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Copyright American Medical Association. A secondary analysis was performed with data from the Third National Health and Nutrition Examination Survey, a national probability survey conducted by the National Center for Health Statistics between January 1, , and December 31, , with oversampling of persons 60 years and older, non-Hispanic black individuals, and Mexican American individuals.

The adjusted prevalence of hypertension odds ratio [OR], 1. Prospective studies to assess a direct benefit of cholecalciferol vitamin D supplementation on cardiovascular disease risk factors are warranted.

Dietary sources of vitamin D are very few and are limited to fatty fish liver and fortified food sources, such as cereals and milk. The synthesis of vitamin D in the skin after exposure to type B UV light remains a major source of vitamin D in humans. The primary circulating form of vitamin D is hydroxyvitamin D 25[OH]D , formed in the liver by the hydroxylation of vitamin D. The active form of the vitamin is 1,dihydroxyvitamin D, formed by a second hydroxylation of vitamin D, primarily in the kidneys, and is responsible for the physiologic functions of vitamin D.

The nutritional status of vitamin D has always been assessed by the circulating level of 25 OH D, but the data for the historical reference range for the circulating level of 25 OH D originated from sun-deprived human populations with suboptimal vitamin D intake and may have underestimated the physiologic demands for vitamin D. The diagnosis of diabetes mellitus was based on interview questions and fasting blood glucose levels.

Participants who reported having ever been told by a physician that they have diabetes mellitus or sugar diabetes or who reported taking insulin or pills to lower blood glucose levels were classified as having diabetes mellitus. Participants with fasting blood glucose levels between and Hypertension status was established by history and blood pressure BP level. A certified technician performed BP measurements using a mercury sphygmomanometer and a standardized procedure.

Four BP readings were taken, with the average of the last 3 readings used for these analyses. Hypertension was defined as an average systolic BP of mm Hg or greater, an average diastolic BP of 90 mm Hg or greater, or reported use of antihypertensive medications.

Weight and height data were captured electronically from the measuring instruments to minimize potential data entry errors. Body mass index was calculated as weight in kilograms divided by the square of height in meters. Overweight was defined as a body mass index of 25 to Serum albumin levels were measured using an albumin test system Boehringer Mannheim Diagnostics, Indianapolis, Ind with bromcresol purple reagent.

Bromcresol purple binds selectively with albumin and eliminates many of the nonspecific reactions with other serum proteins. Albuminuria was assessed by means of the urinary albumin—creatinine ratio and was evaluated at 2 levels defined as microalbuminuria, with a ratio of 30 to , and macroalbuminuria, with a ratio greater than The first step in the assay procedure involves the rapid extraction of 25 OH D and other hydroxylated metabolites from the serum or plasma using acetonitrile.

After extraction, the treated sample was assayed by means of equilibrium radioimmunoassay. The radioimmunoassay method is based on an antibody with a relative specificity to 25 OH D.

Mean levels of serum 25 OH D were computed and compared between groups using the 2-tailed t test or analysis of variance where appropriate. The age- and sex-adjusted prevalences of select CVD risk factors were determined across quartiles of serum 25 OH D levels. The significance of the differences in the age- and sex-adjusted prevalence of select CVD risk factors across quartiles of serum 25 OH D levels analysis were evaluated by calculating the odds ratio for select CVD risk factors in the first and fourth quartiles of serum 25 OH D level.

A random sample of the total number of different vitamin supplements reported by the participants was taken for a sensitivity analysis to determine the average dose of cholecalciferol. Data analyses were conducted using SAS version 8. When the analyses were stratified by race and sex, mean serum levels of 25 OH D were lower in women and in white and Hispanic participants with select CVD risk factors Table 2.

The age-, sex-, and race-adjusted prevalences and odds ratios were higher in the first than in the fourth quartile of serum 25 OH D levels and were statistically significant for all of the select CVD risk factors except for reduced eGFR and elevated serum total and non—high-density lipoprotein cholesterol levels Table 3. There was an inverse relationship between obesity, hypertension, and diabetes mellitus and serum levels of 25 OH D in the overall population, but total cholesterol level was unrelated to serum levels of 25 OH D.

Albuminuria and eGFR were included in all the analyses as indices of renal function to ensure that the association of vitamin D and CVD risk factors is not merely a function of abnormal mineral metabolism or other factors associated with CVD.

Serum albumin concentration was included in all the analyses as a marker of nutritional status to mitigate the effect of malnutrition as a confounder of the association between serum vitamin D level and CVD risk factors. Low serum albumin levels were associated with low serum 25 OH D levels in univariate and multivariate analyses but did not affect the association with CVD risk factors.

This is the first study, to our knowledge, to demonstrate a significant association between low vitamin D levels and CVD risk factors in a nationally representative sample. Previous studies suggesting similar associations between low serum vitamin D levels and CVD risk factors were limited to subpopulations and small study samples. The administration of 1,dihydroxyvitamin D 3 has been shown to prevent the development of type 1 diabetes mellitus in animal models.

Vitamin D deficiency has been associated with congestive heart failure, 25 whereas incresed blood levels of 25 OH D in response to UV-B irradiation have been associated with decreased BP. In vitro studies 30 using a juxtaglomerular cell model have shown that 1,dihydroxyvitamin D 3 and other vitamin D analogues directly suppress renin expression via a vitamin D response element present in the renin gene. The administration of an activated vitamin D analogue has recently been shown to reduce proteinuria, suggesting a direct vascular effect of vitamin D 31 that is consistent with recent findings of 1-hydroxylase activity in vascular smooth muscle cells.

The association of low serum vitamin D levels with obesity is less likely to be a direct effect of vitamin D. It has been shown that UV light exposure and time spent outdoors are better predictors of 25 OH D levels than dietary vitamin D intake.

In addition, the lipid solubility of vitamin D also modifies its bioavailability and may contribute to the lower serum levels of vitamin D in overweight and obese participants. Vitamin D may affect CVD and its risk factors through other pathways, such as its immunosuppressive effects to reduce the proliferation of lymphocytes and the production of cytokines, 37 which have recently been identified as having an important role in atherogenesis.

Disruption of the nuclear vitamin D receptor gene, simulating vitamin D deficiency, has also been associated with increased thrombogenicity in mice. The results of this study originated from the analysis of a representative sample of the US population and are likely to have broad implications with implicit limitations.

Although NHANES III provides some of the best available estimates of the prevalence and treatment of chronic diseases in the United States, its cross-sectional design does not allow for direct causal inference. The timing of blood sample collections for NHANES participants occurred within communities at different latitudes, which may have affected the distribution of serum vitamin D levels.

The staggering of blood sample collection minimized the impact of seasonal variation due to sunlight exposure on vitamin D levels as samples were collected during the warmer months in northern areas, when sunlight is more abundant.

This study provides important information to support a reassessment of the current position on what levels of vitamin D constitute vitamin D insufficiency and necessitate vitamin D repletion. The current recommended levels of serum 25 OH D are primarily based on levels needed to maintain optimum bone health and prevent rickets but do not address the levels of vitamin D that may be necessary to minimize the prevalence of CVD risk factors.

Prospective studies are warranted to assess a direct effect of vitamin D on select CVD risk factors and to establish the optimum serum level of vitamin D.

All of the authors have made significant contributions to the conception, design, or performance of this study. Each author has reviewed the manuscript and agrees with its content and conclusions. Study concept and design: Pan, Zadshir, and Tareen. Analysis and interpretation of data: Pan, Thadhani, Felsenfeld, Mehrotra, and Norris.

Drafting of the manuscript: Martins, Pan, Zadshir, Tareen, and Norris. Critical revision of the manuscript for important intellectual content: Wolf, Pan, and Norris. Administrative, technical, and material support: Martins, Zadshir, Tareen, Felsenfeld, and Norris. Levine, Mehrotra, and Norris. Dr Thadhani has also received honoraria from Genzyme.

Dr Norris has also received honoraria from Merck and Monarch. Dr Mehrotra has received research support from Shire Pharmaceuticals, serves as a consultant for Novartis and Shire Pharmaceuticals, and has received honoraria from Baxter Health Care.

This article was presented as an abstract for poster presentation at the Research Centers for Minority Institutions 20th Anniversary Symposium;December 10, ; Baltimore, Md.

Prevalence of vitamin D insufficiency in an adult normal population. Hypovitaminosis D in medical inpatients. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Assay variation confounds the diagnosis of hypovitaminosis D: Antiproteinuric effect of oral paricalcitol in chronic kidney disease. The relationship between obesity and serum 1,dihydroxy vitamin D concentrations in healthy adults.

Disruption of nuclear vitamin D receptor gene causes enhanced thrombogenicity in mice. Active serum vitamin D levels are inversely correlated with coronary calcification. High bone turnover is an independent predictor of mortality in the frail elderly. See More About Cardiology Nutrition. Sign in to access your subscriptions Sign in to your personal account. Create a free personal account to download free article PDFs, sign up for alerts, and more. Purchase access Subscribe to the journal.

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Lynwood, California - Wikipedia

Previous studies suggesting similar associations between low serum vitamin D levels and CVD risk factors were limited to subpopulations and small study samples. The administration of 1,dihydroxyvitamin D 3 has been shown to prevent the development of type 1 diabetes mellitus in animal models. Vitamin D deficiency has been associated with congestive heart failure, 25 whereas incresed blood levels of 25 OH D in response to UV-B irradiation have been associated with decreased BP.

In vitro studies 30 using a juxtaglomerular cell model have shown that 1,dihydroxyvitamin D 3 and other vitamin D analogues directly suppress renin expression via a vitamin D response element present in the renin gene. The administration of an activated vitamin D analogue has recently been shown to reduce proteinuria, suggesting a direct vascular effect of vitamin D 31 that is consistent with recent findings of 1-hydroxylase activity in vascular smooth muscle cells.

The association of low serum vitamin D levels with obesity is less likely to be a direct effect of vitamin D. It has been shown that UV light exposure and time spent outdoors are better predictors of 25 OH D levels than dietary vitamin D intake. In addition, the lipid solubility of vitamin D also modifies its bioavailability and may contribute to the lower serum levels of vitamin D in overweight and obese participants.

Vitamin D may affect CVD and its risk factors through other pathways, such as its immunosuppressive effects to reduce the proliferation of lymphocytes and the production of cytokines, 37 which have recently been identified as having an important role in atherogenesis.

Disruption of the nuclear vitamin D receptor gene, simulating vitamin D deficiency, has also been associated with increased thrombogenicity in mice. The results of this study originated from the analysis of a representative sample of the US population and are likely to have broad implications with implicit limitations.

Although NHANES III provides some of the best available estimates of the prevalence and treatment of chronic diseases in the United States, its cross-sectional design does not allow for direct causal inference. The timing of blood sample collections for NHANES participants occurred within communities at different latitudes, which may have affected the distribution of serum vitamin D levels.

The staggering of blood sample collection minimized the impact of seasonal variation due to sunlight exposure on vitamin D levels as samples were collected during the warmer months in northern areas, when sunlight is more abundant.

This study provides important information to support a reassessment of the current position on what levels of vitamin D constitute vitamin D insufficiency and necessitate vitamin D repletion. The current recommended levels of serum 25 OH D are primarily based on levels needed to maintain optimum bone health and prevent rickets but do not address the levels of vitamin D that may be necessary to minimize the prevalence of CVD risk factors. Prospective studies are warranted to assess a direct effect of vitamin D on select CVD risk factors and to establish the optimum serum level of vitamin D.

All of the authors have made significant contributions to the conception, design, or performance of this study. Each author has reviewed the manuscript and agrees with its content and conclusions.

Study concept and design: Pan, Zadshir, and Tareen. Analysis and interpretation of data: Pan, Thadhani, Felsenfeld, Mehrotra, and Norris. Drafting of the manuscript: Martins, Pan, Zadshir, Tareen, and Norris.

Critical revision of the manuscript for important intellectual content: Wolf, Pan, and Norris. Administrative, technical, and material support: Martins, Zadshir, Tareen, Felsenfeld, and Norris.

Levine, Mehrotra, and Norris. Dr Thadhani has also received honoraria from Genzyme. Dr Norris has also received honoraria from Merck and Monarch. Dr Mehrotra has received research support from Shire Pharmaceuticals, serves as a consultant for Novartis and Shire Pharmaceuticals, and has received honoraria from Baxter Health Care. This article was presented as an abstract for poster presentation at the Research Centers for Minority Institutions 20th Anniversary Symposium;December 10, ; Baltimore, Md.

Prevalence of vitamin D insufficiency in an adult normal population. Hypovitaminosis D in medical inpatients. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Assay variation confounds the diagnosis of hypovitaminosis D: Antiproteinuric effect of oral paricalcitol in chronic kidney disease. The relationship between obesity and serum 1,dihydroxy vitamin D concentrations in healthy adults.

Disruption of nuclear vitamin D receptor gene causes enhanced thrombogenicity in mice. Active serum vitamin D levels are inversely correlated with coronary calcification.

High bone turnover is an independent predictor of mortality in the frail elderly. See More About Cardiology Nutrition. Sign in to access your subscriptions Sign in to your personal account. Create a free personal account to download free article PDFs, sign up for alerts, and more. Purchase access Subscribe to the journal. The population density is 5, There are 14, housing units at an average density of 1, The racial makeup of the city is There are 14, households out of which The average household size is 4.

In the city, the population is spread out with The median age is 24 years. For every females, there are For every females age 18 and over, there are Out of the total people living in poverty, As of , speakers of Spanish as their first language accounted for Lynwood went through five phases of demographic change in the 20th century. First, a colonial settlement.

Second, a farming small town. Third, a mostly working-class white suburb from to Fourth, a majority African-American city between and , and today, a predominantly Latino.

Boulevard, both in Lynwood, as a part of Battalion On March 20, , former mayor Paul H. Richards had served on the City Council from until he was recalled by voters in ; during that time he served seven terms as mayor. The City of Lynwood operates three parks: From Wikipedia, the free encyclopedia.

City in California, United States of America. This section needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. November Learn how and when to remove this template message. Los Angeles portal Greater Los Angeles portal.

Archived from the original Word on June 28, Retrieved August 25, United States Census Bureau. Retrieved Jun 28, Geographic Names Information System. United States Geological Survey. Retrieved February 8, Archived from the original on March 22, Retrieved March 19, Retrieved June 9, Retrieved June 4, CA - Lynwood city". Retrieved July 12, Archived from the original on

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