Vitamin D status of psychiatric inpatients in New Zealand’s Waikato region

Menkes, David B.; Lancaster, Kaye; Grant, Michael C.; Marsh, Reginald; Dean, Peter J.; Toit, Stephen Andrew du

doi:10.1186/1471-244x-12-68

Cited by 51 publications

(33 citation statements)

References 25 publications

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“…Regarding medication, in our patient sample we found no relationship between exposure to antipsychotic medication and 25(OH)D insufficiency, which is consistent with reports of patents with schizophrenia (Itzhaky et al, 2012), and of first-episode psychosis patients (Crews et al, 2013). Regarding sunlight, although direct exposure was not assessed in our study, patients were relatively short-stay inpatients at a primary care public hospital and we found no relationship between the duration of hospitalization and 25(OH)D levels, which again supports previous reports assessing the duration of hospitalization (Crews et al, 2013; Partti et al, 2012; Menkes et al, 2012), as well as direct sunlight exposure (Itzhaky et al, 2012). Similarly, in a previous study the variables of diet and exercise habits have also not been able to explain the differences between 25(OH)D levels in patients and control subjects (Berg et al, 2010).…”

Section: Discussionsupporting

confidence: 89%

“…A number of small studies have also suggested that 25(OH)D deficits also extend into adulthood schizophrenia: Significantly lower circulating 25(OH)D levels have been reported in adult patients with chronic schizophrenia compared to other psychiatric patients (Humble et al, 2010; Menkes et al, 2012; Itzhaky et al, 2012) as well as healthy controls (Rey-Sánchez et al, 2009; Partti et al, 2010; Doknic et al, 2011; Itzhaky et al, 2012). The importance of 25(OH)D level maintenance in the adult population has also been highlighted by a large cohort study, from which it was reported that women with high dietary vitamin D consumption had a 37% lower risk of psychosis-like symptoms as compared to women with low consumption (Hedelin et al.…”

Section: Introductionmentioning

confidence: 99%

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Vitamin D insufficiency and schizophrenia risk: Evaluation of hyperprolinemia as a mediator of association

Clelland

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Drouet

et al. 2014

Schizophrenia Research

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25-hydroxyvitamin D (25(OH)D) deficits have been associated with schizophrenia susceptibility and supplementation has been recommended for those at-risk. Although the mechanism by which a deficit confers risk is unknown, vitamin D is a potent transcriptional modulator and can regulate proline dehydrogenase (PRODH) expression. PRODH maps to chromosome 22q11, a region conferring the highest known genetic risk of schizophrenia, and encodes proline oxidase, which catalyses proline catabolism. L-Proline is a neuromodulator at glutamatergic synapses, and peripheral hyperprolinemia has been associated with decreased IQ, cognitive impairment, schizoaffective disorder, and schizophrenia. We investigated the relationship between 25(OH)D and schizophrenia, comparing fasting plasma 25(OH)D in 64 patients and 90 matched controls. We then tested for a mediating effect of hyperprolinemia on the association between 25(OH)D and schizophrenia. 25(OH)D levels were significantly lower in patients, and 25(OH)D insufficiency associated with schizophrenia (OR 2.1, adjusted p=0.044, 95% CI: 1.02-4.46). Moreover, 25(OH)D insufficient subjects had three times greater odds of hyperprolinemia than those with optimal levels (p=0.035, 95% CI: 1.08-8.91), and formal testing established that hyperprolinemia is a significantly mediating phenotype that may explain over a third of the effect of 25(OH)D insufficiency on schizophrenia risk. This study presents a mechanism by which 25(OH)D insufficiency confers risk of schizophrenia; via proline elevation due to reduced PRODH expression, and a concomitant dysregulation of neurotransmission. Although definitive causality can not be confirmed, these findings strongly support vitamin D supplementation in patients, particularly for those with elevated proline, who may represent a large subgroup of the schizophrenia population.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Vitamin D insufficiency and schizophrenia risk: Evaluation of hyperprolinemia as a mediator of association

Clelland

Read

Drouet

et al. 2014

Schizophrenia Research

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“…The difference, albeit with smaller magnitude, could be noticed for patients suffering from mental illnesses, too. Compared to our results, in some other societies there were much higher vitamin D serum levels and a lower prevalence of vitamin D deficiency in both in-and outpatients, including those with serious psychotic or depressive disorders (54)(55)(56). At present, the reasons for such differences are not completely understood but, at least in part, could be tied to the abovedescribed country's distinctions (20,21).…”

Section: Discussioncontrasting

confidence: 84%

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Ristic

Živanović

Milovanovic

et al. 2017

J Nutr Sci Vitaminol

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SummaryThis research aimed to investigate factors associated with vitamin D deficiency and to provide data about its prevalence in patients suffering from different psychiatric illnesses. The study had a cross-sectional design and it included 220 patients of both genders, aged from 19-81 y, with a wide range of mental disorders (F00-F89), and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, a study questionnaire and biochemical analysis of patients' serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium). Data were analyzed using descriptive statistics, methods for hypothesis testing and binary logistic regression, at the p#0.05 level. A total of 140 patients (64%) had a deficiency of vitamin D (,12 ng/mL), and 45 (20%) had inadequate vitamin D serum levels (12-20 ng/mL), while 35 (16%) had sufficient vitamin D serum concentrations (.20 ng/mL). Among variables related to demographics, life style habits, mental illness, comorbid disorders and drugs, two of them, female gender (odds ratio (OR)52.5, 95% confidence interval (CI)51.3-4.9, p50.006) and using clozapine (OR515.6, 95% CI 1.7-144.7, p50.02), were significantly associated with vitamin D deficiency. Physical activity (OR5 0.4, p50.02), exercising (OR50.2, 95% CI , p50.02) and offal in the diet (OR50.5, 95% CI 0.3-0.9, p50.03) significantly aggregated in the patients who had a 25(OH)D serum concentration above the deficiency cut-off level. Patients with mental disorders are at high risk for vitamin D deficiency, particularly females and clozapine users as well as those having no adequate physical activity or dietary habits.

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“…Men typically develop schizophrenia about 5 years earlier than women 11 12. It has been shown that patients with psychiatric illness are much more likely to be vitD deficient than the general population; 13 14 patients with schizophrenia in particular are more likely to be deficient than individuals with other psychiatric disorders 10 15. Additionally, several well-established risk factors for the development of schizophrenia such as birth month, migration status and/or latitude of residency might all be related to vitD deficiency 16–18.…”

Section: Introductionmentioning

confidence: 99%

Vitamin D in schizophrenia: a clinical review

Chiang

Natarajan

Fan

2016

Evid Based Mental Health

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Vitamin D (vitD) is known for its essential role in calcium homeostasis and bone health. VitD is made endogenously in the skin from UVB radiation from sunlight. VitD is now considered as a potent neurosteroid hormone, critical to brain development and normal brain function, and is known for its anti-inflammatory property affecting various aspects of human health. VitD ligand-receptor, a receptor that mediates much of vitD's biological actions, has been found throughout the body including the central nervous system. VitD deficiency is common in patients with severe mental illness such as schizophrenia. Schizophrenia is a debilitating chronic mental illness characterised by positive symptoms, such as hallucinations and delusions, and negative symptoms including flat affect and lack of motivation. Several environmental risk factors for schizophrenia, such as season of birth, latitude and migration, have been linked to vitD deficiency. Recent studies have suggested a potential role of vitD in the development of schizophrenia. For example, neonatal vitD status is associated with the risk of developing schizophrenia in later life obesity, insulin resistance, diabetes, hyperlipidaemia and cardiovascular disease, which are commonly seen in patients with schizophrenia. It has been well established that vitD deficiency is related to these metabolic problems. The biological mechanism is most likely related to vitD's action on the regulation of inflammatory and immunological processes, consequently affecting the manifestation of clinical symptoms and treatment response of schizophrenia. Potential benefits of vitD supplementation to improve schizophrenia symptoms as well as physical health in patients with schizophrenia should be further explored in future studies.

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Vitamin D status of psychiatric inpatients in New Zealand’s Waikato region

Cited by 51 publications

References 25 publications

Vitamin D insufficiency and schizophrenia risk: Evaluation of hyperprolinemia as a mediator of association

Vitamin D insufficiency and schizophrenia risk: Evaluation of hyperprolinemia as a mediator of association

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Vitamin D in schizophrenia: a clinical review

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