Vitamin D and Immune System

Hamid Jan B. Jan Mohamed

Nutrition ProgramSchool of Health Sciences, Universiti Sains Malaysia, Kelantan, Malaysia

OUTLINE

• Vitamin D• Immunity• Monsoon study- Vit. D• USM Pregnancy Cohort Study- Vit. D• Conclusions

What is Vitamin D

• There are many vitamins needed by our body to maintain health and prevent disease.

• Each vitamins has a specific role in the body• Vitamin D is one of the important vitamin.• One special character of vitamin D is this is the

only vitamin that can be produced by our body.

Vitamin D Metabolism

UVB (290 – 315 nm) [25(OH)D]

4

Sources of Vitamin D

South East Asia Studies

Khor Geok Lin, 2014

Vitamin D and bone health

Vitamin D - Iceberg ‘phenomena’

[Thacher and Clarke, 2011]8

Publication on Vitamin D

Vitamin D receptors (Proteomics)

Vitamin D receptors in immunity

Adams JS and Hewison M (2008) Unexpected actions of vitamin D: new perspectives on the regulation of innate and adaptive immunity

Nat Clin Pract Endocrinol Metab 4: 80–90 doi:10.1038/ncpendmet0716

Vitamin D and innate immunity

Endocrine, paracrine and intracrine functions of Vitamin D

Vit D and immune System in PubMed

The Universiti Sains Malaysia Pregnancy Cohort Study

Objective

To investigate the effects of vitamin D, prenatal oxidative stress and adipokines on the development of maternal-infant adiposity.

Methodology

Postnatal environment

USM Birth Cohort Study: Conceptual Framework

Prenatal environment

Nicotine exposure

Anthropometric measurements

Physical activity

Pregnancy symptoms

Child care

Dietary intake

Adipokines- Adiponectin- Leptin

Oxidative Stress markers- DNA damage, Malondialdehyde, Protein carbonyl- Total antioxidant capacity, enzymatic antioxidant

Lipid metabolism

Glucose & insulin levels

Breast milk adiponectin

Infant feeding

Blood pressure

Maternal-Infant

Adiposity

At birth, 2, 6 & 12 months

15-22 & 32-39 weeks of gestation

3 years & 5 years

Research Tools and Instruments

Body Composition Analyzer (Tanita SC330-S, Illinois, USA)

Body meter scale (Seca 206)

Harpenden skinfold caliper (British Indicator, UK)

Baby weighing scale (Seca 334, Humburg, Germany)

Measuring tape

Mini electric breast pump

(Medela, Illinous, USA)

Serum 25-Hydroxyvitamin D Measurement

Elecsys® Vitamin D Total Assay

Cobas e 411, ECLIA

Good comparability to reference method to prove accuracy of

measurement20

Objectives

• To assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels.

• To determine the association between maternal serum and breast milk 25(OH)D levels.

Methods

• Sample size: 102 pregnant women, aged 19-40 years• 25(OH)D analysis: Blood samples were drawn at 18 & 34 weeks’ gestation Breast milk samples were collected at delivery, 2, 6 and 12

months postpartum were collected to analyze for 25(OH)D levels

Performed by High Performance Liquid Chromatography (HPLC)

Depending on maternal serum 25(OH)D levels, the women were categorized as severe vitamin D deficiency (<25 nmol/L), mild vitamin D deficiency (25 to <50 nmol/L), vitamin D insufficiency (50 to <75 nmol/L) and vitamin D sufficiency (≥75 nmol/L)

Maternal 25(OH)D levels in the 2nd & 3rd trimesters of pregnancy

48.45 nmol/l (SD 15.27)

58.99 nmol/l (SD 20.43)

p<0.001

Results

Associations between maternal factors during pregnancy and serum 25(OH)D levels

Adjusted for maternal age and gestational age.

The 25(OH)D levels of breast milk

Associations between maternal serum and breast milk 25(OH)D levels

Adjusted for maternal age and prenatal multivitamin intake

Discussion

• Prevalence of vitamin D insufficiency was high among the pregnant women.

• Serum vitamin D level during early pregnancy is associated with the breast milk vitamin D level at birth.

The Monsoon Study

Objectives

• To compare levels of vitamin D between indoor and outdoor workers in Kelantan

1

• To compare levels of vitamin D during monsoon and non-monsoon season among indoor and outdoor workers in Kelantan

2

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Outdoor & Indoor Workers Definition

• Group that receives regular and significant solar ultraviolet rays (UVR) exposure [Gies et al., 1995]

• Those reporting occupational sun exposures for more than 2h/day between 0800 and 1400 h [Azizi et al., 2009]

Outdoor Workers

• Persons who are employed in nonindustrial, nonagricultural indoor settings (indoor work environments) [Mendell et al., 2002]

• Stayed indoors more than half of their working time [Chao and Wang, 1994]

Indoor Workers

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Fishermen

Office staff

Study design & setting

Funding:Fundamental Research Grant Scheme (MOHE)

Kelantan

Setting: Wisma Persekutuan Kota Bharu Kelantan Fishermen Villages (Kota Bharu, Bachok & Semerak)

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Flowchart

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Same subjects

were followed

up

1st Phase

Non-Northeast Monsoon Season

(May – June 2012)

Indoor Workers (n=143)

Outdoor Workers (n=138)

Data Collection

Analysis of Outcome

2nd Phase

Northeast Monsoon Season

(Jan – Feb 2013)

Indoor Workers (n=121)

Outdoor Workers (n=118)

Data Collection

Analysis of Outcome

Comparative Point Prevalence Study

Vitamin D Concentrations between Non Monsoon and Monsoon Season (WORKPLACE)

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P<0.001 P<0.001 NS

Outdoor Workers Indoor Workers

FemaleMale

Vitamin D Concentratios between Non Monsoon and Monsoon Season (SEX)

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n=10 n=127 n=8 n=110 n=101 n=42 n=85 n=36

P<0.001 P<0.001 P<0.001 P<0.001

• Vitamin D has important role in immune systems which should be explored among populations in Asian region

1

• Vitamin D deficiency is common among indoor workers especially females.2

Conclusion

Thank you very much…

Correspondence

• Mobile: 6012-6456477• Office: 609-7677618• Email: hamidjan@usm.my• Website: www.ppsk.usm.my