High Prevalence of Vitamin D Insufficiency in Southern Chinese Renal Transplant Recipients

Maggie, K M; Mok, Maggie M Y; Yung, Susan; Tang, Chun-Lei; Chan, Tak Mao

doi:10.3109/0886022x.2012.706878

Cited by 7 publications

(3 citation statements)

References 22 publications

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“…Feitong Wu et al also found that greater 25(OH)D was associated with reduced serum PTH levels in Chinese patients [26]. Other studies have shown a stronger correlation between 25(OH)D and PTH [40]. A mildly severe 25(OH)D deficiency can lead to an increase in serum PTH, which can cause bone resorption, osteoporosis and fractures.…”

Section: Discussionmentioning

confidence: 96%

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

et al. 2020

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Objective: We aimed to describe the 25-hydroxyvitamin D (25(OH)D) status of southern Chinese individuals by a high-accuracy liquid chromatography tandem mass spectrometry (LC-MS/MS) method which can trace to reference measurement procedure. Materials and methods: From January 2018 to June 2019, a total of 4775 southern Chinese individuals were evaluated in our study. The serum levels of parathyroid hormone (PTH) were detected simultaneously in 162 cases. 25(OH)D was determined by LC-MS/MS, and PTH was detected using routine automated analysers. The distribution of the concentration, prevalence and seasonal variability of 25(OH)D in males and females of different age groups were studied. Results: The mean 25(OH)D concentration in our study was 32.57 ng/mL (4.20-101.40 ng/mL). The global 25(OH)D concentration in males was higher than that in females of different age group. The prevalence of vitamin D deficiency (< 20 ng/mL) in females (16.65%) was higher than that in males (6.83%). The prevalence of vitamin D deficiency (< 20 ng/mL) was most common in winter (22.98% of all women and 15.49% of all men). 25(OH)D concentrations were higher in those from whom blood samples were collected in summer and autumn than in winter and spring. 25(OH)D 2 was detected in 672 serum samples (14.07%). In addition, there was a negative correlation between the concentrations of 25(OH)D and serum PTH (r = − 0.149, P < 0.05). Conclusion: Our study demonstrated that the average serum 25(OH)D concentration in southern Chinese individuals was higher than that in other Chinese cohorts by a high-accuracy LC-MS/MS method. The global 25(OH)D concentration in males was higher than that in females of different ages, and the prevalence of vitamin D deficiency in females was higher than that in males. Seasonal change was an important aspect of 25(OH)D concentration in young and middle-aged people but became less relevant for that in older subjects. 25(OH)D 2 detection was of minor practical significance in our study. In addition, we also found that there was a negative correlation between the serum levels of 25(OH)D and PTH in southern Chinese individuals.

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Section: Discussionmentioning

confidence: 96%

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

et al. 2020

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“…Vitamin D deficiency is common, and serum 25(OH)D levels have been found to be significantly lower in several populations of renal transplant recipients compared to controls . Secondary hyperparathyroidism due to vitamin D insufficiency has been associated with bone loss in the general osteoporotic population in some races but not others .…”

Section: Discussionmentioning

confidence: 99%

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Chandran

Ying

Kwee

et al. 2019

Clinical Transplantation

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The evolution of trabecular bone score (TBS) and bone mineral density (BMD) over the first 5 years after renal transplantation was prospectively evaluated in 164 patients. Dual energy X-ray absorptiometry (DXA) scans were performed at 0, 6, 12, 24, and 60 months. Cumulative steroid dose, serum 25(OH)D, calcium, parathyroid hormone, and total ALP levels at these time points were checked. Incident fractures were identified from X-rays/vertebral fracture assessments. Mean (SD) age, TBS, and lumbar spine BMD at baseline were 47.11 (9.53), 1.424 (0.097), and 0.935 (0.183) gm/cm 2 , respectively. Baseline TBS was lower in tertiary 1.38 (0.07) vs secondary hyperparathyroidism 1.43 (0.01) vs post-parathyroidectomy 1.46 (0.11); P = .035. Trabecular bone score and BMD significantly decreased from baseline->6 months, changes after that at consecutive time points were non-significant. 11% had incident fractures during the follow-up period, majority being metatarsal with no vertebral or hip fractures noted. This first prospective evaluation of TBS and BMD evolution at multiple time points over 5 years suggest that microarchitectural and bone density deteriorations post-renal transplantation stabilize after 6 months. Stabilization of these parameters could partially account for the absence of major fractures noted in this Asian population. Possible genetic and ethnic differences in fracture risk between Asian and Caucasian renal transplant patients have to be explored through large population-based studies. K E Y W O R D SAsian, bone mineral density, fracture, kidney transplantation, renal transplantation, trabecular bone score 2 of 9 | CHANDRAN et Al fracture rates have been claimed to be up to 34% higher in the first 2 years after transplantation compared to the previous year on dialysis. 2 Other studies have found fracture event rates ranging from 5.9 to 7.0 per 1000 years. 3 The most common sites of fracture following renal transplantation have been reported to be in the vertebrae with prevalence rates of up to 38.5% on average follow-up of 4.6 years in one study 4 and in the feet 5 though hip fracture incidence rates of up to 3.8/1000 6 have also been reported.. The fracture incidence and prevalence rates reported following renal transplantation have exclusively been from studies conducted in western populations. In an earlier study of ours on South East Asians living in Singapore, no fractures were observed in the first year following renal transplantation. 7Whether or not these fractures that have been reported to occur, happen as a result of bone mineral density losses or due to compromised bone quality and microarchitectural changes is not clear. Bone mineral density as measured by dual energy X-ray absorptiometry (DXA) only estimates the amount of mineral but not other important key elements that contribute to bone strength such as bone microarchitecture. The only way so far to delineate bone microarchitecture is either through modalities such as micro QCT and HrPQCT with their attendant high radiation exposure, or t...

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“…Ma and colleagues performed a cross sectional study of 94 kidney graft recipients and reported that patients who had a history of acute rejection had a significantly lower level of 25(OH)D than those who did not have a history of acute rejection (14). Kim et al examined the 25(OH)D levels prior to kidney transplantation and reported that patients with 25(OH)D deficiency, defined as less than 10 ng/mL, had a higher incidence of biopsy proven acute rejections than those with levels greater than 10ng/mL (11).…”

Section: Discussionmentioning

confidence: 99%

Circulating Levels of 25-Hydroxyvitamin D and Acute Cellular Rejection in Kidney Allograft Recipients

et al. 2014

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Background Vitamin D, in addition to its established role in bone metabolism, may regulate the immune system and impact the outcome of allografts. Methods We identified 351 kidney allograft recipients who had serum levels of 25-hydroxyvitamin D (25[OH]D) measured within the first 30 days of transplantation. We evaluated the relationship between the circulating levels of 25(OH)D and acute cellular rejection (ACR), CMV disease, BKV nephropathy (BKVN), and kidney graft function. Results Vitamin D deficiency (circulating levels of 25(OH)D ≤20 ng/mL, defined using The Endocrine Society Clinical Practice 2011 Guideline) was observed in 216 (61.5%) of 351 kidney graft recipients. Vitamin D deficiency was more frequent in female recipients (P=0.007, Fisher’s Exact test) and African American recipients (P<0.001) and was less frequent in preemptive kidney graft recipients (P=0.002). Biopsy-confirmed ACR was more frequent in the vitamin D deficient group than in the sufficient group (10.2% vs. 3.7%, P=0.04). By multivariable Cox regression analysis, vitamin D deficiency was an independent risk factor for ACR (Hazard Ratio: 3.3, P=0.02). Vitamin D deficiency was not associated with CMV disease, BKVN, or kidney allograft function at 1 year. 1,25-dihydroxyvitamin D3 supplementation initiated within the first 90 days of transplantation was associated with a lesser incidence of ACR compared to no treatment with 1,25-dihydroxyvitamin D3 (5.1% vs. 13.0%, P=0.099). Conclusions Vitamin D deficiency is an independent risk factor for development of ACR within the first year of kidney transplantation and 1,25-dihydroxyvitamin D3 supplementation may help reduce the occurrence of ACR in the vitamin D deficient group.

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High Prevalence of Vitamin D Insufficiency in Southern Chinese Renal Transplant Recipients

Cited by 7 publications

References 22 publications

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

Determination of serum 25-hydroxyvitamin D status among population in southern China by a high accuracy LC-MS/MS method traced to reference measurement procedure

Addressing bone quality and bone density after renal transplantation: A prospective evaluation of the evolution of trabecular bone score and bone mineral density over the first 5 years following renal transplantation in Asian patients

Circulating Levels of 25-Hydroxyvitamin D and Acute Cellular Rejection in Kidney Allograft Recipients

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