New Link Found Between Vitamin D Deficiency and Asthma

HEALTH NEWS

New research shows that low levels of vitamin D may be linked to asthma, which could help doctors better treat the condition.

The study published in the Journal of Allergy and Clinical Immunology showed that 47 percent of asthmatic patients who participated in the research had considerably low levels of vitamin D.

Researchers says that the findings could be a glimmer of hope for patients struggling to control their asthma with current treatments.

"Our findings suggest that vitamin D supplementation may help reverse steroid resistance in asthmatic children and reduce the effective dose of steroids needed for our patients," researcher Dr Daniel Searing told the news service.

"If future studies confirm these findings vitamin D may help asthma patients achieve better control of their respiratory symptoms with less medication.

Studies by the American Medical Association show that just over 24 percent of adolescents may be vitamin D deficient.

Source: Reprinted from Private MD Health News

Vitamin D and Calcium May Lower Chance of Breast Cancer

HEALTH NEWS

Premenopausal women who get a lot of vitamin D and calcium may cut their risk of breast cancer by almost one-third, according to a study published in the Archives of Internal Medicine.

Researchers at the Harvard Medical School concluded: "Findings from this study suggest that higher intakes of calcium and vitamin D may be associated with a lower risk of developing premenopausal breast cancer. The likely apparent protection in premenopausal women may be more pronounced for more aggressive breast tumors."

In the study, researchers collected data on more than 10,578 premenopausal women and 20,909 postmenopausal women age 45 and older who were part of the Women's Health Study. The data included information on what they ate and the dietary supplements they took. Over an average of 10 years, 276 premenopausal women and 743 postmenopausal women went on to develop breast cancer.

Researchers found that premenopausal women whose intake of vitamin D and calcium was high had about a 30% lower risk of developing breast cancer. However, they didn’t find this association for postmenopausal women.

"Calcium and vitamin D may confer protection against breast tumorigenesis," lead researcher Jennifer Lin, Ph.D. said. "However, more studies are necessary to investigate the potential utility of these two nutrients in breast cancer development," she added.

Source: Archives of Internal Medicine 167(10):1050-1059, 2007

Vitamin D Deficiency Associated with Increased Mortality

HEALTH NEWS

Another study suggesting a link between low levels of vitamin D and cardiac risk has been published, this time showing that vitamin-D deficiency is associated with both cardiovascular mortality and all-cause mortality.(1)

The study, published in the June 23, 2008 issue of the Archives of Internal Medicine, was conducted by a group led by Dr Harald Dobnig (Medical University of Graz, Austria).

They note that it has been estimated that 50% to 60% of people do not have satisfactory vitamin-D status, and this is probably related to factors such as urbanization, demographic shifts, decreased outdoor activity, air pollution and global dimming, and decreases in the cutaneous production of vitamin D with age.

The minimum desirable serum level of 25-hydroxyvitamin D has been suggested to be 20 to 30 ng/mL, and levels lower than this are clearly related to compromised bone-mineral density, falls, and fractures and more recently have also been linked to cancer and immune dysfunction, as well as cardiovascular disease, hypertension, and metabolic syndrome, the authors report.

They point out that recent studies have shown an association of low 25-hydroxyvitamin-D levels with important cardiovascular risk factors, supporting previous findings that demonstrated positive effects of vitamin D and its analogs on fibrinolysis, blood lipids, thrombogenicity, endothelial regeneration, and smooth-muscle-cell growth. "Together, these findings strongly suggest that 25-hydroxyvitamin D has beneficial effects, some involving the cardiovascular system, that are independent of calcium metabolism," they comment.

Low 25-hydroxyvitamin-D levels were also significantly correlated with markers of inflammation (C-reactive protein [CRP] and interleukin 6 [IL-6]), oxidative burden (serum phospholipid and glutathione levels), and cell adhesion (vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 levels).

Dobnig et al say that these results show that a low 25-hydroxyvitamin-D level can be considered a strong risk indicator for all-cause mortality in women and in men.

The authors also report that the increase in risk of all-cause mortality with lower levels of vitamin D was seen regardless of the degree of coronary artery disease seen on angiography, and they comment: "Low 25-hydroxyvitamin-D and 1,25-dihydroxyvitamin-D levels seem to be important mediators of mortality even when there is little or no indication of overt vascular disease."

They say they are unable to tell, based on these results, whether the association between low 25-hydroxyvitamin-D and 1,25-dihydroxyvitamin-D levels and mortality is causal or not. But they believe there are a few indications pointing to a possible link. These include the association with elevated inflammatory markers, which suggests these compounds may have anti-inflammatory properties, and the effects related to oxidative stress and increased cell adhesion suggest that low levels of vitamin D may detrimentally affect vascular biologic function in multiple ways.

They add that other mechanisms whereby low vitamin-D levels may be associated with mortality include effects on matrix metalloproteinases, which have been shown to affect plaque production and stability, increased susceptibility to arterial calcification, or an increase in renin messenger-RNA expression.

They conclude: "This prospective cohort study demonstrates for the first time, to our knowledge, that low 25-hydroxyvitamin-D and 1,25-dihydroxyvitamin-D levels are associated with increased risk in all-cause and cardiovascular mortality compared with patients with higher serum vitamin-D levels. Both vitamins seem to have synergistic biologic action that is largely independent of each other. Based on the findings of this study, a serum 25-hydroxyvitamin-D level of 20 ng/mL or higher may be advised for maintaining general health."

Reference

1. Dobnig H, Pilz S, Scharnagl H, et al. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 2008; 168:1340-1349.

Daily Calcium with Vitamin D Reduces Fracture Risk

HEALTH NEWS

"A large randomised controlled trial in women in French nursing homes or apartments for older people showed that calcium and vitamin D supplementation increased serum 25-hydroxyvitamin D, decreased parathyroid hormone, improved bone density, and decreased hip fractures and other non-vertebral fractures," write B. Abrahamsen, from Copenhagen University Hospital Gentofte, in Copenhagen, Denmark, and colleagues from the DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group.

"Subsequent randomised trials examining the effect of vitamin D supplementation — with or without calcium — on the incidence of fractures have produced conflicting results....We used individual patient data methods to do a meta-analysis of randomised controlled trials of vitamin D — with or without calcium — in preventing fractures and investigated if treatment effects are influenced by patients' characteristics."

The goals of the study were to identify characteristics affecting the antifracture efficacy of vitamin D or vitamin D plus calcium regarding any fracture, hip fracture, and clinical vertebral fracture and to evaluate the effects of dosing regimens and coadministration of calcium.

"The individual patient data analysis indicates that vitamin D given alone in doses of 10-20 μg is not effective in preventing fractures," the study authors write. "By contrast, calcium and vitamin D given together reduce hip fractures and total fractures, and probably vertebral fractures, irrespective of age, sex, or previous fractures."

"We must emphasise that this analysis does not allow for a direct comparison of vitamin D against vitamin D given with calcium, but only comparisons between each intervention and no treatment," the study authors conclude. "Whether intermittent doses of vitamin D given without calcium supplements can reduce the risk of fractures remains unresolved from the studies in this analysis. Additional studies of vitamin D are also needed, especially trials of vitamin D given daily at higher doses without calcium."

In an accompanying editorial, Dr. Opinder Sahota, from Queen's Medical Centre in Nottingham, United Kingdom, notes that these findings are important because they show that vitamin D alone, irrespective of dose, does not reduce the risk for fracture.

"Although the evidence is still confusing, there is growing consensus that combined calcium and vitamin D is more effective than vitamin D alone in reducing non-vertebral fractures," Dr. Sahota writes. "Higher doses are probably necessary in people who are more deficient in vitamin D, and treatment is probably more effective in those who maintain long term compliance. Further studies are needed to define the optimal dose, duration, route of administration, and dose of the calcium combination."

Source: Laurie Barclay, MD/MedScape CME Clinical Briefs, January 22, 2010

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