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The Impact of Air pollutants, UV exposure and Geographic Location on Vitamin D deficiency
... For example, aluminum is neurotoxic and is strongly associated with neurodegenerative diseases such as Alzheimer's. In addition, a burgeoning number of studies demonstrate the presence of aluminum in human brain tissue, and data support that high levels of aluminum in the brain are not a fatality of aging [16]; (3)/ Many diseases are linked to vitamin D deficiency, whose synthesis is impaired by reduced sun exposure due to air pollution [17]. It is important to note that this deficiency is global [18]. ...
... In 2017, the Commission is asked whether measures have been taken to analyze and assess the effects of chemical trails on the environment and how it intends to protect the European population (E-005130- 17). ...
... The main source of vitamin D (90%) comes from the sun. Air pollution has been reported as one of the most significant factors that causes vitamin D deficiency by reducing sun exposure, especially UV-B radiation [17]. Bill 2017 states that if solar geoengineering aerosols are sprayed, solar radiation would decrease, implying a decline in vitamin D synthesis [71]. ...
According to most scientific studies, media and governments, the white trails that can be seen behind aircraft in flight, corresponding to condensation mixed with engine particulate emissions, only persist under specific atmospheric conditions. They are called condensation trails, and cirrus contrails when they remain for hours to reach several kilometers wide. The fact that they have gradually filled the skies over the last twenty years would be due to the increase in air traffic. However, other official documents link these persistent trails to a weather modification technology called solar geoengineering by stratospheric aerosol injection (SAI). These sprays would be mainly composed of metallic particles (Al, Ba, Sr, Fe, nanoparticles) and sulfur, which would considerably increase air, soil and water pollution. Many of the current environmental and health problems are consistent with those described in the literature on solar geoengineering by SAI if this method was employed. For example, metal particles used are well known environmental contaminants, ozone layer depletion, cardiorespiratory diseases, neurodegenerative diseases, sunburn. The observations (whiter skies, less solar power) also correspond to the same risks as those described in the solar geoengineering works. Patents show that this weather modification technology has been known and mastered for a long time. In addition, some scientific papers as well as policy documents suggest that solar geoengineering by SAI has been used for many years. The amount of official information presented in this review is intended to open new ways of investigation, free of conflicts of interest, about the growing global pollution of persistent aircraft trails and their possible links with solar geoengineering by SAI.
... Air pollution can absorb Ultraviolet B (UVB) photons that can restrict the amount of solar UVB radiation reaching the Earth's surface. Air pollution also diminishes the cutaneous photosynthesis of vitamin D by elevating parathyroid hormone levels, increasing bone resorption, and decreasing total body BMD [15,16]. A low air quality index in Isfahan, Iran, was associated with reduced UVB radiation and vitamin D deficiency in young children despite the region having high sunlight exposure [17]. ...
... One report indicated that PM concentrations directly decreased the serum level of parathyroid hormone and BMD in 692 middle-aged men in the USA [18]. Our study could not show a causal relationship between PM 10 and osteoporosis because we were not able to access individuals' serum vitamin D or parathyroid hormone levels in the claims data; however, based on the results from previous studies, we hypothesize underlying mechanisms [15][16][17][18]. ...
Background
This study investigated the associations between exposure to ambient air pollutants and the incidence of osteoporosis using the Korean National Insurance Service–National Sample Cohort.
Methods
This nationwide, population-based, retrospective cohort study included 237,149 adults aged ≥40 years that did not have a diagnosis of osteoporosis at baseline between January 1, 2003, and December 31, 2015. Osteoporosis was defined as claim codes and prescriptions of bisphosphonates or selective estrogen receptor modulators at least twice annually. After matching values for PM10, NO2, CO, and SO2 during the 2002–2015 time period and PM2.5 in 2015 with residential areas, the incidence of osteoporosis was analyzed using a Cox proportional hazards regression model according to the quartile of average yearly concentrations of pollutants.
Results
Overall 22.2% of the study subjects, 52,601 (male: 5.6%, female: 37.6%) adults in total, were newly diagnosed with osteoporosis and treated. Exposure to PM10 was positively associated with incidence of osteoporosis (Q4: 1798 per 100,000 person-years vs. Q1: 1655 per 100,000 person-years). The adjusted hazard ratio (HR) with 95% confidence interval (CI) of Q4 in PM10 was 1.034 (1.009–1.062). The effect of PM10 on osteoporosis incidence was distinct in females (adjusted sub-HR: 1.065, 95% CI: 1.003–1.129), subjects aged < 65 years (adjusted sub-HR: 1.040, 95% CI: 1.010–1.072), and for residents in areas with low urbanization (adjusted sub-HR: 1.052, 95% CI: 1.019–1.087). However, there was no increase in osteoporosis based on exposure to NO2, CO, SO2, or PM2.5.
Conclusions
Long-term exposure to PM10 was associated with newly diagnosed osteoporosis in Korean adults aged ≥40 years. This finding can aid in policy-making that is directed to control air pollution as a risk factor for bone health.
... In the summer, due to fear of malignant skin diseases, use of creams with high ultraviolet (UV) protection is common, which further contributes to VD deficiency [5]. Air pollution in large urban industrial agglomerations with insufficient insolation also predisposes Vitamin D 2 to VD deficiency [6,7]. Taken together, hypovitaminosis D has become a pandemic in itself, identified across ethnicities and age groups worldwide [8][9][10]. ...
... Furthermore, VD can suppress cytokine storm by reducing the severity of influenza A. It significantly decreases the levels of tumor necrosis factor-alpha (TNF-α), interferon-beta (IFN-β), and IFN-stimulated gene-15 [23]. This is very important in case of severe clinical presentations of viral infection, especially those of the respiratory system [6]. VD also influences the acquired immunity and regenerate endothelial function and lining [24]. ...
Recent research about the influence of vitamin D (VD) deficiency on the occurrence of viral infections suggests that children with VD deficiency have attenuated immune response. This, in turn, increases the severity of viral infections, especially those of the respiratory tract, that show a typical seasonality pattern during the winter months. Despite the immunization of children at the global level, outbreaks of influenza do frequently occur. Over the past months, we have witnessed that the explosive pandemic of the corona virus disease 2019 (COVID-19) has caused significant mortality in some countries. Numerous studies have shown that VD deficiency is increasingly prevalent worldwide, and that it is potentially associated with the onset of viral infections. Persons with hypovitaminosis D and subsequent secondary immunodeficiencies ought to be identified and treated, while preventive supplementation of VD should be recommended to the general population to avoid VD deficiency during the winter. In this way, the burden of viral infections on population health and economy could be reduced. This paper also reviews the influence of VD on infections caused by hepatitis B and C viruses, human papil-lomavirus, Epstein-Barr virus, Human herpes virus 6, herpes simplex virus, and human immunodeficiency virus.
... 4 Vitamin D deficiency occurs at elevated levels of greenhouse gases and aerosols which absorb ultraviolet radiation reducing the cutaneous synthesis of vitamin D, thus increasing the susceptibility to viral infections. 66,67 This explains how the initial COVID-19 outbreak occurred in Lombardy, Italy where the population is known to suffer from vitamin D deficiency. 67 ...
Global warming can be defined as the detectable increase in average global temperature in the last ten years regarding frequency and intensity. Climate change represents a long-term detectable climatic variability. The climatic system of the earth is disrupted because of the continuous production of greenhouse gases, which raises the risk of the emergence and re-emergence of human pathogens. In this review, we aimed to present the different mechanisms of climate change that increase human/pathogen exposure, introduce the recent concept of disaster microbiology, and discuss the effects of climate change on zoonoses as well as the effects of climate change on antibiotic resistance and human health.
... Epidemiological studies suggest an association between air pollution and vitamin D deficiency [15]. In cities with high levels of air pollutants (ozone, particulate matter and sulfur dioxide), ultraviolet light is efficiently absorbed by these pollutants, reducing skin synthesis of pro-vitamin D3 [16]. Since toxic metals such as cadmium (Cd) and lead (Pb) are widespread in the environment and may play a role in endocrine disorders, it is necessary to investigate the effects of exposure to toxic metals on human vitamin D status [14,17]. ...
Limited studies have demonstrated that inorganic arsenic exposure is positively associated with serum vitamin D levels, although the correlation between urinary arsenic species and serum vitamin D has not been investigated in areas of water-borne arsenicosis. A cross-sectional study of 762 participants was conducted in Wenshui Country, Shanxi Province, a water-borne arsenicosis area. The results showed a positive relationship between urinary arsenic species (inorganic arsenic (iAs), methylarsonic acid (MMAV), dimethylarsinic acid (DMAV) and serum 25(OH)D. Log-binomial regression analysis indicated a 0.4% increase in the risk of vitamin D excess for every 1-unit increment in the Box–Cox transformed urinary DMAV after adjustment for covariates. After stratifying populations by inorganic arsenic methylation metabolic capacity, serum 25(OH)D levels in the populations with iAs% above the median and primary methylation index (PMI) below the median increased by 0.064 ng/mL (95% CI: 0.032 to 0.096) for every one-unit increase in the Box–Cox transformed total arsenic (tAs) levels. Serum 25(OH)D levels increased by 0.592 ng/mL (95% CI: 0.041 to 1.143) for every one-unit rise in the Box–Cox transformed iAs levels in people with skin hyperkeratosis. Overall, our findings support a positive relationship between urinary arsenic species and serum 25(OH)D. It was recommended that those residing in regions with water-borne arsenicosis should take moderate vitamin D supplements to avoid vitamin D poisoning.
... La exposición solar óptima es esencial para la síntesis suficiente de alrededor del 90% de los niveles de vitamina D en el cuerpo 9 . La vitamina D es un nutriente importante para prevenir varias enfermedades crónicas, y la deficiencia se asocia a muchos problemas de salud 10 . Los estudios experimentales han demostrado que la 1,25-dihidroxivitamina D, la forma activa de la vitamina D, ejerce actividades inmunológicas sobre múltiples componentes del sistema inmunitario innato y adaptativo 11 . ...
Objetivo.
Determinar los niveles plasmáticos de vitamina D y su relación con la ocupación, procedencia y los valores de calcio, leucocitos, hemoglobina y plaquetas en adultos mayores de Lima Metropolitana.
Método.
Estudio observacional descriptivo de corte transversal, participaron 100 adultos mayores de uno u otro sexo de Lima Metropolitana, ellos fueron reclutados durante las estaciones de invierno-primavera del 2022, los niveles de vitamina D se categorizó como suficiente, insuficiente y deficiente, las concentraciones séricas de vitamina D se midieron por radioinmunoensayo. La relación de variables se realizó con el coeficiente de correlación de Spearman y regresión logística.
Resultados.
La edad media fue 69.6 años, el 71%, fueron del sexo femenino, la concentración media de vitamina D fue 36.56 ng/ml, el 13% tuvieron niveles de deficiente, y el 32% de insuficiente y el 53% suficientes. Según sexo, el 77,7% de los que tuvieron niveles de deficiente/insuficiente fueron mujeres. En el análisis bivariado no hubo correlación entre los valores de vitamina D con calcio, hemoglobina leucocitos y plaquetas, los que procedieron de distritos de menor temperatura tuvieron 2,25 veces más riesgo de tener niveles insuficientes/deficiente de vitamina D.
Conclusiones.
El 45% de los adultos mayores tuvieron niveles deficientes/insuficiente de vitamina D, siendo más frecuente en las mujeres y de los procedentes de distritos de menor promedio de temperatura.
... Epidemiologic studies suggest an association between air pollution and vitamin D deficiency. In cities with high levels of air pollutants (ozone, particulate matter, and sulfur dioxide), UV light is efficiently absorbed by these pollutants, thus reducing the skin synthesis of pro-vitamin D3 [11]. In addition, due to toxic metals are widely distributed in the environment and their potential role in endocrine disruption, it is necessary to investigate the influences of exposure to toxic metals on human vitamin D status [10,12]. ...
Limited studies have shown that exposure to arsenic is associated with serum vitamin D levels, but the results are still inconsistent. A cross-sectional study of 762 participants was conducted in Wenshui Country, Shanxi Province, which was identified as an area of water-borne arsenicosis. The results showed positive relationship between arsenic species (iAs, MMA, DMA) and serum 25(OH)D. Binary logistic regression analysis showed that the significant increases of 0.4% and 0.6% in the risk of vitamin D excess for every 1-unit increment in the Box-Cox transformed urinary tAs and DMA, respectively. After stratifying populations based on arsenic methylation metabolic capacity, each one-unit increase in the Box-Cox transformed tAs level was associated with increases of 0.064 (95%CI: 0.032 to 0.096) in serum 25(OH)D in the populations with iAs% above the median. In the populations with skin hyperkeratosis, urinary iAs was positively associated with serum 25(OH)D (β=0.592, 95%CI: 0.041 to 1.143). Overall, our findings support the positive relationship between urinary arsenic and serum 25(OH)D.
... (Participant 2) . . . . High prevalence of VDD risk factors in Iran Some of the main causes of VDD in Iran over the past few decades were reported as changes in socioeconomic factors, food patterns, and lifestyle (7,19). Vitamin D deficiency varies based on age, sex, and location of residence (20). ...
Aim
Iran has a higher prevalence of vitamin D deficiency (VDD) than the global level. This study aimed to assess VDD prevention policies in Iran through a policy analysis of agenda setting using the multiple streams framework (MSF).
Methods
Using Kingdon's MSF model, this qualitative analytical study performed a policy analysis on vitamin D-related policies in Iran. The policy documents were reviewed, and in-depth interviews were conducted with stakeholders (n = 27) using the framework analysis method. To categorize data and extract the related themes, MAXQDA version 10 was used.
Results
According to Kingdon's MSF theory, the problem stream included the high prevalence of VDD among Iranian infants (23.3%), adolescents (76%), and adults (59.1%). The policy stream was identified to focus on preventing programs for non-communicable diseases in the health sector. The political stream indicated that national and international support could provide a political climate for this issue.
Conclusion
According to our results, a window of opportunity for policymaking on VDD prevention has opened. However, there are some challenges related to the implementation of these policies. These include the dominance of a treatment-based view rather than a prevention-based approach in the health sector, economic problems, and restricted access to health services due to the outbreak of coronavirus disease 2019 (COVID-19). To strengthen and implement VDD prevention policies, the stakeholders need support from high-level policymakers.
... 23 health protection, largely impairing the skin's vitamin D production. 41,42 In addition, there is evidence suggesting that exposure to UVB light is linked to a lower risk of RA. 43 The association between SLE and silica dust exposure has been studied extensively, [50][51][52][53][54][55] indicating that exposure to crystalline silica may increase the likelihood of SLE in some individuals. Again, silica dust has been associated with poor prognosis of systemic sclerosis and with younger age at diagnosis. ...
The environment plays a central role in the development and exacerbation of rheumatic musculoskeletal diseases (RMDs). Air pollution is an emergent environmental player; it has been demonstrated to cause several autoimmune diseases and, more recently, to be associated with a higher risk of reactivation of inflammatory conditions. Airborne environmental pollution can be detected using various approaches. All these methods have limitations and strengths. The present review discusses the effects of air pollution on RMDs and focuses on the approaches for investigating the association between air pollution exposure and RMDs.
... This high incidence in this study might be a result of urban dwellers spending more time indoors and participating in less outside activities due to air pollution, which also reduces exposure to sunshine. 21 For women of childbearing age, two to three sessions of roughly 10-15 minutes of sun exposure each week are strongly advised to absorb an adequate quantity of vitamin D. 22 Even 11.1 hours of total body exposure to sunlight per week, according to a recent study among Hawaiians, was insufficient to halt the development of "low vitamin D status." 23 In a study by Chandel et al, it is reported that majority of vitamin D deficient subjects were <30 years of age. 22 In contrast to this, our study indicated that age groups older than 30 years had a higher prevalence of vitamin D deficiency and insufficiency. ...
Background: Objective of the study was to study the prevalence of vitamin D deficiency among antenatal women and in relation to parity, BMI, diet and working status. Methods: Prospective study conducted at NIMS Medical College, Jaipur from Dec 2019-July 2021, in the Department of Gynaecology and Obstetrics. It was a hospital based observational study 160 pregnant women were included in the study after obtaining written informed consent. Blood was collected at their first visit itself and 25 (OH) D3 level was tested by Chemiluminescent Immunoassay (CLIA) in hospital lab. And results were analysed. Results: Out of 160 antenatal women, only 12 (07.50%) had sufficient vitamin D levels of 30-100 ng/ml. Mean (SD) vitamin D level in this group was 41.1±10.8. 41 (25.625%) participants had vitamin D insufficiency (20-29 ng/ml) with a mean (SD) of 22.6±2.3 and 107 (68.875%) participants had vitamin D deficiency with serum level <20 ng/ml with a mean (SD) value of 13.8±3.9. Vitamin D deficiency and insufficiency together (vitamin D <30 ng/ml) constituted 92.50% and the mean (SD) was 16.2±5.6. Among vitamin D deficient group, 26 (16.25%) were having vitamin D level <10 ng/ml with a mean of 8.1±1.3. Conclusions: There is high prevalence of vitamin D insufficiency and deficiency among antenatal women attending the OPD in NIMS Medical College and Hospitals in Rajasthan region. Since vitamin D has crucial role in maternal and foetal health outcomes, it is of utmost importance to correct this deficiency in pregnancy.
... It should be noted that exposure to air pollutants during the gestational period can decrease vitamin D levels in newborns [127]. The absorption/scattering of UVB radiation caused by tropospheric ozone and PMs is becoming a real concern for human health [128]. The skin serves not only as a primary place for vitamin D3 production but also as a target organ for its action, which is vital in the formation of the skin barrier and hair follicles [125]. ...
The increase in air pollution worldwide represents an environmental risk factor that has global implications for the health of humans worldwide. The skin of billions of people is exposed to a mixture of harmful air pollutants, which can affect its physiology and are responsible for cutane-ous damage. Some polycyclic aromatic hydrocarbons are photoreactive and could be activated by ultraviolet radiation (UVR). Therefore, such UVR exposure would enhance their deleterious effects on the skin. Air pollution also affects vitamin D synthesis by reducing UVB radiation, which is essential for the production of vitamin D3, tachysterol, and lumisterol derivatives. Ambient air pollutants , photopollution, blue-light pollution, and cigarette smoke compromise cutaneous structural integrity, can interact with human skin microbiota, and trigger or exacerbate a range of skin diseases through various mechanisms. Generally, air pollution elicits an oxidative stress response on the skin that can activate the inflammatory responses. The aryl hydrocarbon receptor (AhR) can act as a sensor for small molecules such as air pollutants and plays a crucial role in responses to (photo)pollu-tion. On the other hand, targeting AhR/Nrf2 is emerging as a novel treatment option for air pollutants that induce or exacerbate inflammatory skin diseases. Therefore, AhR with downstream regulatory pathways would represent a crucial signaling system regulating the skin phenotype in a Yin and Yang fashion defined by the chemical nature of the activating factor and the cellular and tissue context.
... The amount of sun exposure that is needed to generate sufficient UVB for conversion of 7-dehydrocholesterol varies on latitude, season, time of day, ozone amount, cloud amount, aerosol and reflectivity of the surface (276). Increases in ozone levels and particulate matter in the air can decrease availability of the UVB rays that are necessary for endogenous production of vitamin D (299,300). Children living in areas of higher air pollution may therefore have lower contributions of endogenously produced vitamin D (301,302). In a study in India, children living in 2 areas of the city with differing air quality not only had differences in 25OHD levels, but also in parathyroid hormone and alkaline phosphatase (300) (Fig. 1). ...
Endocrine care of pediatric and adult patients continues to be plagued by health and health care disparities that are perpetuated by the basic structures of our health systems and research modalities, as well as policies that impact access to care and social determinants of health. This scientific statement expands the Society's 2012 statement by focusing on endocrine disease disparities in the pediatric population and sexual and gender minority populations. These include pediatric and adult lesbian, gay, bisexual, transgender, queer, intersex, and asexual (LGBTQIA) persons. The writing group focused on highly prevalent conditions-growth disorders, puberty, metabolic bone disease, type 1 (T1D) and type 2 (T2D) diabetes mellitus, prediabetes, and obesity. Several important findings emerged. Compared with females and non-White children, non-Hispanic White males are more likely to come to medical attention for short stature. Racially and ethnically diverse populations and males are underrepresented in studies of pubertal development and attainment of peak bone mass, with current norms based on European populations. Like adults, racial and ethnic minority youth suffer a higher burden of disease from obesity, T1D and T2D, and have less access to diabetes treatment technologies and bariatric surgery. LGBTQIA youth and adults also face discrimination and multiple barriers to endocrine care due to pathologizing sexual orientation and gender identity, lack of culturally competent care providers, and policies. Multilevel interventions to address these disparities are required. Inclusion of racial, ethnic, and LGBTQIA populations in longitudinal life course studies is needed to assess growth, puberty, and attainment of peak bone mass. Growth and development charts may need to be adapted to non-European populations. In addition, extension of these studies will be required to understand the clinical and physiologic consequences of interventions to address abnormal development in these populations. Health policies should be recrafted to remove barriers in care for children with obesity and/or diabetes and for LGBTQIA children and adults to facilitate comprehensive access to care, therapeutics, and technological advances. Public health interventions encompassing collection of accurate demographic and social needs data, including the intersection of social determinants of health with health outcomes, and enactment of population health level interventions will be essential tools.
... Sun exposure for vitamin D synthesis may be efficient only when the angle of sun rays is more than 45°. As a result of this, inhabitants of the northern hemisphere do not receive sufficient amounts of vitamin D through skin synthesis during winter months, and in some northern areas, defective sun exposure may last up to 6 months of the year [3]. Moreover, a typical Western diet is poor in vitamin D [4]. ...
Vitamin D insufficiency or deficiency (VDD) is a very prevalent condition in the general population. Vitamin D is necessary for optimal bone mineralization, but apart from the bone effects, preclinical and observational studies have suggested that vitamin D may have pleiotropic actions, whereas VDD has been linked to several diseases and higher all-cause mortality. Thus, supplementing vitamin D has been considered a safe and inexpensive approach to generate better health outcomes-and especially so in frail populations. Whereas it is generally accepted that prescribing of vitamin D in VDD subjects has demonstrable health benefits, most randomized clinical trials, although with design constraints, assessing the effects of vitamin D supplementation on a variety of diseases have failed to demonstrate any positive effects of vitamin D supplementation. In this narrative review, we first describe mechanisms through which vitamin D may exert an important role in the pathophysiology of the discussed disorder, and then provide studies that have addressed the impact of VDD and of vitamin D supplementation on each disorder, focusing especially on randomized clinical trials and meta-analyses. Despite there already being vast literature on the pleiotropic actions of vitamin D, future research approaches that consider and circumvent the inherent difficulties in studying the effects of vitamin D supplementation on health outcomes are needed to assess the potential beneficial effects of vitamin D. The evaluation of the whole vitamin D endocrine system, rather than only of 25-hydroxyvitamin D levels before and after treatment, use of adequate and physiologic vitamin D dosing, grouping based on the achieved vitamin D levels rather than the amount of vitamin D supplementation subjects may receive, and sufficiently long follow-up are some of the aspects that need to be carefully considered in future studies.
... In Chinese traditional practice, postpartum con nement could help women recover better. However, the lack of exposure to ultraviolet sunlight may have a negative effect on the synthesis of vitamin D and bones, and increase the incidence of PLO [11]. ...
Objective To illustrate the clinical characteristics of pregnancy- and lactation-associated osteoporosis (PLO) by retrospectively analyzing six cases of PLO.
Methods Six cases of PLO diagnosed in our Endocrinology and Orthopedics Departments from January 2018 to June 2020 were retrospectively studied. The baseline characteristics, clinical features, laboratory findings, radiological manifestations and follow-up outcomes were analyzed and compared with previous reports.
Results The mean age of the six patients was 33.5 years old (range 30-36 years) with a mean height of 163 cm (range 151-171 cm), mean weight of 56.2 kg (range 47-73 kg) and mean body mass index (BMI) of 21.3 kg/m2 (range 17.4-28.5 kg/m²). All enrolled patients complained of low back pain, with a mean visual analogue scale (VAS) score of 7.0 points (4-10). The mean bone mineral density (BMD), as assessed by the Z-score obtained from the dual-energy X-ray absorptiometry measurement, was -2.90 (range -4.37- -1.34). All six patients underwent magnetic resonance imaging (MRI) scans and vertebral compressive fractures were detected in four patients. The main feature of MRI images of the patients was the appearance of strip-shaped abnormal signal area under the upper endplate of the vertebrae, with low T1 phase signal and high T2 fat-suppressed phase signal. The fractures mainly affected the thoracolumbar regions. Fractures in four patients were all multiple vertebral fractures, with at least two and at most nine vertebral fractures. All six patients received conservative treatment, and no surgical intervention. After a mean follow-up of 27.3 months (range 24-31 months), the symptoms of the six patients were significantly relieved, although four patients still had low back pain to varying degrees.
Conclusion PLO tends to occur in older and thinner women with clinical manifestations varying in severity. MRI often reveals multiple vertebral compressive fractures in patients with PLO. PLO has good prognosis with conservative treatment, but complete relief may take a long time.
... Recent epidemiological studies have demonstrated that an insufficiency of vitamin D (<30 ng/ml), affects 50% of the population worldwide, while 1 billion people show vitamin D deficiency (<10 ng/ml), as per the cutoffs established by the Endocrine Society Clinical Practice Guidelines (8) . ...
... Air pollution and its components are considered endocrine disruptor chemicals, which could have an important role in the pathogenesis of type 1 diabetes mellitus [33][34][35] . In addition, the association between air pollution and vitamin D deficiency could also explain the suggested association 36,37 . ...
Aims/introduction:
We aimed to determine the incidence trend of childhood type 1 diabetes mellitus in Isfahan province over a period of 12 years.
Materials and methods:
In this retrospective study, children aged <20 years at the time of type 1 diabetes mellitus diagnosis, from March 2007 to March 2019, were included. The crude and adjusted incidence rate of type 1 diabetes mellitus is calculated as the number of cases per 100,000 person-years by the period. The cumulative, age- and sex-specific incidence rates were also calculated. Age-specific incidence rates were calculated for age and sex groups.
Results:
A total of 1,954 (983 boys and 971 girls) cases of type 1 diabetes mellitus were identified. The mean age at diagnosis in all studied populations was 9.89 (standard deviation 4.76). There were no significant differences between the proportion of boys and girls in different years (P = 0.12) and different age groups (P = 0.19). The average annual percent change of incidence rate for the total population, for girls and boys, was 6.9%, 6.7% and 6.3% respectively. The type 1 diabetes mellitus incidence rate had a significant trend to be increased from 2007 to 2019 (P < 0.001, t = 3.6).
Conclusion:
Our findings showed that currently our region is considered a region with a high incidence rate of type 1 diabetes mellitus. Although we have had fluctuations in the incidence rate over the 12 years, the overall trend is increasing.
... Among factors influencing the synthesis of vitamin D, air pollution was found to be a factor because of the physical characteristic (Barrea et al., 2017;Hoseinzadeh et al., 2018;Mousavi et al., 2019). Some population-based studies indicated that air pollution contributed to VDD in both adults (Hosseinpanah et al., 2010;Manicourt and Devogelaer 2008;Setiati 2008) and children (Agarwal et al., 2002;Calderón-Garcidueñas et al., 2015). ...
Vitamin D metabolism is essential in aging and can be affected by multiple environmental factors. However, most studies conducted single exposure analyses. We aim to assess the individual and combined effects of ultraviolet (UV) radiation, residential greenness, fine particulate matter (PM2.5), and ozone (O3) on vitamin D levels in a national cohort study of older adults in China. We used the 2012 and 2014 Chinese Longitudinal Healthy Longevity Survey data, and measured the environmental exposure in the same year. We interpolated the UV radiation from monitoring stations, measured residential greenness through satellite-derived Normalized Difference Vegetation Index (NDVI), modeled PM2.5 with satellite data, and estimated O3 using machine learning. We dichotomized serum 25-hydroxy vitamin D (25(OH)D), the primary circulating form of vitamin D, into non-deficiency (≥50 nmol/L) and deficiency (
... Some airborne pollutants (e.g., ozone and PM) can limit the level of UV radiation [329] and modify one's UV exposure. Tropospheric ozone and PM can absorb and scatter UVB, reducing the amount of radiation reaching the earth [330,331]. Thus, once the ozone layer is destroyed, caused by the accumulation of ozonedepleting chemicals, such as CFCs, organisms will be exposed to significantly more UV radiation [332]. In addition to the natural barrier of the ozone layer, certain chemicals are used to make UV-blocking products that protect the skin from radiation. ...
Abstract The exposome depicts the total exposures in the lifetime of an organism. Human exposome comprises exposures from environmental and humanistic sources. Biological, chemical, and physical environmental exposures pose potential health threats, especially to susceptible populations. Although still in its nascent stage, we are beginning to recognize the vast and dynamic nature of the exposome. In this review, we systematically summarize the biological and chemical environmental exposomes in three broad environmental matrices—air, soil, and water; each contains several distinct subcategories, along with a brief introduction to the physical exposome. Disease‐related environmental exposures are highlighted, and humans are also a major source of disease‐related biological exposures. We further discuss the interactions between biological, chemical, and physical exposomes. Finally, we propose a list of outstanding challenges under the exposome research framework that need to be addressed to move the field forward. Taken together, we present a detailed landscape of environmental exposome to prime researchers to join this exciting new field.
... According to [55,56], air pollutants intensify the ultraviolet (UV) radiation from sunlight. In other words, the dirtier the air, the more intense the UV radiation reaching the Earth's surface as the air pollutants diffuse and refract the sunlight and UV radiation. ...
This research proposes a set of 12 self-assessed air pollution adaptive capacity (APAC) indicators to determine and mitigate individual-level air pollution-related health risks. In the study, the APAC indicators were first statistically validated based on data from panels of experts using structural equation modeling. The validated indicators were subsequently transformed into a questionnaire to measure the individual-level APAC index. For ease of interpretation, the APAC index was converted into an APAC grade. The APAC grade was compared against the grading criteria based on Air Quality Index (AQI) levels to assess the individual-level health risks from air pollution. The proposed APAC-based self-assessment program to determine the individual-level health impacts from air pollution could be adopted as an economical and efficient alternative to costly and complicated clinical assessment.
... The Vit-D synthesis also depends on UVB light exposure, which in turn is reduced by the pollutants in the atmosphere [48]. Air pollution can be a main factor of VDD in polluted cities [49]. Further studies are needed with a larger sample size, including seasonal variations, genetic determinants, a more detailed systematic record of sun exposure duration, consumption of dietary sources of Vit-D, multivitamins, and Vit-D supplements use. ...
Background
Vitamin D (Vit-D) plays a central role in calcium homeostasis and maintains skeletal integrity. Housewives in Quetta, Pakistan are at increased risk of vitamin D deficiency (VDD). They spend a greater part of their day in cleaning, washing, cooking, managing daily groceries, and other household chores. Thus, little time is left for self-care and outdoor activities. They wear hijab and have very little exposure to sunlight. In addition, their diet is deficient in Vit-D-rich food items, rendering them at high risk of VDD. Fear of getting tanned, melasma, and preference for a fair complexion further limit their sun exposure. This study evaluates the prevalence of VDD in housewives and determines its various risk factors to recommend screening guidelines for VDD.
Methods
A cross-sectional study was performed between November 2020 and April 2021 and recruited housewives aged >18 from the outpatient department of a tertiary care hospital in Quetta. Informed consent was obtained from all participants. VDD was defined as a serum 25(OH)-D level <20 ng/mL (50 nmol/L). Sociodemographic variables and information about the dietary habits, perception, attitudes towards sunlight, and daily duration of sunlight exposure were collected. Mean and standard deviation (SD) were calculated for continuous variables and counts, and proportions were calculated for categorical variables like education, age. Univariate and multivariate logistic regression analyses were performed to determine the risk factors and associations of VDD. Data were analyzed by SAS/STAT software (version 9.4).
Results
Among 151 housewives, 58.9% of housewives had VDD. VDD group had a higher proportion of females aged 18-30 years and a lower proportion of graduates. The reported use of Vit-D supplements was much lower in the VDD group compared with the non-deficient group, 38.2% versus 71.0 %, P-value <0.001. History of fragility fractures was reported by 10.1% of housewives in the VDD group compared to 4.8% in the non-deficient group, P-value: 0.03. Around 77.5% of housewives in the VDD group spent 15 minutes or less outdoors versus 51.6% in the non-deficient group; 55.1% of housewives in the VDD group reported that they never consumed milk versus 17.7 % in the non-deficient group, P-value <0.00001. In the univariate logistic regression model, housewives with an 11-12th grade of education had 4.80-fold higher odds of VDD compared to those who had undergraduate or graduate degrees (OR: 4.80, 95 % CI: 1.07-21.45). Housewives who never consumed milk had 9.72-fold (95 % CI: 3.69-25.58) higher odds of VDD compared to those who consumed milk on daily basis. Odds of VDD were 3.61-fold (95% CI: 1.06-12.31) higher in those who never consumed fish as compared to those who ate fish at least 1-2 days/week. In multivariate logistic regression, age group 18-30 (OR: 17.07, 95% CI: 1.18-246.86), and never consuming milk (OR: 7.33, 95 % CI: 1.99-26.89) were independently associated with VDD.
Conclusion
VDD is highly prevalent (58.9%) in housewives of Quetta. It is the need of time to increase awareness regarding the health benefits, sources, and deficiency symptoms of Vit-D. Our study revealed VDD in housewives irrespective of education and income. Dietary supplementations were greater predictors of VDD. Daily sun exposure should be encouraged, and food items should be fortified with Vit-D. Recommendations for Vitamin D screening would be a good step, especially in Muslim housewives.
... 80% of vitamin D requirements are met by endogenous synthesis in the skin under UV radiation and impacted by time and date, weather, latitude, air pollution, and UV filters [31,32]. ...
Vitamin D deficiency is a global problem with many health consequences, and it is currently recommended to supplement vitamin D. Change of diet should also be considered to ensure adequate vitamin D in the human body. The aim of this study was to assess the concentration of vitamin D metabolites in two different groups: one group on the low-carbohydrate-high-fat (LCHF) diet and the other group on the Eastern European (EE) diet. In the first stage, 817 participants declaring traditional EE diet or LCHF diet were investigated. Nutrition (self-reported 3-day estimated food record) and basic anthropometric parameters were assessed. After extra screening, 67 participants on the EE diet and 41 on the LCHF diet were qualified for the second stage. Plasma 25-hydroxycholecalciferol (25(OH)D3) and (25(OH)D2) concentration was measured by the validated HPLC—MS/MS method. Plasma 25(OH)D3 concentration was significantly higher in the group on the LCHF diet (34.9 ± 15.9 ng/mL) than in the group on the EE diet (22.6 ± 12.1 ng/mL). No statistical differences were observed in plasma 25(OH)D2 concentration between the study groups (p > 0.05). Women had a higher plasma 25(OH)D2 concentration than men regardless of diet type. The LCHF diet had a positive influence on plasma vitamin D concentration. However, long-term use of the LCHF diet remains contentious due to the high risk of cardiovascular disease. This study confirmed that the type of diet influences the concentration of vitamin D metabolites in the plasma.
... Both low vitamin D levels and cigarette smoking are the strongest risk factors [5,6,9,10]. Although many studies have investigated the epidemiology of MS and the association effect of different genetic, environmental factors and lifestyle on this disease [2,6,[11][12][13][14][15][16][17][18][19][20][21], to the best of our knowledge, no study has assessed the associations effects of covariates, space and time on incidence rate of MS in Fars province through Bayesian spatiotemporal model. ...
Background
Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the associations s of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.
Method
Data from 5468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province.
Results
County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.
Conclusion
Bayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.
... Clothing also affects UVB absorption, but there are significant differences in UVB attenuation based on clothing type and color [154]. Sunscreen usage does not result in vitamin D deficiency [155], thereby reducing the possible carcinogenic effects of UV exposure while enabling the adequate synthesis of vitamin D. Smog and pollution can limit UV radiation exposure, mainly by reducing UVB radiation [156]. Together, these data suggest that the common routes that are commonly assumed to limit UV-mediated vitamin D synthesis do not block vitamin D synthesis in physiologically meaningful or clinically relevant amounts. ...
This review examines the beneficial effects of ultraviolet radiation on systemic autoimmune diseases, including multiple sclerosis and type I diabetes, where the epidemiological evidence for the vitamin D-independent effects of sunlight is most apparent. Ultraviolet radiation, in addition to its role in the synthesis of vitamin D, stimulates anti-inflammatory pathways, alters the composition of dendritic cells, T cells, and T regulatory cells, and induces nitric oxide synthase and heme oxygenase metabolic pathways, which may directly or indirectly mitigate disease progression and susceptibility. Recent work has also explored how the immune-modulating functions of ultraviolet radiation affect type II diabetes, cancer, and the current global pandemic caused by SARS-CoV-2. These diseases are particularly important amidst global changes in lifestyle that result in unhealthy eating, increased sedentary habits, and alcohol and tobacco consumption. Compelling epidemiological data shows increased ultraviolet radiation associated with reduced rates of certain cancers, such as colorectal cancer, breast cancer, non-Hodgkins lymphoma, and ultraviolet radiation exposure correlated with susceptibility and mortality rates of COVID-19. Thus, understanding the effects of ultraviolet radiation on both vitamin D-dependent and -independent pathway is necessary to understand how they influence the course of many human diseases.
... There are few natural dietary sources of vitamin D, and serum vitamin D is mainly synthesized in the skin upon sunlight exposure [7]. Insufficient cutaneous absorption of UVB and inadequate radiation are closely related to vitamin D deficiency [8]. Air pollution is a main determinant of the ground level of UVB. ...
Evidence on the effect of ambient air pollution on vitamin D is limited. This study aimed to examine the association of air pollution exposure with serum levels of 25-hydroxyvitamin D (25OHD) using UK Biobank health datasets. A total of 448,337 subjects were included in this analysis. Land Use Regression was applied to assess individual exposures to particulate matter with diameters ≤2.5 µm (PM2.5), ≤10 µm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx). Linear regression models evaluated the associations between air pollutants and serum vitamin D levels after adjustment of a series of confounders. All analyzed air pollutants were negatively associated with serum vitamin 25OHD levels. After adjusting for potential confounders, a 10 μg/m3 increase in concentrations of PM2.5, PM10, NOx, and NO2 was associated with −9.11 (95%CI: −13.25 to −4.97), −2.47 (95%CI: −4.51 to −0.43), −0.56 (95%CI: −0.82 to −0.30), and −1.64 (95%CI: −2.17 to −1.10) nmol/L decrease in serum vitamin 25OHD levels, respectively. Interaction analyses suggested that the effects of air pollution were more pronounced in females. In conclusion, long-term exposures to ambient PM2.5, PM10, NOx, and NO2 were associated with vitamin D status in a large UK cohort.
... At present, air pollution is the most serious negative environmental influence on human health (Chen et al., 2017;Schikowski and Huls, 2020). Many researchers across the globe have studied the influence of air pollution on human health (Hoseinzadeh et al., 2018;Kottner et al., 2020;Mousavi et al., 2019). Air pollutants can be both environmental and anthropic. ...
In recent times, a considerable amount of evidence has come to light regarding the effect that air pollution has on skin conditions. The human skin is the chief protection we have against environmental harm, whether biological, chemical, or physical. The stress from these environmental factors, along with internal influences, can be a cause of skin aging and enlarged pores, thinner skin, skin laxity, wrinkles, fine lines, dryness, and a more fragile dermal layer. This knowledge has led to greater demand for skin cosmetics and a requirement for natural raw ingredients with a high degree of safety and efficiency in combating skin complications. Recent developments in green technology have made the employment of naturally occurring bioactive compounds more popular, and novel extraction methods have ensured that the use of these compounds has greater compatibility with sustainable development principles. Thus, there is a demand for investigations into efficient non-harmful naturally occurring raw ingredients; compounds derived from algae could be beneficial in this area. Algae, both macroalgae and microalgae, consists of waterborne photosynthetic organisms that are potentially valuable as they have a range of bioactive compounds in their composition. Several beneficial metabolites can be obtained from algae, such as antioxidants, carotenoids, mycosporine-like amino acids (MAA), pigments, polysaccharides, and scytonemin. Various algae strains are now widely employed in skincare products for various purposes, such as a moisturizer, anti-wrinkle agent, texture-enhancing agents, or sunscreen. This research considers the environmental stresses on human skin and how they may be mitigated using cosmetics created using algae; special attention will be paid to external factors, both generally and specifically (amongst them light exposure and pollutants).
... It is synthesized in the stratum basale and stratum spinosum in the skin from 7-dehydrocholesterol when there is sufficient exposure to direct sunlight. Synthesis depends on the intensity of UV-B rays, atmospheric air pollution, season, geographic latitude and longitude, ozone layer thickness, cloudiness, time spent outside, clothing, sunscreen usage, skin color, and age [3]. Evidence suggests that skin aging reduces its capacity for vitamin D synthesis even during optimal sun exposure. ...
Background: Vitamin D (calciferol) is a group of fat-soluble compounds, which are essential for calcium homeostasis, immunomodulation, antiproliferative effects, and more. It can also be viewed as a prohormone. Almost every cell in the human body has a receptor for vitamin D. Its synthesis depends on multiple factors.
Review results: Vitamin D deficiency affects almost 50% of the world’spopulation, making it the most common vitamin deficit. There are multiple causes, mostly related to the modern lifestyle and ineffective exposition to the sun. The modern diet also lacks good sources of the vitamin, which makes supplementation the best option for optimal health. Supplements should be administered after serum level tests. Measurements below 20 ng/ml (50 nmol/l) are indication for supplementation. How effective the supplementation is will depend on the type of supplement, individual’s genetic factors, and with what foods the supplement is taken with. Dietary reference values for adequate intake and tolerable upper limit should be taken into consideration as well. Serum levels above 30 ng/ml (above 70 nmol/l) are considered optimal for health. There is a risk of toxicity in cases of over-supplementation and serum levels above 150 ng/ml (375 nmol/l).
Conclusion: The widespread vitamin D deficiency leads to many public health risks. Supplementation can have a therapeutic effect in many different conditions. To maximize the effect, and reduce the risks of toxicity, an individual assessment of the most appropriate regimen and the dosage of vitamin D supplementation is needed.
... Furthermore, areas lying above 37° latitude receive low intensity of UVB radiations, consequently, decreasing the biosynthesis of vitamin D3 [59]. Major air pollutants, i.e., Ozone, Carbon monoxide, Sulfur dioxide, Nitrogen dioxide and Particulate matter absorb and scatter UVB radiation resulting in the decreased biosynthesis of vitamin D in humans [60]. For instance, 50% of UVB radiations are found to be attenuated in highly polluted areas of China and India by air pollution [61]. ...
Vitamin D, like other vitamins, is an essential micronutrient required for proper human metabolic function. It refers to a group of compounds, the most important of which are D2 (ergocalciferol) and D3 (cholecalciferol). Vitamin D is acquired from two main sources, synthesis in lower layers of the skin triggered by exposure to the sun (90%) and through diet (10%). Vitamin D levels can be determined by measuring 25(OH)D concentration in the serum and deficiencies are responsible for a wide range of issues including bone related problems, depression, diabetes, autoimmune disorders, cardio and respiratory problems, infections, autism and obesity. Synthesis in the body can be affected by a variety of factors including skin color, age, lifestyle, clothing, weather and even general health illiteracy. In terms of diet, the staple foods of the Pakistani population are generally deficient in vitamin D. As a result, a significant proportion of the Pakistani population, in particular women and children, suffer from vitamin D deficiency. The various challenges that need to be addressed to overcome this issue are discussed, along with potentially employable strategies such as food fortification (for example by micro and nano encapsulation technologies) and bio fortification.
... Both low vitamin D levels and cigarette smoking are the strongest risk factors [5,6,9,10]. Although many studies have investigated the epidemiology of MS and the association effect of different genetic, environmental factors and lifestyle on this disease [2,6,[11][12][13][14][15][16][17][18][19][20][21], to the best of our knowledge, no study has assessed the associations effects of covariates, space and time on incidence rate of MS in Fars province through Bayesian spatio-temporal model. ...
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the associations s of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.
Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province.
Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.
Conclusion: Bayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.
... Both low vitamin D levels and cigarette smoking are the strongest risk factors [5,6,9,10]. Although many studies have investigated the epidemiology of MS and the effect of different genetic, environmental factors and lifestyle on this disease [2,6,[11][12][13][14][15][16][17][18][19][20][21], to the best of our knowledge, no study has assessed the effects of covariates, space and time on incidence rate of MS in Fars province through Bayesian spatio-temporal model. ...
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the effects of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.
Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province.
Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.
Conclusion: Bayesian spatio-temporal analysis of MS incidence rate revealed that the trend in the south and south east of Fars province is less steep than the mean trend of this disease. The lower incidence rate was associated with a higher percentage of vitamin D supplementation intake and a lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.
... Both low vitamin D levels and cigarette smoking are the strongest risk factors [5,6,9,10]. Although many studies have investigated the epidemiology of MS and the effect of different genetic, environmental factors and lifestyle on this disease [2,6,[11][12][13][14][15][16][17][18][19][20][21], to the best of our knowledge, no study has assessed the effects of covariates, space and time on incidence rate of MS in Fars province through Bayesian spatio-temporal model. ...
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the effects of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions.
Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province.
Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS.
Conclusion: Bayesian spatio-temporal analysis of MS incidence rate revealed that trend is less steep than the mean trend of this disease in the south and south east of Fars province, which is due to the association between the higher percentage of vitamin D supplementation intake and the lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates or risk factors, might be associated with high incidence of MS.
... Both low vitamin D levels and cigarette smoking are the strongest risk factors [5,6,9,10]. Although many studies have investigated the epidemiology of MS and the effect of different genetic, environmental factors and lifestyle on this disease [2,6,[11][12][13][14][15][16][17][18][19][20][21], to the best of our knowledge, no study has assessed the effects of covariates, space and time on incidence rate of MS in Fars province through Bayesian spatio-temporal model. ...
Background: Multiple Sclerosis (MS) remains to be a public health challenge, due to its unknown biological mechanisms and clinical impacts on young people. The prevalence of this disease in Iran is reported to be 5.30 to 74.28 per 100,000-person. Because of high prevalence of this disease in Fars province, the purpose of this study was to assess the spatial pattern of MS incidence rate by modeling both the effects of spatial dependence between neighboring regions and risk factors in a Bayesian Poisson model, which can lead to the improvement of health resource allocation decisions. Method: Data from 5,468 patients diagnosed with MS were collected, according to the McDonald’s criteria. New cases of MS were reported by the MS Society of Fars province from 1991 until 2016. The association between the percentage of people with low vitamin D intake, smoking, abnormal BMI and alcohol consumption in addition to spatial structure in a Bayesian spatio-temporal hierarchical model were used to determine the relative risk and trend of MS incidence rate in 29 counties of Fars province. Results: County-level crude incidence rates ranged from 0.22 to 11.31 cases per 100,000-person population. The highest relative risk was estimated at 1.80 in the county of Shiraz, the capital of Fars province, while the lowest relative risk was estimated at 0.11 in Zarindasht county in southern of Fars. The percentages of vitamin D supplementation intake and smoking were significantly associated with the incidence rate of MS. The results showed that 1% increase in vitamin D supplementation intake is associated with 2% decrease in the risk of MS and 1% increase in smoking is associated with 16% increase in the risk of MS. Conclusion: Bayesian spatio-temporal analysis of MS incidence rate revealed that trend is less steep than the mean trend of this disease in the south and south east of Fars province, which is due to the association between the higher percentage of vitamin D supplementation intake and the lower percentage of smoking. Previous studies have also shown that smoking and low vitamin D, among all covariates might be associated with high incidence of MS
... Recent epidemiological studies have demonstrated that an insufficiency of vitamin D (<30 ng/ml), affects 50% of the population worldwide, while 1 billion people show vitamin D deficiency (<10 ng/ml), as per the cutoffs established by the Endocrine Society Clinical Practice Guidelines (8) . ...
Background
Vitamin D deficiency and insufficiency have become a common problem worldwide. Vitamin D has been associated with all causes of mortality in chronic diseases and associated with a longer hospital stay and poor outcome.
Aim of the Study
to evaluate the role of vitamin D supplementation on the outcome of hospitalization for patients with CLD or CHF admitted to Ain Shams University Hospitals (ASUH) with acute deterioration of their illness.
Subjects and methods
We conducted prospective case control on 80 patients collected from inpatient ward of endocrinology, divided into 2 groups; 40 patients with chronic liver diseases and 40 patients with heart failure. Serum 25OH-vitamin D and calcium, phosphate and PTH were measured to all participants before intervention. 20 patients of each group (Intervention group) received single dose of vitamin D within 3 days of admission and the other 20 patients of each group (control group) did not receive vitamin D vitamin D.
Results
no significant difference between patients who received vitamin D supplementation and who did not receive vitamin D supplementation as regards outcome and survival with P value 1.000 in patients with CLD and 0.823 in patients with CHF. On the other hand, we found baseline vitamin D level was an independent predictor of mortality (P value .018).
Conclusion
We found that a beneficial effect of vitamin D supplementation can't be achieved with single dose vitamin D (200,000 IU) on CHF or CLD hospitalized patients’ mortality. We recommend that vitamin D supplementation should be considered in CLD and CHF outpatients, with exception of hypercalcemic and hyperphosphatemic patients, as baseline vitamin D status affects the disease course and mortality prior to disease deterioration and hospitalization.
Environmental pollution has become a pervasive problem with far-reaching repercussions for human health, especially during crucial life stages like pregnancy. Pregnant women, in particular, are vulnerable to the negative impacts of environmental contaminants such as particulate matter, heavy metals, and industrial emissions, which can disturb the delicate balance of vital nutrients. Among these nutrients, vitamin D plays a decisive part in preserving homeostasis and general health. However, the adverse impacts of environmental pollution on pregnant women’s vitamin D levels have drawn more and more attention. The complex interplay between environmental pollutants and vitamin D homeostasis unfolds through numerous pathways. As, airborne pollutants, such as fine particulate matter and nitrogen oxides, obscure the sun’s UV rays, impeding the Vitamin D production in the epidermis. Concurrently, heavy metals from industrial effluents permeate the soil, jeopardizing the nutritional value of vitamin D-rich food sources. As a consequence of this, a growing number of expecting mothers experience inadequate vitamin D deficiency, which increases their risk of having preterm births, low birth weight babies, etc. Further, this issue not only endangers the pregnant woman’s health but also seriously affects the unborn child’s growth and development. This literature review demonstrates the synthesis and metabolism of vitamin D in expecting mothers and it also showcases the impact of various environmental pollutants, particularly exposure to air pollutants, which can significantly impair the bioavailability and synthesis of vitamin D in expecting mothers. Prolonged exposure to toxic agents precipitates an inevitable decline in the concentration of vitamin D, subsequently manifesting in vitamin D deficiency during gestation.
Rationale
There is still information about pregnancy- and lactation-associated osteoporosis, which is a type of osteoporosis that occurs in women with normal bone in the late pregnancy or lactation period.
Patient concerns
Six cases of pregnancy- and lactation-associated osteoporosis diagnosed in our Endocrinology and Orthopedics Departments from January 2018 to June 2020 were retrospectively studied. The baseline characteristics, clinical features, laboratory findings, radiological manifestations, and follow-up outcomes were analyzed and compared with previous reports.
Diagnoses
All six patients underwent magnetic resonance imaging scans and vertebral compressive fractures were detected in four patients.
Outcomes
All six patients received conservative treatment and no surgical intervention. After a mean follow-up of 27.3 months (range 24–31 months), the symptoms of the six patients were significantly relieved, although four patients still had low back pain to varying degrees.
Introduction
Air pollution is a worldwide problem affecting human health via various body systems, resulting in numerous significant adverse events. Air pollutants, including particulate matter < or = 2.5 microns (PM2.5), particulate matter < or = 10 microns (PM10), ozone (O 3 ), nitrogen dioxide (NO 2 ), and traffic‐related air pollution (TRAP), have demonstrated the negative effects on human health (e.g., increased cerebrovascular, cardiovascular, and respiratory diseases, malignancy, and mortality). Organ transplant patients, who are taking immunosuppressive agents, are especially vulnerable to the adverse effects of air pollutants. The evidence from clinical investigation has shown that exposure to air pollution after organ transplantation is associated with organ rejection, cardiovascular disease, coronary heart disease, cerebrovascular disease, infection‐related mortality, and vitamin D deficiency.
Objectives and method
This review aims to summarize and discuss the association of exposure to air pollutants and serum 25‐hydroxyvitamin D level and outcomes after transplantation. Controversial findings are also included and discussed.
Conclusion
All of the findings suggest that air pollution results in a hazardous environment, which not only impacts human health worldwide but also affects post‐transplant outcomes.
Osteoporosis is a metabolic bone disease, which is characterized by a decreased bone mass and deterioration of bone microstructure, resulting in increased bone fragility and a higher risk of fracture. The main pathological process of osteoporosis is the dynamic imbalance between bone absorption and bone formation, which can be caused by various factors such as air pollution. Particulate matter (PM) 2.5 refers to the fine particles in the atmosphere, which are small in volume and large in specific surface area. These particles are prone to carrying toxic substances and have negative effects on several extrapulmonary organs, including bones. In this review, we present relevant data from studies, which show that PM 2.5 is associated with abnormal bone turnover and osteoporosis. PM 2.5 may cause or aggravate bone loss by stimulating an inflammatory response, inducing oxidative damage, reducing estrogen efficiency by competitive binding to estrogen receptors, or endocrine disorder mediated by binding with aromatic hydrocarbon receptors, and affecting the synthesis of vitamin D to reduce calcium absorption. The cellular and molecular mechanisms involved in these processes are also summarized in this review.
Atmospheric chemistry studies suggest air pollution impedes ultraviolet B photons and thus reduces cutaneous vitamin D3 synthesis. Biological evidence shows that inhaled pollutants disrupt circulating 25-hydroxyvitamin D (25[OH]D) metabolism and ultimately impact bone health. The hypothesis is that higher air pollution concentrations are associated with a higher risk of fractures, mediated by lower circulating 25(OH)D. The study included participants of the UK Biobank who were free of fracture history at enrollment (2006 to 2010) and analyzed their environmental exposure data (2007 to 2010). Air pollution measurements included the annual averages of air particulate matter (PM2.5, PM2.5–10, and PM10), nitrogen oxides (NO2 and NOx), and a composite air pollution score. Multivariable Cox proportional hazard models were used to assess the associations of the individual pollutants and the score with fracture risks. Mediation analyses were conducted to assess the underlying role of serum 25(OH)D in such associations. Among 446,395 participants with a median of 8-year follow-up, 12,288 incident fractures were documented. Participants living in places with the highest quintile of air pollution score had a 15.3% increased risk of fractures (hazard ratio [95%CI]: 1.15[1.09,1.22]) compared to those in the lowest, and 5.49% of this association was mediated through serum 25(OH)D (pmediation < 0.05). Pollutant-specific hazard of top-to-bottom quintiles was 16% for PM2.5, 4% for PM2.5–10, 5% for PM10, 20% for NO2, and 17% for NOx, with a 4% to 6% mediation effect of serum 25(OH)D concentrations. The associations of the air pollution score with fracture risks were weaker among female participants, those who drank less alcohol, and consumed more fresh fruit than their counterparts (pinteraction < 0.05). © 2023 American Society for Bone and Mineral Research (ASBMR).
Abstract
Background:
This study investigates the potential role of preoperative 25(OH)D supplementation as a cost-effective strategy to decrease revision rotator cuff repair (RCR) rates and lower the total healthcare burden from patients undergoing primary arthroscopic RCR. Previous literature has emphasized the importance of vitamin D on bone health maintenance, soft tissue healing, and outcomes in RCR. Inadequate preoperative vitamin D levels may increase revision RCR rates following primary arthroscopic RCR. Although 25(OH)D deficiency is common in RCR patients, serum screening is not routinely performed.
Methods:
A cost-estimation model was developed to determine the cost-effectiveness of both preoperative selective and nonselective 25(OH)D supplementation in RCR patients in order to reduce revision RCR rates. Prevalence and surgical cost data was obtained from published literature through systematic reviews. Cost of serum 25(OH)D assay and supplementation were obtained from public-use data. Mean, lower and upper bounds of one year cost-savings were calculated for both the selective and nonselective supplementation scenarios.
Results:
Preoperative 25(OH)D screening and subsequent selective 25(OH)D supplementation was calculated to result in a mean cost-savings of $6,099,341 (range: $-2,993,000 - $15,191,683) per 250,000 primary arthroscopic RCR cases. Nonselective 25(OH)D supplementation of all arthroscopic RCR patients was calculated to result in a mean cost-savings of $11,584,742 (range: $2,492,401 - $20,677,085) per 250,000 primary arthroscopic RCR cases. Univariate adjustment projects that selective supplementation is a cost-effective strategy in clinical contexts where the cost of revision RCR exceeds $14,824.69 and prevalence of 25(OH)D deficiency exceeds 6.67%. Additionally, nonselective supplementation is a cost-effective strategy in clinical scenarios where revision RCR cost ≥ $4,216.06 and prevalence of 25(OH)D deficiency ≥ 1.93%.
Conclusions:
This cost-predictive model promotes the role of preoperative 25(OH)D supplementation as a cost-effective mechanism to reduce revision RCR rates and lower the overall healthcare burden from arthroscopic RCR. Nonselective supplementation appears to be more cost-effective than selective supplementation, likely due to the lower cost of 25(OH)D supplementation compared to serum assays.
Pregnancy and lactation are physiologically and nutritionally taxing. Requirements for all nutrients increase, and optimal energy and nutrient intake during pregnancy and lactation are crucial for the developmental and future health of both mother and child. Because successful pregnancy depends upon the previous nutritional status of the mother, all women of childbearing age should consume a variety of nutrient-dense foods and beverages from the basic food groups while choosing foods that limit the intake of saturated and trans fats, added sugars, salt, and alcohol. Special attention must be paid to the intake of micronutrients, such as folic acid, vitamin D, iron, and iodine. Regarding energy intake, women should consume an additional 300 kcal per fetus during pregnancy; however, women who are active during their pregnancy may need extra calories for exercise. Ideally, additional energy for active pregnant and lactating women should come from added servings of carbohydrates in order to meet the growth needs of the fetus and provide sufficient energy for exercise.
Pregnancies are a critical window period for environmental influences over the mother and the offspring. There is a growing body of evidence associating indoor and outdoor air pollution exposure to adverse pregnancy outcomes such as preterm birth and hypertensive disorders of pregnancy. Particulate matter (PM) could trigger oxi-inflammation and could also reach the placenta leading to placental damage with fetal consequences. The combination of strategies such as risk assessment, advise about risks of environmental exposures to pregnant women, together with nutritional strategies and digital solutions to monitor air quality can be effective in mitigating the effects of air pollution during pregnancy.
This study investigated the role of preoperative supplementation of 25(OH)D, a precursor of the active form of vitamin D, as a cost-effective strategy to decrease pseudarthrosis rates and overall healthcare burden after posterolateral fusion (PLF). Previous literature has emphasized the importance of vitamin D in bone health maintenance, spinal health, and outcomes in spinal fusion. Inadequate preoperative 25(OH)D levels may increase pseudarthrosis rates after PLF. Thus, a cost-estimation model was developed to determine the cost-effectiveness of both selective and nonselective 25(OH)D supplementation in PLF. Prevalence and cost data were obtained from published literature through systematic reviews. Cost of serum 25(OH)D assay and supplementation were obtained from public-use data. Mean, lower, and upper bounds of 1-year cost-savings were calculated for both supplementation scenarios. Preoperative 25(OH)D screening and subsequent selective 25(OH)D supplementation was calculated to result in a mean cost-savings of $10,978,440 ($9,969,394 to $11,987,485) per 10,000 PLF cases. Nonselective 25(OH)D supplementation of all PLF patients was calculated to result in a mean cost-savings of $11,213,318 ($10,204,272 to $12,222,363) per 10,000 cases. Univariate adjustment projects that selective supplementation is a cost-effective strategy in clinical contexts where revision PLF costs exceed $781.89 and prevalence of 25(OH)D deficiency ≥0.612%. Nonselective supplementation is cost-effective in clinical scenarios where revision PLF cost ≥$198.09 and prevalence of 25(OH)D deficiency ≥0.1645%. This cost-predictive model promotes the role of preoperative 25(OH)D supplementation as a cost-effective mechanism to reduce overall healthcare burden after PLF. Nonselective supplementation appears to be more cost-effective than selective supplementation, likely due to the relatively lower cost of 25(OH)D supplementation compared with serum assays. Level III
Background
Evidence suggests that low individual vitamin D levels enhance adverse effects associated with air pollution on mental health conditions. The aim of this study was to identify associations between ambient air pollution exposure, mental health, and serum vitamin D status in the general population of South Korea.
Methods
We included national representative data for 29,373 adults in the final analysis. We measured serum 25-hydroxyvitamin D concentrations to assess vitamin D status for each participant. We assessed mental health factors (i.e., perceived stress, depressive symptoms, and suicidal ideation), and analyzed associations between these factors and individuals' annual average exposures to air pollutants, including particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide (NO2), sulfur dioxide, and carbon monoxide (CO).
Results
Using an adjusted model, we found PM10 affected mental health outcomes, such as perceived stress (odds ratio [OR] = 1.04; 95 % confidence interval [CI] = 1.00–1.09), depression symptoms (OR = 1.12; 95 % CI = 1.06–1.18), and suicidal ideation (OR = 1.11; 95 % CI = 1.05–1.17). Effects of the pollutants NO2 and CO were significant only in the group with perceived stress and depressive symptoms. PM10 and NO2 exposures were significantly associated with increased odds of adverse mental health in participants with vitamin D deficiency.
Limitations
Since the cross-sectional design of KNHANES data, it is not possible to evaluate the causal relationship between air pollution exposure, vitamin D status and mental health.
Conclusions
This study results suggest that associations between ambient air pollution and mental health outcomes were stronger in participants with vitamin D deficiency.
Background
Serum vitamin D levels are associated with exposure to air pollution, however, the lagged effect of exposure to air pollution remains unknown in pregnant women.
Methods
Pregnant women who delivered at a maternity center in Shanghai, China, from 2015 to 2019 were included in the present study. The concentration of particulate matter 2.5 (PM2.5) before 25-Hydroxyvitamin D [25(OH)D] detection was estimated using the satellite-based grid models. The distributed lag non-linear models were performed to examine the lagged association between weekly-specific PM2.5 exposure and vitamin D deficiency (VDD) or serum 25(OH)D levels.
Results
Among the 58,025 pregnant women included in the study (mean age at conception, 30.77 ± 3.75 years; mean prepregnancy BMI, 21.09 ± 2.55 kg/m²), 61.32% were diagnosed with VDD. Weekly-specific PM2.5 exposure at weeks 1–10 before the detection of 25(OH)D was significantly associated with an increased incidence of VDD (p < 0.05). For every 10 μg/m³ increase in PM2.5 exposure, the serum 25(OH)D level decreased by 1.346 nmol/L (95%CI: 1.183–1.508 nmol/L). The association between average PM2.5 exposure and VDD at 1–10 weeks was more significant in weather conditions with low mean sunshine hours (OR: 1.246, 95%CI: 1.221–1.271).
Conclusion
Our study provided suggestive evidence that PM2.5 exposure at 1–10 weeks before the 25(OH)D detection may decrease the circulating 25(OH)D levels in pregnant women and increase VDD risk in pregnant women. More attention should be paid to the long-term impact of PM2.5, in particular, during weather conditions with a relatively short duration of sunshine.
El principal rol de la vitamina D es la regulación del metabolismo del calcio, cuya principal fuente es la vitamina D3 que se obtiene principalmente por la acción de la luz ultravioleta (UV) en la piel.Objetivo: Evaluar las diferencias estacionales en las concentraciones de 25-hidroxi-vitamina D3 (25OHVitD3), hormona paratiroidea (PTH), fosfatasa alcalina (FA) y calcio en niños en edad escolar.Sujetos y Método: Se midieron las concentraciones de 25OHVitD3, PTH, FA y calcio en niños de 5 a 8 años, sin suplementación de Vitamina D, reclutados en Santiago de Chile (latitud -33.4372) en distintas estaciones del año. El estatus de VitD fue definido como suficiente con concentraciones de 25OHVitD3 > 20 ng/mL (50 nmol/L), insuficiente 12-20 ng/mL (30-50 nmol/L) y deficiente < 12 ng/ mL (30 nmol/L) en base a las recomendaciones del grupo de expertos del “Consenso Global para la Prevención y Manejo del Raquitismo Nutricional”.Resultados: En total participaron 133 niños (89 prematuros menor o igual a 32 semanas), 41 durante el verano, 28 en otoño, 35 en invierno y 29 en primavera. La diferencia de las medias entre el verano y el invierno fue de 9,6 ng/mL para 25OHVitD3 (p < 0,0001), -11,1 pg/mL para PTH (p < 0,0001) y -47,5 UI/mL para FA (p = 0,01). En las concentraciones de calcio no se observaron diferencias. El 97,6% de los sujetos fueron clasificados con estatus de suficiencia (> 20 ng/mL) en verano, lo que disminuyó significativamente en invierno (54,3%, p < 0,0001).Conclusiones: Las concentraciones de 25OHVitD3 disminuyeron en aproximadamente la mitad de los niños durante el invierno, lo que se vio acompañado de un aumento de la PTH y FA, asociado a concentraciones normales de calcio. De acuerdo a nuestros resultados, la suplementación con VitD en niños podría ser necesaria durante otoño e invierno
This study investigates thoroughly whether acute exposure to outdoor PM 2.5 concentration, P, modifies the rate of change in the daily number of COVID-19 infections (R) across 18 high infection provincial capitals in China, including Wuhan. A best-fit multiple linear regression model was constructed to model the relationship between P and R, from 1 January to 20 March 2020, after accounting for meteorology, net move-in mobility (NM), time trend (T), co-morbidity (CM), and the time-lag effects. Regression analysis shows that P ( β = 0.4309, p < 0.001) is the most significant determinant of R. In addition, T ( β = −0.3870, p < 0.001), absolute humidity (AH) ( β = 0.2476, p = 0.002), P × AH ( β = −0.2237, p < 0.001), and NM ( β = 0.1383, p = 0.003) are more significant determinants of R, as compared to GDP per capita ( β = 0.1115, p = 0.015) and CM (Asthma) ( β = 0.1273, p = 0.005). A matching technique was adopted to demonstrate a possible causal relationship between P and R across 18 provincial capital cities. A 10 µg/m ³ increase in P gives a 1.5% increase in R ( p < 0.001). Interaction analysis also reveals that P × AH and R are negatively correlated (β = −0.2237, p < 0.001). Given that P exacerbates R, we recommend the installation of air purifiers and improved air ventilation to reduce the effect of P on R. Given the increasing observation that COVID-19 is airborne, measures that reduce P, plus mandatory masking that reduces the risks of COVID-19 associated with viral-particulate transmission, are strongly recommended. Our study is distinguished by the focus on the rate of change instead of the individual cases of COVID-19 when modelling the statistical relationship between R and P in China; causal instead of correlation analysis via the matching analysis, while taking into account the key confounders, and the individual plus the interaction effects of P and AH on R.
Gestational diabetes mellitus (GDM) has become a new global epidemic with a rapidly increasing prevalence. Previous studies have suggested that air pollution is associated with GDM risk, but the results are inconsistent, and mechanistic studies are limited. Based on a hospital-based cohort, a total of 6374 participants were included in this study. Individual daily PM2.5 exposure at a 1-km resolution was predicted using a full-spatiotemporal-coverage model. The results of multiple linear regression showed that glycated hemoglobin (HbA1c) was significantly associated with PM2.5 both in the 1-month preconception and in the first trimester of pregnancy. Additionally, HbA1c decreased 0.437% (95% CI: − 0.629, − 0.244) as the serum 25-hydroxyvitamin D (25(OH)D) increased by one interquartile range (IQR) (9.2 ng/ml). An IQR increase in PM2.5 exposure was also negatively associated with serum 25(OH)D (estimated change% and 95% CI: − 7.249 (− 9.054, − 5.408) in the 1-month preconception and − 13.069 (− 15.111, − 10.979) in the first trimester of pregnancy). Mediation analysis showed that serum 25(OH)D status mediated the association between HbA1c and PM2.5 exposure both in the preconception and in the first trimester (mediated percent: 2.00% and 4.05% (Sobel p ＜ 0.001), respectively). The result suggested a vicious cycle among PM2.5 exposure, lower serum VD status and a higher HbA1c. More studies are warranted since the protective effect of 25(OH)D against glucose disorders associated with air pollution in this study was limited.
The objective of the study is to perform a critical review, exploration, and strong summary of the relationships between personal and ambient concentrations of mainly particulate matter with diameter of 2.5µm or less with the measures of cardiopulmonary health. A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including Scien Direct, PubMed, Scopus, and ISI Web of Science. The search was applied to the articles that were published between 2017 and early 2019. Needed article information was extracted from each article by: direct information including journal (research article, review article, meeting abstract, conference abstract, correspondence, author index, editorial board meeting abstract, discussion), book chapter, title, authors, abstract, full text documents of candidate studies, publishing year. Study period, Research (study) method used, types of air pollutants variables studied; Types of organ system disorder or disease studied The conclusions made about the health hazards, impacts on humans or animal models, novel therapeutics, and economic loss. With strict literature search and screening processes, it yielded 140 articles (2017=45; 2018=61; and early 2019=34 articles) from 3,968 articles of initial literature database (1952-early 2019). The main compositions of air pollutants are PM, particularly PM2.5 and PM10, O3, CO, SO2, and NOx. Exposure to O3 is frequently associated with respiratory tract inflammation, whereas exposure to PM, CO, No2, and SO2 is related to pulmonary edema, respiratory and cardiovascular hospitalizations, and cardiopulmonary mortality. Any compromise to endothelial cells, the key components of lung barrier integrity contributes to vascular leakage and inflammation. Endothelial cells could be the target of PM exposure. The various effects on various disease entities contribute to hypothesize that Melatonin might protect the lung integrity against PM2.5-induced acute lung injury. Bufei Huoxue (BFHX) could reduce secretory immunoglobulin A (sIgA) and collagen fibers deposition in lung, thus, improved pulmonary function. In conclusion, identification of various crucial signaling pathway involving PM-induced cardiopulmonary disorders and diseases may assist in the development of effective therapeutics, including clean energy use, clean industrialization, proper agriculture, high land use diversity, and proper urbanization for reduction of the air pollution.
References: Brickley, M.B. Ives, R. & Mays, S. (2020). The Bioarchaeology of Metabolic Bone Disease, Second Edition
El principal rol de la vitamina D es la regulación del metabolismo del calcio, cuya principal fuente es la vitamina D3 que se obtiene principalmente por la acción de la luz ultravioleta (UV) en la piel.Objetivo: Evaluar las diferencias estacionales en las concentraciones de 25-hidroxi-vitamina D3 (25OHVitD3), hormona paratiroidea (PTH), fosfatasa alcalina (FA) y calcio en niños en edad escolar.Sujetos y Método: Se midieron las concentraciones de 25OHVitD3, PTH, FA y calcio en niños de 5 a 8 años, sin suplementación de Vitamina D, reclutados en Santiago de Chile (latitud -33.4372) en distintas estaciones del año. El estatus de VitD fue definido como suficiente con concentraciones de 25OHVitD3 > 20 ng/mL (50 nmol/L), insuficiente 12-20 ng/mL (30-50 nmol/L) y deficiente < 12 ng/ mL (30 nmol/L) en base a las recomendaciones del grupo de expertos del “Consenso Global para la Prevención y Manejo del Raquitismo Nutricional”.Resultados: En total participaron 133 niños (89 prematuros menor o igual a 32 semanas), 41 durante el verano, 28 en otoño, 35 en invierno y 29 en primavera. La diferencia de las medias entre el verano y el invierno fue de 9,6 ng/mL para 25OHVitD3 (p < 0,0001), -11,1 pg/mL para PTH (p < 0,0001) y -47,5 UI/mL para FA (p = 0,01). En las concentraciones de calcio no se observaron diferencias. El 97,6% de los sujetos fueron clasificados con estatus de suficiencia (> 20 ng/mL) en verano, lo que disminuyó significativamente en invierno (54,3%, p < 0,0001).Conclusiones: Las concentraciones de 25OHVitD3 disminuyeron en aproximadamente la mitad de los niños durante el invierno, lo que se vio acompañado de un aumento de la PTH y FA, asociado a concentraciones normales de calcio. De acuerdo a nuestros resultados, la suplementación con VitD en niños podría ser necesaria durante otoño e invierno
Introducción:
El principal rol de la vitamina D es la regulación del metabolismo del calcio, cuya principal fuen te es la vitamina D3 que se obtiene principalmente por la acción de la luz ultravioleta (UV) en la piel.
Objetivo:
Evaluar las diferencias estacionales en las concentraciones de 25-hidroxi-vitamina D3 (25OHVitD3), hormona paratiroidea (PTH), fosfatasa alcalina (FA) y calcio en niños en edad esco lar.
Sujetos y Método:
Se midieron las concentraciones de 25OHVitD3, PTH, FA y calcio en niños de 5 a 8 años, sin suplementación de Vitamina D, reclutados en Santiago de Chile (latitud -33.4372) en distintas estaciones del año. El estatus de VitD fue definido como suficiente con concentraciones de 25OHVitD3 > 20 ng/mL (50 nmol/L), insuficiente 12-20 ng/mL (30-50 nmol/L) y deficiente < 12 ng/ mL (30 nmol/L) en base a las recomendaciones del grupo de expertos del “Consenso Global para la Prevención y Manejo del Raquitismo Nutricional”.
Resultados:
En total participaron 133 niños (89 prematuros menor o igual a 32 semanas), 41 durante el verano, 28 en otoño, 35 en invierno y 29 en primavera. La diferencia de las medias entre el verano y el invierno fue de 9,6 ng/mL para 25OHVitD3 (p < 0,0001), -11,1 pg/mL para PTH (p < 0,0001) y -47,5 UI/mL para FA (p = 0,01). En las concentraciones de calcio no se observaron diferencias. El 97,6% de los sujetos fueron clasificados con estatus de suficiencia (> 20 ng/mL) en verano, lo que disminuyó significativamente en invierno (54,3%, p < 0,0001).
Conclusiones:
Las concentraciones de 25OHVitD3 disminuyeron en aproximadamente la mitad de los niños durante el invierno, lo que se vio acompañado de un aumento de la PTH y FA, asociado a concentraciones normales de calcio. De acuerdo a nuestros resultados, la suplementación con VitD en niños podría ser necesaria durante otoño e invierno.
Background: There has been growing interest in vitamin D insufficiency as a predisposing factor for allergy development based on immunoregulatory properties and epidemiological studies. Little is known about vitamin D in adult asthma patients or its association with asthma severity. Aim: The present study is to assess the relationship between vitamin D status and asthma in adult population. Methods: A cross sectional study including 622 asthmatic adults aged older than 18 years and 617 adults healthy control aged older than 18 years assessing the relationship between serum 25 hydroxy vitamin D levels. Result: The difference between mean vitamin D levels in the asthmatic group 24.96 ± 5.58 ng/ml and the healthy control group 32.39 ± 5.28 ng/ml was found to be statistically significant (p < 0.001) and more interestingly there was significant correlation between low 25 OHD level and the severity of asthma. Conclusion: Reduced vitamin D levels are highly prevalent in adult asthmatic patients and are associated severity of the disease.
Introduction:
In 2012, the Mexican National Health Survey showed a moderate prevalence rate of vitamin D deficiency, around 16%, in a national representative sample of children. A decreasing prevalence of anemia during the last 15 years has been observed in Mexico. The aim of this study was to determine the levels of vitamin D in children 3-8 years old in four different locations within the metropolitan area of Mexico City and to compare them to levels of iron and zinc as references of nutritional status.
Methods:
One hundred and seventeen healthy children aged 3-8 years attending four hospitals in Mexico City were invited to participate. All children received medical and nutritional evaluation, and blood samples were obtained.
Results:
Children were selected in the four hospitals between April and August 2008. More than half (51.3%) were boys; their average age was 5.5 ± 1.6 years. The mean height and weight of the children were 112.1 ± 11.2 cm and 20.2 ± 4.9 kg respectively, with a body mass index [BMI] of 15.8 ± 1.7 kg/m². The mean Z-score (BMI) was 0.007 ± 0.999. The prevalence of subjects with deficient levels of 25-OH-vitamin D (<50 nmol/l) was 24.77%. None of the children had haemoglobin levels below the anaemia threshold, and zinc determination revealed 8.26% of individuals with deficient levels (<65 µg/dL). These data confirm the findings reported in the latest National Nutrition Survey (ENSANUT 2012) about the sustained reduction of anaemia prevalence among preschool and schoolchildren since 1999 and the rising rates of vitamin D deficiency in the same population. Similar to other studies, we found a link between socioeconomic status and the deficiency of micronutrients, these being markers of better nutrition, and vitamin D is remarkably related to the quality of the diet. This finding has not been considered in our population before.
Conclusions:
There is evidence of a sustained decrease of anaemia in Mexican children due to general enrichment of foods and focus on vulnerable populations, while vitamin D deficiency seems to have increased. More studies are needed to obtain more information on vitamin D levels at different ages and definition of susceptible groups in order to investigate the possibility of general population measures such as enrichment, which have proven to be effective.
Air pollution is one of the greatest environmental threats and has been implicated for several adverse cardiovascular effects including arterial hypertension (HTN). However, the exact relationship between air pollution exposure and HTN is still unclear. Air contamination provokes oxidative stress, systemic inflammation, and autonomic nervous system imbalance that subsequently induce endothelial dysfunction and vasoconstriction leading to increased blood pressure. The aim of this review was to describe the potential mechanisms by which air pollution contributes to HTN and to summarize the consequences of short- and long-term exposure.
Objective: To evaluate the association between the level of vitamin D and glycemic control among patients with diabetes.
Research design and method: We analyzed data collected from NHANES 2003–2006. We included only non-pregnant adult diabetic persons 18 years or older. Participants who had vitamin D level less than 20 ng/ml were considered as having vitamin D deficiency. Participants were considered to have a glucose control if the HbA1c level was less than 7% [53 mmol/L]. We used student’s t test to compare the difference in HbA1c means between people with Diabetes with and without a vitamin D deficiency. We used a multivariate logistic regression model to predict the relationship between glucose control and vitamin D deficiency. We used race/ethnicity, BMI, age, gender, type of diabetic medication used, having health insurance or not, and comorbid conditions (hypertension, anemia, cholesterol, liver disease, and kidney disease) as control variables.
Results: The study population included a total of 929 non-institutionalized, non-pregnant, diabetic adult persons. About 57% of patients with diabetes had a vitamin D deficiency. Blacks (non-Hispanic patients) with diabetes had the highest rate of vitamin D deficiency (79%). The unadjusted means of HbA1c were significantly different between diabetic patients with no vitamin D deficiency and those with a vitamin D deficiency (7.06% [54 mmol/L], 7.56 % [59 mmol/L], respectively, P
BACKGROUND:
Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year.
METHODS:
We estimated numbers of deaths due to COPD and asthma using the GBD Cause of Death Ensemble modelling (CODEm) tool. First, we analysed data from vital registration and verbal autopsy for the aggregate category of all chronic respiratory diseases. Subsequently, models were run for asthma and COPD relying on covariates to predict rates in countries that have incomplete or no vital registration data. Disease estimates for COPD and asthma were based on systematic reviews of published papers, unpublished reports, surveys, and health service encounter data from the USA. We used the Global Initiative of Chronic Obstructive Lung Disease spirometry-based definition as the reference for COPD and a reported diagnosis of asthma with current wheeze as the definition of asthma. We used a Bayesian meta-regression tool, DisMod-MR 2.1, to derive estimates of prevalence and incidence. We estimated population-attributable fractions for risk factors for COPD and asthma from exposure data, relative risks, and a theoretical minimum exposure level. Results were stratified by Socio-demographic Index (SDI), a composite measure of income per capita, mean years of education over the age of 15 years, and total fertility rate.
FINDINGS:
In 2015, 3·2 million people (95% uncertainty interval [UI] 3·1 million to 3·3 million) died from COPD worldwide, an increase of 11·6% (95% UI 5·3 to 19·8) compared with 1990. There was a decrease in age-standardised death rate of 41·9% (37·7 to 45·1) but this was counteracted by population growth and ageing of the global population. From 1990 to 2015, the prevalence of COPD increased by 44·2% (41·7 to 46·6), whereas age-standardised prevalence decreased by 14·7% (13·5 to 15·9). In 2015, 0·40 million people (0·36 million to 0·44 million) died from asthma, a decrease of 26·7% (-7·2 to 43·7) from 1990, and the age-standardised death rate decreased by 58·8% (39·0 to 69·0). The prevalence of asthma increased by 12·6% (9·0 to 16·4), whereas the age-standardised prevalence decreased by 17·7% (15·1 to 19·9). Age-standardised DALY rates due to COPD increased until the middle range of the SDI before reducing sharply. Age-standardised DALY rates due to asthma in both sexes decreased monotonically with rising SDI. The relation between with SDI and DALY rates due to asthma was attributed to variation in years of life lost (YLLs), whereas DALY rates due to COPD varied similarly for YLLs and years lived with disability across the SDI continuum. Smoking and ambient particulate matter were the main risk factors for COPD followed by household air pollution, occupational particulates, ozone, and secondhand smoke. Together, these risks explained 73·3% (95% UI 65·8 to 80·1) of DALYs due to COPD. Smoking and occupational asthmagens were the only risks quantified for asthma in GBD, accounting for 16·5% (14·6 to 18·7) of DALYs due to asthma.
INTERPRETATION:
Asthma was the most prevalent chronic respiratory disease worldwide in 2015, with twice the number of cases of COPD. Deaths from COPD were eight times more common than deaths from asthma. In 2015, COPD caused 2·6% of global DALYs and asthma 1·1% of global DALYs. Although there are laudable international collaborative efforts to make surveys of asthma and COPD more comparable, no consensus exists on case definitions and how to measure disease severity for population health measurements like GBD. Comparisons between countries and over time are important, as much of the chronic respiratory burden is either preventable or treatable with affordable interventions.
Background:
Chronic obstructive pulmonary disease (COPD) and asthma are common diseases with a heterogeneous distribution worldwide. Here, we present methods and disease and risk estimates for COPD and asthma from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) 2015 study. The GBD study provides annual updates on estimates of deaths, prevalence, and disability-adjusted life years (DALYs), a summary measure of fatal and non-fatal disease outcomes, for over 300 diseases and injuries, for 188 countries from 1990 to the most recent year.
Methods:
We estimated numbers of deaths due to COPD and asthma using the GBD Cause of Death Ensemble modelling (CODEm) tool. First, we analysed data from vital registration and verbal autopsy for the aggregate category of all chronic respiratory diseases. Subsequently, models were run for asthma and COPD relying on covariates to predict rates in countries that have incomplete or no vital registration data. Disease estimates for COPD and asthma were based on systematic reviews of published papers, unpublished reports, surveys, and health service encounter data from the USA. We used the Global Initiative of Chronic Obstructive Lung Disease spirometry-based definition as the reference for COPD and a reported diagnosis of asthma with current wheeze as the definition of asthma. We used a Bayesian meta-regression tool, DisMod-MR 2.1, to derive estimates of prevalence and incidence. We estimated population-attributable fractions for risk factors for COPD and asthma from exposure data, relative risks, and a theoretical minimum exposure level. Results were stratified by Socio-demographic Index (SDI), a composite measure of income per capita, mean years of education over the age of 15 years, and total fertility rate.
Findings:
In 2015, 3·2 million people (95% uncertainty interval [UI] 3·1 million to 3·3 million) died from COPD worldwide, an increase of 11·6% (95% UI 5·3 to 19·8) compared with 1990. There was a decrease in age-standardised death rate of 41·9% (37·7 to 45·1) but this was counteracted by population growth and ageing of the global population. From 1990 to 2015, the prevalence of COPD increased by 44·2% (41·7 to 46·6), whereas age-standardised prevalence decreased by 14·7% (13·5 to 15·9). In 2015, 0·40 million people (0·36 million to 0·44 million) died from asthma, a decrease of 26·7% (-7·2 to 43·7) from 1990, and the age-standardised death rate decreased by 58·8% (39·0 to 69·0). The prevalence of asthma increased by 12·6% (9·0 to 16·4), whereas the age-standardised prevalence decreased by 17·7% (15·1 to 19·9). Age-standardised DALY rates due to COPD increased until the middle range of the SDI before reducing sharply. Age-standardised DALY rates due to asthma in both sexes decreased monotonically with rising SDI. The relation between with SDI and DALY rates due to asthma was attributed to variation in years of life lost (YLLs), whereas DALY rates due to COPD varied similarly for YLLs and years lived with disability across the SDI continuum. Smoking and ambient particulate matter were the main risk factors for COPD followed by household air pollution, occupational particulates, ozone, and secondhand smoke. Together, these risks explained 73·3% (95% UI 65·8 to 80·1) of DALYs due to COPD. Smoking and occupational asthmagens were the only risks quantified for asthma in GBD, accounting for 16·5% (14·6 to 18·7) of DALYs due to asthma.
Interpretation:
Asthma was the most prevalent chronic respiratory disease worldwide in 2015, with twice the number of cases of COPD. Deaths from COPD were eight times more common than deaths from asthma. In 2015, COPD caused 2·6% of global DALYs and asthma 1·1% of global DALYs. Although there are laudable international collaborative efforts to make surveys of asthma and COPD more comparable, no consensus exists on case definitions and how to measure disease severity for population health measurements like GBD. Comparisons between countries and over time are important, as much of the chronic respiratory burden is either preventable or treatable with affordable interventions.
Funding:
Bill & Melinda Gates Foundation.
Objective/background:
Vitamin D has been increasingly recognized as an immunomodulatory agent. Its deficiency has been associated with immune-mediated diseases such as asthma, rhinitis, and atopic dermatitis. These allergic conditions are dependent on T-helper type 2 (Th2) cells secreting interleukins, overproduction of immunoglobulin E (IgE), and eosinophil activation. We investigated the association between serum vitamin D levels and blood absolute eosinophil count.
Methods:
We carried out a cross-sectional study of 669 men and women referred to a clinical pathology laboratory who underwent 25-hydroxyvitamin D testing and complete blood count analysis on the same day.
Results:
Vitamin D levels were stratified into four ranges: severely deficient (<10ng/mL), deficient (≥10ng/mL and <20ng/mL), insufficient (≥20ng/mL and <30ng/mL), or sufficient (≥30ng/mL). The mean/median eosinophil count in the four groups was 267/254cells/μL, 245/238cells/μL, 191/159cells/μL, and 182/146cells/μL, respectively, (p=.001). The difference was significant between the severe deficiency group and each of the other three groups (p=.012, p=.002, and p=.001, respectively). There was no statistical difference among the four groups in terms of leukocyte counts (p=.151), neutrophils (p=.177), or lymphocytes (p=.582).
Conclusion:
Vitamin D deficiency was associated with higher blood eosinophil count. These results support the possible role of vitamin D in the eosinophil immune response.
It has been accepted that vitamin D (VD) plays an important role in bone metabolism. However, the levels of VD in people of different regions are quite different and there is still no final conclusion on the significant correlation between VD and osteoporosis. 245 cases of peri-menopausal women were collected to study the relationship between VD and osteoporosis in western China. The mean value of 25-hydroxyvitamin D for the participants was 14.39 ng/mL. The average values of parathyroid hormone (PTH), calcium (Ca) and phosphorus (P) were 47.62 pg/mL, 2.26 mmol/L and 1.18 mmol/L, respectively. The average value of bone mineral density (BMD) in lumbar vertebrae was -1.20 SD and that in femoral neck was -0.04 SD. Compared with normal group, PTH of VD deficiency group was significantly increased (P < 0.05), Ca was remarkably decreased (P < 0.01) while the BMD between these two groups showed no significant difference (P > 0.05). VD was in positive correlation with the age (P < 0.01) and Ca (< 0.01) of the participants, negative correlation with PTH (P < 0.01) while no significant correlation with the BMD of lumbar vertebrae and femoral neck (P > 0.05). The risk factors resulting in the occurrence of osteoporosis in the lumbar vertebrae of the participants covered Ca increase (OR = 66.247, P<0.05), age growth (OR = 1.194, P<0.01) and menopause (OR = 2.285, P<0.05). This study has found that the status of VD deficiency showed no significant correlation with the level of BMD, which hinted that independent measurement of the bone metabolic markers, including Ca, P, VD and PTH, was difficult to accurately reflect the status of BMD in peri-menopausal women of this region. It's necessary to combine multi-site bone scanning to diagnose the patients' status of osteoporosis so as to provide reasonable guidance for early clinical prevention and treatment.
Background
Skin color is a well-recognized adaptive trait and has been studied extensively in humans. Understanding the genetic basis of adaptation of skin color in various populations has many implications in human evolution and medicine.
Discussion
Impressive progress has been made recently to identify genes associated with skin color variation in a wide range of geographical and temporal populations. In this review, we discuss what is currently known about the genetics of skin color variation. We enumerated several cases of skin color adaptation in global modern humans and archaic hominins, and illustrated why, when, and how skin color adaptation occurred in different populations. Finally, we provided a summary of the candidate loci associated with pigmentation, which could be a valuable reference for further evolutionary and medical studies.
Conclusion
Previous studies generally indicated a complex genetic mechanism underlying the skin color variation, expanding our understanding of the role of population demographic history and natural selection in shaping genetic and phenotypic diversity in humans. Future work is needed to dissect the genetic architecture of skin color adaptation in numerous ethnic minority groups around the world, which remains relatively obscure compared with that of major continental groups, and to unravel the exact genetic basis of skin color adaptation.
PurposeWe investigated the impact of different cut-offs on the prevalence of 25-hydroxyvitamin D [25-(OH)D] deficiency. Methods
We used baseline data of 4149 participants (45–75 years, 50% women) of the population-based Heinz Nixdorf Recall study. Serum 25-(OH)D was measured with the Roche Cobas assay. Quartiles (p25, p50, and p75) were calculated. Data were stratified by months, sex, and age. According to the recommendations of ‘Dachverband Osteologie’, Endocrine Society and National Institute of Health we used 25-(OH)D thresholds of 12, 20, and 30 ng/ml to estimate vitamin D deficiency. ResultsOverall the median of 25-(OH)D was 19.8 ng/ml (p25 = 14.4 ng/ml, p75 = 26.6 ng/ml), with highest concentrations in July (p50 = 23.8 ng/ml, p25 = 18.2 ng/ml, and p75 = 31.2 ng/ml) and lowest in March (p50 = 15.8 ng/ml, p25 = 11.5 ng/ml, and p75 = 20.6 ng/ml). Prevalence of vitamin D deficiency rose from 16, 51 up to 83% using the cut-offs of <12, <20 ng/ml, and <30 ng/ml, respectively. With respect to seasonal variance, prevalence of vitamin D deficiency rose to 92% in February/March using the cut-off <30 ng/ml (<12: 28%, <20 ng/ml: 71%) whereas in June/July prevalence of vitamin D deficiency decreased to 71% (<12: 6%, <20 ng/ml: 30%). The chance to attest the diagnosis of vitamin D deficiency for cut-off 12 ng/ml in March is 6.4-fold higher than in June, for cut-off 20 ng/ml, 5.5-fold higher and for cut-off 30 ng/ml, 3.1-fold higher. Conclusions
Guidelines to define vitamin D deficiency revealed extremely different prevalence rates ranging between 6 and 92%. Accounting for collection time and antecedent sun exposure are important to reduce bias in research studies and improve decision-making in clinical care. Vitamin D thresholds have to be rethought.
The link between air pollution, UV irradiation and skin carcinogenesis has been demonstrated within a large number of epidemiological studies. Many have shown the detrimental effect that UV irradiation can have on human health as well as the long-term damage which can result from air pollution, the European ESCAPE project being a notable example. In total, at present around 2800 different chemical substances are systematically released into the air. This paper looks at the hazardous impact of air pollution and UV and discusses: 1) what we know; 2) where we stand; and 3) what is likely to happen in the future. Thereafter, we will argue that there is still insufficient evidence of how great direct air pollution and UV irradiation are as factors in the development of skin carcinogenesis. However, future prospects of progress are bright due to a number of encouraging diagnostic and preventive projects in progress at the moment.
The association between air pollution and bone health was evaluated in adolescents in the city of Tehran. This study is essentially ecological. Vitamin D deficiency among adolescents has been reported at higher rates in polluted areas than in non-polluted areas. Additionally, residence in polluted areas is associated with lower levels of bone alkaline phosphatase. PurposeThe aim of this study was to evaluate the association between ambient air pollution and bone turnover in adolescents and to compare the prevalence of vitamin D deficiency between polluted and non-polluted areas of Tehran. Methods
This cross-sectional population-based study was conducted on 325 middle- and high-school students (both girls and boys) in Tehran in the winter. During the study period, detailed daily data on air pollution were obtained from archived data collected by Tehran Air Quality Control Company (AQCC). Serum levels of calcium, phosphorus, parathyroid hormone (PTH), bone-specific alkaline phosphatase, 25(OH) vitamin D, osteocalcin, cross-linked C-telopeptide (CTX), total protein, albumin, and creatinine were obtained from the study group. ResultsVitamin D deficiency was more prevalent in polluted areas than in non-polluted areas. After adjustment for age and sex, residence in the polluted area showed a statistically significant positive association with vitamin D deficiency and a statistically significant negative association with bone turnover. Interestingly, high calcium intake (>5000 mg/week) protects against the effects of air pollution on bone turnover. Conclusions
Air pollution is a chief factor determining the amount of solar UVB that reaches the earth’s surface. Thus, atmospheric pollution may play a significant independent role in the development of vitamin D deficiency.
Purpose: To estimate serum vitamin D (25 OH D) level in patients of retinal vein occlusion (RVO) and compare it with age-matched controls.
Methods and material: Forty patients above 18 years of age with retinal vein occlusion and forty age-matched controls underwent serum vitamin D (Vit D) level estimation using a standard protocol. Student’s t test was used to analyse differences between the mean of two groups.
Results: The mean age in RVO and control group was 60.25 and 60.73 years respectively. The mean (±SD) level of vitamin D in RVO patients was 13.68 (±4.58) ng/mL (range 5.5–24.8), and the 95% CI of mean was 12.21–15.14 with SD 4.58 while in control group it was 23.03 (±2.89) ng/ml (range 18.4–30.1) with 95% CI of mean being 22.11–23.96 with SD 2.89 (p value of
Background
Vitamin D deficiency has become prevalent worldwide in recent years. However, less evidence was available for lactating women.
Objective
The purpose of the study was to understand vitamin D status and prevalence of deficiency in lactating women and associated risk factors for vitamin D deficiency from eight provinces and municipalities in China.
Methods
Lactating women within 1–10 months postpartum were recruited in 2011–2013 from eight provinces and municipalities in China. Radioimmunoassay was used to measure serum 25-hydroxyvitamin D [25(OH)D] concentration. Standardized questionnaire was used to collect information on season, living site, ethnicity and socio-demographic characteristics.
Results
Totally 2004 lactating women were recruited. The median (p25, p75) of 25(OH)D was 15.8 (10.5, 24.0) nmol/L. The prevalence of vitamin D deficiency was 85.3% as 25(OH)D <30nmol/L. Serum 25(OH)D levels of lactating women were significantly lower during October-January (14.0nmol/L) than during February-May (18.0nmol/L) (P<0.001), and were significantly higher in Dai ethnicity (22.5nmol/L) than in Hui ethnicity (Chinese Muslims) (9.0nmol/L) (P<0.001). For every 10,000 CNY annual income per capita increasing, serum 25(OH)D levels significantly increased 1.04 times (P<0.001). The odds of vitamin D deficiency in winter were 2.56 times higher than that in spring (OR 2.56, 95%CI: 1.91–3.43).
Conclusions
Vitamin D deficiency of lactating women was highly prevalent in the eight provinces and municipalities in China. It is urgent to study the strategy and intervention ways for improving vitamin D status of lactating women, especially for certain population groups during low sunlight exposure season.
Humans obtain vitamin D from conversion of 7-dehydrocholesterol in the skin by ultraviolet B (UVB) radiation or from dietary sources. As the radiation level is insufficient in winter, vitamin D deficiency is common at higher latitudes. We assessed whether vernal solar UVB radiation at latitudes 61°N and 67°N in Finland has an impact on serum 25-hydroxyvitamin D [S-25(OH)D] concentrations. Twenty-seven healthy volunteers participated in outdoor activities in snow-covered terrain for 4–10 days in March or April, with their face and hands sun-exposed. The personal UVB doses and S-25(OH)D levels were monitored. A mean UVB dose of 11.8 standard erythema doses (SED) was received during an average of 12.3 outdoor hours. The mean S-25(OH)D concentration in subjects with a baseline concentration below 90.0 nmol/L (n=13) increased significantly, by 6.0 nmol/L from an initial mean of 62.4 nmol/L (p<0.001), whereas in those with a basal concentration above 90.0 nmol/L (n=12) it decreased significantly, by 6.7 nmol/L from a mean of 116.9 nmol/L (p<0.01). To conclude, only 7% of total body surface area was exposed to vernal sunlight and this was capable of increasing S-25(OH)D levels in subjects with a baseline level below 90 nmol/L but not in those with higher levels.
The air is polluted and the atmospheric pollution has becoming a great problem for human beings due to the high rate consumption of energy. Most of the scientists dealing with the air pollution state that the first reason of all environmental problems is the population increase. Depending on population, the high consumption of energy (including heating purposes, electricity production, transportation and industries) agricultural activities, waste disposal and the pressure for destroying forest areas create air pollution problem. The atmosphere is polluted and the concentrations of pollutants have increased tremendously. Karabük Province is one of the famous provinces of heavy industries. There are 3 air quality measurement stations. In this study, the last 2 years hourly and daily air pollutants (PM10, SO2, NO, NOx, NO2, O3 and CO) were studied as a time series by using graphical and statistical approaches. The results were considered seasonally and annually. The meteorological condition is also very effective in atmospheric pollution. Moreover, the industrial production and consumption of energy are also high pressure on Karabük province. The concentrations in each station are also showing different characteristics during two years’ period. The highest concentrations (such as PM10, SO2, NO, NOx) are, as usual, seen in winter season due to industrial usage of energy for production and household consumption of energy for heating. However, for O3, the highest concentration is observed in summer season, because the atmospheric ozone trend is supposed to show an opposite trend compared with NO due to photochemical reaction with these gases. For CO, the maximum concentration is recorded as 4779 μg/m3 in august in 2015. The analyses of data have shown that, the atmosphere is polluted highly with PM10, SO2, NO, NOx, NO2, and CO during winter season. The households are very effective using high coal for heating purposes in Karabük Province.
Background & aim of the work: Vitamin D deficiency is highly prevalent in our locality and worldwide. Two major sources of Vit D replenishment are available; sun exposure and dietary supplementation. This study compared sun exposure with vitamin D3 supplementation on restoring bone homeostasis in a vitamin D deficient (VDD) versus vitamin D sufficient (VDS) rat models.
Methods: Vitamin D deficient-normocalcemic diet was used for 6 weeks to produce a group of VDD rats (n = 21), then were subdividedinto three equal subgroups: direct sunlight exposure subgroup (Sd subgroup), vitamin D3 treated subgroup (Tt subgroup), and a Control subgroup (Ct group). Normal rats (group II) (n = 14) were fed on normal vitamin D-diet for equal period and then subdivided into two equal subgroups: direct sunlight exposure subgroup (Ss subgroup), and a control (C) subgroup. For all of the subgroups, Exposures and supplementations were continued for 10 days, then the plasma 25 hydroxy vitamin D3, parathyroid hormone, calcium, phosphorus levels and alkaline phosphatase activity were estimated and femur bones were used to prepare histopathological sections.
Results: The sun-exposed vitamin D deficient group showed a significant reduction of parathyroid hormone more than that in vitamin D supplemented group vs. VDD controls (67.69 ± 13.18 and 78.93 ± 8.31 vs. 86.05 ± 9.67 pg/ml, respectively), while sun-exposed vitamin D sufficient group showed an insignificant change (15.56 ± 2.73 vs. 16.84 ± 3.16 pg/ml). Furthermore, the improvement of osteoid area and the reduction of trabecular separation in the bone sections among vitamin D deficient rats, after sunlight exposure, were better.
Conclusions: Sunlight-exposure have a more positive effect on bone structure and homeostasis than vitamin D supplementation and control. This effect was more with vitamin D deficient than vitamin D sufficient rats.
Various forms of geoengineering have been proposed to counter anthropogenic
climate change. Methods which aim to modify the Earth's energy balance by
reducing insolation are often subsumed under the term solar radiation
management (SRM). Here, we present results of a standard SRM modelling
experiment in which the incoming solar irradiance is reduced to offset the
global mean warming induced by a quadrupling of atmospheric carbon dioxide.
For the first time in an atmosphere–ocean coupled climate model, we include atmospheric composition feedbacks for this experiment. While the SRM scheme
considered here could offset greenhouse gas induced global mean surface
warming, it leads to important changes in atmospheric composition. We find
large stratospheric ozone increases that induce significant reductions in
surface UV-B irradiance, which would have implications for vitamin D
production. In addition, the higher stratospheric ozone levels lead to
decreased ozone photolysis in the troposphere. In combination with lower
atmospheric specific humidity under SRM, this results in overall surface
ozone concentration increases in the idealized G1 experiment. Both UV-B and
surface ozone changes are important for human health. We therefore highlight
that both stratospheric and tropospheric ozone changes must be considered in
the assessment of any SRM scheme, due to their important roles in regulating
UV exposure and air quality.
Objective: To analyze the efficacy of calcium supplementation plus vitamin D on the improved
concentrations of serum 25(OH)D and the blood pressure in working women of childbearing
age.
Methods: The design used in this research was an experimental study (randomized control
trial), with 39 subjects of women at childbearing age who met the inclusion criteria for the
study. Subjects were randomly allocated into two treatment groups, the VDC group (400 IU
of vitamin D plus 500 mg of calcium) and the VD group (400 IU of vitamin D). Supplements
were consumed every day for 12 weeks.
Results: Prior to supplementation, the average level of serum 25(OH)D in the VDC group was
(16.7 ± 4.5) ng/dL which was higher than the average level of serum 25(OH)D in the VD group
which was (14.9 ± 5.1) ng/dL. After supplementation, the subjects of VDC group showed an
average increased 3.6 ng/dL of serum 25(OH)D. The average increase of serum 25(OH)D in
VD group was 6.3 ng/dL. The increase of serum 25(OH)D in VDC group was 21.6%, while in
the VD group the increase was almost two times higher (42.3%) than that of the VDC group.
Statistical test results showed that the average levels of serum 25(OH)D between the two
treatment groups were significantly different.
Conclusions: The average systolic blood pressure prior to supplementation of the VDC group
was (128.5 ± 22.5) mmHg which was slightly lower than that of the VD group [(131.1 ± 18.0)
mmHg].
Vitamin D deficiency is a major public health problem worldwide. However, most countries are still lacking data, particularly in infants, children, adolescents and pregnant women. The objective of the present report was to conduct a more recent systematic review of global vitamin D status, with particular emphasis in at risk groups. A systematic review was conducted between April and June of 2013 to identify articles on vitamin D status worldwide published in the last 10 years in apparently healthy individuals. Only studies with vitamin D status prevalence were included. If available, the first source selected was population-based or representative samples studies. Clinical trials, case-control studies, case reports or series, reviews, validation studies, letters, editorials, or qualitative studies were excluded. A total of 98 articles were eligible and included in the present report. Prevalence of vitamin D status was reported by continent. In areas with available data, the prevalence of low vitamin D status is a global problem in all age groups, in particular in girls and women from the Middle East. These results also evidenced the regions with missing data for each specific population groups, such as in infants, children and adolescents worldwide, and in most countries of South America and Africa. In conclusion, vitamin D deficiency is a global public health problem in all age groups, particularly in those from the Middle East.
Background: Immigration to Sweden from lower latitude countries has increased in recent years. Studies in the general population in other Nordic countries have demonstrated that these groups are at risk of developing vitamin D deficiency, but studies in primary health care patients are rare. Objectives: The aim of this study is to examine possible differences in plasma-25(OH)-vitamin D levels and intake of vitamin D between Swedish and immigrant female patients in a primary health care centre located at 60 degrees N, where half of the inhabitants have an immigrant background. Another objective was to estimate what foods contribute with most vitamin D. Design: Thirty-one female patients from the Middle East and Africa and 30 from Sweden were recruited. P-25(OH)D was measured and intake of vitamin D was estimated with a modified food frequency questionnaire (FFQ). Results: Vitamin D deficiency (plasma-25(OH)D<25 nmol/L) was common among immigrant women (61%). One immigrant woman and half of the Swedish women had optimal levels (plasma-25(OH)D>50 nmol/L). There was a positive correlation between the intake of vitamin D from food and plasma-25(OH) D. Only three women, all Swedish, reached the recommended intake of vitamin D from food. The immigrant women had lower intake compared to Swedish women (median: 3.1 vs. 5.1 mu g/day). The foods that contributed with most vitamin D were fatty fish, fortified milk and margarine. Immigrant women consumed less fortified milk and margarine but more meat. Irrespective of origin, patients with plasma-25(OH)D<25 nmol/L consumed less margarine but more meat. Conclusion: Vitamin D deficiency was common in the immigrant patients and their intake of vitamin D was lower. This highlights the need to target information about vitamin D to immigrant women in order to decrease the risk for vitamin D deficiency. The FFQ was well adapted to its purpose to estimate intake of vitamin D.
Vitamin deficiency is considered to be a major public health problem in Saudi Arabia, especially during summer. The major source of vitamin D is sun exposure. In this study, we aimed to determine the optimum time for sun exposure in four different cities (North, South, West and East regions) in the Kingdom of Saudi Arabia. In the current study ampoules containing 7-dehydrocholesterol in ethanol were exposed to sunlight every hour starting from sunrise until sunset in June 2013. Results indicated that the geographical location and the time of the day have a major influence in vitamin D production. In summer, conversion of pre-vitamin D3 was observed to be elevated between 8.00-9.00 AM to 3:30-4:30 PM, with peak hours between 11:30 AM to 12:30 PM. Moreover in the east region (Dammam), conversion of pre-vitamin D3 showed significant reduction by around 50%. In conclusion, the optimum sun exposure time for vitamin D3 production in the north, south and west regions of Saudi Arabia during summer is from 8:30 AM to 10:30 AM, as well as 2:00 PM to 4:00 PM.Air pollution might be the cause for the decreased conversion of 7-dehydrocholesterol to pre-vitamin D3 in the east region. Conservatively, the optimum time for sun exposure therefore in Dammam city is from 8:30 AM to 10:00 AM, as well as 1:00 PM to 2:30 PM. Knowledge of the optimum sun exposure times during summer can be highly effective in preventing vitamin D deficiency in Saudi Arabia.
Seasonal variability in 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) levels in the general population has been associated with differences in bone turnover markers, bone density and fracture risk. Seasonal variability in 25OHD and PTH levels has also been reported in primary hyperparathyroidism (PHPT).
Given the widespread use of vitamin D supplements, we sought to determine whether patients with PHPT still demonstrated seasonal variation in 25OHD levels.
This cross-sectional study was conducted at a university medical center at a Northeastern US latitude (New York City, NY).
100 PHPT patients participated in the study.
measures: We assessed vitamin D supplement use and seasonal variation in serum 25OHD.
Patients had PHPT ([mean ± SD] calcium: 10.8 ± 1.0 mg/dl; PTH: 85 ± 48 pg/ml) with a mean 25OHD level of 29 ± 10 ng/ml. While only one-fifth of participants had vitamin D deficiency (19% < 20 ng/ml), more than half were either deficient or insufficient (54% < 30 ng/ml). Sun exposure varied by season, but there were no seasonal differences in levels of 25OHD, PTH, bone markers or BMD, or in the prevalence of 25OHD <20 or <30 ng/ml. Most (65%) of the participants took supplemental vitamin D (dose among users: mean 1643 ± 1496 IU; median1000 IU daily), and supplement users had markedly better vitamin D status than non-users (25OHD<20 ng/ml: 8% vs. 40%, p<0.0001; <30 ng/ml: 40% vs. 80%, p=0.0001; ≥30 ng/ml: 60% vs. 20%, p=0.0001).
We found no evidence of seasonal variation in 25OHD levels or PHPT disease severity in the Northeastern US. This change is likely due to widespread high vitamin D supplement intake, which has resulted in better vitamin D status among supplement users and can mask the effect of season on serum 25OHD levels.
Sun exposure is the main source of vitamin D. Due to many lifestyle risk factors vitamin D deficiency/insufficiency is becoming a worldwide health problem. Low 25(OH)D concentration is associated with adverse musculoskeletal and non-musculoskeletal health outcomes. Vitamin D supplementation is currently the best approach to treat deficiency and to maintain adequacy. In response to a given dose of vitamin D, the effect on 25(OH)D concentration differs between individuals, and it is imperative that factors affecting this response be identified. For this review, a comprehensive literature search was conducted to identify those factors and to explore their significance in relation to circulating 25(OH)D response to vitamin D supplementation. The effect of several demographic/biological factors such as baseline 25(OH)D, aging, body mass index(BMI)/body fat percentage, ethnicity, calcium intake, genetics, oestrogen use, dietary fat content and composition, and some diseases and medications has been addressed. Furthermore, strategies employed by researchers or health care providers (type, dose and duration of vitamin D supplementation) and environment (season) are other contributing factors. With the exception of baseline 25(OH)D, BMI/body fat percentage, dose and type of vitamin D, the relative importance of other factors and the mechanisms by which these factors may affect the response remains to be determined.
This study aimed to evaluate the frequency of seasonal 25-hydroxyvitamin D [25(OH)D] deficiency and insufficiency in children and adolescents living in Bağcılar, district of İstanbul city.
Serum vitamin D levels of 280 children aged 3-17 years old were measured at the end of winter and at the end of summer. Of the total group, vitamin D levels were re-measured in 198 subjects. Vitamin D deficiency was defined as a serum 25(OH)D level less than 15 ng/mL and insufficiency-as levels between 15 and 20 ng/mL. Patients whose vitamin D levels were less than 15 ng/mL at the end of winter were treated with 2000 units/day of vitamin D for 3 months.
In the "end of winter" samples, 25(OH)D deficiency was present in 80.36% of the subjects and insufficiency in 11.79%. In the "end of summer" samples, vitamin D deficiency was detected in 3.44% and insufficiency in 27.75%. Vitamin D levels in the "end of winter" samples were not significantly different between boys and girls, while "end of summer" levels were significantly lower in girls (p=0.015). Sunlight exposure was significantly higher in boys (p=0.011). The group with sufficient dairy product consumption had significantly higher vitamin D levels in both "end of summer" and "end of winter" samples. Limb pain was frequently reported in children with low vitamin D levels in the "end of winter" samples (p=0.001). Negative correlations were observed between vitamin D levels and season and also between vitamin D levels and age.
It is essential to provide supplemental vitamin D to children and adolescents to overcome the deficiency seen especially at the end of winter.
Background: It must be obvious that no one factor should be held accountable for the etiology of allergic diseases, asthma or acute asthma exacerbations. Operating on a genetic basis many factors must play a role. It has been postulated that vitamin D deficiency, as a result of industrialization and Westernized lifestyles that have led to sun-avoidance behaviors and more time indoors, has a role in the development of asthma and allergies (Green, 2010) [1].
Objective: To assess the relationship between serum vitamin D levels and severity of asthma in patients with atopic asthma.
Patients and methods: The study was carried out on 30 patients with atopic asthma, divided into three groups according to severity of airway obstruction, and ten healthy control subjects. Serum 25-hydroxyvitamin D3 [25(OH) D], a vitamin D metabolite, was measured using an immunodiagnostic ELISA technique.
Results: 86% of all asthmatic patients were vitamin D insufficient, as defined by a level ⩽30 ng/ml 25(OH) Vit D. Mean vitamin D levels were the lowest in patients with severe asthma.
Conclusion: Vitamin D insufficiency is common in patients with atopic asthma that is correlated with its degree of severity.
Background:
Air quality indices based on the maximum of sub-indices of pollutants are easy to produce and help quantify the degree of air pollution. However, they discount the additive effects of multiple pollutants and are only sensitive to changes in highest sub-index.
Objectives:
We propose a simple and concise method to construct an air quality index that takes into account additive effects of multiple pollutants and evaluate the extent to which this index predicts health effects.
Materials and methods:
We obtained concentrations of four criteria pollutants: particulate matter with aerodynamic diameter ≤ 10μm (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2) and ozone (O3) and daily admissions to Hong Kong hospitals for cardiovascular and respiratory diseases for all ages and those 65 years or older for years 2001-2012. We derived sub-indices of the four criteria pollutants, calculated by normalizing pollutant concentrations to their respective short-term WHO Air Quality Guidelines (WHO AQG). We aggregated the sub-indices using the root-mean-power function with an optimal power to form an overall air quality index. The optimal power was determined by minimizing the sum of over- and under-estimated days. We then assessed associations between the pollution bands of the index and cardiovascular and respiratory admissions using a time-stratified case-crossover design adjusted for ambient temperature, relative.
Vitamin D is critical in mineral homeostasis and skeletal health and plays a regulatory role in nonskeletal tissues. Vitamin D deficiency is associated with chronic inflammatory diseases, including diabetes and obesity, both strong risk factors for cardiovascular diseases (CVDs). CVDs, including coronary artery disease, myocardial infarction, hypertrophy, cardiomyopathy, cardiac fibrosis, heart failure, aneurysm, peripheral arterial disease, hypertension, and atherosclerosis, are major causes of morbidity and mortality. The association of these diseases with vitamin D deficiency and improvement with vitamin D supplementation suggest its therapeutic benefit. The authors review the findings on the association of vitamin D deficiency and CVDs.
Air pollution assessment is an imperative part of megacities planning and control. Hence, a new comprehensive approach for air pollution monitoring and assessment was introduced in this research. It comprises of three main sections: optimizing the existing air pollutant monitoring network, locating new stations to complete the coverage of the existing network, and finally, generating an air pollution map. In the first section, Shannon information index was used to find less informative stations to be candidate for removal. Then, a methodology was proposed to determine the areas which are not sufficiently covered by the current network. These areas are candidates for establishing new monitoring stations. The current air pollution monitoring network of Tehran was used as a case study, where the air pollution issue has been worsened due to the huge population, considerable commuters’ absorption and topographic barriers. In this regard, O3, NO, NO2, NOx, CO, PM10, and PM2.5 were considered as the main pollutants of Tehran. Optimization step concluded that all the 16 active monitoring stations should be preserved. Analysis showed that about 35% of the Tehran's area is not properly covered by monitoring stations and about 30% of the area needs additional stations. The winter period in Tehran always faces the most severe air pollution in the year. Hence, to produce the air pollution map of Tehran, three-month of winter measurements of the mentioned pollutants, repeated for five years in the same period, were selected and extended to the entire area using the kriging method. Experts specified the contribution of each pollutant in overall air pollution. Experts’ rankings aggregated by a fuzzy-overlay process. Resulted maps characterized the study area with crucial air pollution situation. According to the maps, more than 45% of the city area faced high pollution in the study period, while only less than 10% of the area showed low pollution. This situation confirms the need for effective plans to mitigate the severity of the problem. In addition, an effort made to investigate the rationality of the acquired air pollution map respect to the urban, cultural, and environmental characteristics of Tehran, which also confirmed the results.
There is limited evidence showing the mortality effects of temperature variability (TV) on cardiovascular diseases. The joint effects between TV and air pollutants are also less well-established. This study aims to assess the effect modification of TV-cardiovascular mortality by air pollutants in three Chinese cities (Beijing, Nanjing and Chengdu). Data of daily mortality, air pollutants and meteorological factors from 2008 to 2011 was collected from each city. TV was calculated as the standard deviation of daily maximum and minimum temperatures over exposure days. The city-specific effect estimates of TV on cardiovascular mortality were calculated using a quasi-Poisson regression model, adjusting for potential confounders (e.g., seasonality and temperature). An interaction term of TV and a three-level air pollutants stratum indicator was included in the models. Effect modifications by air pollutants were assessed by comparing the estimates of TV's effect between pollutant stratums and calculating the corresponding 95% confidential interval of the differences. Multivariate meta-analysis was conducted to obtain the pooled estimates. The data showed that TV was associated with increased risk of cardiovascular mortality, especially for longer TV exposure days (0–8 days, TV08). This association was still observed after adjusting for air pollutants on current day or the previous two days. Stronger estimates were observed in females, but no significant difference between males and females was detected, indicating the absence of evidence of effect modification by gender. Estimates of TV-cardiovascular mortality varied across two season periods (warm and cool season) and age groups, but the evidence of effect modification by age and seasons was absent. Regarding the effect modification of TV-cardiovascular mortality association by air pollutants, a significant effect modification was identified for PM10, but not for NO2 and SO2 in the whole population for all TV exposure days. This finding also persisted in subgroups, specifically in females and the elderly.
In this review, we summarize and discuss the evidence regarding the interaction between air pollution, especially particulate matter (PM), and genomic instability. PM has been widely studied in the context of several diseases, and its role in lung carcinogenesis gained relevance due to an increase in cancer cases for which smoking does not seem to represent the main risk factor. According to epidemiological and toxicological evidence, PM acts as a carcinogenic factor in humans, inducing high rates of genomic alterations. Here, we discuss not only how PM is capable of inducing genomic instability during the carcinogenic process but also how our genetic background influences the response to the sources of damage.
Bone is a dynamic tissue that is strongly influenced by endocrine factors to restore the balance between bone resorption and bone formation. Bone formation involves the mineralization of the extracellular matrix formed by osteoblasts. In this process the role of vitamin D (1α,25(OH)2D3) is both direct and indirect. The direct effects are enabled via the Vitamin D Receptor (VDR); the outcome is dependent on the presence of other factors as well as origin of the osteoblasts, treatment procedures and species differences. Vitamin D stimulates mineralization of human osteoblasts but is often found inhibitory for mineralization of murine osteoblasts.
Ground level ozone (GLO), a secondary pollutant having adverse impact on human health, ecology, and agricultural productivity, apart from being a major contributor to global warming, has been a subject matter of several studies. In order to identify appropriate strategies to control GLO levels, accurate assessment and prediction is essential, for which elaborate simulation and modelling is required. Several studies have been undertaken in the past to simulate GLO levels at different scales and for various applications. It is important to evaluate these studies, widely spread over in literature. This paper aims to critically review various studies that have been undertaken, especially in the past 15 years (2000–15) to model GLO. The review has been done of the studies that range over different spatial scales – urban to regional and continental to global. It also includes a review of performance evaluation and sensitivity analysis of photo-chemical transport models in order to assess the extent of application of these models and their predictive capability.
One year-long criteria air pollutants data collected in Beijing were analyzed in this paper, which can support the research on formation, transport and human health effects of air pollutants. This is the first time to study the spatial and temporal variations of criteria pollutants in Beijing using hourly observational data from 12 sites between June 2014 and May 2015 released by the Ministry of Environmental Protection (MEP) of China. Beijing is facing tremendous air pollution as the daily averaged PM2.5 (particulate matter with aerodynamic diameter less than 2.5 µm) concentrations in all sites exceeding the Chinese Ambient Air Quality Standards (CAAQS) Grade I & II standards (15 and 35 µg/m³). Slightly differences in PM2.5 and ozone (O3) were observed between sites at the urban and rural areas. Pearson correlation coefficients show that most pollutants are temporally correlated in Beijing except for O3. The coefficients of divergence (COD) indicate that PM2.5 is associated at most sites with only one rural site (Dingling) having observable difference and one site may be insufficient for monitoring surrounding area. The 8 h peak O3 (O3-8 h) also correlates at different sites but with one urban site (Haidianquwanliu) different from others. In addition, an extreme PM2.5 event (hourly average concentration exceeding 300 μg/m³ for ~40 h) was examined with the consideration of meteorological conditions. Southerly wind with low speed and high relative humidity allow the accumulation of pollutants while northerly wind with high speed and low relative humidity result in good air quality.
Vitamin D deficiency has been shown to be associated with many adverse health problems. Studies have shown that patients with Crohn’s disease who have low vitamin D levels have a poorer quality of life than those with more adequate levels. It has also been shown that patients with mal-absorption problems have a difficult time achieving normal vitamin D levels in spite of aggressive supplementation, and that exposure to UVB radiation may be the most effective treatment option for these patients. We present a case in which 25-hydroxyvitamin D levels were normalized within 2 weeks in a severely vitamin D deficient patient with Crohn’s disease with mal-absorption and a new ileostomy, utilizing sublingually administered vitamin D2. A 58 year-old white female was admitted with a new ileostomy following partial bowel resection due to complications from Crohn’s disease. She was found to be severely vitamin D deficient at the time of admission, with a level of 6.1 ng/ml on hospital day 3. Her treatment with vitamin D was delayed for a few days. She was initially treated with 5000 units of vitamin D3 orally twice a day for 3 days (days 7-10). After discussion with the patient and obtaining her consent, vitamin D3 was stopped, and she was then treated with a total of 8 doses of 50,000 units of vitamin D2 administered sublingually. She was given the first 3 doses on alternating days (days 11, 13, 15), and then 5 more doses on consecutive days (days 17-21). The rise in her 25-hydroxyvitamin D level in response to treatment with sublingual vitamin D2 was significant. On day 10, after receiving 3 days of orally administered vitamin D3, her level was 9.8 ng/ml. One week later, after receiving 3 sublingual doses of vitamin D2, it rose to 20.3 ng/ml. It was then measured on alternating days twice over the next 4 days, and it rose to 45.5 ng/ml, and then to 47.4 ng/ml on the day of discharge to home. The major finding of this study is that sublingual administration of vitamin D2 appears to work effectively when intestinal absorption is impaired. The optimal dosing regimen still needs to be determined for the average Crohn’s disease patient.
Vitamin D has emerged as a key regulator of innate immune responses to pathogen threat. The hormonal form of vitamin D signals through a nuclear receptor transcription factor and regulates gene transcription. Several papers have shown that vitamin D signaling is active both upstream and downstream of pattern recognition receptors, vanguards of innate immune responses. Crohn’s disease (CD) is a relapsing-recurring inflammatory bowel disease (IBD) that arises from dysregulated intestinal innate immunity. Indeed, genetic studies have identified several CD susceptibility markers linked to mechanisms of innate immune responses to infection. Interest in links between vitamin D deficiency and CD has grown substantially, particularly in the last five years. While a number of studies have consistently revealed an association between CD and vitamin D deficiency, recent experimental work has uncovered a compelling mechanistic basis for the contribution of vitamin D deficiency to the pathogenesis of the disease. Moreover, a number of intervention trials have provided generally solid evidence that robust vitamin D supplementation may be of therapeutic benefit to patients with CD. This review summarizes these laboratory and clinical findings.
Various epidemiological studies conducted in different parts of the world have conclusively established that the adverse health effects are associated with common urban air pollutants. Although several recent studies revealed the poor air quality status in Delhi, but limited evidence of the impact of criterion air pollutants on human health remains a big limitation for relevant policy changes. So we conducted a time series to estimate the short term effects of ambient air pollution on all-natural-cause mortality in Delhi for the period 2008 to 2010. The study examined the impact of criteria air pollutants [particulate matter less than 10 micron in diameter (PM10), sulphur di-oxide (SO2), Nitrogen di-oxide (NO2), Carbon monoxide (CO) and Ozone (O3)] on daily all-cause-mortality rate. A semi-parametric regression model was developed to estimate the short term effects of air pollutants on daily all-natural-cause-mortality adjusting nonlinear confounding of time, temperature and relative humidity. A significant association of all-natural-cause mortality in association with short-term exposure to particulate as well as all the gaseous pollutants were observed. The study estimated 0.14% (95% CI 0.02%–0.26%) increase in all-cause-mortality for every 10 μg/m³ increase in PM10 concentration. Among the gaseous pollutants, NO2 has been found to show most significant positive association of 1.00% (95% CI 0.07%–1.93%) increase in all-cause-mortality with every 10 μg/m³ increase in daily NO2 concentration. The effect of O3 and CO has been observed to be significant after controlling the effects of NO2. Analysis by different age groups reveals that particulate matter has maximum effect estimate in the age group ≥65 years (RR 1.002, 95% CI 1.000 to 1.004) whereas gaseous pollutants have been found to exhibit maximum effect estimate (RR 1.016, 95% CI 1.002 to 1.030) in the age group 5–44 years. The results of the present effect estimates appeared consistent with previous findings and can enhance the strength of the previous evidences to understand health burden associated with local air quality.
Background and aims:
Chronic pancreatitis (CP) patients are at risk for fat-soluble vitamins (A, D, E, K) deficiency, but available studies are small and heterogeneous. We conducted a systematic review and meta-analysis to determine the prevalence of fat-soluble vitamins deficiency in CP patients.
Methods:
Medline was searched up to January 2016 for case series and case-control studies reporting prevalence of fat-soluble vitamin deficiency in CP patients. The prevalent deficiency rate was pooled for included studies, and deficiency rate between CP and controls, with relative odds ratio (OR) and 95% confidence interval (CI) calculated for case-control studies.
Results:
Twelve studies including 548 patients included. With a random-effect model, the pooled prevalence rate of vitamin A, D and E deficiency were 16.8% (95%CI 6.9-35.7), 57.6% (95%CI 43.9-70.4) and 29.2% (95%CI 8.6-64.5) respectively, with considerable heterogeneity (I(2) = 75%, 87.1% and 92%). Only one study evaluated vitamin K deficiency. The pooled OR for vitamin D deficiency in CP cases compared with controls was 1.17 (95% CI 0.77-1.78). Sensitivity analyses showed lower prevalence of vitamin A and E, and higher prevalence of vitamin D deficiency in high-quality studies. The rate of pancreatic exocrine insufficiency did not seem affect the deficiency rates, while the use of different cut-offs influences results and heterogeneity for vitamin E, but not A.
Conclusions:
Fat-soluble vitamins deficiency is frequent in CP patients, with considerable heterogeneity. There is, however, no apparent increased risk of vitamin D deficiency in CP compared to controls. Larger, high-quality studies are necessary to better estimate the prevalence of fat-soluble vitamins deficiency, including vitamin K.
In the past two decades, epidemiological studies have shown that air pollution is one of the causes of morbidity and mortality. In this study the effect of PM10, PM2.5, NO2, SO2 and O3 pollutants on human health among the inhabitants of Mashhad has been evaluated. To evaluate the health effects due to air pollution, the Air Q model software 3.3.2, developed by WHO European Centre for Environment and Health, was used.. The daily data related to the pollutants listed above has been used for the short term health effects (total mortality, cardiovascular and respiratory mortality, hospitalization due to cardiovascular and respiratory diseases, chronic obstructive pulmonary disease and acute myocardial infarction). PM2.5 had the most health effects on Mashhad inhabitants. With increasing in each 10μg/m3, relative risk rate of pollutant concentration for total mortality due to PM10, PM2.5, SO2, NO2 and O3 was increased of 0.6%, 1.5%, 0.4%, 0.3% and 0.46 % respectively and, the attributable proportion of total mortality attributed to these pollutants was respectively equal to 4.24%, 4.57%, 0.99%, 2.21%, 2.08%, and 1.61% (CI 95%) of the total (non-accident) mortality happened in the year of study. The results of this study have a good compatibly with other studies conducted on the effects of air pollution on human beings. The AirQ software model can be used in decision-makings as a useful and easy tool.
This chapter introduces the processes related to atmospheric composition considering the atmosphere as a dynamic system which is continuously changing. It focuses on air pollutants, including definitions, classifications, sources, levels and relationships.Air pollutants can be classified as primary or secondary pollutants depending on whether they would be emitted directly into the air from natural or anthropogenic sources or they would be formed from primary ones. On the other hand, air pollutants can also be classified into three major types: (1) criteria, (2) hazardous and (3) biological pollutants. Criteria air pollutants is a term internationally used to describe air pollutants that have been regulated and are commonly used as indicators of air quality. Special attention is paid to carbon monoxide, lead, nitrogen dioxide, ozone, particles and aerosols and sulphur dioxide.The different hazardous pollutants that are present in the air, at low concentrations, include volatile organic compounds, polycyclic aromatic hydrocarbons, persistent organic pollutants and other pollutants with characteristics such as toxicity or persistence. Hence as they involve a hazard to humans, their different sources and particular effects are also described in detail.Additionally, this chapter briefly describes the different biological pollutants that can be present in air including bacteria, moulds, mildew, viruses, animal dander and cat saliva, house dust, mites and pollen, their sources and levels and, also, emerging air pollutants.
The health effects of air pollution remain a public health concern worldwide. Exposure to air pollution has many substantial adverse effects on human health. Globally, seven million deaths were attributable to the joint effects of household and ambient air pollution. Subjects with chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD) and asthma are especially vulnerable to the detrimental effects of air pollutants. Air pollution can induce the acute exacerbation of COPD and onset of asthma, increase the respiratory morbidity and mortality. The health effects of air pollution depend on the components and sources of pollutants, which varied with countries, seasons, and times. Combustion of solid fuels is a major source of air pollutants in developing countries. To reduce the detrimental effects of air pollution, people especially those with COPD or asthma should be aware of the air quality and take extra measures such as reducing the time outdoor and wearing masks when necessary. For reducing the air pollutants indoor, people should use clean fuels and improve the stoves so as to burn fuel more efficiently and vent emissions to the outside. Air cleaners that can improve the air quality efficiently are recommended.
Background & aims:
Serum vitamin D concentration is reduced in patients with non-alcoholic fatty liver disease (NAFLD). Although the mechanism of vitamin D deficiency in liver disease is not fully understood, a few reports have suggested the beneficial effects of vitamin D supplements. The present study investigated changes in serum 25-hydroxy vitamin D level and clinical parameters after total calorie restriction with vitamin D intake reduction in NAFLD patients.
Methods:
Newly diagnosed NAFLD patients with elevated aminotransferase levels were chosen for a calorie restriction and weight-reduction program. A total of 82 patients received nutritional education from nutritionists every 2 weeks for 2 months. Serum 25-hydroxy vitamin D level, amount of vitamin D intake, and physical activity were thoroughly investigated.
Results:
The mean serum 25-hydroxy vitamin D concentration was 13.0 ng/ml. Twenty-nine patients (35.4%) had severe vitamin D deficiency. Patients with a 25-hydroxy vitamin D concentration <10 ng/ml had an increased risk of abdominal obesity (72.4% vs. 47.2%, P = 0.023) and a higher prevalence of metabolic syndrome (69% vs. 42.2%, P = 0.015) compared with patients with 25-hydroxy vitamin D levels >10 ng/ml. Although total energy and vitamin D intake were reduced during the program, serum 25-hydroxy vitamin D levels increased in patients with NAFLD (P < 0.001). Liver enzymes and metabolic parameters also improved, even as vitamin D intake decreased. Serum vitamin D concentration increased with body weight and intrahepatic fat reduction, independent of decreases in vitamin D intake.
Conclusions:
Weight loss per increased serum vitamin D level without vitamin D supplementation and improved metabolic parameters in NAFLD.
Assessment of the global burden of disease is based on epidemiological cohort studies that connect premature mortality to a wide range of causes, including the long-term health impacts of ozone and fine particulate matter with a diameter smaller than 2.5 micrometres (PM2.5). It has proved difficult to quantify premature mortality related to air pollution, notably in regions where air quality is not monitored, and also because the toxicity of particles from various sources may vary. Here we use a global atmospheric chemistry model to investigate the link between premature mortality and seven emission source categories in urban and rural environments. In accord with the global burden of disease for 2010 (ref. 5), we calculate that outdoor air pollution, mostly by PM2.5, leads to 3.3 (95 per cent confidence interval 1.61-4.81) million premature deaths per year worldwide, predominantly in Asia. We primarily assume that all particles are equally toxic, but also include a sensitivity study that accounts for differential toxicity. We find that emissions from residential energy use such as heating and cooking, prevalent in India and China, have the largest impact on premature mortality globally, being even more dominant if carbonaceous particles are assumed to be most toxic. Whereas in much of the USA and in a few other countries emissions from traffic and power generation are important, in eastern USA, Europe, Russia and East Asia agricultural emissions make the largest relative contribution to PM2.5, with the estimate of overall health impact depending on assumptions regarding particle toxicity. Model projections based on a business-as-usual emission scenario indicate that the contribution of outdoor air pollution to premature mortality could double by 2050.
Objectives: The prevalence of vitamin D deficiency (VDD) varies among migrants from different geographic regions. The aim of this study was to estimate the pooled prevalence of VDD among dark-skinned migrants
Method: A meta-analysis using meta-regression was undertaken to determine the prevalence of VDD in dark-skinned migrant populations. Prevalence also was determined by study characteristics including study methodology, age of populations examined, and length of time in migrated country.
Results: Thirty-six studies were identified in nonpregnant populations. Of 13 974 individuals in the studies, 9562 were vitamin D deficient. Pooled prevalence in dark-skinned migrants, adjusted for latitude of study country was estimated at 77% (95% confidence interval [CI], 70%–84%). Examination of studies in which migrants from both Sub-Saharan Africa and the extended Middle east were examined (N ¼ 7) showed immigrants from the extended Middle East had a higher prevalence of VDD (65%; 95% CI, 45%–94%) compared with those from Sub-Saharan Africa (56%; 95% CI,34%–77%). Seven studies were identified in pregnant dark-skinned migrant women. This group tended to have much higher prevalence of VDD compared with native-born pregnant women.
Conclusion: Immigrants with dark skin, and in particular those from the extended Middle East region, have high prevalence of VDD. Migrants who are at high risk for VDD should be educated, screened, and monitored for VDD.