Vitamin D Supplementation and Hemoglobin Levels in Hypertensive Patients: A Randomized Controlled Trial

Ernst, Jana B.; Tomaschitz, Andreas; Grübler, Martin; Gaksch, Martin; Kienreich, Katharina; Verheyen, Nicolas; März, Winfried; Pilz, Stefan; Zittermann, Armin

doi:10.1155/2016/6836402

Cited by 23 publications

(21 citation statements)

References 41 publications

(40 reference statements)

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“…This is consistent with several studies in chronic kidney disease, cardiovascular disease, and the general population, which have described a positive association between vitamin D status and hemoglobin and/or an inverse association between vitamin D status and anemia (9–13, 15, 39, 40). Data from clinical trials have been mixed (39–42), but recent studies in CKD and critically ill adult patient populations found that treatment with vitamin D or its analogues resulted in significant increases in hemoglobin concentrations (24, 43). This association has not been previously studied in IBD animal models or clinical studies.…”

Section: Discussionsupporting

confidence: 93%

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

Syed

Michalski

Tangpricha

et al. 2017

Inflammatory Bowel Diseases

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BACKGROUND Anemia, iron deficiency and hypovitaminosis D are well-known comorbidities in inflammatory bowel disease (IBD). Epidemiologic studies have linked vitamin D deficiency with increased risk of anemia, and in vitro studies suggest that vitamin D may improve iron recycling through down-regulatory effects on hepcidin and pro-inflammatory cytokines. DESIGN/METHODS We aimed to investigate the association of vitamin D status with inflammation, iron biomarkers, and anemia in pediatric IBD. Cross-sectional data was obtained from N=69 IBD patients aged 5 to <19y. Iron biomarkers [ferritin, soluble transferrin receptor (sTfR)], 25-hydroxyvitamin D (25(OH)D), inflammatory biomarkers [C-reactive protein (CRP), α1-acid glycoprotein (AGP)], hepcidin, and hemoglobin were collected. Iron biomarkers were regression corrected for inflammation. Multivariable logistic/linear models were used to examine the associations of 25(OH)D with inflammation, iron status, hepcidin, and anemia. RESULTS ~ 50% of subjects were inflamed (CRP>5 mg/L or AGP>1 g/L). Iron deficiency prevalence (inflammation-corrected ferritin < 15 μg/L or sTfR > 8.3mg/L) was 67%; anemia was 36%, vitamin D insufficiency (25(OH)D < 30 ng/mL) was 77%. In linear regression models, vitamin D insufficiency was associated with increased hepcidin levels (β(SE)=0.6(0.2), P=0.01) and reduced hemoglobin (β(SE)= −0.9 (0.5), P=0.046), controlling for age, sex, race, insurance status, body mass index-for-age, inflammation, disease diagnosis (ulcerative colitis vs. Crohn’s) and disease duration, compared to 25(OH)D ≥ 30 ng/mL. CONCLUSIONS Our results suggest that concentrations of 25(OH)D ≥ 30 ng/mL are associated with lower hepcidin and higher hemoglobin levels. Further research is needed to clarify the association of vitamin D with inflammation, iron status and anemia in pediatric IBD.

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Section: Discussionsupporting

confidence: 93%

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

Syed

Michalski

Tangpricha

et al. 2017

Inflammatory Bowel Diseases

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“…However, very few trials have directly evaluated the effect of vitamin D treatment on hemoglobin concentrations or anemia. Among those that have, the results have been mixed, likely due to the differences in dosage and form of vitamin D administered, and the population studied [26-28]. In studies of patients with CKD, vitamin D or its analogues have been shown to increase hemoglobin concentrations [27, 29-31].…”

Section: Discussionmentioning

confidence: 99%

High-dose vitamin D 3 reduces circulating hepcidin concentrations: A pilot, randomized, double-blind, placebo-controlled trial in healthy adults

et al. 2017

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Background & Aims In vitro studies suggest that vitamin D may reduce hepcidin expression and pro-inflammatory cytokine release from monocytes. However, data assessing the vitamin D-mediated effects on iron recycling in healthy individuals are lacking. We aimed to examine the effect of high-dose vitamin D3 on plasma hepcidin, inflammatory cytokine, and ferritin concentrations in healthy adults. Methods This was a pilot, double-blind, placebo-controlled trial in healthy adults (N=28) randomized to receive a one-time oral dose of 250,000 IU of vitamin D3 or placebo. Between-and within-group differences in plasma hepcidin, pro-inflammatory cytokine [interleukin (IL)-1β, IL-6, IL-8, monocyte chemoattractant protein-1 (MCP-1)], and ferritin concentrations at baseline and 1 week were determined using two-sample and paired t-tests, respectively. Results At baseline, plasma 25-hydroxyvitamin D [25(OH)D], hepcidin, pro-inflammatory cytokine, and ferritin concentrations did not differ between the two groups, and greater than 70% of subjects in both groups were vitamin D deficient (25(OH)D < 20 ng/mL). After 1 week, plasma hepcidin concentrations decreased by 73% from baseline in those who received vitamin D3 (geometric mean ratio [GMR] = 0.27 (95% CI: 0.11-0.62); P = 0.005); there was no significant change in the placebo group (GMR = 0.73 (95% CI: 0.49-1.09); P = 0.11). Plasma cytokine and ferritin concentrations did not change significantly in either group. Conclusions High-dose vitamin D3 significantly reduced plasma hepcidin concentrations in healthy adults 1 week post-dosing, without a change in plasma pro-inflammatory cytokine or ferritin concentrations. These data suggest that vitamin D may have a role in regulating iron recycling by acting independently of changes in pro-inflammatory markers.

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“…However, so far, the results of observational studies have not been confirmed by RCT (27)(28)(29). In a recent randomized control trial, Ernst et al (27) found no effect of daily vitamin D supplementation (2,800 IU) for 8 wk on hemoglobin level or the reduction of risk of anemia in non-anemic hypertensive patients with various vitamin D statuses. In addition, 12-wk vitamin D supplementation (600,000 IU once) did not improve the outcomes of parenteral iron therapy in subjects with both vitamin D deficiency and iron deficiency anemia (29).…”

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confidence: 98%

“…Several possible mechanisms for the association between vitamin D and anemia have been proposed, such as a direct stimulatory proliferative effect of vitamin D on bone marrow cells via VDR (24), silencing of inflammatory reactions that lead to anemia or chronic diseases (25) or parathyroid hormone (PTH)-dependent alteration in erythrocyte osmotic resistance (26). However, so far, the results of observational studies have not been confirmed by RCT (27)(28)(29). In a recent randomized control trial, Ernst et al (27) found no effect of daily vitamin D supplementation (2,800 IU) for 8 wk on hemoglobin level or the reduction of risk of anemia in non-anemic hypertensive patients with various vitamin D statuses.…”

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confidence: 99%

Iron, Hematological Parameters and Blood Plasma Lipid Profile in Vitamin D Supplemented and Non-Supplemented Young Soccer Players Subjected to High-Intensity Interval Training

Jastrzębska

Kaczmarczyk

Suárez

et al. 2017

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

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Summary Vitamin D deficiency has been associated with increased risk for cardiovascular disease and anemia. Vitamin D-related changes in lipid profile have been studied extensively but the relationship between vitamin D and lipid metabolism is not completely understood. As both vitamin D and intermittent training may potentially affect iron and lipid metabolism, the aim of the study was to evaluate whether a daily supplementation of vitamin D can modulate the response of hematological and lipid parameters to high-intensity interval training (HIIT) in soccer players. Thirty-six young elite junior soccer players were included in the placebo-controlled, double-blind study. Participants were non-randomly allocated into either a supplemented group (SG, n520, HIIT and 5,000 IU of vitamin D daily) or placebo group (PG, n516, HIIT and sunflower oil). Hematological parameters were ascertained before and after the 8-wk training. The change score (post-and pre-training difference) was calculated for each individual and the mean change score (MCS) was compared between SG and PG using the t test and analysis of covariance. There were no differences between SG and PG at baseline. The red and white cell count, hemoglobin, hematocrit, MCHC, ferritin, and HDL-cholesterol changed significantly over the 8-wk HIIT. However, no significant differences in MCS were observed between SG and PG for any variable. A daily vitamin D supplement did not have any impact on alteration in hematological or lipid parameters in young soccer players in the course of high-intensity interval training. Key Words nutrition, athletic training, sport, interval training, intermittent exercise In recent years, vitamin D has been the subject of intensive research with the primary goal of identifying and understanding its roles beyond the bones, such as cancer, immunity, cardiovascular risk, erythropoiesis, muscle function and athletic performance, to name a few (1, 2). Several lines of evidence, observational studies in particular, suggest that vitamin D lowers the risk of cardiovascular disease (3, 4). Numerous mechanistic explanations for this effect are proposed, such as change in insulin resistance, inflammatory reactions, and parathyroid hormone (PTH), renin and blood pressure levels (5). In addition, owing to a well-known relationship between dyslipidemia and atherosclerotic disease as well as a high prevalence of both vitamin D deficiency and cardiovascular disease, vitamin D-dependent changes in lipid profile have recently been given much attention (6). However, the relationship between vitamin D and lipid metabolism is not completely understood (7-10). Moreover, found that genetically reduced plasma 25-hydroxyvitamin D (25(OH)D) is not associated with increased risk of ischemic heart disease. Moreover, the results of Scragg et al.'s (12) randomized controlled trial (RCT) study showed no evidence that monthly high-dose vitamin D supplementation (100,000 IU a month) prevented cardiovascular diseases.In cross-sectional observational studies, lower p-2...

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Vitamin D Supplementation and Hemoglobin Levels in Hypertensive Patients: A Randomized Controlled Trial

Cited by 23 publications

References 41 publications

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

Vitamin D Status Is Associated with Hepcidin and Hemoglobin Concentrations in Children with Inflammatory Bowel Disease

High-dose vitamin D 3 reduces circulating hepcidin concentrations: A pilot, randomized, double-blind, placebo-controlled trial in healthy adults

Iron, Hematological Parameters and Blood Plasma Lipid Profile in Vitamin D Supplemented and Non-Supplemented Young Soccer Players Subjected to High-Intensity Interval Training

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