• Clinical and Experimental Pediatrics
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• 제51권8호
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• pp.812-819
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• 2008

목 적 : 비타민 D는 뼈의 무기질화에 필수적인 역할을 하는 호르몬으로 부족하게 되면 구루병이 생길 수 있다. 본 연구는 비타민 D 결핍증이 잘 발생하는 위험군을 알아보고 그 예방 대책에 대한 관심을 고지하고자 계획하게 되었다. 방 법 : 2003년 3월부터 2007년 7월까지 노원을지병원 소아과에 내원한 환아들중에서 검사 상 우연히 알칼리성인산분해효소가 증가해 있으면서 방사선사진으로 무증상 구루병으로 진단받은 환아들에 대하여 후향적으로 그 특징과 치료 경과를 조사하였다. 결 과 : 남아 6명과 여아 2명의 총 8명이 무증상 구루병으로 진단되었다. 이들의 진단 시 연령은 $12.6{\pm}5.8$개월이었으며, 1월부터 7월 사이에 진단되었고 동반질환으로 폐렴, 요로감염, 장염, 철결핍성 빈혈이 있었다. 이들은 모두 모유 수유를 위주로 하고 있었고, 진단당시 2명의 환아가 몸무게가 3백분위수 미만으로 성장 장애를 보이고 있었다. 진단 시 평균 혈중 알칼리성인산분해효소는 $1,995.8{\pm}739.5IU/L$로 증가되어 있었고, 평균 혈중 칼슘은 $9.5{\pm}0.6mg/dL$, 평균 혈중 인은 $3.6{\pm}1.5mg/dL$였다. 평균 intact-PTH는 $214.8{\pm}155.9pg/mL$로 증가되어 있었고 25-hydroxyvitamin D는 2명을 제외한 6명의 환아에서 30 ng/mL 미만으로 감소되어 있었다. 모든 환자들은 손목 방사선 촬영에서 구루병양 변화를 보이고 있었으나 외관상 골기형이나 발달 장애는 없었다. 이들 중 6명은 3개월간 calcitriol을 투여한 후 생화학적인 검사와 손목 방사선 사진 상의 변화는 호전되었고 정상적으로 성장하였다. 2명은 치료하지 않은 채 저절로 호전되었으며 역시 외관상 성장장애를 보이지는 않았으나 2년간의 추적 관찰 후 현재 1명은 무릎 관절면의 골간단 이형성을 보이고 있으며 다른 1명은 일시적인 척추 측만증을 보였다가 호전되고 있다. 결 론 :무증상 구루병으로 진단된 환아들이 비타민 D 결핍이나 부족으로 인한 것으로 생각되며 모유 수유아에서 비타민 D 결핍증의 빈도가 높으므로 알칼리성인산분해효소가 높은 환자에서는 이를 의심하여 25-hydroxyvitamin D와 손목 방사선 사진을 검사하여 확인하여야 하며 이들 중 일부는 비타민 D 결핍성 구루병으로 진행할 수 있으므로, 모유 수유아에서 비타민 D 보충에 대한 교육이 필요하리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2227-2230
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• 2015

Background: Prostate cancer (PCa) is one of the most commonly diagnosed neoplasms and the second leading cause of cancer death in men in the Western world. Vitamin D (1,25dihydroxy vitamin D) is linked to many biological processes that influence oncogenesis but data on relations between its genetic variants and cancer risk have been inconsistent. The aim of this study was to determine associations between a vitamin D genetic polymorphism and 25-hydroxyvitamin D [25(OH)D] levels and prostate cancer. Materials and Methods: Genomic DNA was extracted from 124 Jordanian prostate cancer patients and 100 healthy volunteers. Ethical approval was granted from the ethical committee at Hashemite University and written consent was given by all patients. PCR was used to amplify the vitamin D receptor Fok1 polymorphism fragment. 25(OH)D serum levels were measured by competitive immunoassay. Results: All genotypes were in Hardy-Weinberg equilibrium. Genotype frequency for Fok1 genotypes FF, Ff and ff was 30.7%, 61.3% and 8.06%, for prostate cancer patients, while frequencies for the control group was 28.0%, 66.0% and 6.0%, respectively, with no significant differences. Vitamin D serum level was significantly lower in prostate cancer patients (mean 7.7 ng/ml) compared to the control group (21.8 ng/ml). No significant association was noted between 25(OH)D and VDR Fok1 gene polymorphism among Jordanians overall, but significant associations were evident among prostate cancer patients (FF, Ff and ff : 25(OH)D levels of 6.2, 8.2 and 9.9) and controls (19.0, 22.5 and 26.3, respectively). An inverse association was noted between 25(OH)D serum level less than 10ng/ml and prostate cancer risk (OR 35.5 and 95% CI 14.3- 88.0). Conclusions: There is strong inverse association between 25(OH)D serum level less than 10ng/ml level and prostate cancer risk.

• Nutritional Sciences
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• 제8권2호
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• pp.111-117
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• 2005

It has been more than three decades since the first assay assessing circulating 25 (OH)D in human subjects was performed That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25 (OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25 (OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400 IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25 (OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25 (OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of 25 (OH)D$\leq$30 ng/mL. In certain cases, such as pregnancy and lactation, significantly higher circulating 25 (OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.

• 한국영양학회:학술대회논문집
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• 한국영양학회 2004년도 추계학술대회
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• pp.22-33
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• 2004

It has been more than three decades since the first assay assessing circulating 25(OH)D in human subjects was performed. That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25(OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25(OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25(OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25(OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of $25(OH)D{\leq}30ng/mL$. In certain cases, such as pregnancy and lactation, significantly higher circulating 25(OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.

• Childhood Kidney Diseases
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• 제26권1호
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• pp.63-67
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• 2022

Nephrocalcinosis often occurs in infants and is caused by excessive calcium or vitamin D supplementation, neonatal primary hyperparathyroidism, and genetic disorders. Idiopathic infantile hypercalcemia (IIH), a rare cause of nephrocalcinosis, results from genetic defects in CYP24A1 or SLC34A1. Mutations in CYP24A1, which encodes 25-hydroxyvitamin D 24-hydroxylase, disrupt active vitamin D degradation. IIH clinically manifests as failure to thrive and hypercalcemia within the first year of life and usually remits spontaneously. Herein, we present a case of IIH wih CYP24A1 mutations. An 11-month-old girl visited our hospital with incidental hypercalcemia. She showed failure to thrive, and her oral intake had decreased over time since the age of 6 months. Her initial serum parathyroid hormone level was low, 25-OH vitamin D and 1,25(OH)₂ vitamin D levels were normal, and renal ultrasonography showed bilateral nephrocalcinosis. Whole-exome sequencing revealed compound heterozygous variants in CYP24A1 (NM_000782.4:c.376C>T [p.Pro126Ser] and c.1310C>A [p.Pro437His]). Although her hypercalcemia and poor oral intake spontaneously resolved in approximately 8 months, we suggested that her nephrocalcinosis and renal function be regularly checked in consideration of potential asymptomatic renal damage. Hypercalcemia caused by IIH should be suspected in infants with severe nephrocalcinosis, especially when presenting with failure to thrive.

• Clinical and Experimental Pediatrics
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• 제60권8호
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• pp.248-253
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• 2017

Purpose: Vitamin D plays a key role in immune function. Vitamin D deficiency may play a role in the pathogenesis of infections, and low levels of circulating vitamin D are strongly associated with infectious diseases. In this study, we aimed to evaluate the effects of low vitamin D levels in cord blood on neonatal sepsis in preterm infants. Methods: One hundred seventeen premature infants with gestational age of <37 weeks were enrolled. In the present study, severe vitamin D deficiency (group 1) was defined as a 25-hydroxyvitamin D (25(OH)D) concentration <5 ng/mL; vitamin D insufficiency (group 2), 25(OH)D concentration ${\geq}5ng/mL$ and <15 ng/mL; and vitamin D sufficiency (group 3), 25(OH)D concentration ${\geq}15ng/mL$. Results: Sixty-three percent of the infants had deficient levels of cord blood vitamin D (group 1), 24% had insufficient levels (group 2), and 13% were found to have sufficient levels (group 3). The rate of neonatal sepsis was higher in group 2 than in groups 1 and 3. Conclusion: There was no significant relationship between the cord blood vitamin D levels and the risk of neonatal sepsis in premature infants.

• Journal of Nutrition and Health
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• 제49권6호
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• pp.437-446
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• 2016

본 연구는 국민건강영양조사 5기의 2011년 자료를 이용하여 만 19세 이상 남녀를 대상으로 비타민D 섭취량과 혈중 25OHD 농도, 골밀도와의 관계를 분석하였다. 평균 비타민D 섭취량은 남성이 $3.84{\pm}0.23{\mu}g/day$, 여성은 $2.22{\pm}0.11{\mu}g/day$로 나타났으며, AI 미만 섭취 비율은 남성은 71.6~96.6%,여성은 80.2~98.5%로 모두 높게 나타났으며 여성이 남성에 비해 더 높았다. 혈중 25OHD 농도는 연령이 높아질수록 증가했으며, 혈중 25OHD의 결핍수준을 20 ng/mL 미만으로 보았을 때 남성은 47.8~81.1%, 여성은 59.4~92.8%의 결핍률을 보였고 젊은 층의 결핍률이 더 높았다. 50세 미만과 이상으로 나누어 비타민D 섭취량과 혈중 25OHD 농도, BMD와의 관계를 조사한 결과 50세 미만 연령층군에서는 비타민D 섭취량이 $10{\mu}g/day$ 이상인 군이 $5{\mu}g/day$ 이하인 군에 비하여 유의하게 혈중 25OHD 농도가 더 높았으며, 50세 이상 여성에서는 비타민D 섭취량이 $10{\mu}g/day$ 이상인 군이 $5{\mu}g/day$ 이하인 군에 비하여 골밀도가 유의하게 높게 나타났다. 즉, 한국 성인 남녀의 비타민D 섭취량 수준은 상당히 취약한 상태이나 식사를 통한 비타민D가 혈중 25OHD 농도를 상승시킬 수 있음을 보여주고 있다. 그러므로 한국인이 비타민D 섭취량을 늘릴 수 있도록 강화식품 정책 등을 통해 비타민D 섭취량을 늘리는 방안을 모색하여야 한다. 특히, 2010년에 비해 2015년 한국인영양소섭취기준에서 19~49세 연령층의 비타민D 충분섭취량을 $5{\mu}g$에서 $10{\mu}g$으로 상향조정한 것은 바람직한 방향으로 개정된 것으로 판단된다.

• Clinical Nutrition Research
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• 제12권3호
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• pp.184-198
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• 2023

Early prevention of sarcopenia can be an important strategy for muscle maintenance, but most studies target subjects at slightly pre-sarcopenic state. Our previous paper describes the effect of protein supplements rich in leucine and vitamin D on muscle condition, and in this paper, we performed a sub-analysis to evaluate who benefitted the most in terms of improvement in muscle health. A 12-week randomized clinical trial of 120 healthy adults (aged 50 to 80) assigned to an intervention group (n = 60) or control group (n = 60) were analyzed. Subjects in the intervention group received, twice per day, a protein supplement containing (per serving) 800 IU of vitamin D, 20 g of protein (3 g of total leucine), 300 mg of calcium, 1.1 g of fat, and 2.5 g of carbohydrate. The subjects were classified into 'insufficient' and 'sufficient' groups at 25-hydroxyvitamin D (25[OH]D) value of 30 ng/mL. The skeletal muscle mass index normalized to the square of the skeletal muscle mass (SMM) height (kg/m²) increased significantly in the 'insufficient group' difference value of change between weeks 0 and 12 (Δ1.07 ± 2.20; p = 0.037). The SMM normalized by body weight (kg/kg, %) was higher, but not significantly, in the insufficient group (Δ0.38 ± 0.69; p = 0.050). For people with insufficient (serum 25[OH]D), supplemental intake of protein and vitamin D, calcium, and leucine and adequate energy intake increases muscle mass in middle-aged and older adults and would be likely to exert a beneficial effect on muscle health.

• Journal of Nutrition and Health
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• 제51권4호
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• pp.287-294
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• 2018

본 연구는 국민건강영양조사 2010 ~ 2014년 원시자료를 통합하여 우리나라 10 ~ 18세 청소년을 대상으로 검진조사, 구강조사, 영양조사 정보가 있는 총 2,655명의 자료를 이용하여 혈중 비타민 D 농도와 치아우식 경험과의 연관성에 대해 분석하였다. 1) 대상의 인구 사회학적 특성과 치아우식 경험과의 상관성을 분석한 결과, 남녀 모두 범주화한 연령이 높아질수록 치아우식 경험군의 비율이 높았다 (p < 0.0001). 여자 청소년의 경우 소득수준이 낮아질수록 치아우식 경험이 높았으며 (p = 0.026) 기초수급경험이 있을 경우 치아우식 경험율이 높았으나 (p = 0.001) 남자 청소년은 유의한 차이가 없었다. 2) 혈중 25(OH)D 농도가 1 ng/mL증가할 때마다 우식경험 치아개수는 남자 청소년의 경우 0.059개씩 감소하는 것으로 나타났고 (p = 0.007, $R^2=0.009$) 여자 청소년의 경우 0.08개씩 감소하는 것으로 나타났으나 (p = 0.005, $R^2=0.010$) 보정 후 이러한 관련성이 통계적으로 유의하지 않았다. 3) 혈중 비타민 D 상태와 치아우식증 경험율간의 연관성을 알아본 결과 교란변수를 보정하지 않은 경우 남자 청소년에서 혈중 25(OH)D 농도가 30.0 ng/mL 이상인 군 대비 10.0 ng/mL 이상 20.0 ng/mL 미만인 군은 2.878배 (OR = 2.878, 95% CI = 1.106-7.491), 10.0 ng/mL미만인 군은 3.877배 (OR = 3.877, 95% CI = 1.250-12.028)로 치아우식 경험율이 증가하였다. 연령, 가구소득, 기초수급여부, 칫솔질횟수, 치과병의원 방문여부를 보정한 경우 혈중 25(OH)D 농도가 30.0 ng/mL 이상인 군 대비 20.0 ng/mL 이상 30.0 ng/mL 미만인 군에서 2.577배 (OR = 2.577, 95% CI = 1.013-6.557)로 치아우식 경험율이 증가하였으나 여자 청소년의 경우 유의한 연관성을 보이지 않았다. 결과적으로 혈중 비타민 D 수치가 치아우식 경험과 관련성이 있음을 시사하며 적절한 비타민 D 농도 유지의 중요성을 인식하고 향후 이를 위해 식사지침에 대한 연구 및 영양교육이 필요할 것이다.

• Asian Spine Journal
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• 제12권6호
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• pp.1127-1145
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• 2018

Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.