Vitamin D: Health News Updates

Low Vitamin D Levels Linked To Increased Risks After Noncardiac Surgery
From Science Daily (08/14)

Patients with low blood levels of vitamin D are at increased risk of death and serious complications after noncardiac
surgery, suggests a study in Anesthesia & Analgesia. "Vitamin D concentrations were associated with a composite of in-hospital death, serious infections, and serious cardiovascular events," according to the new research by Dr Alparslan Turan and colleagues of the Cleveland Clinic. They believe their results warrant further study to see if giving vitamin D supplementation before surgery can reduce the risk of these adverse outcomes.

The researchers analyzed the relationship between vitamin D level and surgical outcomes in approximately 3,500 patients who underwent operations other than heart surgery between 2005 and 2011. Only patients who had available data on vitamin D levels around the time of surgery -- from three months before to one month afterward -- were included in the study. The concentration of vitamin D (specifically, 25-hydroxyvitamin D) in blood samples was analyzed as a risk factor for death, cardiovascular events, or serious infections while in the hospital. The analysis included adjustment for other factors such as demographic characteristics, medical conditions, and type and duration of surgery.

Most patients did not meet the recommended 25-hydroxyvitamin D concentration of greater than 30 nanograms per milliliter (ng/mL). The median vitamin D level was 23.5 ng/mL -- more than 60 percent of patients were in the range of vitamin D insufficiency (10 to 30 ng/mL). Nearly 20 percent had vitamin D deficiency (less than 10 ng/mL). "Higher vitamin D concentrations were associated with decreased odds of in-hospital mortality/morbidity," the researchers write. For each 5 ng/mL increase in 25-hydroxyvitamin D level, the combined risk of death, cardiovascular events, or serious infections decreased by seven percent.

Patients at the lowest level of 25-hydroxyvitamin D (less than 13 ng/mL) were at highest risk of death or serious complications. Those with higher vitamin D levels (up to 44 ng/mL) had about half the risk as those in the lowest group. The association with low vitamin D was statistically significant only for cardiovascular complications, although there were "strong trends" for mortality and infections.

Further Study Needed to Determine Cause and Effect "Vitamin D deficiency is a global health problem," according to Dr Turan and coauthors. In addition to protective cardiovascular and neurological effects, vitamin D plays an important role in the immune system. The high rates of vitamin D insufficiency and deficiency in the surgical patients studied are consistent with previous findings in the general population. In recent years, studies have suggested that vitamin D levels may affect a wide range of health outcomes.  

Patients undergoing surgery are at risk of cardiovascular and infectious complications, both of which may be aggravated
by vitamin D deficiency. Previous studies found no increased risk of adverse outcomes related to vitamin D levels in
patients undergoing cardiac surgery. It may be that the tissue injury and inflammation associated with heart surgery
overwhelms any potential protective effect of vitamin D.  However, Dr Turan and colleagues note that their study had some important limitations of their study -- especially the fact that it included only patients who had recent measurements of vitamin D levels. They may represent a less-healthy group, introducing a potential source of selection bias.

The study can't determine whether there is any cause-and-effect relationship between vitamin D levels and the risk of adverse outcomes. Dr Turan and colleagues suggest a formal randomized trial to evaluate whether preoperative vitamin D supplementation can reduce the risk of serious complications and death after surgery.

Low Vitamin D Levels Might Be Linked To Dementia
From Science Daily (08/14)

Vitamin D deficiency is associated with a substantially increased risk of dementia and Alzheimer's disease in older people, according to the most robust study of its kind ever conducted.An international team, led by Dr David Llewellyn at the University of Exeter Medical School, found that study participants who were severely Vitamin D deficient were more than twice as likely to develop dementia and Alzheimer's disease.The team studied elderly Americans who took part in the Cardiovascular Health Study. They discovered that adults in the study who were moderately deficient in vitamin D had a 53 per cent increased risk of developing dementia of any kind, and the risk increased to 125 per cent in those who were severely deficient.Similar results were recorded for Alzheimer's disease, with the moderately deficient group 69 per cent more likely to develop this type of dementia, jumping to a 122 per cent increased risk for those severely deficient.

The study was part-funded by the Alzheimer's Association, and is published in Neurology, the medical journal of the American Academy of Neurology. It looked at 1,658 adults aged 65 and over, who were able to walk unaided and were free from dementia, cardiovascular disease and stroke at the start of the study. The participants were then followed for six years to investigate who went on to develop Alzheimer's disease and other forms of dementia.Dr Llewellyn said: "We expected to find an association between low Vitamin D levels and the risk of dementia and Alzheimer's disease, but the results were surprising -- we actually found that the association was twice as strong as we anticipated. "Clinical trials are now needed to establish whether eating foods such as oily fish or taking vitamin D supplements can delay or even prevent the onset of Alzheimer's disease and dementia. We need to be cautious at this early stage and our latest results do not demonstrate that low vitamin D levels cause dementia. That said, our findings are very encouraging, and even if a small number of people could benefit, this would have enormous public health implications given the devastating and costly nature of dementia."

Research collaborators included experts from Angers University Hospital, Florida International University, Columbia University, the University of Washington, the University of Pittsburg and the University of Michigan. The study was supported by the Alzheimer's Association, the Mary Kinross Charitable Trust, the James Tudor Foundation, the Halpin Trust, the Age Related Diseases and Health Trust, the Norman Family Charitable Trust, and the National Institute for Health Research Collaboration for Leadership in Applied Research and Care South West Peninsula (NIHR PenCLAHRC).

Dementia is one of the greatest challenges of our time, with 44 million cases worldwide -- a number expected to triple by 2050 as a result of rapid population aging. A billion people worldwide are thought to have low vitamin D levels and many older adults may experience poorer health as a result.

The research is the first large study to investigate the relationship between vitamin D and dementia risk where the diagnosis was made by an expert multidisciplinary team, using a wide range of information including neuroimaging. Previous research established that people with low vitamin D levels are more likely to go on to experience cognitive problems, but this study confirms that this translates into a substantial increase in the risk of Alzheimer's disease and dementia.

Vitamin D comes from three main sources -- exposure of skin to sunlight, foods such as oily fish, and supplements. Older people's skin can be less efficient at converting sunlight into Vitamin D, making them more likely to be deficient and reliant on other sources. In many countries the amount of UVB radiation in winter is too low to allow vitamin D production.

The study also found evidence that there is a threshold level of Vitamin D circulating in the bloodstream below which the risk of developing dementia and Alzheimer's disease increases. The team had previously hypothesized that this might lie in the region of 25-50 nmol/L, and their new findings confirm that vitamin D levels above 50 nmol/L are most strongly associated with good brain health.

Commenting on the study, Dr Doug Brown, Director of Research and Development at Alzheimer's Society said: "Shedding light on risk factors for dementia is one of the most important tasks facing today's health researchers. While earlier studies have suggested that a lack of the sunshine vitamin is linked to an increased risk of Alzheimer's disease, this study found that people with very low vitamin D levels were more than twice as likely to develop any kind of dementia. "During this hottest of summers, hitting the beach for just 15 minutes of sunshine is enough to boost your vitamin D levels. However, we're not quite ready to say that sunlight or vitamin D supplements will reduce your risk of dementia. Large scale clinical trials are needed to determine whether increasing vitamin D levels in those with deficiencies can help prevent the dementia from developing."
 
Caffeine Lowers Risk of Skin Cancer: Coffee-Based Sunscreen Might Work Best 
From ScienceDaily (8/11)

There might be a time when instead of just drinking that morning cup of coffee you lather it on your skin as a way of preventing harmful sun damage or skin cancer. A new Rutgers study strengthens the theory that caffeine guards against certain skin cancers at the molecular level by inhibiting a protein enzyme in the skin, known as ATR. Scientists believe that based on what they have learned studying mice, caffeine applied directly to the skin might help prevent damaging UV light from causing skin cancer.

Prior research indicated that mice that were fed caffeinated water and exposed to lamps that generated UVB radiation that damaged the DNA in their skin cells were able to kill off a greater percentage of their badly damaged cells and reduce the risk of cells becoming cancerous. "Although it is known that coffee drinking is associated with a decreased risk of non-melanoma skin cancer, there now needs to be studies to determine whether topical caffeine inhibits sunlight-induced skin cancer," said Allan Conney, director of the Susan Lehman Cullman Laboratory for Cancer Research.

In this newly-published study, instead of inhibiting ATR with caffeinated water, Rutgers researchers, in collaboration with researchers from the University of Washington, genetically modified and diminished ATR in one group of mice. The results: the genetically modified mice developed tumors more slowly than the unmodified mice, had 69 percent fewer tumors than regular mice and developed four times fewer invasive tumors.

The study also found, however, that when both groups of mice were exposed to chronic ultraviolet rays for an extended period of time, tumor development occurred in both the genetically modified and regular mice. What this seems to indicate, says Conney, is that inhibiting the ATR enzyme works best at the pre-cancerous stage before UV-induced skin cancers are fully developed.

According to the National Cancer Institute, sunlight-induced skin cancer is the most prevalent cancer in the United States with more than 1 million new cases each year. Although multiple human epidemiologic studies link caffeinated beverage intake with significant decreases in several different types of cancer, including skin cancer, just how and why coffee protects against the disease is unknown. "Caffeine might become a weapon in prevention because it inhibits ATR and also acts ad as a sunscreen and directly absorbs damaging UV light," said Conney.
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