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Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D : Vitamin D assays and defining hypovitaminosis D

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      Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline.

      The objective was to provide guidelines to clinicians for the evaluation, treatment, and prevention of vitamin D deficiency with an emphasis on the care of patients who are at risk for deficiency. The Task Force was composed of a Chair, six additional experts, and a methodologist. The Task Force received no corporate funding or remuneration. Consensus was guided by systematic reviews of evidence and discussions during several conference calls and e-mail communications. The draft prepared by the Task Force was reviewed successively by The Endocrine Society's Clinical Guidelines Subcommittee, Clinical Affairs Core Committee, and cosponsoring associations, and it was posted on The Endocrine Society web site for member review. At each stage of review, the Task Force received written comments and incorporated needed changes. Considering that vitamin D deficiency is very common in all age groups and that few foods contain vitamin D, the Task Force recommended supplementation at suggested daily intake and tolerable upper limit levels, depending on age and clinical circumstances. The Task Force also suggested the measurement of serum 25-hydroxyvitamin D level by a reliable assay as the initial diagnostic test in patients at risk for deficiency. Treatment with either vitamin D(2) or vitamin D(3) was recommended for deficient patients. At the present time, there is not sufficient evidence to recommend screening individuals who are not at risk for deficiency or to prescribe vitamin D to attain the noncalcemic benefit for cardiovascular protection.
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        The IUPHAR/BPS Guide to PHARMACOLOGY in 2018: updates and expansion to encompass the new guide to IMMUNOPHARMACOLOGY

        Abstract The IUPHAR/BPS Guide to PHARMACOLOGY (GtoPdb, www.guidetopharmacology.org) and its precursor IUPHAR-DB, have captured expert-curated interactions between targets and ligands from selected papers in pharmacology and drug discovery since 2003. This resource continues to be developed in conjunction with the International Union of Basic and Clinical Pharmacology (IUPHAR) and the British Pharmacological Society (BPS). As previously described, our unique model of content selection and quality control is based on 96 target-class subcommittees comprising 512 scientists collaborating with in-house curators. This update describes content expansion, new features and interoperability improvements introduced in the 10 releases since August 2015. Our relationship matrix now describes ∼9000 ligands, ∼15 000 binding constants, ∼6000 papers and ∼1700 human proteins. As an important addition, we also introduce our newly funded project for the Guide to IMMUNOPHARMACOLOGY (GtoImmuPdb, www.guidetoimmunopharmacology.org). This has been ‘forked’ from the well-established GtoPdb data model and expanded into new types of data related to the immune system and inflammatory processes. This includes new ligands, targets, pathways, cell types and diseases for which we are recruiting new IUPHAR expert committees. Designed as an immunopharmacological gateway, it also has an emphasis on potential therapeutic interventions.
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          Demographic differences and trends of vitamin D insufficiency in the US population, 1988-2004.

          Vitamin D insufficiency is associated with suboptimal health. The prevalence of vitamin D insufficiency may be rising, but population-based trends are uncertain. We sought to evaluate US population trends in vitamin D insufficiency. We compared serum 25-hydroxyvitamin D (25[OH]D) levels from the Third National Health and Nutrition Examination Survey (NHANES III), collected during 1988 through 1994, with NHANES data collected from 2001 through 2004 (NHANES 2001-2004). Complete data were available for 18 883 participants in NHANES III and 13 369 participants in NHANES 2001-2004. The mean serum 25(OH)D level was 30 (95% confidence interval [CI], 29-30) ng/mL during NHANES III and decreased to 24 (23-25) ng/mL during NHANES 2001-2004. Accordingly, the prevalence of 25(OH)D levels of less than 10 ng/mL increased from 2% (95% CI, 2%-2%) to 6% (5%-8%), and 25(OH)D levels of 30 ng/mL or more decreased from 45% (43%-47%) to 23% (20%-26%). The prevalence of 25(OH)D levels of less than 10 ng/mL in non-Hispanic blacks rose from 9% during NHANES III to 29% during NHANES 2001-2004, with a corresponding decrease in the prevalence of levels of 30 ng/mL or more from 12% to 3%. Differences by age strata (mean serum 25[OH]D levels ranging from 28-32 ng/mL) and sex (28 ng/mL for women and 32 ng/mL for men) during NHANES III equalized during NHANES 2001-2004 (24 vs 24 ng/mL for age and 24 vs 24 ng/mL for sex). National data demonstrate a marked decrease in serum 25(OH)D levels from the 1988-1994 to the 2001-2004 NHANES data collections. Racial/ethnic differences have persisted and may have important implications for known health disparities. Current recommendations for vitamin D supplementation are inadequate to address the growing epidemic of vitamin D insufficiency.
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            Author and article information

            Affiliations
            [1 ]Vitamin D Standardization Program; Havre de Grace MD USA
            [2 ]Endocrine Laboratory, Department of Clinical Chemistry; VU University Medical Center; Amsterdam The Netherlands
            [3 ]Laboratory of Endocrinology; Academic Medical Center; Amsterdam The Netherlands
            [4 ]San Francisco, San Francisco Department of Veterans Affairs Medical Center, Endocrine Research Unit; University of California; San Francisco CA USA
            [5 ]Section of Specialized Endocrinology, Department of Endocrinology; Oslo University Hospital, Rikshospitalet; Oslo Norway
            [6 ]Faculty of Medicine; University of Oslo; Oslo Norway
            [7 ]Department of Chronic Diseases, Metabolism and Ageing; Laboratory of Clinical and Experimental Endocrinology; KU Leuven Belgium
            [8 ]Division of Nutritional Sciences; Cornell University; Ithaca NY USA
            [9 ]Department of Biochemistry; University of Wisconsin-Madison; Madison WI USA
            [10 ]Department of Biomedical and Molecular Sciences; Queen's University; Kingston ON Canada
            [11 ]Institute of Endocrinology and Diabetes; The Children's Hospital at Westmead; Sydney NSW Australia
            [12 ]Department of Medicine, Endocrinology Division, College of Physicians and Surgeons; Columbia University; New York NY USA
            [13 ]Division of Endocrinology; San Raffaele University Hospital; Milan Italy
            [14 ]Osteoporosis Clinical Research Program and Institute on Aging; University of Wisconsin-Madison; Madison WI USA
            Journal
            British Journal of Clinical Pharmacology
            Br J Clin Pharmacol
            Wiley
            03065251
            October 2018
            October 2018
            July 17 2018
            : 84
            : 10
            : 2194-2207
            10.1111/bcp.13652
            © 2018

            http://doi.wiley.com/10.1002/tdm_license_1.1

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