Vitamin D: Is it a superhero??
|
|
- Alyson Walters
- 6 years ago
- Views:
Transcription
1 Vitamin D: Is it a superhero?? Dr. Ashraf Abdel Basset Bakr Prof. of Pediatrics
2 1 2 History of vitamin D discovery Sources of vitamin D and its metabolism 13 Actions of vitamin D 4 Vitamin D deficiency 15 Vitamin D supplementation
3 Introduction Vitamin D is a fat-soluble vitamin. It has a role in bone metabolism and other extra-mineral metabolism functions
4 History of vitamin D In 17 th century, the first extensive description of the clinical picture of rickets, carried out by Daniel Whistler and Francis Glisson. At the beginning of the 20th century, the discovery of the dual origin of vitamin D; dietary vitamin D and the curative effects of UV light.
5 History of vitamin D In 1938, Adolf Windaus earned the Nobel prize due to the chemical identification and chemical synthesis of vitamin D. In , acceptance that Vitamin D was a precursor of a steroid hormone (1,25(OH)2 D3) and the first isolation and characterization of a specific binding protein (receptor) for 1,25(OH)2 D3; vitamin D receptor (VDR).
6 History of vitamin D In , expansion of the vitamin D endocrine system after discovery of VDR in many tissues.
7
8 Sources and Metabolism of vitamin D 25-OHase 1 α-ohase
9 Sources and Metabolism of vitamin D 1,25(OH)2 D3 Major biologically active metabolite The hormonal form of vitamin D A steroid hormone Binds to hormone receptor (VDR) VDR Widely distributed VDR in over 40 tissues applying the endocrine paradigm beyond intestinal calcium absorption and the prevention of rickets and osteomalacia
10 Sources and Metabolism of vitamin D Pancreas Immune system Cardiovascular system Add Title Bone Kidney Muscle Nervous system
11 Sources of Vitamin D and its mineral role were discovered since 20 th century Vitamin D Active metabolite of vitamin D is 1,25 (OH)2 D3 VDRs are widely distributed in many tissues
12
13 Actions of vitamin D Pancreas Immune system Cardiovascular system Add Title Bone Kidney Muscle Nervous system
14 Action of vitamin D on calcium homeostasis These actions of 1,25 (OH)2 D3 Maintain an adequate calcium and phosphorus product which results in the mineralization of osteoid laid down by osteoblasts.
15 Deficiency of vitamin D and bone disease Decrease in the efficiency of intestinal calcium absorption and results in a decrease in ionized calcium itamin D deficiency Hypocalcemia stimulates calcium sensor in the parathyroid glands and increases the production and the secretion of PTH Increasing tubular reabsorption of calcium Stimulation of 1 α (OH) Act on their receptors in bone which stimulates the formation of osteoclasts, which in turn dissolves the bone matrix to release the calcium into the extracellular space
16 Deficiency of vitamin D and bone The net result is an inadequate calcium phosphate product necessary for the mineralization of the collagen matrix Rickets osteomalacia osteopenia osteoporosis
17 Sources and Metabolism of vitamin D Pancreas Immune system Cardiovascular system Add Title Calcium homeostasis Kidney Muscle Nervous system
18 Action of vitamin D and immune system
19 Action of vitamin D and immune system VDR is widely expressed in the immune system leads to the recognition of a central immunomodulatory role for 1,25(OH)2D Vit D effect on innate immunity Enhancing the antimicrobial properties of immune cells such as monocytes and macrophages. Vit D effect on adaptive immunity Exerts an inhibitory action on the adaptive immune system
20 Action of vitamin D and immune system Role in autoimmunity Role in infection Role in allergy
21 Action of vitamin D and immune system Role in autoimmunity Role in infection Role in allergy
22 Deficiency of vitamin D and infection Respiratory tract infection TB Vitamin D Neonatal infection
23 Deficiency of vitamin D and infection Sun light and cod liver oil had been used in TB treatment 1840 Vit D and TB Vit D isolated from cod liver oil 1930 Using chemotherapy decreased the interest in using sun light, cod liver oil in TB treatment Discovery chemotherapy Vit D deficiency is a risk factor for active TB and impaired antimicrobial activity Last two decades
24 Deficiency of vitamin D and infection Vit D and TB These initial clinical associations and early trials suggest that vitamin D may be beneficial as an adjunctive treatment to the traditional therapy for TB; however, additional randomized trials need to be conducted to clarify the role of vitamin D.
25 Deficiency of vitamin D and infection Vit D and RTI Early epidemiological studies found a strong association between rickets and RTI as influnza and RSV.
26 RTI Deficiency of vitamin D and infection More studies are needed to examine the direct effect of vitamin D supplementation and to establish the optimal serum levels of 25(OH)D to aid prevention of RTI
27 Deficiency of vitamin D and infection Neonatal infections Many studies performed in neonates and infants supported the preventive role of vitamin D against respiratory tract infections. Low cord blood levels of 25-OHD were found to be associated with a higher risk of RTI by the age of 3 months and a higher cumulative risk of wheezing in early childhood.
28 Deficiency of vitamin D and infection Neonatal sepsis
29 Deficiency of vitamin D and infection Respiratory tract infection TB Vitamin D Neonatal infection
30 Action of vitamin D and immune system Role in autoimmunity Role in infection Role in allergy
31 Action of vitamin D and autoimmunity 1,25(OH)2 D3 Immunomodulatory effects T cells *Decreases Th1/Th17 CD4+ T cells *Increases regulatory T cells B cells Inhibits Igs production Dentritic cells Maturation and the differentiation
32 Deficiency of vitamin D and autoimmune diseases
33 Deficiency of vitamin D and autoimmune diseases There have been several animal models of autoimmunity in which disease could either be prevented or ameliorated with the administration of either 1,25(OH)2D3. Type-1 diabetes mellitus Inflammatory bowel disease Autoimmune uveitis Systemic lupus Autoimmune encephalomyelitis Collageninduced arthritis
34 Deficiency of vitamin D and autoimmune DM diseases
35 Deficiency of vitamin D and autoimmune diseases SLE
36 Action of vitamin D and immune system Role in autoimmunity Role in infection Role in allergy
37 Deficiency of vitamin D and autoimmune diseases BA Experimental studies and genetic association studies of the VDR have motivated observational studies of vitamin D and asthma in humans.
38 Deficiency of vitamin D and autoimmune diseases BA Increased serum vitamin D Decreases atopy Increases steriod responsiveness Decreases viral infection Increases lung maturity and development Differentiation of naive T cells into IL-10 secreting Tregs * Vitamin D can increases glucocorticoidinduced secretion of IL-10 bytregs *Enhanced corticosteroid receptor signalling Down-regulates dendritic cell required for Th2 priming Up-regulates TGF-b Increase TGF-b positive Tregs and lower Th2 cytokine levels Modulates fetal lung maturation and airway smooth muscle cell proliferation and differentiation, although the mechanisms are unclear Decreases Asthma morbidity
39 Deficiency of vitamin D and autoimmune diseases Can vitamin D protect against or reduce asthma morbidity?
40 BA Deficiency of vitamin D and autoimmune diseases Observational studies Many observational studies of vitamin D and asthma were carried out with many limitations and controversy results.
41 Deficiency of vitamin D and autoimmune diseases BA
42 Sources and Metabolism of vitamin D Pancreas Immune system Cardiovascular system Add Title Calcium homeostasis Kidney Muscle Nervous system
43 Action of vitamin D and glucose metabolism Increases insulin sensitivity Expression of insulin receptors Increases insulin secretion Increases glucose uptake
44 Deficiency of vitamin D and glucose metabolism DM type 2
45 Deficiency of vitamin D and glucose metabolism Pre-diabetes
46 Sources and Metabolism of vitamin D Pancreas Immune system Cardiovascular system Add Title Calcium homeostasis Kidney Muscle Nervous system
47 Action of vitamin D and renoprotection
48 Action of vitamin D and renoprotection Increases nephrin expression Decreases inflammation Concept of renoprotection Antiproteinuric effect Supression of renin, AT II, AT1R and vascular endothelial growth factor
49 Deficiency of Vitamin D and kidney diseases CKD
50 Action of vitamin D and renoprotection DN
51 Action of vitamin D and renoprotection
52 Action of vitamin D and renoprotection
53 Vitamin D: Is it a superhero??
54
55
56 Definition of vitamin D deficiency What do we measure to define vit D deficiency?
57 Definition of vitamin D deficiency
58 Definition of vitamin D deficiency Why do we use vit D3 to define vit D deficiency?
59 Definition of vitamin D deficiency It has long half-life of 2 to 3 weeks Robust circulating concentration Resilience to fluctuations in PTH concentrations
60 Definition of vitamin D deficiency How can we define vit D deficiency?
61 Definition of vitamin D deficiency Actual values of 25- OH-D that determine vitamin D insufficiency in children have not been defined. Low levels of vitamin D refers to hormone deficiency which is defined by a serum level <20ng/mL. Vitamin D insufficiency, typically defined by levels ranging from 20-29ng/ ml, has also been regarded as clinically important particularly in children.
62 Definition of vitamin D deficiency Vitamin D Status Based on Calcidiol Concentrations
63
64 Requirement for prevention of vit D deficiency
65 Requirement for prevention of vit D deficiency Full-body exposure during summer months for 10 to 15 minutes in an adult with lighter pigmentation will can generate 10,000 to 20,000 IU of vitamin D. The amount of sunshine exposure necessary to maintain an adequate 25-OH-D concentration in any given infant at any point in time is not easy to determine. Skin pigmentation, latitude, and amount of skin exposed can influence vitamin D synthesis.
66 Requirement for prevention of vit D deficiency According to the American Academy of Pediatrics, 2008
67 Requirement for prevention of vit D deficiency AAP 2008 Infants who are formula-fed exclusively will most likely have an adequate level of vitamin D. AAP recommend 200 to 400 units per day of vitamin D supplementation in very low birth weight infants (<1500 g) and 400 units per day of vitamin D supplementation in infants weighing > 1500 g. Vitamin D should begin within the first few days of life and continue throughout childhood
68 Requirement for prevention of vit D deficiency The Endocrine Society recommendation for vit D deficiency
69 Requirement for prevention of vit D deficiency The Endocrine Society recommendation for vit D deficiency 0-1 y 1-18 y M\F The U.S. Endocrine Society recommendation for vit D supplementation is higher than AAP Pregnancy Lactation
70 Requirement for prevention of vit D deficiency Obese children Anticonvulsant medications Antifungals medications Given at least two to three times more vitamin D for their age group to satisfy their body s vitamin D requirement Children with malabsorption Medications for AIDS Glucocorticoids medication
71 Requirement for treatment of vit D deficiency
72 Requirement for treatment of vit D deficiency The Endocrine Society recommendation for vit D deficiency For infants and children aged 0 18 yr who are vitamin D deficient, the Endocrine Society suggests treatment with 2000 IU/d of vitamind2 or vitamind3, or with 50,000 IU of vitamind2 or vitamind3 once weekly for 6wk to achieve a blood level of 25(OH)D above 30 ng/ml followed by maintenance therapy.
73 Widespread expression of VDR in many organ systems constitutes the biological basis for the pleiotropic and non-skeletal actions of vitamin D. Current clinical and experimental evidences suggest that vitamin D deficiency is a new risk factor for progression of many diseases.
74 Further clinical trials should more accurately define the precise therapeutic agent, dose, timing, monitoring parameters and indications of vitamin D therapy.
75 Although 1,25 (OH)2D is the active form of vitamin D, 25(OH)D level is recommended in evaluation of vitamin D state. Parents should be adherent to the recommended dose of vitamin D supplementation.
76
Endocrine Regulation of Calcium and Phosphate Metabolism
Endocrine Regulation of Calcium and Phosphate Metabolism Huiping Wang ( 王会平 ), PhD Department of Physiology Rm C516, Block C, Research Building, School of Medicine Tel: 88208252 Email: wanghuiping@zju.edu.cn
More informationIn addition to bone health, emerging science reveals a non-skeletal benefit of vitamin D for several other health outcomes.
Vitamin D AT A GLANCE Introduction Vitamin D comprises a group of fat-soluble compounds that are essential for maintaining the mineral balance in the body. The vitamin D form synthesized in humans is called
More informationVitamin D Replacement ROCKY MOUNTAIN MEETING NOV 2013 BANFF W.COKE UNIVERSITY OF TORONTO
Vitamin D Replacement ROCKY MOUNTAIN MEETING NOV 2013 BANFF W.COKE UNIVERSITY OF TORONTO Disclosures: (Academic Mea Culpa) No financial conflicts I have no expertise re: Vitamin D. OBJECTIVES: 1) Review
More informationHellenic Endocrine Society position statement: Clinical management of Vitamin D Deficiency. Spyridon Karras MD, Phd Endocrinologist
Hellenic Endocrine Society position statement: Clinical management of Vitamin D Deficiency Spyridon Karras MD, Phd Endocrinologist Pregnancy We recommend a minimum intake of 600 international units of
More informationFOCUS ON CARDIOVASCULAR DISEASE
The Consequences of Vitamin D Deficiency: FOCUS ON CARDIOVASCULAR DISEASE Vitamin D deficiency is a global health problem. With all the medical advances of the century, vitamin D deficiency is still epidemic.
More informationWelcome to mmlearn.org
Welcome to mmlearn.org VITAMIN D SUNSHINE VITAMIN INTRODUCTION Familiar with skeletal needs Rickets Osteoporosis Fractures INTRODUCTION Not as familiar other associations Immune system Cancer Cardiovascular
More informationSupplementary Information to Chapter 36
REVIEW ON VITAMIN-D NEW INSIGHTS Elmer Verner McCollum (1879-1967) was the first to discover the antirachitic vitamin which he named as vitamin D in the early part of 20th century (1919). He had earlier
More informationESPEN Congress Prague 2007
ESPEN Congress Prague 2007 Key papers in the field of nutrition Dietitian Geila S Rozen Key Papers in the field of Nutrition ESPEN 2007 Prague Geila S Rozen Clinical Nutrition Dep. Rambam health campus
More informationVitamin D & Cardiovascular Disease
Vitamin D & Cardiovascular Disease Disclosures None Vitamin D Objectives: Discuss the basics of vitamin D metabolism Discuss the role of vitamin D deficiency in the development of coronary disease Review
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: testing_serum_vitamin_d_levels 9/2015 2/2018 2/2019 2/2018 Description of Procedure or Service Vitamin D,
More informationOSTEOMALACIA UPDATE. Nothing to Disclose. Daniel D Bikle, MD, PhD Professor of Medicine University of California and VA Medical Center San Francisco
OSTEOMALACIA UPDATE Daniel D Bikle, MD, PhD Professor of Medicine University of California and VA Medical Center San Francisco Nothing to Disclose 1 Case History 59 YO WM referred for evaluation of diffuse
More informationVITAMIN D. Christina Nieuwoudt RD(SA) CCSSA/SASPEN 2018
VITAMIN D Christina Nieuwoudt RD(SA) CCSSA/SASPEN 2018 1 OBJECTIVES Why is it in the spotlight? Vit D and acute illness If it has a role how much should we give? Future 2 Why is it in the spotlight? FUNCTIONS
More informationCorporate Medical Policy
Corporate Medical Policy File Name: Origination: Last CAP Review: Next CAP Review: Last Review: testing_serum_vitamin_d_levels 9/2015 2/2017 2/2018 2/2017 Description of Procedure or Service Vitamin D,
More informationOMICS Journals are welcoming Submissions
OMICS Journals are welcoming Submissions OMICS International welcomes submissions that are original and technically so as to serve both the developing world and developed countries in the best possible
More informationVitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP
Vitamin D Vitamin functioning as hormone Todd A Fearer, MD FACP Vitamin overview Vitamins are organic compounds that are essential in small amounts for normal metabolism They are different from minerals
More informationVITAMIN D IN HEALTH AND DISEASE
VITAMIN D IN HEALTH AND DISEASE Margus Lember University of Tartu, Estonia ESIM, Saas Fee, January 16, 2014 l It`s most healthy to live on the southern side of a mountain l Hippokrates of Kos 460-370 BC
More informationTHE SUNSHINE VITAMIN. Maureen Molini, MPH, RDN, CSSD University of Nevada Reno Student Health Services
THE SUNSHINE VITAMIN Maureen Molini, MPH, RDN, CSSD University of Nevada Reno Student Health Services Vitamin vs. Prohormone Technically not a vitamin since it isn t obtained solely through diet Synthesized
More informationThe Skeletal Response to Aging: There s No Bones About It!
The Skeletal Response to Aging: There s No Bones About It! April 7, 2001 Joseph E. Zerwekh, Ph.D. Interrelationship of Intestinal, Skeletal, and Renal Systems to the Overall Maintenance of Normal Calcium
More informationVitamin D Hormone Du Jour
Vitamin D Hormone Du Jour J R Minkoff MD, FACP Endocrinology Clinical Professor of Family and Community Medicine UCSF Why Is Vitamin D Important? Musculo-skeletal effects Possible other effects Immunomodulatory
More informationSteroid hormone vitamin D: Implications for cardiovascular disease Circulation research. 2018; 122:
Steroid hormone vitamin D: Implications for cardiovascular disease Circulation research. 2018; 122:1576-1585 November 20, 2010: Canadian and US government request the Institute of Medicine to provide a
More informationMEDICAL POLICY EFFECTIVE DATE: 08/21/14 REVISED DATE: 04/16/15, 06/16/16, 07/20/17 SUBJECT: SCREENING FOR VITAMIN D DEFICIENCY
MEDICAL POLICY SUBJECT: SCREENING FOR VITAMIN D DEFICIENCY A nonprofit independent licensee of the BlueCross BlueShield Association PAGE: 1 OF: 5 If a product excludes coverage for a service, it is not
More informationVitamin D in Cattle: Calcium and Beyond. Corwin D. Nelson, Ph.D. Assistant Professor of Physiology Department of Animal Sciences
OH HO OH Vitamin D in Cattle: Calcium and Beyond Corwin D. Nelson, Ph.D. Assistant Professor of Physiology Department of Animal Sciences Seminar Outline 1. Basics of vitamin D metabolism and genomic actions
More informationVitamin D and Inflammation
Vitamin D and Inflammation Susan Harris, D.Sc. Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University Boston, MA Vitamin D Liver 25(OH)D storage form nmol/l=ng/ml x 2.5 Renal 1,25(OH)
More informationTITOLO RELAZIONE Vitamina D e aspetti immunologici. DOCENTE Michele Miraglia del Giudice
TITOLO RELAZIONE Vitamina D e aspetti immunologici DOCENTE Michele Miraglia del Giudice ????? bone skin placenta adrenal glands Vitamin D Receptors (VDR) are present in different tissues intestine kidneys
More information02/27/2018. Objectives. To Replace or Not to Replace: Nutritional Vitamin D in Dialysis.
To Replace or Not to Replace: Nutritional Vitamin D in Dialysis. Michael Shoemaker-Moyle, M.D. Assistant Professor of Clinical Medicine Objectives Review Vitamin D Physiology Review Current Replacement
More informationRegulation of the skeletal mass through the life span
Regulation of the skeletal mass through the life span Functions of the skeletal system Mechanical protection skull Movement leverage for muscles Mineral metabolism calcium store Erythropoiesis red blood
More informationCalcium metabolism and the Parathyroid Glands. Calcium, osteoclasts and osteoblasts-essential to understand the function of parathyroid glands
Calcium metabolism and the Parathyroid Glands Calcium, osteoclasts and osteoblasts-essential to understand the function of parathyroid glands Calcium is an essential element for contraction of voluntary/smooth
More informationVitamin D Deficiency. Micol Rothman, MD Assistant Professor of Medicine Clinical Director Metabolic Bone Program University of CO-Denver
Vitamin D Deficiency Micol Rothman, MD Assistant Professor of Medicine Clinical Director Metabolic Bone Program University of CO-Denver 50 yo woman referred for osteoporosis What is striking about her
More informationThe Role of Vitamin D Deficiency as a Risk Factor for Acute Lung Injury in Severe Sepsis
The Role of Vitamin D Deficiency as a Risk Factor for Acute Lung Injury in Severe Sepsis Nurnaningsih Pediatric Emergency & Intensive Care Working Group 7 th Indonesian Picu-Nicu Update, Yogyakarta, 25-26
More informationDr Seeta Durvasula.
Dr Seeta Durvasula seeta.durvasula@sydney.edu.au 1 Avoid sun skin cancer risk Australia has highest rates of skin cancer in the world Epidemic of Vitamin D deficiency Lack of Vitamin D increases risk of
More informationThe Parathyroid Glands Secrete Parathyroid Hormone, which Regulates Calcium, Magnesium, and Phosphate Ion Levels
17.6 The Parathyroid Glands Secrete Parathyroid Hormone, which Regulates Calcium, Magnesium, and Phosphate Ion Levels Partially embedded in the posterior surface of the lateral lobes of the thyroid gland
More informationVITAMIN D AND THE ATHLETE
VITAMIN D AND THE ATHLETE CONSIDERATIONS FOR THE PRACTITIONER Written by Bruce Hamilton, Qatar Vitamin D is a steroid hormone that has previously been given little attention, partially as a result of its
More informationThe Role of the Laboratory in Metabolic Bone Disease
The Role of the Laboratory in Metabolic Bone Disease Howard Morris PhD, FAACB, FFSc(RCPA) President, IFCC Professor of Medical Sciences, University of South Australia, Clinical Scientist, SA Pathology
More information1. Adults; a. Risk factors. b. Who should be tested for vitamin D deficiency? c. Investigations. d. Who do we treat and how do we treat? 2.
Vitamin D and Bone Health: A Practical Clinical Guideline for Patient Management For Adults and Children Adapted from existing local guidance, National Osteoporosis Society Practical Guides and from Royal
More informationVitamina D: un ormone multifunzione
Vitamina D: un ormone multifunzione Introduction And Infections Diego Peroni Clinica Pediatrica Universita di Ferrara Food Allergy Asthma Conclusions diego.peroni@unife.it Holick, M. F. J. Clin. Invest.
More informationIndex. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A A Diabetes Outcome Progression Trial (ADOPT), 194 Adaptive immunity, 129 131 ADOPT (A Diabetes Outcome Progression Trial), 194 Aging, vitamin
More informationManaging Endocrine Related Issues after Bariatric Surgery. Jenny Tong, MD, MPH Division of Endocrinology March 3, 2018
Managing Endocrine Related Issues after Bariatric Surgery Jenny Tong, MD, MPH Division of Endocrinology March 3, 2018 Bariatric Surgery was Associated with Higher Remission Rate than Usual Care 72.3% 38.1%
More informationVitamin D The hidden deficiency. Dr Pamela von Hurst Senior Lecturer Human Nutrition Director of the Massey Vitamin D Research Centre
Vitamin D The hidden deficiency Dr Pamela von Hurst Senior Lecturer Human Nutrition Director of the Massey Vitamin D Research Centre Overview Vitamin D what, where from, how much The New Zealand situation
More informationThe Impact of Life Style & Dietary Habits on Vitamin D status Among Young Emiratis. Fatme Al Anouti, Ph.D. Zayed University, Abu Dhabi
The Impact of Life Style & Dietary Habits on Vitamin D status Among Young Emiratis Fatme Al Anouti, Ph.D. Zayed University, Abu Dhabi The Sun-Shine Vitamin Vitamin D is unique because it can be synthesized
More informationCholecalciferol (D3) - sources Vitamin D. Endogenous - synthesis in the skin
Department of Pediatrics and Developmental Disorders Medical University of Bialystok Vitamin D metabolism and clinical manifestation of its deficit Pawel Abramowicz M.D., Ph.D. Jerzy Konstantynowicz MD,
More informationVitamin D in pregnancy and lactation
Vitamin D in pregnancy and lactation October 2014 Dr Pamela von Hurst Co-Director, Vitamin D Research Centre Massey University Vitamin D 101 Metabolism Sources Measuring status Overview of presentation
More informationThe discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements.
The discovery of Vitamin D and the elimination of rickets has been considered as one of Medicine s Greatest Achievements. SIR EDWARD MELLANBY 1 8 8 4-1 9 5 5 A D I E T C H A R A C T E R I S T I C O F S
More informationDisclosure 7/2/2018. Consultant : Ultragenyx, Alexion, Ferrings. Research grant support: Ultragenyx, Shire, Amgen. Clinical Trial : Ultragynyx, Amgen
Pisit (Duke) Pitukcheewanont, MD, FAAP Clinical Director, Pediatric Bone Program, Center for Diabetes, Endocrinology & Metabolism Children s Hospital Los Angeles Professor of Clinical Pediatrics The Keck
More informationVitamin D Deficiency. Decreases renal calcium excretion. Increases intestinal absorption Calcium. Increases bone resorption of calcium
Vitamin D Deficiency Deborah Gordish, MD Assistant Professor of Clinical Internal Medicine Lead Physician Lewis Center Primary Care Associate Division Director General Internal Medicine The Ohio State
More informationOutline. The Role of Vitamin D in CKD. Essential Role of Vitamin D. Mechanism of Action of Vit D. Mechanism of Action of Vit D 7/16/2010
Outline The Role of Vitamin D in CKD Priscilla How, Pharm.D., BCPS Assistant Professor National University of Singapore Principal Clinical Pharmacist National University Hospital (Pharmacy and Nephrology,
More informationVITAMIN D CRITICAL TO BONE HEALTH
VITAMIN D CRITICAL TO BONE HEALTH Vitamin D supplementation is now all the rage, as physicians are finally realizing that many diseases are caused by Vitamin D deficiencies. It will be helpful to know
More informationOverview. Musculoskeletal consequences of Vitamin D deficiency. Non-musculoskeletal associations of Vitamin D deficiency
Vitamin D Zulf Mughal Consultant in Paediatric Bone Disorders Department of Paediatric Endocriology Royal Manchester Children's Hospital Manchester M13 0JH Bone Study Day, 28 th September 2012 Overview
More informationIpovitaminosi D e metabolismo calcio-fosforo in dialisi peritoneale. Maurizio Gallieni Università degli Studi di Milano
Ipovitaminosi D e metabolismo calcio-fosforo in dialisi peritoneale Maurizio Gallieni Università degli Studi di Milano G Ital Nefrol 2018 - ISSN 1724-5990 Nutrients 2017, 9, 328 Vitamin D deficiency (
More informationTestosterone and other male hormones seem to be related to aggressive behavior in some species
Testosterone and Male Aggression Testosterone and other male hormones seem to be related to aggressive behavior in some species In the fish species Oreochromis mossambicus, elevated levels have been found
More informationDisclosure. Objective. Body Benefits. How Does it Work? How Much is Needed? 4/9/2013
Disclosure Vitamin D: A Lung Lifesaver? Lindsay Landgrave, Pharm.D., BCPS Clinical Pharmacy Specialist-Pulmonary Medicine Nationwide Children s Hospital I have no actual or potential conflict of interest
More informationRENAL GRAND ROUNDS. Vitamin D- Beyond the bone. Dr Krishna Pakkivenkata. 9 th April 2010.
RENAL GRAND ROUNDS Vitamin D- Beyond the bone Dr Krishna Pakkivenkata. 9 th April 2010. Brief history Secosteroid. 1920 s-exposure to sunlight prevented rickets. 1936- structure of Vit D was discovered.
More informationVitamin D and Calcium Therapy: how much is enough
Vitamin D and Calcium Therapy: how much is enough Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco DISCLOSURE Nothing to disclose 1 RECOMMENDATIONS
More informationClinical Policy: Measurement of Serum 1,25-dihydroxyvitamin D
Clinical Policy: Reference Number: CP.MP.152 Last Review Date: 12/17 Coding Implications Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description
More informationThe Endocrine System. I. Overview of the Endocrine System. II. Three Families of Hormones. III. Hormone Receptors. IV. Classes of Hormone Receptor
The Endocrine System I. Overview of the Endocrine System A. Regulates long term metabolic processes B. Releases hormones from endocrine cells 1. Hormones are chemicals 2. Alter metabolism of cells 3. Release
More informationThe Endocrine Society Guidelines
Vitamin D and Calcium Therapy: how much is enough DISCLOSURE Daniel D Bikle, MD, PhD Professor of Medicine VA Medical Center and University of California San Francisco Nothing to disclose RECOMMENDATIONS
More informationVITAMIND. Frequently asked questions about Vitamin D in childhood
VITAMIND Frequently asked questions about Vitamin D in childhood Introduction Around the UK there are different recommendations for the prevention, detection and treatment of Vitamin D deficiency. The
More informationSkeletal Manifestations
Skeletal Manifestations of Metabolic Bone Disease Mishaela R. Rubin, MD February 21, 2008 The Three Ages of Women Gustav Klimt 1905 1 Lecture Outline Osteoporosis epidemiology diagnosis secondary causes
More informationRickets Simple complement 1. What factor influences on vitamin D absorption at the level of small intestine? A. Normal absorption of lipids B.
Rickets Simple complement 1. What factor influences on vitamin D absorption at the level of small intestine? A. Normal absorption of lipids B. Increased concentration of proteins in foods C. Decreasing
More informationChapter 45-Hormones and the Endocrine System. Simple Hormone Pathways
Chapter 45-Hormones and the Endocrine System Simple Hormone s Low ph in duodenum Hormones are released from an endocrine, travel through the bloodstream, and interact with the receptor or a target to cause
More informationYEAST A NATURAL SOLUTION
Lalmin Vitamin D Yeast: An All Natural Solution for Deficiency YEAST A NATURAL SOLUTION THE ROLE OF VITAMIN D Vitamin D refers to a group of fat-soluble vitamins, mainly the two forms called vitamin D2
More informationCh45: Endocrine System
Ch45: Endocrine System Endocrine System Homeostasis is the tendency to maintain a stable internal environment. Function = coordinate and control the body with hormones to maintain homeostasis Works with
More informationHormones. Introduction to Endocrine Disorders. Hormone actions. Modulation of hormone levels. Modulation of hormone levels
Introduction to Endocrine Disorders Hormones Self-regulating system (homeostasis) Affect: Growth Metabolism Reproduction Fluid and electrolyte balance Hormone actions Endocrine gland Hormone synthesis
More informationRama Nada. - Mousa Al-Abbadi. 1 P a g e
- 1 - Rama Nada - - Mousa Al-Abbadi 1 P a g e Bones, Joints and Soft tissue tumors Before we start: the first 8 minutes was recalling to Dr.Mousa s duties, go over them in the slides. Wherever you see
More informationVitamin D in Pregnancy and Infancy
Vitamin D in Pregnancy and Infancy Charles B. Stephensen, Ph.D. USDA Western Human Nutrition Research Center and Nutrition Department, UC Davis Vitamin D Outline Metabolism of vitamin D Calcium Balance
More informationIndex. B BMC. See Bone mineral content BMD. See Bone mineral density Bone anabolic impact, Bone mass acquisition
A Acid base balance dietary protein detrimental effects of, 19 Acid base balance bicarbonate effects, 176 in bone human studies, 174 mechanisms, 173 174 in muscle aging, 174 175 alkali supplementation
More informationJournal of Pediatric Sciences
Journal of Pediatric Sciences Effect of vitamin D supplementation on growth parameters in children with Vitamin D deficiency Yashwant Rao, Tanu Midha, Prashant Tripathi, Satyajeet Singh, Rahul Deo Sharma,
More informationRahaf AL-Jafari. Marah Qaddourah. Rahmeh Abdullah. Saleem. 1 P a g e
15 Rahaf AL-Jafari Marah Qaddourah Rahmeh Abdullah Saleem 1 P a g e If you are following with the record you may notice a little bit difference in information sequences. Hormones that function on growth
More informationVitamin D: How to Translate the Science of the New Dietary Reference Intakes for This Complex Vitamin More Is Not Always Better!
April 2012 Volume 50 Number 2 Article Number 2TOT7 Return to Current Issue Vitamin D: How to Translate the Science of the New Dietary Reference Intakes for This Complex Vitamin More Is Not Always Better!
More informationProfessor Md. Mahtab Uddin Hassan FCPS(Med) MRCP(UK) FRCP(Edin) Professor of Medicine AKMMCH
Professor Md. Mahtab Uddin Hassan FCPS(Med) MRCP(UK) FRCP(Edin) Professor of Medicine AKMMCH Introduction The sunshine vitamin is a hot topic. Vitamin D deficiency and insufficiency is becoming a global
More informationGuideline for the Diagnosis and Management of Vitamin D Deficiency
Colchester Hospital University NHS Foundation Trust Guideline for the Diagnosis and Management of Vitamin D Deficiency As the symptoms and treatment doses can be different for adults and children, this
More informationHypocalcemia 6/8/12. Normal value. Physiologic functions. Nephron a functional unit of kidney. Influencing factors in Calcium and Phosphate Balance
Normal value Hypocalcemia Serum calcium Total mg/dl Ionized mg/dl Cord blood 9.0 ~ 11.5 5.0 ~ 6.o New born (1 st 24 hrs) 9.0 ~ 10.6 4.3 ~ 5.1 24~ 48 hrs 7.0 ~12.0 4.0 ~4.7 Child 8.8 ~10.8 4.8 ~4.92 There
More informationVitamin D. Mrs Sophie Barnes FRCPath Consultant Clinical Scientist
Vitamin D Mrs Sophie Barnes FRCPath Consultant Clinical Scientist Learning objectives Biochemistry and physiology of vitamin D Causes and consequences of vitamin D deficiency Current and anticipated guidelines
More informationChemical Regulation. Chapter 26. Testosterone and Male Aggression: Is There a Link? THE NATURE OF CHEMICAL REGULATION
Chapter 6 Chemical Regulation PowerPoint Lectures for Biology: Concepts and Connections, Fifth Edition Campbell, Reece, Taylor, and Simon Testosterone and Male Aggression: Is There a Link? Among male animals,
More informationEndocrine System Notes
Endocrine System Notes is the tendency to maintain a stable internal environment. - parts of the body that secrete hormones directly into the body. - parts of the body that make secretions which travel
More informationSachin Soni DNB Pediatrics
Sachin Soni DNB Pediatrics Vitamin D physiology Introduction Etiology Clinical feature Radiology Diagnosis Lab Treatment Source: -Fish, liver and oil, - Human milk (30-40 IU/L) - Exposure to sun light
More informationVitamin D physiology
Progress in Biophysics and Molecular Biology 92 (2006) 4 8 Review Vitamin D physiology P. Lips www.elsevier.com/locate/pbiomolbio Department of Endocrinology, VU University Medical Center, P.O. Box 7057,
More informationPARATHYROID, VITAMIN D AND BONE
PARATHYROID, VITAMIN D AND BONE G M Kellerman Pathology North Hunter Service 30/01/2015 BIOLOGY OF BONE Bone consists of protein, polysaccharide components and mineral matrix. The mineral is hydroxylapatite,
More informationImportance of Vitamin D in Healthy Ageing. Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014
Importance of Vitamin D in Healthy Ageing Peter Liu, B Pharmacy Market Development Manager DSM Nutritional Products Asia Pacific 11 th November 2014 Healthy life expectancy the challenge! Life expectancy
More informationThe Urinary System and Homeostasis *
OpenStax-CNX module: m46446 1 The Urinary System and Homeostasis * OpenStax This work is produced by OpenStax-CNX and licensed under the Creative Commons Attribution License 3.0 By the end of this section,
More information9.2 Hormonal Regulation of Growth
9.2 Hormonal Regulation of Growth Hormonal Regulation of Growth Pituitary gland regulates growth and development Thyroid gland regulates metabolic rate (exception: some hormones for growth and development)
More informationCa, Mg metabolism, bone diseases. Tamás Kőszegi Pécs University, Department of Laboratory Medicine Pécs, Hungary
Ca, Mg metabolism, bone diseases Tamás Kőszegi Pécs University, Department of Laboratory Medicine Pécs, Hungary Calcium homeostasis Ca 1000g in adults 99% in bones (extracellular with Mg, P) Plasma/intracellular
More informationLab Activity 21. Endocrine System Glucometer. Portland Community College BI 232
Lab Activity 21 Endocrine System Glucometer Portland Community College BI 232 2 Hormone Functions ACTH (adrenocorticotropic hormone) Regulates the activity of the cortex of the adrenal gland TSH (thyroid
More informationDrugs Affecting Bone. Rosa McCarty PhD. Department of Pharmacology & Therapeutics
Drugs Affecting Bone Rosa McCarty PhD Department of Pharmacology & Therapeutics rmccarty@unimelb.edu.au Objectives At the end of this lecture you should have gained: An understanding of bone metabolism
More informationCh45: Endocrine System
Ch45: Endocrine System Endocrine System Homeostasis is the tendency to maintain a stable internal environment. Function = with hormones to maintain homeostasis Works with nervous system Anatomy Location:
More informationOPTIMISING NUTRITION IN CF ADULTS DR HELEN WHITE
OPTIMISING NUTRITION IN CF ADULTS DR HELEN WHITE MULTISYSTEM DISEASE Pancreatic insufficiency Nutritional status CF related diabetes Fat soluble vitamin status Bone health Greater complexity of care in
More informationVITAMIN D: MORE THAN GOOD FOR BONES
VITAMIN D: MORE THAN GOOD FOR BONES Daniel D Bikle, MD, PhD Professor of Medicine and Dermatology UCSF and SFVAMC Liver P Ca 1,25(OH)2D FGF23 Kidney P Ca PTH FGF23 1 SERUM LEVELS OF MAJOR VITAMIN D METABOLITES
More informationInvited Re vie W. Steroid hormones and bone. Histology and Histopathology
Histol Histopathol (1 999) 14: 1257-1 268 http://www.ehu.es/histol-histopathol Histology and Histopathology Steroid hormones and bone Invited Re vie W W.H. Huang and M.H. Zheng Department of Ortopaedic
More informationBONE REMODELLING. Tim Arnett. University College London. Department of Anatomy and Developmental Biology
BONE REMODELLING Tim Arnett Department of Anatomy and Developmental Biology University College London The skeleton, out of sight and often out of mind, is a formidable mass of tissue occupying about 9%
More informationIOM DRI Research Synthesis Workshop June 7-8, 2006
The Dietary Requirement for Vitamin D: Looking Beyond Bone Bruce W. Hollis, Ph.D. Medical University of South Carolina Charleston, SC Presentation: Dr. Bruce Hollis 1 Metabolism of Vitamin D Under Conditions
More informationVitamin D: Vitamin D deficiency: 7/6/2010
Vitamin D: Nancy Eyler, MD, FACP Medical Director, Diabetes & Endocrinology Community Medical Center Missoula, MT Calcium and bone metabolism: Enhances intestinal absorption of both calcium and phosphorus
More informationActivity 3-F: Micronutrient Activity Station
Activity 3-F: Micronutrient Activity Station 1 Vitamin A deficiency 1 Instructions Please read through this Vitamin A information package and discuss amongst your group. You have 15 minutes to review this
More informationEastern Paediatric Epilepsy Network
1. Objective 2. Background 3. Vitamin D and epilepsy 4. Monitoring and optimizing bone health in healthy children 5. 6. Recommendations 1.) Objective: 1.1) To provide a rational basis for monitoring bone
More informationKlotho: renal and extra-renal effects
Klotho: renal and extra-renal effects Juan F. Navarro-González, MD, PhD, FASN Nephrology Service and Research Division University Hospital Nuestra Señora de Candalaria Santa Cruz de Tenerife. Spain Klotho:
More informationUnderstanding Vitamin D: To D or not to D? Anastassios G Pittas, MD MS Tufts Medical Center
Understanding Vitamin D: To D or not to D? Anastassios G Pittas, MD MS Tufts Medical Center D2dstudy.org pittas@d2dstudy.org Disclosure: NIH funding Popularity of vitamin D RESEARCH CONSUMERS 40000 Publications
More informationBenefits of Vitamin D for Cancer and Pregnancy/Birth Outcomes. William B. Grant, PhD Sunlight, Nutrition and Health Research Center, San Francisco
Benefits of Vitamin D for Cancer and Pregnancy/Birth Outcomes William B. Grant, PhD Sunlight, Nutrition and Health Research Center, San Francisco Disclosure I receive funding from Bio Tech Pharmacal, Inc.
More informationVitamin D: The Preventative Solution Robert J Silver DVM, MS, CVA Sponsored by RxVitamins
Introduction Vitamin D: The Preventative Solution Robert J Silver DVM, MS, CVA Sponsored by RxVitamins Vitamin D is a group of secosteroids with anti-rachitic activity. (Prevents rickets) It is similar
More informationThe role of IL-17A in postmenopausal inflammatory events, such as in osteoporosis
The role of IL-17A in postmenopausal inflammatory events, such as in osteoporosis 1 Ildikó Molnár, MD, CSc, 2 Ilona Bohaty, MD, 1 Éva Somogyiné-Vári 1 Immunoendocrinology and Osteoporosis Centre, 2 Regional
More informationElecsys bone marker panel. Optimal patient management starts in the laboratory
bone marker panel Optimal patient management starts in the laboratory Complete solution for osteoporosis The most complete bone metabolism panel on a single platform bone marker assays are important diagnostic
More informationChapter 6: SKELETAL SYSTEM
Chapter 6: SKELETAL SYSTEM I. FUNCTIONS A. Support B. Protection C. Movement D. Mineral storage E. Lipid storage (Fig. 6.8b) F. Blood cell production (Fig. 6.4) II. COMPONENTS A. Cartilage 1. Hyaline 2.
More information