3. Prof. Dr. Hamid Jan - Vitamin D and Immunity-230415
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Transcript of 3. Prof. Dr. Hamid Jan - Vitamin D and Immunity-230415
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
34
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: [email protected]• Website: www.ppsk.usm.my