Dissertations / Theses on the topic 'Serum 25D'

Dr Wyatt’s study investigated the complex relationship between vitamin D and melanoma, specifically if vitamin D status is associated with more aggressive melanomas. Exposure to solar ultraviolet radiation is the principal risk factor for melanoma and also the main source of vitamin D. This research found that insufficient vitamin D at time of melanoma diagnosis is significantly associated with poorer prognosis (as defined by tumour thickness). These results will contribute to a more refined public health message concerning melanoma and vitamin D, particularly in Queensland, which has the highest global incidence of melanoma, but vitamin D deficiency is not uncommon.

The magnetic nanocomplex (MNC) comprised of Fe3O4 nanoparticles (NP) and doxorubicin (DOXO) with a saturation magnetic magnetic moment m3 = 10.5 emu/g during magnetic nanotherapy initiated greater antitumor effect than MNC with m3 = 8.55 emu/g. After treatment of Walker 256 tumor the concentration of iron ions in the blood serum of animals with tumor increased and did not depend on the magnetic properties of MNC.

Adequate vitamin D status plays an important role in bone health and may also protect against Type 1 Diabetes (T1D), multiple sclerosis and certain cancers. Vitamin D is obtained from two sources; diet and through skin synthesis through the action of ultraviolet (UV) light. Dietary intakes of vitamin D are low in New Zealand (NZ) and the majority of our vitamin D comes from UV exposure. The NZ population may be at risk of low vitamin D status because of low dietary intakes, the country�s latitude (35-46 �S), and high proportion of darker skinned Maori and Pacific People. While case reports have described the occurrence of rickets, predominantly in immigrant groups, there are currently no national data on the vitamin D status of the NZ population. Reports of low vitamin D status in countries of similar latitude to NZ justify an examination of New Zealanders� vitamin D status. The best method to assess of vitamin D status is to measure circulating 25-hydroxyvitamin D concentrations. This thesis comprises three main studies. The first two had the following aims: to measure 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=1585) of NZ children aged 5-14 y and to measure serum 25-hydroxyvitamin D concentrations and their determinants in a national sample (n=2948) of New Zealanders aged 15 y and over. The 2002 Children�s Nutrition Survey CNS02 was a year long (December, March-November) cross-sectional survey of a nationally representative sample of NZ school children 5-14 y. Over-sampling of Maori and Pacific children allowed ethnic specific analyses. The 1997 National Nutrition Survey (NNS97) participants were recruited over one year according to an area-based sampling frame with a 3 stage stratified design consisting of primary sampling units, households within each unit, and one randomly selected respondent from each household. Mean (99% CI) serum 25-hydroxyvitamin D concentrations were similar in children and adults (both 50 nmol/L). Among Maori, Pacific and NZEO children respectively, prevalence (%, 99% CI) of serum 25-hydroxyvitamin D deficiency (< 17.5 nmol/L) was 5% (2, 12), 8% (5, 14), and 3% (1,7). Based on a cutoff of < 37.5 nmol/L, prevalence of insufficiency was 41% (29, 53), 59% (42, 75) and 25% (15, 35), respectively. Based on a cutoff of 50 nmol/L, 56% of children were insufficient. Three percent of adult New Zealanders had serum 25-hydroxyvitamin D concentrations indicative of deficiency ([less than or equal to] 17.5 nmol/L); 48% and 84% were insufficient based on cutoffs of [less than or equal to] 50 and [less than or equal to] 80 nmol/L The main determinants of vitamin D status in NZ children were season, ethnicity and sex. After adjustment for other factors and covariates, boys had an adjusted mean (99% CI) 25-hydroxyvitamin D concentration 5 (1, 9) nmol/L higher than girls, Maori children were 7 (2, 11) and Pacific children 15 (11, 20) nmol/L lower than NZ European and Other (NZEO) children. Obese children were 7 (2, 11) nmol/L lower than overweight or �normal� weight. Children�s mean 25-hydroxyvitamin D concentrations (adjusted for other variables) peaked in March (69 nmol/L) and was at its lowest in August (36 nmol/L). In adults, there were effects of a similar magnitude of ethnicity and season on serum 25-hydroxyvitamin D concentrations. Obesity, latitude and age were determinants of vitamin D status in women but not men. Obese (BMI > 30) women had an adjusted mean vitamin concentration 6 (3, 10) nmol/L lower than women with BMI < 25. Women living in the South Island were 6 (3, 9) nmol/L lower than women living in the North Island. Additionally, adjusted mean serum 25-hydroxyvitamin D was 13 (8, 18) higher in women 15 -18 y than women 65 y or older. The third and final study aimed to determine whether the higher rates of vitamin D inadequacy reported in the winter than summer months in NZ also result in higher PTH concentrations, which would provide evidence for functional effect of inadequate vitamin D status. We also aimed to objectively explore the effect of natural skin colour on vitamin D status, given the higher prevalence of vitamin D insufficiency in dark-skinned groups living far from the equator. Skin colour measurements were taken with a hand-held light reflectometer (Datacolor Mercury[TM] 1000 colorimeter, Lawrenceville, NJ). In the 342 residents of Invercargill and Dunedin, mean serum 25-hydroxyvitamin D concentrations were lower in the late summer versus early spring (79 vs 51 nmol/L; P< 0.001). The lower serum 25-hydroxyvitamin D in early spring versus summer was associatedwith a 2 pg/mL (P< 0.001) higher parathyroid hormone (PTH) concentration. Interestingly, no significant effect of natural skin colour, based on light reflectance at the inside of the upper arm, was discovered, though there was a positive effect of tanning, based on light reflectance at the upper forearm, on serum 25-hydroxyvitamin D concentrations. Ethnicity and season are major determinants of serum 25-hydroxyvitamin D in New Zealanders. There is a high prevalence of vitamin D insufficiency in NZ children and adults, which may contribute to increased risk of osteoporosis and other chronic disease. While there is a pressing need for more convincing evidence with regards to the health risks associated with the low vitamin D status in children, evidence from the study of adults, where higher PTH concentrations were found during spring versus summer, suggests that the low 25-hydroxyvitamin D concentrations are having an adverse effect on bone health of adults. The high prevalence of vitamin D insufficiency in New Zealanders, warrants serious consideration of strategies such as fortification, to improve the vitamin D status of the population.

Thesis (M.A.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
Objectives: In this study, we investigated the relationship between serum vitamin D status and the prevalence of musculoskeletal pain among individuals on statin therapy. We hypothesized that lower serum vitamin D concentration would be associated with a higher odds of self-reported musculoskeletal pain among statin users. Background: HMG-CoA reductase inhibitors, or statins, are widely used lipid-lowering drugs that significantly reduce morbidity and mortality associated with heart disease. Statin use is associated with a higher prevalence of self-reported musculoskeletal pain in the general population. Non-blinded studies have shown improvement in statin-associated myalgia symptoms and increased tolerance to statin therapy after treatment of vitamin D deficiency. Methods: We performed secondary data analyses using the National Health and Nutrition Examination Survey (NHANES) 2001-2004. Employing SAS and SUDAAN, we carried out logistic regression to evaluate whether vitamin D deficiency modified the relationship between statin use and musculoskeletal pain. Based on a priori assumptions, we adjusted for the effects of demographics, selected disease states, and health habits in the logistic regression model. We also explored concentration-related trends of the effect of vitamin D on musculoskeletal pain. Results: Among 5941 participants age 40 years and older, the mean serum vitamin D concentration was 23.5 ng/mL [95% Confidence Interval (CI) 22.4, 24.2]. There was no significant difference in the mean serum vitamin D concentration between statin users (23.3 ng/mL, 95% CI 22.3, 24.3) and non-statin users (23.5 ng/mL, 95% CI 22.8, 24.2). Statin users had higher odds [adjusted odds ratio (aOR) 1.57, 95% CI 1.15, 2.13)] of self-reported musculoskeletal pain in any area (specifically including the lower extremities, lower back, upper extremities, and upper back) compared with non-users. Vitamin D deficiency was not a predictor of musculoskeletal pain (aOR 0.95, 95% CI 0.70, 1.28) in the overall sample. However, we found vitamin D deficiency to have a significant interaction with statin use for the outcome of musculoskeletal pain (p for interaction = 0.01). After stratifying the sample according to statin use, we found that compared to statin users with a vitamin D concentration of 15 ng/mL or higher, those using statins with vitamin D concentration less than 15 ng/mL demonstrated substantially higher odds of musculoskeletal pain (aOR 2.56, 95% CI 1.25, 5.25). Assessment of vitamin D as a continuous variable did not reveal a concentration-related trend between increasing vitamin D concentrations and musculoskeletal pain (p for trend = 0.4). Conclusions: After controlling for multiple confounders, our analyses showed that serum vitamin D concentration less than 15 ng/mL was associated with musculoskeletal pain among statin users. However, among those not using statins, no association between serum vitamin D levels and self-reported musculoskeletal pain was demonstrated. We showed that vitamin D deficiency modifies the relationship between statio use and musculoskeletal pain. Treating vitamin D deficiency has other proven benefits including, bone health and skeletal muscle function. Our data suggests it may be reasonable to identify and treat vitamin D deficiency in patients who report musculoskeletal pain, using statins.

Background: Contribution of dietary sources to vitamin D status is not clearly known. Some studies have shown that dietary intake of certain vitamin D rich foods had a significant positive influence on serum 25-hydroxyvitamin D [25(OH)D] concentrations, whereas other studies have shown no effect. Although sunlight exposure is a major source of circulating serum 25(OH)D, children and adolescents have been advised on the dangers of sun exposure. Diet may therefore be an important contributor of circulating serum 25(OH)D in absence of or reduced sunlight exposure. Objective: The aim of this study was to determine whether serum 25(OH)D concentrations were associated with any specific dietary patterns in US children and adolescents using assay-adjusted serum 25(OH)D data from National Health and Nutrition Examination Survey (NHANES) 2003-2004 and 2005-2006. Methods: Data from 2 cycles of the NHANES 2003-2004 and 2005-2006 for individuals aged 2 to ≤19 y, were used to study the association between dietary patterns and serum 25(OH)D. Dietary patterns were established using factor analysis based on food-frequency questionnaire data. Eigenvalues and Scree plot were used to derive 2 major principal factors. They were labeled as High Fat Low Vegetable (HFLV) and Prudent dietary patterns. Results: Serum 25(OH)D was significantly lower in HFLV dietary pattern group compared to Prudent dietary pattern group (25.1 vs 27.0 ng/mL; P=0.001). The highest serum 25(OH)D concentrations for all subjects were in the low-intake HFLV group or medium and high-intake Prudent groups (P=0.003 and P=0.012, respectively). In multivariate adjusted analysis, children with higher Prudent dietary contribution scores to overall diet showed a significant positive relation with serum 25(OH)D (β=62.01, P=0.016). When data were stratified by sex, a significant positive relation was observed in girls who consumed the Prudent diet (β=86.34, P=0.014) and a significant negative relation was observed in girls who consumed the HFLV diet (β=-84.32, P=0.022). Conclusion: Overall, serum 25(OH)D concentrations were associated with Prudent dietary pattern but not with HFLV dietary pattern in US children and adolescents. When stratified by sex, the relation between dietary patterns and serum 25(OH)D was confined to only girls. Children consuming HFLV pattern diet may benefit from vitamin D supplementation and sunlight exposure (outdoor activities), and should be encouraged to consume more vitamin D fortified foods.

Purpose: National prevalence of childhood overweight and obesity has plateaued in recent years, but rates remain high, with approximately 10% among children“high weight.” The relationship between adiposity and serum 25-hydroxyvitamin D [25(OH)D] status has been well-explored in older individuals, with inconsistent results. Furthermore, previous studies have suggested a relationship between adequate consumption of calcium and vitamin D and healthy weight status in older children and adults. However, in the infant population, there are few studies detailing the interaction between body composition and serum 25(OH)D or intake of calcium and vitamin D. Our study aims were to assess the association between serum 25(OH)D and body composition and to examine the association between adiposity and dietary intake of calcium and vitamin D in a sample of infants and toddlers. Methods: Our population included healthy male and female infants and toddlers from Pittsburgh, PA who participated in the “Practices Affecting Vitamin D Status in Pittsburgh Infants and Toddlers” study. Parents completed a Vitamin D and Sunlight Exposure Questionnaire, which assessed dietary intake of foods high in calcium and vitamin D as well as daily sunlight exposure (≥2 hours vs. >2 hours). Anthropometric measures and bloodwork for serum 25(OH)D were obtained during at the time of the study visit. Weight-for-length (WFL) percentile status was determined using WHO growth standards (low weight97.7 %ile) and WFL z-scores were calculated. ANOVA was used to compare mean serum 25(OH)D and calcium and vitamin D intake by WFL status. Chi square analysis was used to evaluate the relationship between serum 25(OH) D status (deficient =/mL, insufficient = 12-20 ng/mL, sufficient >20 ng/mL), calcium intake status (sufficient = >700 mg), vitamin D intake status (sufficient = >400 IU) and WFL percentile status. Pearson’s correlation coefficient was used to assess the strength and significance of associations between serum 25(OH)D, calcium and vitamin D intake and WFL z-score. The analysis was repeated after subdivision by race and sun exposure. Results: 125 infants and toddlers (9 to 24 months of age, 68% African American) participated in the study. Approximately 11% of the population had a high weight. Mean vitamin D intake (~600 IU/d) and median calcium intake (~1550 mg/d) exceeded recommendations. Prevalence of high weight was higher among children with adequate intake compared to those who consumed less than the recommendations (calcium: 41% vs. 36%, respectively; vitamin D: 45% vs. 29%, respectively). However, this difference was not statistically significant. Mean serum 25(OH)D level (37 ng/mL) was sufficient. When compared across WFL status, neither mean serum 25(OH)D nor mean intake of calcium and vitamin D varied significantly. No significant correlation was found between WFL and serum 25(OH)D for the cohort or any of the subgroups examined. Conclusions: Rates of infant overweight and obesity in our sample are similar in comparison with the national average. Our results do not support a relationship between calcium and vitamin D intake on weight status or an association between serum vitamin D and body composition in children of this age. Future studies are needed to re-examine these relationships in a larger group of children of more evenly distributed weight status.

Thesis (Ph.D.)--Boston University PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.
In circulation human serum albumin (HSA) is the principal carrier for endogenous lipophilic compounds, primarily non-esterified long chain fatty acids (FA). Since FA bind multiple binding sites with varying affinities, it would be useful to probe the relative affinities for FA binding sites with a method that distinguishes individual binding sites. NMR spectroscopy is a powerful approach for studying interactions of FA with HSA and FA-competitive drugs. In the physiologically relevant solution state, 2D-NMR provides a unique view of HSA-ligand binding in a site-specific manner. Here we show nine, well-resolved peaks in 1H-13C-NMR spectra of 18-13C-oleic acid (OA)/HSA complexes. Different NMR signals arise, representing FA bound at different sites throughout the protein, with the varying intensities corresponding to the different relative affinities of HSA for OA. This investigation probes the site-specific FA binding sites with four approaches: (i) observation of order of filling with increasing FA molar ratios to HSA; (ii) addition of FA acceptors to observe the dissociation of FA from HSA; (iii) addition of drugs known to bind to low affinity FA sites; and (iv) development and use of HSA mutants that disrupt the binding of FA at high affinity sites. From the order of filling, the three highest affinity-binding sites are clearly differentiated from the six lower/medium affinity-binding sites at the physiologically relevant FA:HSA molar ratio- 4:1 . Methyl-β-cyclodextrin (MβCD) extracted FA from individual sites, in a concentration dependent manner, with the highest concentrations removing FA from the highest affinity sites. Relative affinities determined as above were consistent with the binding of drugs to previously defined primary drug binding sites, which displaced bound FA from specific lower affinity sites. HSA mutants were successfully expressed and purified, but FA binding to these proteins did not yield interpretable data. The other aim of this study was to identify the binding location of bilirubin on HSA, for it remains elusive despite intensive study. Unlabeled bilirubin competition suggested binding at primary drug binding sites, while directly probing the bilirubin-binding site with 13C-bilirubin analogs suggested binding in subdomain IB. These studies provide a methodological approach for further analysis of site-specific binding on HSA.

Made available in DSpace on 2016-01-26T18:55:33Z (GMT). No. of bitstreams: 1 Cristiane de Pauli Pereira.pdf: 1503472 bytes, checksum: 59921819ab10ff8a49c25d968609430f (MD5) Previous issue date: 2012-03-20
This study evaluated the effects of the venom from Crotalus durissus terrificus and snakebite serum on the clinical signs and liver function in 120 Wistar rats by performing physical examinations, laboratory and histopathology tests. The animals were divided into four experimental groups of thirty animals in each group. The control group (C) - received only solution of sodium chloride 0.9%; Group venom (V) - received 1mg/kg venom; Group snakebite serum (S) - received the indicated dose snakebite serum to neutralize the poison; Poison and serum group (VS) - received venom and the snakebite serum six hours later. The clinical evaluation and specimen obtained for laboratory and histological examinations were performed at time 2 hours, 8 hours and 24 hours in all groups. It was observed for the S Group elevation of serum enzyme alkaline phosphatase (FA), inflammatory reaction, changes in Kupffer cells, necrosis and hyaline degeneration; Group V heart rate decrease over time, increase in rectal temperature (TR), increased FA, increase of serum aspartate aminotransferase (AST), inflammatory infiltrate, changes in Kupffer cells, necrosis and hyaline degeneration; Group VS increased TR and also respiratory rate, elevated serum FA, AST and alanine aminotransferase (ALT), inflammatory reaction, changes in Kupffer cells, necrosis and hyaline degeneration. The results indicate that the venom and snakebite serum alter the clinical parameters and cause liver damage at the doses and times studied. However, further studies with the venom and antivenom to be able to understand the effect of time and changes in the percentage contribution of hepatotoxicity in serum isolated. In addition, to investigate the need for additional treatments to protect the liver.
Este estudo avaliou os efeitos hepatotóxicos do veneno de Crotalus durissus terrificus e soro antiofídico em 120 ratos Wistar, através da realização de exames físico, laboratorial e histopatológico. Os animais foram divididos em quatro grupos experimentais, com trinta animais em cada grupo, sendo: grupo controle (C) - recebeu solução de cloreto de sódio 0,9%; grupo veneno (V) - recebeu veneno crotálico 1mg/Kg; grupo soro antiofídico (S) - recebeu soro antiofídico na dose indicada para neutralizar o veneno; grupo veneno e soro (VS) - recebeu veneno crotálico e após 6 horas o soro antiofídico. A avaliação clínica e a colheita de material para exames laboratorial e histopatológico do fígado foram realizadas nos momentos 2 horas (n=10), 8 horas (n=10) e 24 horas (n=10) para todos os grupos. Observou-se para o grupo S elevação sérica da enzima fosfatase alcalina (FA), infiltrado inflamatório, alterações nas células de Kupffer, necrose e degeneração de hialina; Grupo V diminuição da frequência cardíaca no decorrer do tempo, aumento na temperatura retal (TR), elevação da FA, elevação sérica da aspartato aminotransferase (AST), infiltrado inflamatório, alterações nas células de Kupffer, necrose e degeneração de hialina; Grupo VS aumento da TR e na frequência respiratória, elevação sérica da FA, elevação sérica da AST, elevação sérica da alanina aminotransferase (ALT), infiltrado inflamatório, alterações nas células de Kupffer, necrose e degeneração de hialina. Os resultados encontrados indicam que o veneno crotálico e o soro antiofídico, associados ou não, alteram os parâmetros clínicos e provocam danos hepáticos nas doses e momentos estudados. No entanto, são necessários novos estudos com o veneno crotálico e a soroterapia para que se possa entender o efeito do tempo nas alterações e a porcentagem de contribuição do soro isolado na hepatotoxicidade. Além disso, investigar a necessidade de tratamentos complementares para a proteção hepática.

Allergi förekommer hos cirka 20 % av befolkningen i Sverige. Av de 20 % bedöms 40 % vara allergiska mot pollen. Allergi uppstår då en individ upprepade gånger exponeras för ett allergiframkallande ämne sk allergen. IgE-antikroppar bildas och binder till basofila granulocyter och mastceller. Den allergiska reaktionen eller överkänslighetsreaktionen av typ I uppkommer när ett allergen exempelvis pollen, kommer i direkt kontakt med IgE-antikroppar på mastceller eller basofila granulocyter. Allergiska individer har högre koncentration av IgE-antikroppar i blodet än icke allergiska. Normal koncentration av IgE i serum hos icke allergiker är <0.35 kU/L. Syftet med studien var att genom analys av serumprover från 50 patienter jämföra två immunokemiska metoder på analysinstrumenten, Siemens immulite® 2000 XPi och Thermo Fisher Phadia® 250, för detektion av IgE-antikroppar riktade mot en inhalationspanel respektive björkpollen. Immulite® 2000 XPi användes som referensmetod. Jämförelsen gjordes för att bedöma om metoderna gav överensstämmande resultat och om Phadia® 250 skulle kunna användas som ett alternativ till rutinmetoden. Studiematerialet bestod av 50 patienter i åldrarna 18–80 år, 17  män (34 %) och 33 kvinnor (66 %). Resultatet visade att metoderna överlag gav överrensstämmande resultat med avseende på positiva och negativa IgE-värden, men att de uppmätta värdena för metoderna saknade överrensstämmelse. Analysresultaten från de båda metoderna gav överlag god korrelation vid analys av specifikt IgE mot björk (R=0,977) men en svagare korrelation vid analys av inhalationspanel (R=0,609). Med hjälp av Man-Whitney u-test sågs en signifikant skillnad vid IgE-analys mot björk (p= 0,0006) däremot sågs inte en signifikant skillnad mellan metodernas IgE-värden mot inhalationspanelerna (p=0,2398). För att kunna utvärdera om Phadia® 250 skulle kunna användas som ett alternativ till rutinmetoden, krävs en större population av prover samt fler analystillfällen.
Allergy is nowadays a public health problem that’s affecting 20 % of the Swedish population. A very common allergen that is related to 40% of all the allergic cases is pollen. Allergic reactions occur when an  individual is repeatedly exposed to an allergenic substance called allergene. IgE antibodies then form and bind to basophilic granulocytes and mast cells. The allergic reaction or type I hypersensitivity reaction, occurs when an allergen such as pollen comes into direct contact with IgE antibodies on mast cells or basophilic granulocytes. IgE is produced by plasma cells under the influence of CD4+ T lymphocytes. The IgE antibodies synthesized then sensitize the mast cells and basophilic granulocytes which are the most active cell types involved in allergic reactions. Allergic individuals have a higher concentration of IgE antibodies in the blood than non-allergic. Normal serum IgE concentration in non-allergic patients is <0.35 kU / L. The aim of the study was to compare two immunochemical instruments, Siemens Immulite® 2000 XPi and Thermo Fisher Phadia® 250, by analyzing 50 serum samples to detect possible presence of IgE antibodies directed against an inhalation panel and a single allergen (IgE against birch). The study material consisted of 50 patients between the ages of 18-80, 17 men (34%) and 33 women (66%). The results showed that overall the two methods yielded consistent results due to positive and negative IgE values, but the measured values of the methods lacked concordance. The analysis results from the two methods generally yielded good correlation in the analysis of specific IgE against birch (R = 0.977) but a weaker correlation in the inhalation panel analysis (R = 0.609). Man-Whitney u-test showed a significant difference in IgE analysis against birch (p = 0.0006). However, a significant difference between the IgE values of the methods against the inhalation panels (p = 0.22398) was not observed. To be able to evaluate whether Phadia® 250 could be used as an alternative to the routine method, a larger population of samples and more analytical occasions is required.

Change particularities of the blood serum levels of vitamin D, calcitonin and parathyroid hormone were analysed in healthy cows of different feeding, age and productivity and in sick cows with metabolic diseases. It was investigated how biochemical indicators vary in cows with metabolic diseases (parturient paresis, osteomalacia and mastitis) and the most informative indicators for diagnostics of these diseases (for levels of calcium, phosphorus and magnesium) were determined. Obtained findings were processed statistically. The method of electrochemiluminescence analysis used for analysis of the blood serum levels of PTH in humans was applied. Compared with radioimmunic method, this method is not expensive and quite fast; in addition, this method is sensitive and reliable, because it permits to detect low levels of PTH in the blood serum (up to 0.127 pmol/l). The method of chemiluminescence immunometric analysis used to find the level of CT in humans was tested. Also the method of immunoferment analysis (ELISA) was tested to measure the blood serum level of 25-OH vitamin D in cattle using human antibodies.

Background: The role of nutrients in mental health has recently been recognized and investigated. Vitamin D has been known to play a role in a wide range of diseases, such as bone, cardiovascular, and autoimmune diseases, and cancers. Recently, its role in cognitive function and mental health has been reported. Vitamin D receptor and hydroxylases have been mapped throughout the brain, suggesting a role for vitamin D in brain tissue. An inverse association between vitamin D and depression was observed in European epidemiologic studies. There is a paucity of data on the association between vitamin D concentrations and depression in the U.S. population. Objective: The objective of this study was to investigate the association between serum vitamin D concentrations and depression in a large, nationally representative sample survey, the third National Health and Nutrition Examination Survey 1988-1994 (NHANES III). Methods: The study sample included 7970 adults, ages 15-39 years, who completed the Diagnostic Interview Schedule for depression and had vitamin D concentrations measured. SAS and SUDAAN statistical software packages were used in data analysis. Multivariate logistic regression was used to estimate the likelihood of having depression in vitamin D deficient persons in relation to vitamin D sufficient persons, after taking several confounding variables into consideration. Significance was set at α < 0.05. Results: The prevalence of vitamin D deficiency was higher in women than in men (24 % vs. 15%), higher in African-Americans than in whites (60% vs. 10%), higher in people living in metropolitan rather than in rural areas (25% vs. 14%), and higher in subjects below the poverty threshold than in higher income subjects (29% vs. 14%). The prevalence of vitamin D deficiency increased as BMI increased. The diagnostic variables for depression did not show an association with vitamin D deficiency after adjusting for several confounding factors. However, subjects having a depressive episode at the time of the interview, were significantly more likely to exhibit vitamin D deficiencies (OR = 1.85; P = 0.0210). Conclusions: This is the first large epidemiologic study on the association between vitamin D and depression in a US representative sample survey. A significant positive association was found between subjects having an episode of depression and vitamin D deficiency. However, a causal relationship could not be established due to the cross-sectional nature of the study. Further studies need to investigate the mechanistic and causal relation between vitamin D and depression.

Background: Vitamin D deficiency is a concern in the US. Association between vitamin D status and metabolic syndrome (MetS), insulin resistance (IR), and inflammation is unclear in children. Objective: The relationship between serum vitamin D and MetS, C-reactive protein (CRP), and Homeostatic Model Assessment-IR (HOMA-IR) was investigated. Design: Data from 3 cycles of National Health and Nutrition Examination Survey, 2001-2006 for 3700 (1820, boys; 1880, girls) children and adolescents, aged 12-17 y were used to assess prevalence of vitamin D deficiency (<20 ng>/mL) and association between serum vitamin D and prevalence of MetS, various components of MetS, CRP, and HOMA-IR using multivariate regression models. Results: Overall, prevalences of MetS and vitamin D deficiency were 6.1% and 30.5%, respectively. Prevalence of vitamin D deficiency was higher in girls (52%), blacks (74%), non-supplement users (50%), persons who were examined in winter (56%), and persons in the low poverty income ratio group (57%) compared to their counterparts. Serum vitamin D was inversely associated with waist circumference (P<0.001), systolic blood pressure (P=0.009), and HOMA-IR (P=0.003) and positively associated with HDL-cholesterol (P<0.001). Children with lowest serum vitamin D are at increased risk for MetS (P=0.04; OR 2.26; 95% CI: 1.11, 4.61). Serum vitamin D was not related to CRP (P<0.10). Conclusions: Children with poor vitamin D status are at increased risk for MetS and IR. Because of negative health outcomes associated with MetS and poor vitamin D status when existed individually or in combination, early detection and intervention of these conditions are paramount, especially in children.

Master of Science
Department of Animal Sciences and Industry
Jim Nelssen
Seven experiments using a total of 3,251 preweaned pigs, nursery pigs, and sows were used to determine the effects of: 1) supplemental vitamin D[subscript]3 on suckling and nursery pig growth, and maternal performance, and 2) high sulfate water, dietary zeolite and humic substance on nursery pig performance. Also, a web-based survey was developed to question pork producers and advisors of the swine industry on their knowledge of feed efficiency. Experiment 1 tested an oral dose of either; none, 40,000 or 80,000 IU vitamin D[subscript]3 given to pigs 24 to 48 h after farrowing. No differences in growth performance or bone mineralization were observed, but vitamin D[subscript]3 supplementation increased serum 25(OH)D[subscript]3 on d 10, 20, and 30, but returned to control values by d 52. Experiments 2 and 3 evaluated an oral dose of vitamin D[subscript]3 to pigs just before weaning, as well as added D[subscript]3 in nursery diets and in drinking water. There were no effects on growth performance; however, serum 25(OH)D[subscript]3 increased with all sources of vitamin D[subscript]3 supplementation. Experiment 4 evaluated if pigs had a preference to 1 of 3 dietary concentrations of vitamin D[subscript]3. Pigs ate less feed from diets containing very high levels of vitamin D[subscript]3 compared to commonly supplemented levels. Experiment 5 evaluated 3 levels of vitamin D[subscript]3 in sow diets. There were no effects on sow productivity, subsequent pig performance, or piglet bone ash content. However, increasing vitamin D[subscript]3 increased sow serum 25(OH)D[subscript]3, milk vitamin D, and pig serum 25(OH)D[subscript]3. Experiment 6 and 7 evaluated the effects of dietary zeolite and humic substances in nursery pigs drinking high sulfate water. Ultimately, pigs drinking high sulfate water had increased fecal moisture content and decreased growth performance, and feed additives evaluated were ineffective in ameliorating these negative effects. Finally, data collected from the feed efficiency survey suggest that there are knowledge gaps about practices that effect feed efficiency. Results from this survey will help extension educators better target specific industry segments with current information and provide more specific areas of future research where lack of information has been identified.

Hepcidin-25 is regarded as the master regulator of iron homeostasis. Three N-truncated isoforms of hepcidin-25 have been identified in human serum; hepcidin-20, -22, and -24, although information is scant as to the serum concentrations of these isoforms. A liquid chromatography-high resolution-mass spectrometry (LC-HR-MS) assay was developed for the simultaneous quantitation of hepcidin isoforms in human serum. Serum (200 μL) was mixed with aqueous formic acid (600 μL), and the supernatant loaded onto a 96-well- SPE-plate. Eluted sample (70 μL) was diluted with deionised water (60 μL) and analysed using LC–HR–MS. Samples previously analysed by a published LC-MS/MS assay were analysed for method comparison. All hepcidin isoforms were quantified in samples from healthy volunteers as controls, and patients with hereditary haemochromatosis (HH), non-alcoholic fatty liver disease (NAFLD), iron deficient anaemia (IDA), anaemia of chronic disease (ACD), and sickle cell anaemia (SCA). Samples were also analysed from individuals with chronic kidney disease (CKD) not requiring haemodialysis, and those pre- and post-haemodialysis. Intra-/inter-assay accuracy and precision were acceptable, calibration was linear (R2 > 0.90, all analytes), and the LLoQ was 1 μg/L (all analytes). There was a good correlation for hepcidin-25 to a published LC-MS/MS assay (y = 0.85x -3.2, R2 = 0.96). Median (range) hepcidin-25 concentrations in controls, and individuals with IDA, SCA, HH, ACD and sepsis were: 8 (1–31), <1 (< 1–2), < 1 (< 1–10), 2 (< 1–15), 60 (10–213), and 92 (11–216) μg/L, respectively. Hepcidin-20, -22, or -24 were not detected in any control sample, but were detected in 30–100 % of all samples at 10–20 % of the hepcidin-25 concentration. Following haemodialysis, all hepcidin isoforms declined by some 35–50 %. Hepcidin-25 was most strongly correlated to hepcidin-24, and less so to hepcidin-22 and -20, in all disease states. The developed method was applicable for clinical use. However, further controlled studies are required to fully evaluate the role of hepcidin-20, -22, and -24 measurement in a clinical setting.

This research uses data from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) to determine dietary and other factors associated with serum 25(OH)-Vitamin D concentration for 5,474 adults age 20 years and older. After multivariate adjustment, we found that serum 25(OH)-Vitamin D concentration was positively associated with diets high in fruits, vegetables, and lean meats, while diets high in processed foods and high-fat meats were inversely associated with vitamin D level. Serum 25(OH)-Vitamin D concentration was also signifi-cantly associated with age, gender, race/ethnicity, BMI, physical activity, supplementation, and the season of survey administration. Self-reported cardiovascular and kidney disease were significantly associated with serum 25 (OH)-Vitamin D concentration after adjustment for significant confounders.

Approximately 50% of individuals may be resistant to infection with Mycobacterium tuberculosis (M.tb), the causative agent of tuberculosis (TB). Pulmonary innate immunity is likely to be important in shaping this, although it is unclear how this is determined in the human lung. Ethnicity influences infection rates following exposure to TB, and is associated with differential phenotypes in established TB disease; the latter is driven by variation in serum 25-hydroxyvitamin D3 [25(OH)D3]. Through genomic vitamin D-response elements, 25(OH)D3 can influence gene transcription, potentially linking changes in serum 25(OH)D3, and innate pulmonary immune function. Aim 1 of this project involved the recruitment of a cohort of precisely-defined individuals in recent close contact with smear-positive pulmonary TB. Their exposure to TB was quantified, along with variables associated with TB transmission. Vitamin D metabolites were measured in serum at the point of recruitment, and associations with outcome were tested. Elevation in serum 25(OH)D3 was associated with resistance to TB infection, and not confounded by other transmission factors. Aim 2 involved the development of an experimental pathway where human alveolar macrophages (AMs) could be acquired and identified, and then infected intracellularly with the virulent M.tb strain H37Rv. The concentration of 25(OH)D3 in the serum to which these cells were exposed was varied; a higher concentration was associated with enhanced growth control of H37Rv. Aim 3 involved the isolation of RNA from human AMs, so that gene expression in response to intracellular H37Rv could be assessed using qPCR and RNAseq. The AM was able to upregulate the genes required to activate 25(OH)D3 within the cell, but growth control in response to higher serum 25(OH)D3 exposure was not associated with transcription of the anti-mycobacterial gene cathelicidin. RNAseq suggested networks of genes, possibly involving eicosanoid metabolism, may be more important in the 25(OH)D3-driven AM response to virulent mycobacteria.

As crianças com fissura labiopalatina geralmente apresentam alterações fonoaudiológicas com manifestações em vários aspectos, especialmente no da comunicação. No que se refere à audição, os bebês que nascem com fissura no palato tendem a apresentar acúmulo de fluido na orelha média, devido ao mau funcionamento do mecanismo de abertura e fechamento da tuba auditiva. O quadro pode evoluir para otites, que é umas das causas mais comuns de perda auditiva em crianças com fissura labiopalatina com até 10 anos. Esta perda auditiva geralmente é do tipo condutiva bilateral. Sabe-se que a audição normal é essencial para a aquisição da linguagem oral e efetiva comunicação verbal, e que déficits do sistema auditivo, congênitos ou adquiridos afetam a transmissão e a percepção do som. Qualquer perda auditiva oferece privação sensorial, podendo, assim, levar a alterações em diferentes habilidades auditivas. São crescentes os estudos científicos relacionados às habilidades auditivas em crianças com fissura labiopalatina, contudo, existe uma escassez de trabalhos relacionando habilidades auditivas centrais com as alterações de fala na fissura labiopalatina. Assim, hipotetizou-se que as habilidades auditivas centrais em crianças com fissura labiopalatina que apresentam alterações de fala seriam diferentes das habilidades das crianças com fissura labiopalatina sem alteração de fala e também que poderia existir uma relação entre as alterações de fala relacionadas à Disfunção Velofaríngea e às habilidades auditivas centrais. Este trabalho teve por objetivo verificar a associação entre as habilidades auditivas centrais e alterações de fala decorrentes da Disfunção Velofaríngea (hipernasalidade e emissão de ar nasal), e Articulações Compensatórias em crianças com fissura labiopalatina operada. Nesta pesquisa, foi realizado um estudo prospectivo de 45 pacientes, subdividos em 3 grupos. Todos matriculados no Hospital de Reabilitação de Anomalias Craniofaciais da Universidade de São Paulo, com fissura labiopalatina operada. Foram averiguados inicialmente em prontuário dados quanto à Disfunção Velofaríngea e ao uso de Articulações Compensatórias a fim de compor os três grupos do estudo, sendo o G1 com alterações de fala decorrentes da Disfunção Velofaríngea e Articulações Compensatórias, o G2 com alterações de fala decorrentes da Disfunção Velofaríngea, porém sem Articulações Compensatórias, e G3 (grupo controle) sem alterações de fala decorrentes da Disfunção Velofaríngea e sem Articulações Compensatórias. Posteriormente, os sujeitos foram submetidos à avaliação audiológica periférica e a testes do processamento auditivo central. A Articulação Compensatória de maior ocorrência foi a golpe de glote, seguida pela fricativa faríngea e plosiva dorso médio palatal. O G1 foi o grupo que apresentou o maior número de sujeitos com habilidades auditivas alteradas, seguido pelo G2, e G3. Foi encontrada significância estatística na associação do grupo com alterações de fala decorrentes da DVF e AC com as habilidades de figura-fundo e ordenação temporal. A habilidade de resolução temporal esteve alterada em toda amostra estudada.
Children with cleft lip and palate usually have speech-language disorders with manifestations in various aspects of communication and supply. With regard to auditing, children with cleft palate tend to have fluid buildup in the middle ear due to malfunction of the opening and closing mechanism of the Eustachian tube. The table may develop into Otitis, which is one of the most common causes of hearing loss in children up to 10 years with cleft lip and palate. This hearing loss is usually conductive type and bilateral. Normal hearing is essential for the acquisition of oral language and effective verbal communication and that deficits of the auditory system, congenital or acquired, affect the transmission and perception of sound. Any hearing loss offers sensory deprivation and may thus lead alteration in different hearing abilities.Scientific studies related to the auditory abilities in children with cleft lip and palate are increasing, however, there is a paucity of studies linking central auditory skills with speech disorders in the cleft lip and palate. Thus hypothesized dry the central auditory skills in children with cleft lip and palate who have speech disorders would be different from the skills of children with cleft lip and palate speechless change and also that could be a relationship between speech disorders related to velopharyngeal dysfunction and central auditory skills .The objective of this study is investigate the association between central auditory skills and speech disorders resulting from the velopharyngeal dysfunction (hypernasality and nasal air emission) and compensatory articulations in children with cleft palate. In this research it performed a prospective study of 45 patients, subdivided into 3 groups. All enrolled in the Craniofacial Anomalies Rehabilitation Hospital of the University of São Paulo, with operated cleft lip and palate. They were initially investigated in medical records data on the velopharyngeal dysfunction and use of compensatory articulations in order to compose the three study groups: the G1 with speech disorders resulting from the velopharyngeal dysfunction and compensatory articulations, G2 with speech disorders resulting from the velopharyngeal dysfunction But without compensatory articulations and G3 (control group) without speech disorders resulting from the velopharyngeal dysfunction and no compensatory articulations. Later the subjects underwent a peripheral audiological evaluation and auditory processing tests. The compensatory articulation was the most frequent glottal stop, followed by pharyngeal fricative and plosive average back palatal. The G1 was the group that had the highest number of subjects with altered auditory skills, followed by G2 and G3. Found statistically significant association between the group with speech disorders resulting from VPD and CA with the figure-ground skills and temporal skills. The temporal resolution skill was altered in all groups of this study.

A erosão dentária apresenta uma etiologia multifatorial, com isto, existem várias possibilidades preventivas e terapêuticas. A saliva é um dos mais importantes fatores biológicos envolvidos, tendo um papel protetor contra desafios erosivos, por contribuir na formação da película adquirida. Já a incorporação de proteínas á película adquirida, através da sua adição a produtos odontológicos, como soluções para bochecho ou géis, por exemplo, pode afetar sua habilidade em proteger contra a erosão. Experimentos preliminares revelaram que uma cistatina clonada recentemente a partir da cana-de-açúcar, denominada CaneCPI-5, tem uma grande força de interação com o esmalte, sendo capaz de protegê-lo contra a erosão inicial. O objetivo do presente estudo foi avaliar o efeito de soluções ou géis contendo CaneCPI-5, em diferentes concentrações, na proteção contra a erosão inicial do esmalte n vitro. Foram confeccionados 150 blocos de esmalte bovino (4 X 4 mm). Para cada um dos veículos a ser testado (solução ou gel) foram constituídos 5 grupos, sendo um grupo controle, constituído por água deionizada ou gel placebo e 4 grupos experimentais. Para as soluções, os grupos experimentais foram constituídos de: Mucina 0,27% + Caseína 0,5%, CaneCPI-5 0,025 g/L, CaneCPI-5 0,1 g/L e CaneCPI-5 1,0 g/L. Para os géis, os grupos experimentais foram: Mucina 0,27% + Caseína 0,5%, CaneCPI-5 0,1 g/L, CaneCPI-5 1,0 g/L e CaneCPI-5 2,0 g/L O tratamento dos espécimes com as soluções foi feito por 2 h a 30°C, sob agitação, enquanto com os géis foi feito por 1 min. Saliva estimulada foi coletada de 3 voluntários para formação da película adquirida (durante 2 h) sobre os espécimes. Os espécimes foram então incubados em solução de ácido cítrico 0,65% (pH = 3,4) por 1 min a 30ºC sob agitação constante. Cada espécime foi assim tratado uma vez ao dia durante 3 dias. As análises de microdureza de superfície (SHM) foram feitas e as alterações na SMH (SHM baseline SMH pós-erosão; %SHC) foram calculadas nos dias 1 e 3. Os dados foram analisados pelos teste de Kruskal-Wallis, seguido pelo teste de Dunn (p<0,05). As soluções contendo CaneCPI-5 a 0,1 e 1,0 g/l reduziram significativamente %SHC em comparação aos demais tratamentos, para ambos os períodos experimentais, sem diferença entre si. Para os géis resultados semelhantes aos das soluções foram obtidos apenas no primeiro dia de tratamento. Após 3 dias, entretanto, o efeito protetor foi perdido. Em conclusão, o tratamento com solução contendo CaneCPI-5 a 0,1 g/L parece ser uma boa alternativa para prevenir a erosão inicial do esmalte, o que deve ser confirmado em estudos utilizando condições experimentais mais similares às situações clínicas.
Dental erosion has a multifactorial etiology, thus, there are several preventive and therapeutic possibilities. Saliva is one of the most important biological factors involved, having a protective role against erosive challenges and contributing to the formation of the acquired enamel pellicle. The incorporation of proteins in the acquired enamel pellicle, by their addition to dental products such as mouthwashes or gels, for example, can affect its ability to protect against erosion. Preliminary experiments from our group have shown that a sugar cane-derived protein that was recently cloned, known as CaneCPI-5 has a strong interaction force with the enamel and is capable of protecting it against initial erosion. The aim of this study was to evaluate the effect of solutions or gels containing CaneCPI-5, in different concentrations, on the protection against initial enamel erosion in vitro. Bovine enamel blocks (n=150) (4X4 mm) were prepared. For each of the vehicles tested (solution or gel) 5 groups (one control, constituted by deionized water or placebo gel and four experimental) were constituted. For the solutions, the experimental groups were constituted of: 0.27% mucin + 0.5% casein, 0.025 g/L CaneCPI-5, 0.1 g/L CaneCPI-5 or 1.0 g/L CaneCPI-5. For the gels, they were: 0.27% mucin + 0.5% casein, 0.1 g/L CaneCPI-5, 1.0 g/L CaneCPI-5 or 2.0 g/L CaneCPI-5. The specimens were treated with the solutions for 2 h at 30°C under stirring or with the gels for 1 min. Stimulated saliva was collected from three volunteers and the acquired enamel pellicle was formed for 2 h. Then the specimens were incubated in a solution of 0.65% citric acid (pH = 3.4) for 1 min at 30°C under stirring. Each specimen was treated once a day for 3 days. Surface hardness analysis (SHM) was made and changes in SMH (SHM baseline - posterosion SMH; %SHC) was calculated on days 1 and 3. Data were analyzed by Kruskall-Wallis and Dunn´s tests (p<0.05). The solutions containing 0.1 and 1.0 g/L CaneCPI-5 significantly reduced %SHC when compared with the other treatments, for both experimental periods, without significant difference between them. As for the gels, similar results were obtained but only at the first day of treatment. After 3 days, the protective effect was lost. In conclusion, the treatment with solution containing 0.1g/L CaneCPI-5 seems to be a good alternative to prevent initial enamel erosion, what needs to be confirmed using experimental conditions that more closely resemble the clinical situation.

Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

Vitamin D deficiency and insufficiency are now seen as a contemporary health problem in Australia with possible widespread health effects not limited to bone health1. Despite this, the Vitamin D status (measured as serum 25-hydroxyvitamin D (25(OH)D)) of ambulatory adults has been overlooked in this country. Serum 25(OH)D status is especially important among this group as studies have shown a link between Vitamin D and fall risk in older adults2. Limited data also exists on the contributions of sun exposure via ultraviolet radiation and dietary intake to serum 25(OH)D status in this population. The aims of this project were to assess the serum 25(OH)D status of a group of older ambulatory adults in South East Queensland, to assess the association between their serum 25(OH)D status and functional measures as possible indicators of fall risk, obtain data on the sources of Vitamin D in this population and assess whether this intake was related to serum 25(OH)D status and describe sun protection and exposure behaviors in this group and investigate whether a relationship existed between these and serum 25(OH)D status. The collection of this data assists in addressing key gaps identified in the literature with regard to this population group and their Vitamin D status in Australia. A representative convenience sample of participants (N=47) over 55 years of age was recruited for this cross-sectional, exploratory study which was undertaken in December 2007 in south-east Queensland (Brisbane and Sunshine coast). Participants were required to complete a sun exposure questionnaire in addition to a Calcium and Vitamin D food frequency questionnaire. Timed up and go and handgrip dynamometry tests were used to examine functional capacity. Serum 25(OH)D status and blood measures of Calcium, Phosphorus and Albumin were determined through blood tests. The Mean and Median serum 25-Hydroxyvitamin D (25(OH)D) for all participants in this study was 85.8nmol/L (Standard Deviation 29.7nmol/L) and 81.0nmol/L (Range 22-158nmol/L), respectively. Analysis at the bivariate level revealed a statistically significant relationship between serum 25(OH)D status and location, with participants living on the Sunshine Coast having a mean serum 25(OH)D status 21.3nmol/L higher than participants living in Brisbane (p=0.014). While at the descriptive level there was an apparent trend towards higher outdoor exposure and increasing levels of serum 25(OH)D, no statistically significant associations between the sun measures of outdoor exposure, sun protection behaviors and phenotypic characteristics and serum 25(OH)D status were observed. Intake of both Calcium and Vitamin D was low in this sample with sixty-eight (68%) of participants not meeting the Estimated Average Requirements (EAR) for Calcium (Median=771.0mg; Range=218.0-2616.0mg), while eighty-seven (87%) did not meet the Adequate Intake for Vitamin D (Median=4.46ug; Range=0.13-30.0ug). This raises the question of how realistic meeting the new Adequate Intakes for Vitamin D is, when there is such a low level of Vitamin D fortification in this country. However, participants meeting the Adequate Intake (AI) for Vitamin D were observed to have a significantly higher serum 25(OH)D status compared to those not meeting the AI for Vitamin D (p=0.036), showing that meeting the AI for Vitamin D may play a significant role in determining Vitamin D status in this population. By stratifying our data by categories of outdoor exposure time, a trend was observed between increased importance of Vitamin D dietary intake as a possible determinant of serum 25(OH)D status in participants with lower outdoor exposures. While a trend towards higher Timed Up and Go scores in participants with higher 25(OH) D status was seen, this was only significant for females (p=0.014). Handgrip strength showed statistically significant association with serum 25(OH)D status. The high serum 25(OH)D status in our sample almost certainly explains the limited relationship between functional measures and serum 25(OH)D. However, the observation of an association between slower Time Up and Go speeds, and lower serum 25(OH)D levels, even with a small sample size, is significant as slower Timed Up and Go speeds have been associated with increased fall risk in older adults3. Multivariable regression analysis revealed Location as the only significant determinant of serum 25(OH)D status at p=0.014, with trends (p=>0.1) for higher serum 25(OH)D being shown for participants that met the AI for Vitamin D and rated themselves as having a higher health status. The results of this exploratory study show that 93.6% of participants had adequate 25(OH)D status-possibly due to measurement being taken in the summer season and the convenience nature of the sample. However, many participants do not meet their dietary Calcium and Vitamin D requirements, which may indicate inadequate intake of these nutrients in older Australians and a higher risk of osteoporosis. The relationship between serum 25(OH)D and functional measures in this population also requires further study, especially in older adults displaying Vitamin D insufficiency or deficiency.

Abstract The aim of the present study was to examine associations between serum 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D[(1,25(OH)2D]—the circulating and active forms of vitamin D—and periodontal infection. The data were gathered from a case-control study (63 periodontitis patients and 30 periodontally healthy controls) and an intervention study among individuals with type 1 diabetes mellitus (T1DM, 80 patients at the baseline and 65 after periodontal treatment). The periodontal data and the levels of serum 25(OH)D, 1,25(OH)2D and parathyroid hormone (PTH) were available. A third data set included periodontal data and the serum level of 25(OH)D of 1262 non-smoking and non-diabetic 30–49-year-old individuals (Health 2000 Survey). Serum 25(OH)D analyses were done using enzyme-linked immunoassay and radioimmunoassay, 1,25(O)2D analyses using enzyme-immunoassay after purification of 1,25(OH)2D by immunoextraction and PTH analyses using electrochemiluminescence immunoassay. In the case-control study individuals with a low serum 1,25(O)2D level were more likely to belong to the periodontitis group than to the periodontally healthy group and an inverse association was observed between serum 1,25(OH)2D and severity of periodontitis at the baseline of the intervention study. Serum 1,25(OH)2D increased significantly after periodontal treatment in the T1DM patients; a finding that was considered suggestive of a causal relationship between serum 1,25(OH)2D and periodontal infection. Also, serum PTH increased after periodontal treatment; this increase, which was statistically significant (p = 0.016) in patients with moderate or severe periodontitis, may partly account for the earlier observed post-treatment increase in serum 1,25(OH)2D level. Possible explanations for low serum 1,25(OH)2D in periodontal infection may be increased degradation of 1,25(OH)2D, increased use of 1,25(OH)2D, or decreased hydroxylation of 25(OH)D The association between serum 25(OH)D level and periodontal infection was weak, if existent. An inverse association between serum 25(OH)D and the severity of periodontal infection was observed only in the T1DM patients. Among individuals with low plaque level, those in higher 25(OH)D quintiles tended to have fewer teeth with deepened periodontal pockets than those in lower quintiles; a finding which was interpreted to mean a slight protective role of 25(OH)D against periodontal infection
Tiivistelmä Tutkimuksen tarkoituksena oli selvittää seerumin 25-hydroksivitamiini D:n [25(OH)D, D-vitamiinin varastomuoto] ja 1,25-dihydroksivitamiini D:n [1,25(OH)2D, D-vitamiinin aktiivinen muoto] tasojen yhteyttä parodontiumin alueen infektiosairauksiin. Tulokset perustuvat kolmeen tutkimusasetelmaan: tapaus-verrokki-tutkimus (63 parodontiitti-potilasta, 30 verrokkia), interventio-tutkimus [80 tyypin 1 diabetes mellitus (T1DM) potilasta, joista 65 osallistui seurantaan parodontologisen hoidon jälkeen] ja poikittaistutkimus Terveys 2000 tutkimuksen osa-aineistossa (1262 30-49 vuotiasta tupakoimatonta ei-diabeetikkoa). Tapaus-verrokki- ja interventiotutkimuksissa tutkittiin myös seerumin parathormoonin (PTH) yhteyttä parodontaali-infektioon sekä PTH:n vaikutusta seerumin 1,25(OH)2D tasoon infektion hoidon jälkeen. D-vitamiinin ja PTH:n tasot määritettiin immunologisin menetelmin. Yhteyksiä tutkittiin käyttäen vakioituja monimuuttujamalleja. Tapaus-verrokki-tutkimuksessa yksilöt, joilla seerumin 1,25(OH)2D taso oli alhainen, kuuluivat todennäköisemmin parodontiitti- kuin verrokkiryhmään. Interventiotutkimuksen alkutilanteessa seerumin 1,25(OH)2D:n ja parodontaali-infektion vaikeusasteen välillä vallitsi tilastollisesti merkittävä käänteinen yhteys ja taso nousi merkittävästi infektion hoidon jälkeen. Myös seerumin PTH taso nousi parodontaali-infektion hoidon jälkeen; nousu oli tilastollisesti merkittävä (p = 0.016) pitkälle edennyttä parodontiittia sairastavilla. Interventiotutkimuksen tulokset viittaavat kausaaliseen yhteyteen 1,25(OH)2D:n ja parodontaali-infektion välillä. Alhainen seerumin 1,25(OH)2D pitoisuus infektion vallitessa voi selittyä sen suurella käytöllä immuunipuolustukseen infektion aikana tai lisääntyneellä hajoamisella. Tason nousu hoidon jälkeen tukee edellä mainittua. PTH on 25(OH)D:n hydroksylaation pääsäätelijä ja 1,25(OH)2D:n nousua hoidon jälkeen voi osittain selittää myös seerumin PTH tason kohoaminen. Seerumin 25(OH)D:n ja parodontaali-infektion välillä havaittu yhteys oli heikko, mutta ei täysin sulje pois 25(OH)D:n suojaavaa vaikutusta. Käänteinen yhteys löytyi vain interventiotutkimuksen alkutilanteessa T1DM potilailla. Infektion hoito ei vaikuttanut 25(OH)D tasoon. Terveys 2000 tutkimuksen osa-aineistossa havaittiin hyvän suuhygienian omaavilla jonkin verran alhaisempi määrä syventyneitä ientaskuja ylemmissä kuin alemmissa 25(OH)D kvintiileissä

Adequate dietary vitamin D and calcium intake have shown to be important in regulating skeletal development and bone mineralization. Vitamin D insufficiency is associated with increased fracture risk suggesting that a minimum 25-hydroxyvitamin D (25D) production in bone may be essential for maintaining a healthy skeleton. However, the required level of vitamin D to maintain/improve bone quality is still undetermined. This thesis investigates the regulation of dietary vitamin D on bone in young adult rats as well as the interaction between vitamin D requirement and dietary calcium intake on bone structure and the mechanical measures of bone quality in aged rats. Bone mineral content in trabecular and cortical bones and a number of biochemical factors known to regulate renal metabolism of 1,25D hydroxyvitamin D3 (1,25D) such as PTH, calcium, 25D and 1,25D were examined. Enzymes responsible for the production of 1,25D, 25-hydroxyvitamin D3-1a-hydroxylase (CYP27B1) and the catabolism of 1,25D (25-hydroxyvitamin D-24-hydroxylase (CYP24)) mRNA expression in the kidney was also studied. Furthermore, bone mechanical quality was determined using 3-point bending on rat tibia with the aim to validate mechanical testing as well as determining the effects of varying levels of dietary vitamin D and calcium on bone strength. We have previously shown that serum 25D levels, which represents the level of vitamin D status is a strong determinant of bone volume. Despite that vitamin D deficiency results in trabecular bone loss in the femur and vertebrae, further cortical bone analysis demonstrated that cortical bone volume, bone mineral distribution and strength was preserved in short term vitamin D deficiency suggesting that the effect of vitamin D deficiency in young adult rats varies between trabecular and cortical regions. To further understand the reported effects on low dietary calcium induced bone loss, mRNA expressions of the renal enzymes were examined. High renal CYP27B1 mRNA expressions and serum 1,25D levels in long term low dietary calcium animals suggested that the effects of bone loss may be due to 25D metabolism leading to the reduction in vitamin D status. CYP24 and other liver enzymes were not regulated by the low calcium diet. We have reported that circulating levels of serum 25D are greater in animals fed a diet containing high levels of calcium. Thus, the effects of a high calcium diet to protect against bone loss may be due to the subsequent effects on the maintenance of circulating 25D levels. μ-CT analysis demonstrated that both femoral and tibial cortical bone volume as well as trabecular bone volume is higher in animals that are fed high calcium and vitamin D diet. Furthermore, 3-point bending demonstrated the greatest maximum load to failure was achieved in the same dietary group. Cortical bone volume and the sagittal loading are both strong determinants of ultimate load suggesting that mechanical forces and bone mineral content are crucial in maintaining the quality and function of bone strength. In addition, these results have validated our mechanical testing suggesting that bone strength is affected despite the subtle changes in cortical bone volume which may be the result of ovariectomy or dietary changes. The studies of this thesis reveal a complex interaction between dietary calcium and vitamin D, and show that physiological changes in biochemical factors can affect structure and strength in different regions of bone. More importantly, it also demonstrate the optimal levels of dietary calcium and vitamin D that are required to prevent the development of osteoporosis.
Thesis (Ph.D.) -- University of Adelaide, School of Medical Sciences, 2011

Although maternal vitamin D status has been linked to asthma in offspring, the relationship between vitamin D status and asthma in adults still remains unclear. The current study assessed the relationship between measures of vitamin D status and self-reported asthma/wheeze in 186 healthy women aged 18-30 years. Although the risk of asthma/wheeze symptoms was three-times higher among women with low dietary vitamin D intake (<200 IU>/day) than in those with higher vitamin D intake, suboptimal serum levels of 25(OH)D ( <70 nmol>/L) were associated with a 48% lower risk of asthma/wheeze than “optimal” serum levels. These contradictory effects underscore the poor correlation between dietary vitamin D intake and serum vitamin levels and suggest that other components in vitamin D-rich foods may be protective. Alternatively, women with higher serum vitamin D levels may have spent more time outdoors, increasing their exposure to asthma triggers. This study also identified predictors of serum 25 (OH) D in this sample. In addition to total dietary vitamin D (r= 0.2; p=0.03), intake of cold cereal (p=0.02) also significantly predicted serum 25(OH)D levels. Among non-dietary factors, month of blood draw (p=0.05) and oral contraceptive use (p<0.0001) were positive predictors of serum 25(OH) D; sunscreen use (p=0.04) was a negative predictor. After adjusting for covariates, oral contraceptive use was associated with 25(OH)D levels that were on average 24 nmol/L greater than those observed in women who did not use oral contraceptives. Additional prospective studies are needed to further evaluate the relationship between vitamin D status and asthma.

by Priscilla Miu-kuen Poon.
Thesis (M.Phil.)--Chinese University of Hong Kong, 1991.
Includes bibliographical references.
ACKNOWLEDGEMENT --- p.1
ABSTRACT --- p.2
CONTENTS
Chapter 1. --- INTRODUCTION --- p.4
Chapter 1.1 --- Discovery of vitamin D
Chapter 1.2 --- Bioavailability of vitamin D and its metabolites
Chapter 1.3 --- Metabolism of vitamin D and its metabolites
Chapter 1.4 --- Mode of action of vitamin D
Chapter 1.5 --- Vitamin D-related diseases
Chapter 2. --- METHODS OF MEASURING VITAMIN D AND ITS METABOLITES --- p.32
Chapter 2.1 --- Deproteinization
Chapter 2.2 --- Extraction
Chapter 2.3 --- Separation
Chapter 2.4 --- Quantitation
Chapter 3. --- OBJECTIVES --- p.51
Chapter 4. --- MATERIALS & METHODS --- p.52
Chapter 4.1 --- Materials
Chapter 4.2 --- General methods
Chapter 4.3 --- Blood collection
Chapter 4.4 --- Radioreceptor assay
Chapter 4.5 --- Serum treatment
Chapter 4.6 --- High Performance Liquid Chromatography (HPLC)
Chapter 4.7 --- Gas Chromatography-Mass Spectrometry (GC-MS)
Chapter 4.8 --- "Serum 1α,25-dihydroxyvitamin D3 analysis"
Chapter 4.9 --- Application of the established GC-MS method
Chapter 4.10 --- Study on hypercalcaemia of tuberculosis
Chapter 5. --- RESULTS --- p.66
Chapter 5.1 --- Analysis of vitamin D3 standard
Chapter 5.2 --- "Analysis of 1α,25-dihydroxyvitamin D3 standard"
Chapter 5.3 --- Separation of vitamin D3 metabolites
Chapter 5.4 --- "Analysis of lα,25-dihydroxyvitamin D3 in serum samples"
Chapter 5.5 --- Study on hypercalcaemia of tuberculosis
Chapter 6. --- DISCUSSIONS --- p.118
Chapter 6.1 --- Derivatization
Chapter 6.2 --- Optimization of GC-MS parameters
Chapter 6.3 --- Sample pre-treatment
Chapter 6.4 --- "GC-MS analysis of serum lα,25-dihydroxyvitamin D3"
Chapter 6.5 --- Study on hypercalcaemia of tuberculosis
Chapter 7. --- CONCLUSION --- p.129
LIST OF ABBREVIATIONS --- p.131
LIST OF FIGURES --- p.134
LIST OF TABLES --- p.137
REFERENCES --- p.139

We determined whether children older than 1 year from non-western immigrant families had lower serum 25-hydroxyvitamin D levels than children from western born families. Children ages 1-6 years were recruited through the TARGet Kids! practice based research network. Univariable analysis revealed that non-western immigrant children had 4 nmol/L lower 25-hydroxyvitamin D (p=0.006; 95% CI:1.4-8.0) and increased odds of 25-hydroxyvitamin D <50 nmol/L (OR 1.9, 95% CI:1.3–2.9). After adjustment for known vitamin D determinants, cow’s milk intake, vitamin D supplements, season and age were significant covariates and current vitamin D supplementation had the strongest confounding effect. In order to use the ethnicity variable, we developed a new standardized geographically based closed-ended ethnicity question, which was a practical alternative to the widely used open-ended ethnicity questions. There was an association between non-western immigration and lower 25-hydroxyvitamin D in early childhood and this appears primarily related to known vitamin D determinants.

D. Tech. (Food Service Management, Dept. of Hospitality, Faculty of Human Sciences)|cVaal University of Technology
Main Purpose of the study: To evaluate the impact of soy protein feeding intervention over a period of six months on the nutritional status of an elderly (≥60 years old) community of Sharpeville, in which poverty, household food security and malnutrition were prevalent. Methods: An experimental design that had no control group but a comparison between hypercholesterolaemic (HC) and normocholesterolaemic (NC) groups was used with 134 randomly selected elderly respondents. The first stage involved a baseline survey which determined the prevalence of risk factors for cardiovascular disease (CVD) and nutritional status among participants. Measurements included biochemical indices (serum lipids, vitamin B12, folate and homocysteine), anthropometry (weight, height and waist circumference) and dietary intake using 24h-recall and 7-day dietary diversity questionnaire. Socio-demographic information gathered from previous studies on the same subjects was used. The second stage was the preparation, formulation, and implementation of a nutrition education programme to assess its impact on nutrition knowledge after the nutrition education intervention. The nutrition education was conducted in two sections, namely an exploratory study and an experimental study. An exploratory study was conducted to assess the nutrition education needs of the elderly and was followed by the experimental study, which assessed nutrition knowledge before and after the intervention. The third stage was the implementation of the 10 grams soy protein daily feeding intervention for a period of six months and evaluation of its impact on risk factors for cardiovascular disease and on nutritional status. Sensory tests, compliance and the same measurements conducted at baseline were used at follow-up (feeding intervention). A comparison of the findings of the baseline study and follow-up study was conducted. Also to provide deeper insight into the effect of soy on the risk factors for CVD and nutritional status, respondents were further stratified into HC and NC groups based on their LDL-C levels at baseline study and results were also presented as such. The data analyses included descriptive statistics and t-tests on SPSS version 21.0. Results: From the baseline study, the dietary intake results revealed a poor dietary intake which contributed to inadequate estimated average requirements (EAR) and adequate intakes (AI) of nutrients. A mainly carbohydrate-based diet was consumed with minimal intake of dairy and legumes despite a medium dietary diversity score. The anthropometric indices at baseline indicated over-nutrition based on the reported waist circumference 97.32±10.32 (80.6%) above substantial risk of CDL, obesity (75.3%) and hypertension (56.7%), with the highest percentages for both waist circumference of substantial risk and overweight/obesity found among the women (80.9% and 79.9% respectively) and for hypertension among the men (79.1%). For the biochemical results at baseline, the prevalence of risk factors for CVD was observed as abnormal mean serum lipids such as LDL-cholesterol (3.6±1.1), HDL-cholesterol (0.73±0.4), total cholesterol:HDL-cholesterol ratio (7.9±2.9), triglyceride:HDL-cholesterol ratio (2.7±2.1) and homocysteine (17.1±9.2) in the total group. The women had high TC (5.2±1.1) indicating borderline risk of CVD as compared with men who had lower TC (4.5±0.8) and this was significantly different (p=0.049). The nutrition education programme was effective in increasing knowledge with an improvement of 14.5 percent from pre- (62.3%) to post-test (76.8%) for the total group which was statistically significant (p=0.000). The results for the soy protein feeding intervention, the dietary intake for the total group indicated a statistically significant decrease in energy intake (p=0.001), by about 20.4 percent form baseline to follow-up, while energy intake at baseline was already below the EAR. Also a statistically significant decrease was seen from baseline to follow-up for total dietary fat (p=0.004), cholesterol (p=0.008) and animal protein (p=0.000), with a statistically significant increase only on dietary folate (p=0.001) and iron (0.001). These dietary changes were also observed for the HC and NC groups after the intervention with only fat not decreasing significantly for the HC group. For the anthropometry indices, and hypertension no significant impact after the intervention for the total group and also for the HC and NC groups was observed. The biochemical results indicated a beneficial effect of the soy-based products on the following serum lipids: a significant improvement in LDL-C (p=0.000), HDL-C (p=0.000) and TC:HDL ratio (p=0.000) for the HC group while only TC:HDL ratio showed a significant improvement for the NC group after the intervention. However, high risk factors for CVD in this elderly group were still observed, with a significant decrease after the intervention of serum folate (p=0.000) below the recommended level and a significant increase in homocysteine (p=0.000) above the recommended level. Significant differences between the HC and NC groups were seen in TC, LDL-C, LDL:HDL-C ratio and TC:HDL-C ratio at the beginning of the intervention (baseline). However, at the end of the intervention (follow-up), significant differences were observed only in TC, LDL-C and homocysteine. Conclusion: Although the energy intake reduced significantly, only three of the micro-nutrients (pantothenate, Niacin and selenium) had a significant decrease between baseline and follow-up. Therefore the nutritional status of these elderly was not affected as it was also observed that there was no significant impact on anthropometric indices that took place. However this intervention had a significant impact on iron intake, which was one of the deficiencies identified amongst this elderly people from previous study. Also the nutrition education and a daily consumption of at least 10g of soy had a significant beneficial effect on LDL-C, HDL-C and TC:HDL ratio for the HC groups, thus reducing risk of CVD. Although soy had a beneficial effect on blood lipid profile no effect on hypertension was observed. The guideline of a 25g intake of soy should be encouraged as recommended by FDA as an effective cholesterol-lowering food item.

碩士
國立臺灣大學
臨床醫學研究所
99
Background The cellular and humoral immune responses in patients on chronic hemodialysis (HD) are impaired. To achieve an adequate immune response, the naïve T-cells will be differentiated to T helper cell and then to Th1 and Th2 cells after they are stimulated by pathogen. 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), the activated form vitamin D is widely used in HD patients with secondary hyperparathyroidism (SHPT) and also is a well known immunomodulatory agent. Here we investigated the T cells differentiation and cytokines expression in different serum 25-hydroxyvitamin D (25(OH)D) levels patients, the T cell differentiation and cytokine results after treatment with activated vitamin D in the SHPT patients, and patient’s clinical manifestation. Material and methods: 57 patients on chronic HD over 3 months were enrolled during January 1st, 2009 to June 30th, 2010 in Cardinal Tien Hospital and Yung-Ho Branch. Patients with systemic infection, malignancy, taking immunosuppressive medication and who took activated vitamin D or analogues in the past 3 months were all excluded. The peripheral blood mononuclear cells (PBMCs) and sera were collected while mid-week predialysis. The PBMCs were cultured and stimulated by mitogens in different time point. Then the T cells were triplely stained by surface and intracellular cytokine markers and the differentiation was analyzed by flow cytometry. The 25(OH)D level in the sera was detected by enzyme-linked immunosorbent assay (ELISA). The Th1 (interleukin (IL)-2 and interferon (IFN)-γ) and Th2 (IL-4 and IL-5) cytokine levels in the sera and culture supernatants were also evaluated by enzyme-linked immunosorbent assay (ELISA) methods. In the SHPT patients, we prescribed the different dosage of activated vitamin D (Calcijex®, Abbott.) according to the NKF K/DOQI guideline for 3 months. Repeated previous cell culture and ELISA exam were done after 3 months later. Patient’s outcome and clinical condition would be followed and analyzed during study period. Results We divided the patients into 2 groups (vitamin D deficiency (VDD): &lt;20 ng/ml in vitamin D and non-vitamin D deficiency (NVDD): ≧20 ng/ml in vitamin D) according to their 25(OH)D level. In the VDD group, the Th2 cytokine (IL-4 and IL-5) were lower in the sera, and the Th1 cytokine (IL-2 and IFN-γ) were higher and Th2 cytokine (IL-4 and IL-5) were lower in the culture supernatant. Besides, the T cell differentiation was towards to Th1 type in the VDD group, but Th2 type in the NVDD group. The T cell differentiation was not influenced by biochemistry examinations, such as albumin, hematocrit, calcium, phosphate, creatinine or dialysis vintage. After treatment with activated vitamin D in the SHPT patients, the serum iPTH and 25(OH)D level were not significant difference. However, the level in Th1 cytokines was decreased and that of Th2 cytokines were both increased in the sera and the culture supernatant. The T cell differentiation was also more towards to Th2 phenotype than Th1 phenotype. The mortality cases were found with prevalent Th1 cell differentiation and vitamin D deficiency. Conclusion Our finding indicated that the T-cell differentiation is only correlated with serum 25(OH)D level. The higher vitamin D in the sera, the more prevalent in Th2 cytokines and Th2 differentiation was found. Treatment with activated vitamin D also influenced the T cell differentiation and cytokines expression in the SHPT patients. Because Th2 cell has the anti-inflammatory effect, activated vitamin D treatment may not only have therapeutic potential for secondary hyperparathyroidism, but also can improve the immune response in the chronic HD patients.

Vitamin D deficiency has been linked with many health problems. Early research demonstrated the importance of vitamin D for bone health, but it may also play a larger role than first reported in muscle health and function. Specifically, low vitamin D may hinder athletic performance, as such evaluation of serum vitamin D levels in high volume training athletes has merit. The purpose of this study was to evaluate serum levels of 25(OH)D in college athletes to determine how many had levels below the recommended values. Data from student-athletes who were attending a large university in the south included: serum vitamin D levels, demographics information, and injury reports. Mean serum vitamin D level for the group was 34.17 ng/mL ± 0.88. Average injury for the group was 1.3± 0.14. The mean value of serum vitamin D for Caucasian players was 38.3 ng/mL ± 1.33 with a range of 23-59 ng/mL. The mean value of serum vitamin D for African American players was 31.16 ng/mL ± 1.08 with a range of 16-52 ng/mL. African American players had significantly lower serum vitamin D levels (p<0.01) than Caucasian players. Players with one or more injury had significantly lower serum vitamin D values (p<0.05) than players who had zero injuries. Forty-eight players (44.4%) had insufficient levels of vitamin D (20-31.9ng/ml). 60 players (55.6%) had values within normal limits (>32 ng/ml). Players with one or more musculoskeletal injury or fracture had significantly lower serum vitamin D levels (p<0.05) compared to players that had zero injuries. African American players had significantly lower serum vitamin D levels (p<0.01) compared to Caucasian players. It is important for athletes to monitor serum vitamin D levels and adhere to a supplementation protocol when levels are insufficient.
text

該前瞻性研究對香港中國裔孕婦的25羥基維生素D（25（OH）D）的水平及其影響因素進行調查，并對25（OH）D與甲狀旁腺激素（PTH）、孕期肌肉酸痛、不良妊娠結局、孕期及産後骨質流失，以及嬰兒的骨骼發育等關係進行探索，力求建立適用于香港的中國孕婦的25（OH）D正常值。
共有237名單胎妊娠婦女以及62名多胎妊娠的婦女在2010年8月至2011年11月間參加本研究中的隊列研究，分別在參加研究時（<20 孕周）、24-28孕周、31-36孕周以及産後6-11周進行抽血測量血清25（OH）D以及PTH水平，同時填寫一份包括對每月攝取含維生素D的食物以及營養補充劑頻度、接受日照情況及喜好、以及肌肉不適等情況的問卷，并在24-28孕周進行75克口服葡萄糖耐量試驗。參與隊列研究的單胎孕婦在20周前、31-36孕周以及産後隨訪時接受用定量超聲測量非優勢手的橈骨遠端以及中指近掌指骨的骨質超聲速率（SoS）。在産後複查時，對其嬰兒左側腓骨中部的骨質SoS進行測量。記錄婦女各次檢查時的體重、抽血月份紫外線輻射強度的歷史記錄、以及妊娠結局。另外募集一批孕婦參加病例對照研究，比較患早產（PTB）、子癇前期（PET）、妊娠糖尿病 （GDM）以及胎兒生長受限（FGR）併發癥的婦女與對照組 （體重指數以及抽血時紫外線強度配對）的血清25（OH）D水平。
孕婦在孕期的平均25（OH）D水平在44.7 ± 12.6 至48.9 ± 17.1 nmol/l範圍，25（OH）D水平與體重指數、維生素D營養補充劑、抽血時紫外線強度以及個人對陽光的喜好情況有關，而與胎兒數量、孕次、孕周以及終止妊娠無關。
單胎妊娠的孕婦三個孕期的血清25（OH）D與PTH水平均負相關，但在多胎妊娠中，二者無明顯相關性。PTH在孕期以及産後的變化相對不受25（OH）D影響。孕婦25（OH）D的水平與孕婦肌肉酸痛癥狀、産後恢復、孕期及產褥期骨質流失以及嬰兒骨質無關。患早期PTB（< 34孕周）、PET或FGR的孕婦的血清25（OH）D比對照組低，但GDM患者的25（OH）D水平與對照組無差別。血清25（OH）D低於34.3 nmol/l者的早期早產以及子癇前期的風險增高，低於50 nmol/l者發生胎兒生長受限的風險增高。服用維生素D補充劑情況可能影響25（OH）D與FGR的關係。
總而言之，血清25（OH）D水平不足以全面完全反映孕期維生素D的情況，對預測不良妊娠結局的作用有限。
This prospective study explored the maternal serum level of 25(OH)D in Chinese pregnant women in Hong Kong and the factors affecting 25(OH)D level. It also explored the correlation between maternal 25(OH)D with PTH level, maternal musculoskeletal complaints, adverse pregnancy outcome, maternal bone turnover during pregnancy and postpartum, and the bone development of the offspring, aiming to explore and establish a normal range of 25(OH)D level in pregnancy for the Hong Kong Chinese women.
A total of 237 women with singleton pregnancy and 62 women with multiple pregnancies were recruited for the cohort study from August, 2010 to November, 2011. Maternal blood samplings for 25(OH)D and PTH measurements were performed at recruitment, 24-28 weeks, 31-36 weeks of gestation, and 6-11 weeks postpartum respectively. A questionnaire which included the monthly dietary and supplement intake of vitamin D, questions about sunlight exposure, and musculoskeletal complaints was administered on each visit. A 75g oral glucose tolerance test (OGTT) was performed on cohort cases at 24-28 weeks of gestation. Measurements of the speed of sound (SoS) at the distal one third of the maternal radius and the proximal phalanx of the third finger of the non-dominant side were performed with quantitative ultrasonography (QUS) measurement during the visits at the first and third trimesters, and postnatal period. The SoS at the left mid-shaft tibia of the offspring was determined during the postnatal visit. Maternal characteristics, ultraviolet radiation (UVR) intensity at blood sampling, and pregnancy outcome, were also recorded. Cases with pregnancy complications were recruited for case-control studies, and maternal 25(OH)D level was examined with respect to preterm birth (PTB), preeclampsia (PET), gestational diabetes (GDM), and fetal growth restriction (FGR, birthweight below the 10th percentile of the customized estimated birthweight). The controls were matched for booking body mass index (BMI) and UVR intensity at blood sampling.
The mean 25(OH)D level in ranged from 44.7 ± 12.6 to 48.9 ± 17.1 nmol/l in the three trimesters, and was related to BMI, vitamin D supplementation, UVR intensity at blood sampling, and the acceptance of sunlight exposure, but not the number of fetus, parity, gestational age, or the completion of pregnancy.
Inverse correlation between PTH and 25(OH)D were observed in singleton, but not in multiple, pregnancy. The change in maternal PTH level is found to be relatively independent from that of 25(OH)D. There was no correlation between maternal 25(OH)D level with musculoskeletal complaints, postnatal recovery, bone turnover during and after pregnancy, or the bone density of the offspring. Maternal 25(OH)D level was lower in women with early PTB ( < 34 weeks), PET, and FGR, but not for GDM. A maternal 25(OH)D level of lower than 34.3nmol/l and 50 nmol/l was associated with increased risk of early PTB, PET, and FGR respectively. But the correlation between maternal 25(OH)D level with FGR might be affected by supplementation.
In conclusion, serum level of 25(OH)D is insufficient in reflecting maternal vitamin D status and metabolism in pregnancy, and is of limited use in predicting adverse pregnancy outcome.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Hu, Zhiyang.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 201-223).
Abstracts and appendixes also in Chinese.
Thesis dedication --- p.i
Acknowledgments --- p.ii
Abstract --- p.v
Abstract (Chinese) --- p.viii
List of Abbreviation --- p.x
Table of contents --- p.xiii
List of Figures --- p.xxii
List of Tables --- p.xxiv
Chapter Chapter 1: --- Literature Review --- p.1
Chapter 1.1 --- The synthesis and metabolism of vitamin D --- p.3
Chapter 1.1.1 --- The synthesis of vitamin D --- p.3
Chapter 1.1.2 --- The metabolism of vitamin D --- p.4
Chapter 1.1.3 --- Vitamin D binding protein --- p.10
Chapter 1.1.4 --- Factors related to 25(OH)D level --- p.11
Chapter 1.2 --- Function of vitamin D --- p.13
Chapter 1.2.1 --- Mechanism of vitamin D function --- p.13
Chapter 1.2.2 --- Classic function --- p.14
Chapter 1.2.3 --- Non-classic function --- p.16
Chapter 1.2.3.1 --- Immune system --- p.17
Chapter 1.2.3.2 --- Cardiovascular system --- p.18
Chapter 1.2.3.3 --- Cell proliferation and differentiation --- p.18
Chapter 1.2.3.4 --- Neurological system --- p.19
Chapter 1.2.3.5 --- Reproductive system --- p.20
Chapter 1.2.3.6 --- Fetal development --- p.21
Chapter 1.3 --- The definition of vitamin D deficiency --- p.21
Chapter 1.4 --- Vitamin D status and pregnancy --- p.24
Chapter 1.4.1 --- Alteration in vitamin D metabolism during pregnancy --- p.24
Chapter 1.4.2 --- Factors affecting maternal serum level of 25(OH)D --- p.25
Chapter 1.4.3 --- Vitamin D and bone resorption during pregnancy and lactation --- p.27
Chapter 1.4.3.1 --- Alteration of calcium metabolism, bone absorption and the role of vitamin D --- p.27
Chapter 1.4.3.2 --- Measurement of bone density in pregnant women and babies --- p.33
Chapter 1.4.4 --- Current studies on maternal vitamin D status and pregnancy outcome --- p.35
Chapter 1.4.4.1 --- Birthweight --- p.35
Chapter 1.4.4.2 --- Infection --- p.37
Chapter 1.4.4.3 --- Preterm delivery --- p.39
Chapter 1.4.4.4 --- Diabetes (DM) and gestational diabetes (GDM) --- p.39
Chapter 1.4.4.5 --- Hypertension and preeclampsia --- p.41
Chapter 1.4.4.6 --- Multiple pregnancy, muscular symptoms --- p.42
Chapter 1.4.4.7 --- Vitamin D supplementation and pregnancy outcome --- p.44
Chapter 1.5 --- Defining vitamin D deficiency in pregnancy --- p.45
Chapter 1.6 --- Objective of the study --- p.46
Chapter Chapter 2: --- Study design and methods --- p.48
Chapter 2.1 --- Case recruitment and study design --- p.48
Chapter 2.1.1 --- Longitudinal singleton study --- p.49
Chapter 2.1.2 --- Cross-sectional study --- p.50
Chapter 2.1.2.1 --- Preterm birth (PTB) --- p.51
Chapter 2.1.2.2 --- Preeclampsia (PET) --- p.51
Chapter 2.1.2.3 --- Gestational diabetes (GDM) --- p.52
Chapter 2.1.3 --- Multiple pregnancy study --- p.52
Chapter 2.2 --- Measurements --- p.53
Chapter 2.2.1 --- Hormonal analysis of serum levels of 25(OH)D and PTH --- p.53
Chapter 2.2.2 --- Calculation of monthly intake of vitamin D from diet --- p.55
Chapter 2.2.3 --- SoS measurements --- p.56
Chapter 2.2.4 --- Ultraviolet radiation strength assessment --- p.59
Chapter 2.3 --- Statistical analysis --- p.60
Chapter Chapter 3 --- Longitudinal Study on the Level of and Factors Affecting Vitamin D in Singleton Pregnancy --- p.62
Chapter 3.1 --- Introduction --- p.62
Chapter 3.2 --- Material and method --- p.63
Chapter 3.3 --- Statistics --- p.64
Chapter 3.4 --- Results --- p.65
Chapter 3.4.1 --- Demographic data of the subjects --- p.65
Chapter 3.4.2 --- Maternal levels of 25(OH)D and PTH, and the factors affecting their levels --- p.66
Chapter 3.4.2.1 --- Distribution of 25(OH)D level and PTH level in the four visits --- p.66
Chapter 3.4.2.2 --- Dietary intake of vitamin D and supplementation --- p.69
Chapter 3.4.2.3 --- Seasonality and sunlight exposure --- p.73
Chapter 3.4.2.4 --- Parity --- p.76
Chapter 3.4.3 --- Changes of maternal levels of 25(OH)D and PTH in pregnancy --- p.78
Chapter 3.4.4 --- Independent factors related to maternal 25(OH)D level in pregnancy --- p.79
Chapter 3.4.5 --- Maternal and fetal 25(OH)D level at delivery --- p.80
Chapter 3.4.6 --- Muscular symptoms and other complaints in pregnancy, pregnancy outcome, and their relationships with maternal 25(OH)D level --- p.81
Chapter 3.4.7 --- Postnatal recovery and factors related to postnatal level of 25(OH)D and PTH --- p.86
Chapter 3.4.7.1 --- Postnatal symptoms and relationship with 25(OH)D and PTH --- p.86
Chapter 3.4.7.2 --- The postnatal level of 25(OH)D and PTH in women with different feeding mode --- p.88
Chapter 3.4.7.3 --- Independent factors related to postnatal 25(OH)D and PTH level --- p.89
Chapter 3.4.7.4 --- Factors related to the change of 25(OH)D and PTH after delivery --- p.90
Chapter 3.4.8 --- Correlation between 25(OH)D with PTH in pregnancy and postnatal period --- p.91
Chapter 3.5 --- Discussion --- p.92
Chapter 3.5.1 --- 25(OH)D level in Chinese pregnant women --- p.92
Chapter 3.5.2 --- Factors related to maternal 25(OH)D level --- p.93
Chapter 3.5.2.1 --- Dietary and supplementation --- p.93
Chapter 3.5.2.2 --- Seasonality and outdoor activity --- p.96
Chapter 3.5.2.3 --- Gestational age --- p.98
Chapter 3.5.2.4 --- Age and parity --- p.98
Chapter 3.5.3 --- Relationship of 25(OH)D level in the cord blood with maternal 25(OH)D level --- p.99
Chapter 3.5.4 --- 25(OH)D level and muscular complains in pregnancy --- p.100
Chapter 3.5.5. --- Postnatal recovery and 25(OH)D level --- p.101
Chapter 3.5.6 --- PTH level in pregnancy and postnatal period --- p.101
Chapter 3.6 --- Conclusion --- p.102
Chapter Chapter 4 --- Longitudinal Study on the Relationship between Maternal 25(OH)D level with Changes of Maternal Bone Density in Pregnancy and Lactation, and Factors Affecting Bone Density of newborn Infants --- p.105
Chapter 4.1 --- Introduction --- p.105
Chapter 4.2 --- Material and method --- p.106
Chapter 4.3 --- Statistics --- p.108
Chapter 4.4 --- Results --- p.108
Chapter 4.4.1 --- Demographic data --- p.108
Chapter 4.4.2 --- Maternal bone density and the changes in pregnancy and postnatal recovery --- p.109
Chapter 4.4.2.1 --- Maternal bone density in the first trimester and related factors --- p.109
Chapter 4.4.2.2 --- Maternal bone density in the three visits --- p.109
Chapter 4.4.2.3 --- The change in maternal bone density in the three visits --- p.110
Chapter 4.4.2.4 --- Diversity in the change of bone density in pregnant women --- p.112
Chapter 4.4.3 --- Factors related to the changes in bone density --- p.114
Chapter 4.4.3.1 --- Changes between the first and the third trimesters --- p.114
Chapter 4.4.3.2 --- Change between the third trimester and postnatal visits --- p.116
Chapter 4.4.4 --- The bone density in infants and related factors --- p.120
Chapter 4.5 --- Discussion --- p.122
Chapter 4.5.1 --- Maternal bone density changes in pregnancy and postnatal period --- p.122
Chapter 4.5.2 --- Factors related to the maternal bone density changes in pregnancy and postnatal period --- p.124
Chapter 4.5.2.1 --- Initial bone density, parity, and BMI --- p.125
Chapter 4.5.2.2 --- 25(OH)D and PTH level --- p.126
Chapter 4.5.2.3 --- Supplement --- p.127
Chapter 4.5.2.4 --- Lactation --- p.128
Chapter 4.5.2.5 --- Height --- p.129
Chapter 4.5.3 --- Factors related to bone density of the infant. --- p.130
Chapter 4.5.3.1 --- Maternal 25(OH)D level --- p.130
Chapter 4.5.3.2 --- Gestational age and birthweight --- p.131
Chapter 4.5.3.3 --- Maternal bone density change --- p.131
Chapter 4.5.3.4 --- The gender of the offspring and feeding method --- p.132
Chapter 4.6 --- Conclusion --- p.133
Chapter Chapter 5 --- Maternal 25(OH)D Level in Multiple Pregnancy --- p.134
Chapter 5.1 --- Introduction --- p.134
Chapter 5.2 --- Material and method --- p.135
Chapter 5.3 --- Statistics --- p.136
Chapter 5.4 --- Results --- p.137
Chapter 5.4.1 --- Demographic data of the subjects --- p.137
Chapter 5.4.2 --- The level of 25(OH)D in multiple pregnancy and singleton pregnancy --- p.137
Chapter 5.4.3 --- Supplementation in multiple pregnancy --- p.140
Chapter 5.4.4 --- The change of maternal 25(OH)D and PTH levels in the three trimesters --- p.141
Chapter 5.4.5 --- 25(OH)D level in cord blood and its correlation with 25(OH)D level of the sibling --- p.143
Chapter 5.4.6 --- Correlation between 25(OH) with PTH in pregnancy --- p.143
Chapter 5.5 --- Discussion --- p.144
Chapter 5.5.1 --- 25(OH)D level in multiple pregnancy and singleton pregnancy --- p.144
Chapter 5.5.2 --- Supplementation in multiple pregnancy --- p.146
Chapter 5.5.3 --- Changes of maternal levels of 25(OH)D and PTH in the three trimesters in multiple pregnancy --- p.146
Chapter 5.5.4 --- The PTH/25(OH) correlation --- p.147
Chapter 5.6 --- Conclusion --- p.148
Chapter Chapter 6 --- Maternal level of 25(OH)D in complicated pregnancy --- p.150
Chapter 6.1 --- Introduction --- p.150
Chapter 6.2 --- Method --- p.153
Chapter 6.2.1 --- Preterm birth --- p.155
Chapter 6.2.2 --- Preeclampsia --- p.155
Chapter 6.2.3 --- Gestational diabetes --- p.156
Chapter 6.2.4 --- Fetal growth restriction --- p.157
Chapter 6.2.5 --- The association between 25(OH)D level with pregnancy complication --- p.158
Chapter 6.3 --- Statistics --- p.159
Chapter 6.4 --- Results --- p.160
Chapter 6.4.1 --- Setting of the cutoff values of hypovitaminosis D --- p.160
Chapter 6.4.2 --- Preterm birth --- p.160
Chapter 6.4.3 --- Preeclampsia --- p.164
Chapter 6.4.4 --- Gestational diabetes --- p.168
Chapter 6.4.4.1 --- Case-control study --- p.168
Chapter 6.4.4.2 --- Factors affecting OGTT results --- p.170
Chapter 6.4.5 --- Fetal growth restriction --- p.173
Chapter 6.5 --- Discussion --- p.179
Chapter 6.5.1 --- Adjustment for confounders for case-control study --- p.179
Chapter 6.5.2 --- PTB and 25(OH)D level --- p.181
Chapter 6.5.3 --- PET and 25(OH)D level --- p.182
Chapter 6.5.4 --- GDM and 25(OH)D level --- p.186
Chapter 6.5.5 --- FGR and 25(OH)D level --- p.189
Chapter 6.5.6 --- Defining vitamin D deficiency in pregnancy --- p.192
Chapter 6.6 --- Conclusion --- p.195
Chapter Chapter 7 --- Summary --- p.196
References --- p.201
Chapter Appendix 1 --- Antenatal questionnaire (English/Chinese) --- p.224
Chapter Appendix 2 --- Postnatal questionnaire (English/Chinese) --- p.238

BACKGROUND: The prevalence of Vitamin D deficiency is roughly 40% in the world and is increasing every year. Populations 65 years and older show a higher prevalence of vitamin D deficiency, because the aging process decreases the capacity of the skin to produce vitamin D. Some studies have reported that the prevalence of vitamin D deficiency is higher in the winter, however the effect of seasonal change on serum vitamin D level remains controversial in some specific populations. Moreover, this association remains uncertain in the elderly population because there is no study that specifically targets individuals over the age of 65. This study investigated the effect of seasonal changes and serum 25-hydroxyvitamin D among individuals 65 years and older residing in the Boston, Massachusetts and Stockholm, Sweden. METHODS: Cross-sectional and longitudinal cohort designs were both adapted to examine an existing data from VIVE2 parent study; the data was collected from 2012 to 2014. Data from the subjects who had finished this 6-month trial were analyzed for this study. Serum 25(OH)D levels, BMI, sex, study sites and age were collected and analyzed by univariate regression analysis and t-test. Serum 25(OH)D and confounders were included in multivariate analysis. Study sites were analyzed by effect modification model. RESULTS: In total, the prevalence of vitamin D deficiency (serum 25(OH)D levels less than 20 ng/ml) was 70%, while the mean serum 25(OH)D level was 20 ng/ml in summer and 16.4 ng/ml in winter. The average of seasonal serum 25(OH)D level changes were 6 ng/ml and 3 ng/ml in Stockholm, Sweden and Boston, MA, respectively. In addition, the prevalence of vitamin D deficiency increased 80% during winter (95CI: 1.1 – 2.9). There was no significant different in serum 25(OH)D levels among elderly populations between low latitude study site Boston, MA and high latitude site Stockholm, Sweden. There was no significant relation found in BMI, age and sex with serum 25(OH)D levels in the study. The seasonal serum 25(OH)D level changes was significantly different in the cross-sectional study design but not in the longitudinal study. CONCLUSION: Serum 25(OH)D levels were higher in the summer than in the winter among the elderly population resided in Boston, MA and Stockholm, Sweden.

Philosophiae Doctor - PhD
Obesity is a medical condition in which an energy imbalance leads to excessive accumulation of body fat. Obesity leads to a reduction in life expectancy through its association with chronic diseases of lifestyle. The prevalence of obesity is rapidly increasing throughout the world. It is now accepted that most cases of obesity result from an interaction between genetic and environmental factors. This rapid increase in obesity generally leads to an increase in morbidity and mortality from chronic diseases such as cardiovascular disease, type 2 diabetes, osteoarthritis and cancer of which obesity is a risk factor. There is a lack of information in molecular research to explain how obesity predisposes individuals to these diseases. Proteomics is a molecular tool and a set of techniques used to identify changes at protein level from a diseased state. This study aims to identify differentially expressed proteins in serum of obese rats fed different isocaloric diets using proteomics.