Objective To explore the relationship between 25-hydroxy vitamin D [25(OH)D] and metabolic syndrome (MS) in non-dialysis patients with stage 3–5 chronic kidney disease (CKD). Methods Between January 2014 and May 2015, a total of 61 non-dialysis patients with stage 3–5 CKD were included. The patients’ height, weight, blood lipid, levels of 25(OH)D and serum creatinine were conducted. The relationship between 25(OH)D and MS was analyzed. Results The average level of 25(OH)D was (39.99±17.66) nmol/L. Normal level (≥75 mmol/L) of 25(OH)D was observed in 3.3% (2/61) of the patients, insufficiency of 25(OH)D (≥37.5 nmol/L and <75 nmol/L) was observed in 50.8% (31/61), and deficiency (<37.5 nmol/L) was observed in 45.9% (28/61). The prevalence of MS was 67.2% ( 41/61). The body mass index (BMI), proportion of hypertension, proportion of diabetes mellitus, level of triglyceride in the MS group were higher than those in the non-MS group, while the levels of high-density lipoprotein and 25(OH)D were lower in the MS group than those in the non-MS group, and the differences were statistically significant (P<0.05). The patients’ BMI, proportion of hypertension, level of triglyceride and proportion of MS in the 25(OH)D deficiency group were higher than those in the 25(OH)D non-deficiency group, meanwhile, the level of high-density lopoprotein was lower in the 25(OH)D deficiency group than that in the 25(OH)D non-deficiency group, and the differences were statistically significant (P<0.05). Serum 25(OH)D level was correlated negatively with BMI (r=–0.35, P=0.006) and the level of triglyceride (r=–0.16, P=0.039), and correlated positively with the level of high-density lipoprotein (r=0.18, P=0.026). Conclusions Low level of 25(OH)D and MS are both of high incidence rate in non-dialysis patients with stage 3–5 CKD. 25(OH)D is associated with MS.
ObjectiveTo summarize the current research progress of the relationship between vitamin D and the development and progression of hepatocellular carcinoma (HCC), and relevant clinical translational application researches.MethodsThe related literatures at home and abroad were searched to review the studies on the synthesis and metabolism of vitamin D, classic and non-classical effects of vitamin D, and the relationship between vitamin D and the development and progression of HCC, as well as relevant clinical translational application.ResultsVitamin D was an important cytokine that regulated the body’s mineral and bone metabolism, and its anti-proliferation, pro-differentiation, pro-apoptosis, anti-inflammation, immune regulation, and other non-classical effects, had received more and more attentions in recent years. The existing studies had found that vitamin D was closely associated with HCC, which affected the development and progression of HCC through various mechanisms. Epidemiology showed that vitamin D levels were closely related to the prognosis of HCC patients. Whether vitamin D could be used as a clinical prognostic indicator and treatment plan for HCC still needed further clinical evidence to confirm.ConclusionVitamin D plays an important role in the regulation of the development and progression of HCC, and exploration of the association between vitamin D and HCC and related clinical translation problems are expected to provide a new approach for the prevention and treatment of HCC.
Objective To summarize the changes of serum vitamin D level in patients with primary hyperparathyroidism (pHPT), the correlation between vitamin D and clinical manifestations, and feasible pathogenesis of pHPT. Method The literatures related to vitamin D and pHPT in recent years were reviewed. Results The level of vitamin D was decreased in patients with pHPT. Vitamin D level was negatively correlated with the weight of parathyroid adenoma, parathyroid hormone and blood calcium level, and positively correlated with bone mineral density. Conclusions Vitamin D nutritional status affects the severity of symptoms, main biochemical indexes and main clinical complications of patients with pHPT. There are various reasons accounted for the decline of vitamin D level, and the specific pathogenesis needs to be further explored. For patients with pHPT, vitamin D should be supplemented carefully and appropriately before surgical operation.
ObjectiveTo investigate the role of 1,25-dihydroxyvitamin D3 in the posterior transforaminal lumbar interbody fusion (TLIF) for patients with osteoporosis and lumbar degenerative disease. MethodsBetween November 2011 and October 2012,44 patients with osteoporosis and lumbar degenerative disease were treated with TLIF and the clinical data were retrospectively analyzed.The patients were divided into 2 groups based on the administration of 1,25-dihydroxyvitamin D3.After TLIF operation,1,25-dihydroxyvitamin D3 was used in 21 patients (trial group),and was not used in 23 patients (control group).There was no significant difference in gender,age,etiology,affected segment,and disease duration between 2 groups (P>0.05).Lumbar interbody fusion was observed by X-ray and thin-section CT scan reconstruction of lumbar spine according to Brantigan assessment system at 6 months after operation and last follow-up.Clinical outcome was evaluated by Oswestry disability index (ODI) before and after operation. ResultsThe patients of 2 groups were followed up 12-27 months (mean,14.5 months).No fixation loosening or breaking occurred during follow-up.ODI scores in both groups were significantly improved at 6 months after operation and last follow-up (P<0.05) when conpared with preoperative value.Although at preoperation there was no significant difference in ODI score between 2 groups (P>0.05),ODI score of trial group was significantly lower than that of control group at 6 months after operation and last follow-up (P<0.05).At 6 months after operation,the interbody fusion rate was 76.19% (16/21) in trial group and 43.48% (10/23) in control group,showing significant difference (χ2=3.60,P=0.03); at last follow-up,the fusion rate was 95.24% (20/21) in trial group and 65.22% (15/23) in control group,showing significant difference (χ2=4.38,P=0.02). Conclusion1,25-dihydroxyvitamin D3 can improve the lumbar interbody fusion rate and general conditions in the patients with osteoporosis and lumbar degenerative disease.
Parkinson’s disease is a common chronic progressive neurodegenerative disease, and its main pathological change is the degeneration and loss of dopaminergic neurons in substantia nigra striatum. Vitamin D receptors are widely distributed in neurons and glial cells, and the normal function of substantia nigra striatum system depends on the level of vitamin D and the normal expression of vitamin D receptors. In recent years, from basic to clinical research, there are some differences in the conclusion of the correlation of vitamin D and its receptor gene polymorphism with Parkinson’s disease. This paper aims to review the research on the correlation of vitamin D and vitamin D receptor gene polymorphism with Parkinson’s disease, and discuss the future research direction in this field.
ObjectiveTo explore the correlation of BMI and 25 hydroxyvitamin D3 level with colon cancer.MethodsA total of 100 cases who underwent colonoscopy and were excluded from bowel diseases at the physical examination center of the First Hospital of Qinhuangdao from March 2017 to October 2017 were retrospectively selected as the control group. A total of 100 patients who underwent colonoscopy at general surgery or physical examination center and were confirmed to have colon cancer by pathological examination were included in the colon cancer group. The height, weight and body mass index (BMI) were measured in the morning, and the level of 25 hydroxyvitamin D3 (25(OH)D3) was determined by fasting blood sampling.Results① There was no statistical significance in age and 25(OH)D3 level between the two groups (P>0.05), and BMI of the colon cancer group was significantly higher than that of the control group (P<0.05). ② The proportion of overweight and obesity in the colon cancer group was significantly higher than that in the control group (P<0.05), and the proportion of vitamin D deficiency was significantly higher as well (P<0.05). ③ Logistic regression analysis showed that the incidence of colon cancer in patients with vitamin D deficiency was 12.263 times higher than that in patients without vitamin D deficiency, and the incidence of colon cancer in patients with overweight and obesity was 2.215 times higher than that in patients with normal BMI, with statistically significant differences (P<0.05).ConclusionThe incidence of colon cancer in patients with vitamin D deficiency and those with BMI of overweight or obesity is significantly increased.
ObjectiveTo introduce patients with long-term hypocalcemia and normal parathyroid hormone (PTH) values after total thyroidectomy, and to analyze the possible causes of this phenomenon. MethodsThe medical records of 1 010 consecutive patients with total thyroidectomy treated in the Center for Diagnosis and Treatment of Thyroid Disease, the First Affiliated Hospital of Kunming Medical University from January 2019 to December 2020 were collected. Seven patients with normal PTH and blood calcium before operation and at least 2 times of PTH with hypocalcemia detected more than 6 months after operation were followed-up to understand the symptoms of hypocalcemia, vitamin D level and calcium consumption. ResultsSeven patients with thyroid papillary carcinoma underwent total thyroidectomy without parathyroid autotransplantation, and there were 6 cases with mild deficiency or insufficient of vitamin D before operation. The follow-up time was 12–28 months, and the median follow-up time was 19 months. Seven patients developed hypocalcemia after continuous administration of calcium and calcitriol, and vitamin D levels remained mild deficiency or insufficient, PTH decreased by more than 50% in 6 patients one year after operation compared with that before operation. ConclusionsPatients with long-term normal PTH values and hypocalcemia after total thyroidectomy have obviously lower PTH levels than those before operation. The possible factors are parathyroid damage during operation and vitamin D deficiency. Such these patients should be more properly referred to as “parathyroid insufficiency”.
Objective To systematically evaluate the correlation between serum 25-hydroxyvitamin D [25(OH)D] level and mortality risk in adult with sepsis. Methods We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang, and Chongqing VIP databases for studies on the correlation between serum 25(OH)D and mortality risk in adults with sepsis. The search period was from the establishment of databases to December 2023. Meta-analysis was conducted using RevMan 5.4 software. Results A total of 9 studies were included, with a total of 2267 patients. The meta-analysis results showed that sepsis patients with low serum 25(OH)D levels (<30 ng/mL), insufficient levels (20-30 ng/mL), and deficient levels (<20 ng/mL) had a higher mortality risk compared to those with normal levels (relative risk=1.96, 1.62, 2.21, P<0.05). Subgroup analysis based on different sepsis diagnostic criteria, regions, and research types also showed that sepsis patients with lower serum 25(OH)D levels (<30 ng/mL) had a higher mortality risk compared to those with normal levels (P<0.05). Conclusions Adult sepsis patients with low serum 25(OH)D levels have a higher mortality risk than those with normal levels.
Nuclear receptors are transcriptional regulators involved in almost all biological processes such as cell growth, differentiation, apoptosis, substance metabolism and tumor formation, and they can be regulated by small molecules that bind to them. Autophagy is a special way of programmed cell death and it is a highly conserved metabolic process. Once autophagy defects or excessive autophagy occur, the disease will develop. In recent years, numerous studies have shown that nuclear receptors are related to autophagy. Therefore, this paper mainly reviews the research progress on nuclear receptors involved in the regulation of autophagy, and focuses on the mechanism of several nuclear receptors involved in the regulation of autophagy, aiming at understanding the molecular basis of how nuclear receptors participate in regulating autophagy, as well as providing possible ideas and strategies for the treatment of corresponding diseases.
Pain, as a complex physiological and pathological phenomenon, has always been a hot topic in medical research in terms of its mechanism of occurrence and influencing factors. Vitamin D, as a fat soluble vitamin, has been shown to be closely associated with pain in recent years, in addition to its classic role in regulating calcium and phosphorus metabolism. The polymorphism of the vitamin D receptor (VDR) gene can lead to changes in the structure and function of VDR, thereby affecting vitamin D levels. Meanwhile, VDR gene polymorphism can indirectly or directly participate in the occurrence and development of pain. This article aims to review the research on the relationship between vitamin D and its receptor gene polymorphism and pain, and provide reference for potential therapeutic targets and personalized intervention strategies for pain.