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Dr.S. Abbas Raza

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Pk Doctors
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"Vitamin D beyond bone” Vitamin or Vitamone??? ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D
Vitamin D Role in Health Maintenance
Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Vitamin D
Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Additional trials are needed to definitively determine the role of vitamin D in these conditions
Vitamin D Physiology
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D
Production, Metabolism, and Biological Function of Vitamin D 1,25(OH) 2 D 3 1,25(OH) 2 D 3 Vitamin D 3 25(OH)D 3 Prostate Gland, Breast, Colon, Lung Calcium Homeostasis Muscle Health Bone Health Blood pressure regulation Cardiovascular Health Immunomodulation (prevention of autoimmune diseases) Regulation of Cell Growth (cancer prevention) Kidney 25(OH)D 3 =25-hydroxyvitamin D 3 ; 1,25(OH) 2 D 3 = 1,25-dihydroxyvitamin D 3 . Holick MF. Am J Clin Nutr 2004;80(suppl):1678S-88S. D D Milk Orange juice Supplement Cod liver oil Salmon Liver Skin
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Lessons learned in 2010 - 2011
Studies Published in First Quarter of 2010
Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations: a nested case-control study Mazda Jenab, H Bas Bueno-de-Mesquita, Pietro Ferrari, et al. Correspondence to: M Jenab, Lifestyle and Cancer Group, International Agency for Research on Cancer, Lyon, France [email_address] ,[object Object],[object Object]
Low Vitamin D levels in Northern American Adults with the Metabolic Syndrome ,[object Object],[object Object],[object Object]
Predicted 25-hydroxyvitamin D score and incident type 2 diabetes in the Framingham Offspring Study Enju Liu, James B Meigs, Anastassios G Pittas, Christina D Economos, Nicola M McKeown, Sarah L Booth and Paul F Jacques 1 Received for publication July 24, 2009. Accepted for publication March 19, 2010. ,[object Object],[object Object],[object Object],[object Object]
Studies Published in Second Quarter of 2010
Vitamin D Deficiency and Coronary Artery Calcification in Subjects with Type 1 Diabetes Received May 11, 2010. Accepted October 11, 2010. ,[object Object],[object Object],[object Object],[object Object]
Vitamin D and pregnancy: An old problem revisited ,[object Object],[object Object],[object Object],[object Object]
Studies Published in Third Quarter of 2010
Vitamin D is vital in activating human defences and low levels suffered by around half the world's population may mean their immune systems' killer T cells are poor at fighting infection ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D is vital in activating human defences and low levels suffered by around half the world's population may mean their immune systems' killer T cells are poor at fighting infection ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D and cardiovascular disease risk: emerging evidence Swales, Heather H a ; Wang, Thomas J b Current Opinion in Cardiology: September 2010 - Volume 25 - Issue 5 - p 513–517 ,[object Object],[object Object],[object Object]
Maternal Vitamin D Status in Gestational Diabetes Mellitus Nutrition in Clinical Practice, 10/27/2010 Soheilykhah S et al. ,[object Object]
Studies Published in Last Quarter of 2010
Vitamin D status, physical performance and body mass in patients surgically cured for primary hyperparathyroidism compared with healthy controls Clinical Endocrinology, 12/29/2010 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D for the management of multiple sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D and the heart: Why we need large-scale clinical trials Cleveland Clinic Journal of Medicine, 12/27/2010 Manson JE et al. ,[object Object],[object Object]
Optimal use of vitamin D when treating osteoporosis Current Osteoporosis Reports. van den Bergh JPW et al. 12/21/2010 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Role of Vitamin D in Blood Pressure Homeostasis American Journal of Therapeutics 11/22/2010 - Feneis JF ,[object Object],[object Object],[object Object]
Diverse associations of 25-hydroxyvitamin D and 1,25-dihydroxy-vitamin D with dyslipidaemias Journal of Internal Medicine, Karhapaa P et al. – 12/13/2010  Clinical Article ,[object Object],[object Object]
Maternal vitamin D status affects bone growth in early childhood--A prospective cohort study Osteoporosis International, 12/14/2010  Clinical Article Viljakainen HT et al. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D and the vascular sensitivity to angiotensin II in obese Caucasians with hypertension Journal of Human Hypertension, 12/14/2010 Vaidya A et al. ,[object Object],[object Object]
Serum 25-hydroxyvitamin D and parathyroid hormone are independent determinants of whole-body insulin sensitivity in women and may contribute to lower insulin sensitivity in African Americans American Journal of Clinical Nutrition, 12/06/2010 Alvarez JA et al. – ,[object Object],[object Object]
Vitamin D, UV, and Skin Cancer in the Elderly: To Expose or Not to Expose Gerontology, 12/29/2010, Glossmann H et al. ,[object Object],[object Object]
Is there any thing else associated with Vitamin D Deficiency ?????? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Astonishing Figures from the subcontinent
Astonishing Figures from the subcontinent ,[object Object],[object Object],[object Object]
High prevalence of vitamin D deficiency among pregnant women and their newborns in northern India ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D status in a sunny country: Where has the sun gone Clinical Nutrition, 12/07/2010 Unger MD et al. ,[object Object],[object Object],[object Object]
Determination of vitamin D status:
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D
Vitamin D Inadequacy = hypovitaminosis D serum 25(OH)D 3 levels < 30 ng/ml (≈ 75 nmol/L) Please note: These cutpoints are a general guideline only. Determination of vitamin D status   Vitamin D Deficiency Vitamin D Insufficiency Serum 25(OH)D 3 < 10 ng/mL (≈ 25 nmol/L) 10–30 ng/mL (≈ 25-75 nmol/L)
Vitamin D – Inadequacy: Caused / Etiology
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D - Inadequacy
Prevalence of Vitamin D Insufficiency in Healthy Canadians Rucker, CMAJ 2002 Calgary (51° N) Subjects: 188 Female: 128 Male: 60 Mean age: 64
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Vitamin D - Inadequacy
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D Levels Decline With Advancing Age Baker, Age Ageing 1980 Due to: -Low dietary intake -Low sun exposure -Less effective skin production
Does Race Make a difference….
Effect of Season and Skin Color on Vitamin D Insufficiency (NHANES III) Nesby-O’Dell, AJCN 2002 African American : 1546 And White Women: 1426 Age: 15-49
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D - Inadequacy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],Vitamin D
Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How Can We Correct Vitamin D Insufficiency? Mastaglia, ASBMR 2003 34 Subjects from Buenos Aires were randomized into 3 groups. 50% of the 5,000 IU group 75% of the 10,000 IU achieved vitamin D values > 34 ng/ml after 3 months of supplementation.
Vitamin D is Food:
So, We Don’t Get Enough Vitamin D, is Cod Liver Oil an Answer?? One tablespoon of cod liver oil contains : ~1400 IU vitamin D ~13,500 IU vitamin A
Vitamin D is Rare in Foods
Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How Much Sunlight Is Equivalent to Vitamin D Supplementation? ,[object Object],[object Object],[object Object],[object Object]
How Much Sunlight Is Equivalent to Vitamin D Supplementation? ,[object Object],[object Object],[object Object],[object Object]
All That Glitters is not GOLD…
Skepticism grows regarding widespread vitamin D supplementation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D - Conclusions
Vitamin D Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The Planet is Vitamin D Deficient
I Thank You for your Attention

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Dr.S. Abbas Raza

  • 1.
  • 2.
  • 3.
  • 4. Vitamin D Role in Health Maintenance
  • 5.
  • 6.
  • 7.
  • 9.
  • 10. Production, Metabolism, and Biological Function of Vitamin D 1,25(OH) 2 D 3 1,25(OH) 2 D 3 Vitamin D 3 25(OH)D 3 Prostate Gland, Breast, Colon, Lung Calcium Homeostasis Muscle Health Bone Health Blood pressure regulation Cardiovascular Health Immunomodulation (prevention of autoimmune diseases) Regulation of Cell Growth (cancer prevention) Kidney 25(OH)D 3 =25-hydroxyvitamin D 3 ; 1,25(OH) 2 D 3 = 1,25-dihydroxyvitamin D 3 . Holick MF. Am J Clin Nutr 2004;80(suppl):1678S-88S. D D Milk Orange juice Supplement Cod liver oil Salmon Liver Skin
  • 11.
  • 12. Lessons learned in 2010 - 2011
  • 13. Studies Published in First Quarter of 2010
  • 14.
  • 15.
  • 16.
  • 17. Studies Published in Second Quarter of 2010
  • 18.
  • 19.
  • 20. Studies Published in Third Quarter of 2010
  • 21.
  • 22.
  • 23.
  • 24.
  • 25. Studies Published in Last Quarter of 2010
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37. Astonishing Figures from the subcontinent
  • 38.
  • 39.
  • 40.
  • 42.
  • 43. Vitamin D Inadequacy = hypovitaminosis D serum 25(OH)D 3 levels < 30 ng/ml (≈ 75 nmol/L) Please note: These cutpoints are a general guideline only. Determination of vitamin D status   Vitamin D Deficiency Vitamin D Insufficiency Serum 25(OH)D 3 < 10 ng/mL (≈ 25 nmol/L) 10–30 ng/mL (≈ 25-75 nmol/L)
  • 44. Vitamin D – Inadequacy: Caused / Etiology
  • 45.
  • 46.
  • 47. Prevalence of Vitamin D Insufficiency in Healthy Canadians Rucker, CMAJ 2002 Calgary (51° N) Subjects: 188 Female: 128 Male: 60 Mean age: 64
  • 48.
  • 49.
  • 50.
  • 51.
  • 52. Vitamin D Levels Decline With Advancing Age Baker, Age Ageing 1980 Due to: -Low dietary intake -Low sun exposure -Less effective skin production
  • 53. Does Race Make a difference….
  • 54. Effect of Season and Skin Color on Vitamin D Insufficiency (NHANES III) Nesby-O’Dell, AJCN 2002 African American : 1546 And White Women: 1426 Age: 15-49
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62. How Can We Correct Vitamin D Insufficiency? Mastaglia, ASBMR 2003 34 Subjects from Buenos Aires were randomized into 3 groups. 50% of the 5,000 IU group 75% of the 10,000 IU achieved vitamin D values > 34 ng/ml after 3 months of supplementation.
  • 63. Vitamin D is Food:
  • 64. So, We Don’t Get Enough Vitamin D, is Cod Liver Oil an Answer?? One tablespoon of cod liver oil contains : ~1400 IU vitamin D ~13,500 IU vitamin A
  • 65. Vitamin D is Rare in Foods
  • 66.
  • 67.
  • 68.
  • 69. All That Glitters is not GOLD…
  • 70.
  • 71. Vitamin D - Conclusions
  • 72.
  • 73. The Planet is Vitamin D Deficient
  • 74. I Thank You for your Attention