Genetic Vitamin D Metabolism Linked To Fatal Prostate Cancer
MedicalResearch.com Interview with Irene Shui ScD MPH Staff Scientist Fred Hutchinson Cancer Research Center Seattle, WA 98109 MedicalResearch: What is the background for this study?...
MedicalResearch.com Interview with Irene Shui ScD MPH Staff Scientist Fred Hutchinson Cancer Research Center Seattle, WA 98109 MedicalResearch: What is the background for this study?...
MedicalResearch.com Interview with:with
Stuart M. Sprague, DO, FACP, FASN, FNKF
Chairperson, Division of Nephrology and Hypertension
NorthShore University HealthSystem
Evanston, Illinois 60201
Medical Research: Congratulations, Dr. Sprague, on your presentation of another successful phase 3 clinical trial program at the recently concluded Annual Meeting of the American Society of Nephrology. Your presentation unveiled a new vitamin D repletion therapy that effectively controls secondary hyperparathyroidism in chronic kidney disease. Can you give us a little background for the presented studies?
Dr. Sprague: Thanks! Vitamin D insufficiency is a big problem in chronic kidney decease (or CKD): it afflicts more than 20 million adults in the United States who have stages 1 through 4 CKD. Its prevalence increases with CKD severity and it drives secondary hyperparathyroidism. The studies which I presented evaluated a novel therapy to treat secondary hyperparathyroidism (SHPT) arising from vitamin D insufficiency in patients diagnosed with stage 3 or 4 CKD. This new therapy is a modified-release formulation of calcifediol.
Medical Research: Can you tell us more about vitamin D insufficiency?
Dr. Sprague: Vitamin D insufficiency is a condition in which the body has low vitamin D stores. It is characterized by inadequate blood levels of the vitamin D, known as 25-hydroxyvitamin D. An estimated 70-90% of CKD patients have vitamin D insufficiency, which can lead to SHPT and resultant debilitating bone diseases. Vitamin D insufficiency has also been associated with increased mortality in CKD.
MedicalResearch.com: Interview with:
Jonathon Maguire MD MSc FRCPC
Pediatrician and Scientist Department of Pediatrics
Li Ka Shing Knowledge Institute
St. Michael’s Hospital University of Toronto
Medical Research: What is the background for this study? What are the main findings?
Dr. Maguire: One of the main health benefits of cow’s milk is vitamin D. We were interested to know if non-cow’s milk supports children’s vitamin D blood levels as well as cow’s milk.
MedicalResearch.com Interview with:
Karin Amrein, MD, MSc
Assistant Professor Department of Internal Medicine
Division of Endocrinology and Metabolism
Medical University of Graz
8036 Graz, Austria
Medical Research: What are the main findings of the study?
Dr. Amrein: This is the first large clinical trial on vitamin D in critical care. In a double-blind, randomized, placebo-controlled clinical trial, a population of mixed adult ICU patients with vitamin D deficiency (defined as 25-hydroxyvitamin D [25(OH)D] level ≤ 20ng/ml) was assigned to receive either vitamin D3 or placebo. We used a high loading dose of vitamin D3 followed by monthly maintenance doses of 90,000 IU for a total of 5 months. Because of a substantially increased risk for skeletal complications below 12ng/ml of 25-hydroxyvitamin D, we used this threshold for a predefined subgroup analysis.
Overall, high-dose vitamin D3 compared with placebo did not reduce hospital length of stay (primary endpoint), intensive care unit (ICU) length of stay, hospital mortality, or 6 month-mortality
MedicalResearch.com Interview with:
Adetunji Toriola, MD, PhD, MPH
Assistant Professor Division of Public Health Sciences
Department of Surgery
Washington University School of Medicine
Siteman Cancer Center St. Louis, MO
MedicalResearch: What are the main findings of the study?
Dr. Toriola: Very little is known about the impact of vitamin D in prognosis among cancer patients. This knowledge is of importance because of the increasing number of people living cancer and the high prevalence of vitamin D deficiency among cancer patients. We conducted a systematic review of studies published to date on the association of circulating vitamin D (25-OHD) levels with prognosis among cancer patients. This review suggests that higher circulating vitamin D levels may improve overall survival among breast and colorectal cancer patients but there is paucity of information on the role of circulating vitamin D levels in prognosis among patients with other cancer types.
MedicalResearch.com Interview with:
Hui Wang, M.D., Ph.D., Professor
Principal Investigator
Director, Food Safety Research Center
Institute for Nutritional Sciences, SIBS, CAS
MedicalResearch.com: What are the main findings of the study?
Dr. Wang:
This meta-analysis has systematically reviewed 25 relevant studies composed of 17,332 cancer cases to give a comprehensive perspective on the relationship between vitamin D and cancer patient outcomes. Our result demonstrated that vitamin D levels are linked to better outcomes in several types of cancer patients. The strongest link was found in breast cancer, lymphoma and colorectal cancer. There was less evidence of a connection in people with lung cancer, gastric cancer, prostate cancer, leukemia, melanoma or Merkel cell carcinoma, but the available data were positive. We also found that a 10 nmol/L increase in vitamin D levels was tied to a 4 percent increase in survival among people with cancer.
MedicalResearch.com Interview with:
Joshua Lewis, Ph.D
Raine Foundation / Alan Robson Fellow
Bone and Vascular Research Group
School of Medicine and Pharmacology
University of Western Australia
Department of Endocrinology and Diabetes
Sir Charles Gairdner Hospital
MedicalResearch.com: What are the main findings of the study?
Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease.
MedicalResearch.com Interview with: Tomás Ahern MB, BCh, BAO St Columcille's Hospital and St Vincent's University Hospital Dublin, Ireland MedicalResearch.com: What are the main findings...
MedicalResearch.com Interview with: Evropi Theodoratou School of Molecular, Genetic and Population Health Sciences University of Edinburgh MedicalResearch.com: What are the main findings of the...
MedicalResearch.com Interview with:
Dr. Jill A Poole MD
Pulmonary, Critical Care, Sleep, and Allergy Division, Department of Medicine
College of Medicine, University of Nebraska Medical Center
The Nebraska Medical Center, Omaha, Nebraska
MedicalResearch.com: What are the main findings of the study?
Dr. Poole: Our study found that adding vitamin D 4000 IU daily to a cocktail of anti-allergy medications resulted in a further 40% reduction in hive symptom scores at 3 months. There was no further reduction in hive symptoms when 600 IU of vitamin D was added to the anti-allergy medications. The anti-allergy regimen utilized was triple drug therapy with cetirizine (twice daily), ranitidine (twice daily), and montelukast (once daily). No adverse reactions occurred.
MedicalResearch.com Interview with:
Sadeq A. Quraishi, MD, MHA
Massachusetts General Hospital, Harvard Medical School
Boston, Massachusetts
MedicalResearch.com: What are the main findings of the study?
Dr. Quraishi: Our retrospective study suggests that there is an association between pre-operative 25-hydroxyvitamin D [25(OH)D] levels and the risk of hospital-acquired infections after gastric bypass surgery. In particular, patients with 25(OH)D levels <30 ng/ml before surgery were almost 4 times more likely to develop a surgical site infection within 30 days of surgery than patients with pre-operative 25(OH)D levels at 30 ng/ml or higher.
MedicalResearch.com Interview with:
Eirik Magnus Meek Degerud
Department of Clincal Medicine University of Bergen
MedicalResearch.com: What are the main findings of the study?
Answer: That among patients with established coronary artery disease there was no observable relationship between the amount of vitamin D circulating in their blood and the extent of disease progression during the following year.
MedicalResearch.com Interview with:
Meredith Atkinson, MD, MHS
Assistant Professor of Pediatrics
Division of Pediatric Nephrology
Johns Hopkins University School of Medicine
Baltimore, MD 21287
MedicalResearch.com: What are the main findings of the study?
Dr. Atkinson: First, among a healthy cross-section of U.S. children, vitamin D deficiency defined as levels below 30 ng/mL (the currently accepted threshold for adequate vs. inadequate vitamin D) were associated with nearly twice the risk for anemia compared to those with sufficient vitamin D levels. Secondly, when we looked specifically at Caucasian and African-American children, we found that children with the lowest vitamin D levels were at increased risk for anemia in both groups, but that the specific vitamin D level below which the anemia risk started to increase was much lower in the African-American children (12 ng/mL) than in the Caucasian children (20 mg/mL).
MedicalResearch.com Interview with: Miles D. Witham, PhD
Aging and Health, University of Dundee, Dundee, United Kingdom
MedicalResearch.com: What are the main findings of the study?
Answer: We gave high dose vitamin D3 (100,000 units) or placebo every 3 months to people aged 70 or over, who all had isolated systolic hypertension (ISH). The main focus of the trial was to test whether vitamin D supplementation could reduce blood pressure in this group of patients – this pattern of blood pressure, whether the systolic (top number) is high, and the diastolic (bottom number) is normal, is very common in older people. Previous studies have suggested a link between low vitamin D levels and higher blood pressure, but no trial has yet tested this idea in older patients with ISH.
Despite the treatment causing a significant increase in circulating vitamin D levels, we saw no significant reduction in blood pressure with vitamin D supplementation, despite the trial running for a year. We tested whether certain groups might still benefit – e.g. those with very high blood pressure or very low vitamin D levels, but even these groups did not show a reduction in blood pressure.
We also tested whether vitamin D supplementation reduced the health and stiffness of arteries – both important predictors of future heart attack or stroke. Unfortunately, vitamin D did not affect these measures either, and didn’t reduce cholesterol or glucose levels.
On the more positive side, vitamin D supplements did appear safe, and the number of falls in the vitamin D group was slightly lower than in those people who received placebo. This is reassuring, as an earlier study (Sanders et al) had suggested that very high doses of vitamin D might make falls more likely, in contrast to previous low dose studies that show a protective effect of vitamin D against falls.
Dr. Mitchell Jones, MD, PhD
Faculty of Medicine at McGill University in Montreal
MedicalResearch.com: What are the main findings of the study?
Dr. Jones: We had previously reported on the cholesterol lowering efficacy of bile salt hydrolase active L. reuteri NCIMB 30242 due to reduced intestinal sterol absorption.
However, the effects of bile salt hydrolase active L. reuteri NCIMB 30242 on fat soluble vitamins was previously unknown and was the focus of the study.
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