta and Omicron variants. Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2, indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection. The therapeutic effect of vitamin D raises interest in its potential role as a prophylactic and treatment adjunct. We evaluate the immunomodulatory effects of vitamin D and its ability to enhance the efficacy of new antiviral drugs like molnupiravir and paxlovid against SARS-CoV-2. This review discusses the role of vitamin D sufficiency and VDD in COVID-19 initiation and progression, emphasizing the molecular mechanisms by which vitamin D exerts its actions as a proactive step for the next pandemic. However, there is still no clear evidence of vitamin D's impact on prevention and treatment, leading to contradictory findings. Therefore, large-scale randomized trials are required to reach a definitive conclusion. A bibliometric analysis of publications related to vitamin D, immunity, and COVID-19 revealed a significant increase in research activity in this area, particularly in 2020-2024, underscoring the growing recognition of vitamin D's potential role in the context of the pandemic.
- MeSH
- COVID-19 * imunologie MeSH
- farmakoterapie COVID-19 MeSH
- lidé MeSH
- nedostatek vitaminu D * farmakoterapie imunologie MeSH
- pandemie MeSH
- receptory kalcitriolu metabolismus MeSH
- SARS-CoV-2 imunologie MeSH
- vitamin D * terapeutické užití aplikace a dávkování MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Vitamin D is an important steroid hormone that exerts immunomodulatory actions, controls calcium and phosphate homeostasis, and significantly affects human health. Vitamin D deficiency is a global health problem, affecting approximately 60% of adults worldwide, and has been implicated in a range of different types of diseases, e.g., cancer. Vitamin D is involved in the regulation of cell proliferation, differentiation, energetic metabolism, and different types of cell death (e.g., apoptosis, autophagy, etc.). In physiological conditions, it is also able to modulate immune responses, angiogenesis, etc., which belongs to fundamental cancer-related processes. Vitamin D deficiency has been associated with an increased risk of some types of cancer, e.g., colorectal, breast, ovarian, prostate, pancreatic, etc. The role of vitamin D in cancer prevention, carcinogenesis, and cancer treatment is still under investigation and depends on the type of cancer. This review summarizes the role of vitamin D in all three above-mentioned aspects and discusses the mechanism of action and potential possibilities in cancer treatment.
- MeSH
- lidé MeSH
- nádory * prevence a kontrola farmakoterapie MeSH
- nedostatek vitaminu D komplikace MeSH
- potravní doplňky * MeSH
- vitamin D * terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: Vitamin D deficiency associates with the risk of developing many diseases, including cancer. At the molecular level, vitamin D appears to have an antineoplastic effect. However, the role of vitamin D deficiency in cancer pathogenesis remains unelucidated and numerous studies have resulted in discordant results. This study aimed to determine whether vitamin D deficiency during melanoma diagnosis increases the risk of developing non-cutaneous second primary cancers (SPC). MATERIALS AND METHODS: A retrospective study on 663 patients diagnosed with melanoma between 1 January 2011 and 31 October 2022. The effect of each variable on the development of a subsequent non-cutaneous cancer was performed using Kaplan-Meier curves and differences were assessed by log-rank tests. Cox proportional hazard univariate and multivariate models were used to quantify the effect of each variable in the time to develop a non-cutaneous neoplasia. RESULTS: Out of 663 patients, 34 developed a non-cutaneous SPC. There was no statistically significant association between vitamin D levels and non-cutaneous SPC development (log-rank, p=0.761). Age>60 years, stage III/IV, and nodular melanoma subtype were significantly associated with the development of a SPC. After multivariate analysis, only age>60 years (HR 3.4; HR CI 95%: 1.5-7.6) and nodular melanoma subtype (HR 2.2; HR CI 95%: 1.0-4.8) were included in the final model. CONCLUSIONS: Our results suggest that vitamin D deficiency is not associated with an increased risk of developing non-cutaneous SPC in melanoma patients. However, age over 60 years and nodular melanoma subtype increase the risk for non-cutaneous SPC development.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom * epidemiologie etiologie diagnóza MeSH
- nádory kůže * etiologie komplikace MeSH
- nedostatek vitaminu D * komplikace epidemiologie MeSH
- retrospektivní studie MeSH
- sekundární malignity * epidemiologie etiologie MeSH
- vitamin D škodlivé účinky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
V tomto článku sa venujeme endokrinne sprostredkovanej osteoporóze spôsobenej poruchami sekrécie rastového hormónu (RH); nedostatku rastového hormónu u dospelých a akromegálii. RH a inzulínu podobný rastový faktor-1 (IGF-1) stimulujú lineárny rast kostí prostredníctvom komplexných hormonálnych interakcií a aktivujú epifýzové prechondrocyty. GH prostredníctvom receptorového aktivátora jadrového faktora-kappaB (RANK), jeho ligandu (RANK-L) a osteoprotegerínového systému stimuluje produkciu osteoprotegerínu a jeho akumuláciu v kostnej matrici. Nesprávna funkcia tohto mechanizmu môže viesť k špecifickému poškodeniu kostí. Primárnym problémom kostného postihnutia pri poruchách sekrécie rastového hormónu je riziko osteoporotických fraktúr, preto je dôležité posúdiť kvalitu kosti, ktorá lepšie odráža skutočnú predispozíciu pacienta na fraktúru. Metódou odhadu kvality kostí z DXA skenov bedrovej chrbtice je trabekulárne kostné skóre (TBS). Pri akromegálii TBS lepšie definuje riziko zlomeniny, pretože BMD je normálna alebo dokonca zvýšená. TBS pomáha sledovať efekt liečby rastovým hormónom a vitamínom D. Napriek týmto zisteniam by sa TBS nemal používať samostatne, ale je potrebné komplexné zváženie všetkých rizikových faktorov zlomenín, BMD a markerov kostného obratu.
In this article, we address endocrine-mediated osteoporosis caused by disorders of growth hormone (GH) secretion; growth hormone deficiency in adults and acromegaly. GH and insulin-like growth factor-1 (IGF-1) stimulate linear bone growth through complex hormonal interactions and activate epiphyseal prechondrocytes. GH stimulates the production of osteoprotegerin and its accumulation in the bone matrix through the receptor activator of nuclear factor-kappaB (RANK), its ligand (RANK-L) and the osteoprotegerin system. Incorrect function of this mechanism can lead to specific bone damage. The primary problem of bone involvement in disorders of GH secretion is the risk of osteoporotic fractures, so it is important to assess the quality of the bone, which better reflects the actual predisposition of the patient to fracture. The method for estimating bone quality from DXA scans of the lumbar spine is the trabecular bone score (TBS). In acromegaly, TBS better defines fracture risk because BMD is normal or even elevated. TBS helps to monitor the effect of treatment with growth hormone and vitamin D. Despite these findings, TBS should not be used alone, but a comprehensive consideration of all fracture risk factors, BMD and markers of bone turnover is required.
- Klíčová slova
- trabekulární kostní skóre,
- MeSH
- absorpční fotometrie metody MeSH
- akromegalie diagnóza komplikace MeSH
- insulinu podobný růstový faktor I nedostatek MeSH
- kostní denzita * účinky léků MeSH
- lidé MeSH
- osteoporotické fraktury etiologie prevence a kontrola MeSH
- osteoporóza etiologie MeSH
- růstový hormon * nedostatek terapeutické užití MeSH
- vitamin D terapeutické užití MeSH
- Check Tag
- lidé MeSH
Vztah složení naší stravy a vzniku a léčby diabetes mellitus 1. typu (DM1) je znám již od dob před objevením inzulinu, kdy se poprvé objevila snaha pomocí dietních opatření zpomalit či zastavit progresi onemocnění. Kromě toho je k dietě přistupováno i jako k doplňkové léčbě k inzulinoterapii, jejímž účelem má být snaha o dosažení terapeutických cílů. V rámci dietních opatření v souvislosti s DM1 byl dosud zejména zkoumán vliv umělé dětské výživy, lepku, respektive jeho vysazení, vitaminu D, omega-3 mastných kyselin a sníženého příjmu sacharidů v rámci takzvané nízkosacharidové diety. Cílem tohoto přehledového článku je uceleně shrnout nejnovější vědecké poznatky o nutričních intervencích v různých fázích DM1.
Nutrition and type 1 diabetes (T1D) have been closely linked even before the discovery of insulin where the dietary interventions have been part of the effort to prevent or slow the progression of the disease. Additionally, alternative dietary approaches are sought as an adjuvant therapy to insulin use. The focus is given to these dietary approaches – infant formula, gluten and its exclusion, vitamin D, omega-3 fatty acids and limiting of the carbohydrate intake. The aim of this review is to summarize the scientific knowledge regarding dietary interventions in different stages of T1D.
- MeSH
- bezlepková dieta klasifikace metody MeSH
- diabetes mellitus 1. typu * diagnóza dietoterapie imunologie MeSH
- dieta s omezením sacharidů klasifikace metody MeSH
- dietoterapie * klasifikace metody MeSH
- dítě MeSH
- kalcitriol terapeutické užití MeSH
- kojenec MeSH
- kyseliny mastné omega-3 terapeutické užití MeSH
- lidé MeSH
- strava, jídlo, výživa MeSH
- Check Tag
- dítě MeSH
- kojenec MeSH
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- Gravesova nemoc * diagnóza farmakoterapie MeSH
- hmotnostní úbytek MeSH
- hypertyreóza diagnóza farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- methimazol aplikace a dávkování terapeutické užití MeSH
- opožděná diagnóza MeSH
- pyridoxin aplikace a dávkování terapeutické užití MeSH
- thyreostatika MeSH
- vitamin B komplex MeSH
- vitamin D aplikace a dávkování terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
