6. Vitamin D2 vs D3
Participants received 50 000 IU of either D2 or D3 twice weekly for 5 weeks,
followed by a 5-week period during which we allowed serum 25D concentrations to
equilibrate.
33. Vitamin D is made in the skin when it is
exposed to ultraviolet B rays; in children and
adults exposure of the hands, face and arms
to the sun for 10 to 15 minutes per day
is usually sufficient for most individuals.
39. Recommended vitamin D intake
(IOF)
AGE GROUP
RECOMMENDED DIETARY ALLOWANCE
(IU/DAY)
Infants 0-6 months *
Infants 6-12 months *
1-70 years 600 **
>70 years 800
→ For seniors -> take a supplement at a dose of 800 to
1000 IU/day.
→Vitamin D supplementation at these levels has been
shown to reduce the risk of falls and fractures by about
20%.
40. Role of Vitamin D Beyond the
Skeletal Function
• Studies of Vitamin D in Various Diseases
– Type 1 Diabetes
– Type 2 Diabetes
– Hypertension
– Autoimmune disease
– Cancer
46. Type II diabetes
• Animal studies:
– Decreased the plasma glucose and insulin
resistance by modulating the pancreatic
oxidative stress and the inflammatory markers
– Reduce the insulin-degrading enzyme and
activated the insulin receptor phosphorylation,
which improved the insulin resistance
Ali, T.M, et al. Ir. J. Med. Sci.
Elseweidy, M.M, et al. Biomed. Pharmacother. 2017
61. Effect of vitamin D on immune and b cell-
related events in type 1 diabetes
pathogenesis
62. Type 1 Diabetes
• Animal study :
– Derakhshanian et al. (2017) : improving fasting
glucose, insulin, and IGF-1
– Wang, Y el at. (2016) : enhance the insulin secretion
and to suppress the apoptosis of pancreatic cells
• Mao et al.(2014) : calcitriol supplementation
down-regulated serum and urinary inflammation
markers like TNF-, IL-6, and ICAM-1 in T1D
patients
Derakhshanian, H. et al. Growth Horm. IGF Res. 2017.
Wang, Y. et al..Mol. Med. Rep. 2016.
Mao, L., et al. nt. J. Clin. Exp. Med. 2014.
63. Vitamin D intake during early life may be
associated with a reduced risk of type 1
diabetes
Dong, J.Y, et al. Nutrients 2013
64. The anti-inflammatory effects of 1,25(OH)2D3
on cells of the immune system
Wendy Dankers, et al. Front Immunol.
2016
65.
66.
67. The risk estimates of developing
autoimmune disease associated with
vitamin D intake
68. Circulating levels of vitamin D
metabolites related to cancer
• Many studies that associate vitamin D
levels with cancer risk measure serum
levels of 25(OH)D to determine if the
subjects are deficient.
– Melanoma
– Thyroid cancer
– Glioblastoma
– Invasive breast cancer
69. The renal endocrine pathway and the extrarenal
autocrine or paracrine
pathway of calcitriol synthesis.
Nature Reviews Cancer | AOP, published online 4 April 2014; doi:10.1038/nrc3691
71. Genomic mechanism of calcitriol action
through the VDR and its antineoplastic actions
72. Vitamin D can indirectly prevent
cancer.
• Patients that failed treatment t eradicate Helicobacter
pylori, which is associated with gastric cancer, had a
higher prevalence of 25(OH)D deficiency than those
that were successfully treated.
• Men with prostate cancer had reduced 25(OH)D and
increased inflammatory mediator levels compared to
controls.
• Inflammatory mediators were increased in colorectal
cancer patients that had lower levels of 25(OH)D.
86. Our findings suggest that vitamin D supplementation
does not prevent fractures or falls, or have clinically
meaningful effects on bone mineral density. There were
no differences between the effects of higher and lower doses of
vitamin D. There is little justification to use vitamin D supplements
to maintain or improve musculoskeletal health. This conclusion
should be reflected in clinical guidelines.
95. Conclusion:
Supplementation with vitamin D did not result in
a lower incidence of invasive cancer or
cardiovascular events than placebo. (Funded by
the National Institutes of Health and others; VITAL
ClinicalTrials.gov number, NCT01169259.)
