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Introduction: Tenofovir disoproxil fumarate with emtricitabine (TDF/FTC) is used for HIV pre-exposure prophylaxis (PrEP). TDF may affect bone mineral density (BMD), particularly in youth who are at a stage of peak bone mass accrual. The objective of this study was to evaluate the effect of vitamin D and calcium supplementation on BMD among Thai youth receiving daily oral PrEP. Methods: This open-label randomized trial was conducted in male youth aged between 15 and 24 years. Participants were randomized to Arm A who received once-daily TDF/FTC plus vitamin D3 and calcium supplementation with meals twice daily (400 units of vitamin D3 and 1200 mg of elemental calcium/day) or Arm B who received once-daily TDF/FTC only. PrEP users were defined as taking at least two tablets/week (tenofovir-diphosphate level of >350 fmol/punch). Adherence to vitamin D/calcium supplementation was defined as self-reported adherence of >50%. Lumbar spine (L2-L4) BMD (LSBMD) was evaluated by dual-energy X-ray absorptiometry scan zero and six months after PrEP initiation. Results: From March 2019 to March 2020, 100 youth were enrolled. Baseline characteristics between the two arms were similar. Median (IQR) age was 18 (17 to 20) years. At entry median (IQR) LSBMD z-score was -0.8 (-1.5 to -0.3), 17% had low LSBMD (Z-score < -2). The median amount of calcium intake from nutritional three-day recall was 167 (IQR 94 to 272) mg/day 39% of participants had vitamin D deficiency defined as 25(OH)D levels 3% increase in LSBMD at month 6 compared to baseline (67.6% vs. 42.9% respectively; p = 0.03). There were significantly higher increases in LSBMD among youth with vitamin D deficiency who were supplemented; arm A + 0.05 (0 to 0.05) compared to arm B + 0.03 (-0.1 to 0.03), p = 0.04. Conclusions: Increases in LSBMD over six months among youth using PrEP who received vitamin D/calcium supplementation was greater than those not supplemented. Long-term follow-up should be considered to explore long-term outcomes. Keywords: HIV pre-exposure prophylaxis; young men who have sex with men; young transgender women; bone mineral density; vitamin D; calcium, 1 | INTRODUCTION Men who have sex with men (MSM) make up the largest population receiving new HIV diagnoses in the United States (87%) [1], a trend also seen in [...]

The review provides a historical perspective on the convergence of our understanding of the physiology and pathophysiology of bone, calcium, phosphorus, vitamin D, parathyroid hormone, and FGF-23 their impact on rickets., Author(s): Aaron Friedman [sup.1] [sup.2] Author Affiliations: (1) grid.17635.36, 0000000419368657, University of Minnesota, , Minneapolis, MN, USA (2) grid.28803.31, 0000 0001 0701 8607, University of Wisconsin, , Madison, WI, USA [...]

Author(s): Maryam Ebadi [sup.1], Aldo J. Montano-Loza [sup.1] Author Affiliations: (1) Division of Gastroenterology & Liver Unit, University of Alberta Hospital, Edmonton, Canada Introduction A novel coronavirus disease 2019 (COVID-19) [...]

Background/objectives To date, only two studies have investigated the relationship between vitamin D (vitD) deficiency and candidiasis in spite of vitD's antimicrobial and immunomodulatory roles. We examined the relationship between sunlight exposure and consumption of vitD-rich foods, markers of vitD status, and vulvovaginal candidiasis (VVC) in an African population to add to the limited evidence and stimulate additional research. Subjects/methods Three hundred cases (females diagnosed as suffering from VVC) and three hundred controls (females diagnosed as suffering from any condition other than VVC) were selected from three health facilities in Cape Coast, Ghana. Sunlight exposure was assessed in a structured questionnaire with a food frequency questionnaire used to ascertain the frequency of consumption of vitD-rich foods. Results Self-reported low sunlight exposure was associated with 3.38 (95% CI:1.99, 5.74) increased odds of VVC. Low and moderate sunlight exposure estimated by outdoor visits was also associated with increased odds of VVC. In sensitivity analysis restricted to matched sunlight exposure data, low and moderate exposure was associated with 5.78 (95% CI: 2.57, 12.99) and 3.53 (95% CI: 1.85, 6.75) increased odds of VVC. Odds of VVC increased with decreasing levels of consumption of vitD-rich foods (Likelihood-ratio test trend p = 0.1382). In the joint analysis, low and moderate vitD intake was associated with much higher increased odds of VVC. Conclusions Our findings should be confirmed in prospective studies and clinical trials to strengthen the evidence base for preventive action and to also inform clinical decision making., Author(s): A. K. Amegah [sup.1] [sup.2] , F. K. Baffour [sup.1] , A. Appiah [sup.1] , E. Adu-Frimpong [sup.1] , C. L. Wagner [sup.3] Author Affiliations: (1) Public Health Research [...]

Chronic kidney disease (CKD) is considered an independent risk factor for cardiovascular disease, with increased cardiovascular morbidity and mortality seen even in the early stages of CKD. Several studies have shown a high prevalence of vitamin D deficiency in individuals with CKD. Low vitamin D levels upregulate the renin-angiotensin-aldosterone system (RAAS), cause endothelial dysfunction, and increase inflammation. Epidemiological studies show an association between vitamin D deficiency and risk factors for cardiovascular disease, but a causal relationship has not been established. The high cardiovascular morbidity and mortality associated with CKD in adults requires therapies to decrease this elevated risk. However, results from several meta-analyses and randomized clinical trials in adults have not shown convincing evidence for the use of vitamin D therapy in improving cardiovascular outcomes. Lack of high-quality evidence from randomized clinical trials in children regarding the effectiveness and long-term safety of vitamin D treatment precludes any recommendations on its use to mitigate the cardiovascular burden of CKD., Author(s): Gurpreet Kaur [sup.1] , Jatinder Singh [sup.2] , Juhi Kumar [sup.3] Author Affiliations: (Aff1) grid.262863.b, 0000 0001 0693 2202, State University of New York Downstate Medical Center, , 11203, [...]

CYP3A enzymes are involved in the metabolism of calcineurin inhibitor tacrolimus as well as vitamin D. In this review, we summarize the clinical aspects of CYP3A-mediated metabolism of tacrolimus and vitamin D with emphasis on the influence of single-nucleotide polymorphisms on tacrolimus disposition. We describe the utility of 4[beta] hydroxycholesterol as a marker of CYP3A activity. Then, we discuss the possible interaction between calcineurin inhibitors and vitamin D in solid organ transplant recipients. Also, we review other mechanisms which may contribute to side effects of calcineurin inhibitors on bone. Lastly, suggestions for future research and clinical perspectives are discussed., Author(s): Agnieszka Prytula [sup.1] , Karlien Cransberg [sup.2] , Ann Raes [sup.1] [sup.3] Author Affiliations: (Aff1) 0000 0004 0626 3303, grid.410566.0, Paediatric Nephrology and Rheumatology Department, Ghent University Hospital, , [...]

We evaluated the efficacy of vitamin D (VID), omega-3 long chain polyunsaturated fatty acids (omega-3 LCPUFA, OM), or both (VIDOM) on core symptoms of ASD. New Zealand children with ASD (n = 73; aged 2.5-8.0 years) received daily 2000 IU vitamin D.sub.3, 722 mg docosahexaenoic acid, both, or placebo. Outcome measures were Social Responsiveness Scale (SRS) and Sensory Processing Measure (SPM). Of 42 outcome measures comparisons (interventions vs. placebo), two showed greater improvements (P = 0.03, OM and VIDOM for SRS-social awareness) and four showed trends for greater improvements (P < 0.1, VIDOM for SRS-social communicative functioning, OM for SRS-total, VIDOM for SPM-taste/smell and OM for SPM-balance/motion). Omega-3 LCPUFA with and without vitamin D may improve some core symptoms of ASD but no definitive conclusions can be made., Author(s): Hajar Mazahery [sup.1] , Cathryn A. Conlon [sup.1] , Kathryn L. Beck [sup.1] , Owen Mugridge [sup.1] , Marlena C. Kruger [sup.1] , Welma Stonehouse [sup.2] , Carlos A. [...]

Background Several epidemiological studies have suggested that vitamin D status is associated with risk of dementia in general populations. However, due to the synergistic effect between diabetic pathology and neuroinflammation, and the prothrombotic profile in patients with diabetes, whether vitamin D is associated with risk of dementia among patients with diabetes is unclear. This study aimed to investigate the associations of circulating vitamin D levels with risks of all-cause dementia, Alzheimer disease (AD), and vascular dementia (VD) among adults with type 2 diabetes (T2D). Methods and findings This study included 13,486 individuals ([greater than or equal to]60 years) with T2D and free of dementia at recruitment (2006-2010) from the UK Biobank study. Serum 25-hydroxyvitamin D (25[OH]D) concentrations were measured using the chemiluminescent immunoassay method at recruitment. Serum 25(OH)D [greater than or equal to] 75 nmol/L was considered sufficient, according to the Endocrine Society Clinical Practice Guidelines. Incidence of all-cause dementia, AD, and VD cases was ascertained using electronic health records (EHRs). Each participant's person-years at risk were calculated from the date of recruitment to the date that dementia was reported, date of death, date of loss to follow-up, or 28 February 2018, whichever occurred first. Among the 13,486 individuals with T2D (mean age, 64.6 years; men, 64.3%), 38.3% had vitamin D [greater than or equal to] 50 nmol/L and only 9.1% had vitamin D [greater than or equal to] 75 nmol/L. During a mean follow-up of 8.5 years, we observed 283 cases of all-cause dementia, including 101 AD and 97 VD cases. Restricted cubic spline analysis demonstrated a nonlinear relationship between serum 25(OH)D and risk of all-cause dementia (P.sub.nonlinearity < 0.001) and VD (P.sub.nonlinearity = 0.007), and the nonlinear association reached borderline significance for AD (P.sub.nonlinearity = 0.06), with a threshold at around a serum 25(OH)D value of 50 nmol/L for all the outcomes. Higher serum levels of 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD. The multivariate hazard ratios and 95% confidence intervals for participants who had serum 25(OH)D [greater than or equal to] 50 nmol/L, compared with those who were severely deficient (25[OH]D < 25 nmol/L), were 0.41 (0.29-0.60) for all-cause dementia (P.sub.trend < 0.001), 0.50 (0.27-0.92) for AD (P.sub.trend = 0.06), and 0.41 (0.22-0.77) for VD (P.sub.trend = 0.01). The main limitation of the current analysis was the potential underreporting of dementia cases, as the cases were identified via EHRs. Conclusions In this study, we observed that higher concentrations of serum 25(OH)D were significantly associated with a lower risk of all-cause dementia, AD, and VD among individuals with T2D. Our findings, if confirmed by replication, may have relevance for dementia prevention strategies that target improving or maintaining serum vitamin D concentrations among patients with T2D., Author(s): Tingting Geng 1,2, Qi Lu 1, Zhenzhen Wan 1, Jingyu Guo 1, Liegang Liu 1, An Pan 2, Gang Liu 1,* Introduction Type 2 diabetes (T2D) is a serious [...]