To investigate, the researchers measured 6-minute walk distance and frailty phenotype in 60 patients with an ejection fraction of 40% or less. Of the 60 patients, 43 were men (mean age 77 years) and 17 were women (mean age 78 years). The mean ejection fraction was 29%.
A correlation was observed between a longer 6-minute walk distance and higher vitamin D level, lower cortisol:DHEAS ratio, and lower hsCRP and IL-6 levels. No correlation was found with percentage of free testosterone or DHEAS.
A higher frailty phenotype score (greater frailty) correlated with higher hsCRP and IL-6 levels and lower vitamin D level.
On further analysis, age, sex, vitamin D, and hsCRP were each independently associated with 6-minute walk distance, and age, vitamin D, and hsCRP were predictive of frailty status.
The authors note that interventions geared toward raising vitamin D and lowering CRP levels in heart failure patients are possible, but "it remains unclear whether vitamin D therapy has a role in the management of elderly patients with HF." If it is shown that "vitamin D therapy improves physical performance and modulates the inflammatory response, this could become an attractive therapy for patients with HF."
J Am Geriatr Soc 2008;56:454-461
The synthesis of Vitamin D, know also as calcitrol.Researchers in this field are sufficiently concerned from the results of their studies to pronounce that we are in the midst of an epidemic of vitamin D deficiency of immense proportion. Study after study of nursing home populations, of nursing mothers, of healthy male and female volunteers and of various children’s groups have consistently documented how relatively rare it is to have optimal levels of Vitamin D.
Some authorities support more liberal dietary supplementation of Vitamin D in our foodstuff. Others are urging that practical new approaches for vitamin D repletion in our country are urgently needed. This high prevalence of vitamin D deficiency, even in those taking multivitamins, indicates that a critical review of vitamin D needs is a major priority.
A vitamin D precursor is synthesized in the skin from cholesterol in response to absorbing UVB rays. It then gets converted in the liver to an intermediate form. In the kidneys it joins with an important enzyme for conversion into its active hormonal form.
Many factors potentially interfere with the UVB conversion. People having darker skins are much more likely to have vitamin D deficiency. The aged skin of the elderly impairs cholesterol conversion as does the presence of obesity Use of statins lowers vitamin-D. Our present day emphasis on protecting our skin from the sun, using sun-screens and blockers, also cuts down on the ability of UVB to convert cholesterol to vitamin D. Last but not least, one needs UVB exposure.
Without any sun exposure you need about 4,000 units of vitamin D a day. In the absence of other supplements you would need 40 glasses of milk or ten multi-vitamins capsules daily to supply your vitamin D needs. Most of us make about 20,000 units of vitamin D after 20 minutes of summer sun due to UVB conversion of cholesterol. Numerous studies document that the majority of our society falls short of meeting either their dietary of UVB conversion needs for vitamin D.Duane Graveline
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