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      Meteorological Condition and Air Pollution Exposure Associated with Vitamin D Deficiency: A Cross-Sectional Population-Based Study in China

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          Abstract

          Objective

          The aim of this study was to investigate the status of Vitamin D deficiency and the effect of environmental factors on Vitamin D levels so as to provide theoretical support for public health promotion in this region.

          Methods

          A total of 22,387 subjects who underwent a physical examination at the center in the West China Hospital, Sichuan University, between April, 2018 and May, 2020 were enrolled in this study. Their data on gender, age, inspection date, serum 25 hydroxyvitamin D (25-(OH) D), parathyroid hormone (PTH), and total calcium were retrospectively reviewed. Next, the percentage of Vitamin D status was compared in different sex and age groups, and the fluctuation of Vitamin D level was described in relation to the change of environment. Finally, the univariable and multivariable linear regression analyses were performed to explore the risk and protective factors of Vitamin D deficiency.

          Results

          The proportion of Vitamin D deficiency in this area was 42.17%, and it was significantly higher among women and young people. The fluctuation trend of 25-(OH) D levels are consistent with temperature and solar radiation, and opposite to air quality, in the whole year. There was a positive relationship between 25-(OH) D levels with temperature and solar radiation; however, parathyroid hormone, female and AQI were negatively correlated with Vitamin D levels.

          Conclusion

          Vitamin D deficiency is common in subtropic areas, such as Sichuan Basin, which is related to solar radiation and air pollution.

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          Most cited references30

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          Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.

          The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency. The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration. Consensus was guided by systematic reviews of evidence and discussions during several conference calls and e-mail communications. The draft prepared by the Task Force was reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and cosponsoring associations, and it was posted on The Endocrine Society web site for member review. At each stage of review, the Task Force received written comments and incorporated needed changes. Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recommended supplementation at suggested daily intake and tolerable upper limit levels, depending on age and clinical circumstances. The Task Force also suggested the measurement of serum 25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D(2) or vitamin D(3) was recommended for deficient patients. At the present time, there is not sufficient evidence to recommend screening individuals who are not at risk for deficiency or to prescribe vitamin D to attain the noncalcemic benefit for cardiovascular protection.
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            Vitamin D for health: a global perspective.

            It is now generally accepted that vitamin D deficiency is a worldwide health problem that affects not only musculoskeletal health but also a wide range of acute and chronic diseases. However, there remains cynicism about the lack of randomized controlled trials to support the association studies regarding the nonskeletal health benefits of vitamin D. This review was obtained by searching English-language studies published up to April 1, 2013, in PubMed, MEDLINE, and the Cochrane Central Register of Controlled Trials (search terms: vitamin D and supplementation) and focuses on recent challenges regarding the definition of vitamin D deficiency and how to achieve optimal serum 25-hydroxyvitamin D concentrations from dietary sources, supplements, and sun exposure. The effect of vitamin D on fetal programming epigenetics and gene regulation could potentially explain why vitamin D has been reported to have such wide-ranging health benefits throughout life. There is potentially a great upside to increasing the vitamin D status of children and adults worldwide for improving musculoskeletal health and reducing the risk of chronic illnesses, including some cancers, autoimmune diseases, infectious diseases, type 2 diabetes mellitus, neurocognitive disorders, and mortality. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
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              Association between vitamin D supplementation and mortality: systematic review and meta-analysis

              Abstract Objective To investigate whether vitamin D supplementation is associated with lower mortality in adults. Design Systematic review and meta-analysis of randomised controlled trials. Data sources Medline, Embase, and the Cochrane Central Register from their inception to 26 December 2018. Eligibility criteria for selecting studies Randomised controlled trials comparing vitamin D supplementation with a placebo or no treatment for mortality were included. Independent data extraction was conducted and study quality assessed. A meta-analysis was carried out by using fixed effects and random effects models to calculate risk ratio of death in the group receiving vitamin D supplementation and the control group. Main outcome measures All cause mortality. Results 52 trials with a total of 75 454 participants were identified. Vitamin D supplementation was not associated with all cause mortality (risk ratio 0.98, 95% confidence interval 0.95 to 1.02, I2=0%), cardiovascular mortality (0.98, 0.88 to 1.08, 0%), or non-cancer, non-cardiovascular mortality (1.05, 0.93 to 1.18, 0%). Vitamin D supplementation statistically significantly reduced the risk of cancer death (0.84, 0.74 to 0.95, 0%). In subgroup analyses, all cause mortality was significantly lower in trials with vitamin D3 supplementation than in trials with vitamin D2 supplementation (P for interaction=0.04); neither vitamin D3 nor vitamin D2 was associated with a statistically significant reduction in all cause mortality. Conclusions Vitamin D supplementation alone was not associated with all cause mortality in adults compared with placebo or no treatment. Vitamin D supplementation reduced the risk of cancer death by 16%. Additional large clinical studies are needed to determine whether vitamin D3 supplementation is associated with lower all cause mortality. Study registration PROSPERO registration number CRD42018117823.
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                Author and article information

                Journal
                Risk Manag Healthc Policy
                Risk Manag Healthc Policy
                rmhp
                rmhp
                Risk Management and Healthcare Policy
                Dove
                1179-1594
                29 October 2020
                2020
                : 13
                : 2317-2324
                Affiliations
                [1 ]Department of Laboratory Medicine, West China Hospital, Sichuan University , Chengdu, People’s Republic of China
                [2 ]Department of Endocrinology and Metabolism, West China Hospital, Sichuan University , Chengdu, People’s Republic of China
                Author notes
                Correspondence: Mei Zhang Department of Laboratory Medicine, West China Hospital, Sichuan University , No. 37, Guoxue Lane, Chengdu, People’s Republic of China Email meizi5337@163.com
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0002-1513-3987
                http://orcid.org/0000-0002-2354-257X
                Article
                273145
                10.2147/RMHP.S273145
                7605970
                33154683
                98647751-bd7a-4eae-af12-cd7ee6c7ca78
                © 2020 He et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 22 July 2020
                : 28 September 2020
                Page count
                Figures: 2, Tables: 3, References: 31, Pages: 8
                Categories
                Original Research

                Social policy & Welfare
                vitamin d deficiency,25 hydroxyvitamin d,environmental factors,air quality index

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