human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Vitamin D deficiency is widely prevalent and has been associated with many diseases . It has been suggested that vitamin D has effects on the immune system and inhibits inflammation . The aim of our study was to investigate whether vitamin D has an inhibitory effect on systemic inflammation by assessing the association between serum levels of vitamin D and C-reactive protein . We studied the association between serum 25-hydroxyvitamin D and C-reactive protein through linear regression in 9,649 participants of the Rotterdam Study , an observational , prospect i ve population -based cohort study . We used genetic variants related to vitamin D and CRP to compute a genetic risk score and perform bi-directional Mendelian r and omization analysis . In linear regression adjusted for age , sex , cohort and other confounders , natural log-transformed CRP decreased with 0.06 ( 95 % CI : -0.08 , -0.03 ) unit per st and ard deviation increase in 25-hydroxyvitamin D. Bi-directional Mendelian r and omization analyses showed no association between the vitamin D genetic risk score and lnCRP ( Beta per SD = -0.018 ; p = 0.082 ) or the CRP genetic risk score and 25-hydroxyvitamin D ( Beta per SD = 0.001 ; p = 0.998 ) . In conclusion , higher levels of Vitamin D are associated with lower levels of C-reactive protein . In this study we did not find evidence for this to be the result of a causal relationship OBJECTIVE —Accumulating epidemiological evidence suggests that hypovitaminosis D may be associated with type 2 diabetes and related metabolic risks . However , prospect i ve data using the biomarker serum 25-hydroxyvitamin D [ 25(OH)D ] are limited and therefore examined in the present study . RESEARCH DESIGN AND METHODS —A total of 524 r and omly selected nondiabetic men and women , aged 40–69 years at baseline , with measurements for serum 25(OH)D and IGF-1 in the population -based Ely Study , had glycemic status ( oral glucose tolerance ) , lipids , insulin , anthropometry , and blood pressure measured and metabolic syndrome risk ( metabolic syndrome z score ) derived at baseline and at 10 years of follow-up . RESULTS —Age-adjusted baseline mean serum 25(OH)D was greater in men ( 64.5 nmol/l [ 95 % CI 61.2–67.9 ] ) than women ( 57.2 nmol/l [ 54.4,60.0 ] ) and varied with season ( highest late summer ) . Baseline 25(OH)D was associated inversely with 10-year risk of hyperglycemia ( fasting glucose : β = −0.0023 , P = 0.019 ; 2-h glucose : β = −0.0097 , P = 0.006 ) , insulin resistance ( fasting insulin β = −0.1467 , P = 0.010 ; homeostasis model assessment of insulin resistance [ HOMA-IR ] : β = −0.0059 , P = 0.005 ) , and metabolic syndrome z score ( β = −0.0016 , P = 0.048 ) after adjustment for age , sex , smoking , BMI , season , and baseline value of each metabolic outcome variable . Associations with 2-h glucose , insulin , and HOMA-IR remained significant after further adjustment for IGF-1 , parathyroid hormone , calcium , physical activity , and social class . CONCLUSIONS —This prospect i ve study reports inverse associations between baseline serum 25(OH)D and future glycemia and insulin resistance . These associations are potentially important in underst and ing the etiology of abnormal glucose metabolism and warrant investigation in larger , specifically design ed prospect i ve studies and r and omized controlled trials of supplementation Background & objectives : Patients with diabetes and vitamin-D insufficiency have increased insulin resistance . Similar observations among individuals with prediabetes are not well documented . The aim of this study was to find the occurrence of vitamin-D insufficiency/deficiency among individuals with prediabetes and to evaluate the relationship between vitamin-D status and insulin resistance . Methods : One hundred fifty seven individuals with prediabetes who fulfilled all the inclusion and exclusion criteria underwent clinical examination , anthropometric measurements ( waist circumference , waist-hip ratio , waist-height ratio ) and blood sampling after overnight fast for estimation of fasting blood glucose , fasting insulin , 25(OH)vitamin-D , intact parathyroid hormone ( iPTH ) and lipid profile . One hour post 75 g glucose ( 1hPG ) blood glucose during oral glucose tolerance test was measured . Results : Vitamin-D deficiency/insufficiency was found in 115 ( 73.25 % ) individuals with prediabetes .  Severe vitamin-D deficiency ( < 10 ng/ml ) was seen in 14.65 per cent individuals . Individuals with the lowest vitamin-D levels ( < 10 ng/ml ) had the highest insulin resistance ( HOMA2-IR : 2.04 ± 0.67 ) . Serum 25(OH)D had a statistically significant inverse correlation with insulin resistance ( HOMA2-IR ; r=-0.33 ; P=0.008 ) , and positive correlation with insulin sensitivity ( QUICKI ; r=0.39 ; P=0.002 ) , after adjusting for BMI and HbA1c . There was no correlation between vitamin-D status and estimated beta cell mass ( HOMA-β ) . The mean waist-height ratio among individuals with prediabetes was 0.57 ( normal<0.5 ) indicating a high risk of cardiovascular morbidity . Individuals with elevated 1hPG>155 mg/dl had significantly higher BMI and worse insulin resistance , and 1hPG correlated well with 2 hour post glucose blood glucose ( r=0.57 ; P<0.001 ) . Interpretations & conclusions : Vitamin-D deficiency/insufficiency may have some role in the development/worsening of insulin resistance in individuals with prediabetes in our country who have a high cardiovascular risk . Prospect i ve studies on a large group of individuals need to be done to confirm the findings Background and Aims . Despite growing interest in the protective role that vitamin D may have in health outcomes , little research has examined the mechanisms underlying this role . This study aim ed to test two hypotheses : ( 1 ) serum 25-hydroxyvitamin D [ 25(OH)D ] is inversely associated with type 2 diabetes mellitus ( T2DM ) and elevated hemoglobin A1c ; ( 2 ) these associations are mediated by serum C-reactive protein ( CRP ) . Methods . Participants aged 20 and older in 2001–2006 National Health and Nutrition Examination Surveys ( n = 8,655 ) with measures of serum 25(OH)D , CRP , hemoglobin A1c , and other important covariates were included in the present study . Logistic regression and path analysis methods were applied to test the study hypotheses . Results . Decreased serum 25(OH)D concentration was significantly associated with increased odds of T2DM .  In males , an estimated 14.9 % of the association between 25(OH)D and hemoglobin A1c was mediated by serum CRP . However , this mediation effect was not observed in females . Conclusion . Using a nationally representative sample , the present study extends previous research and provides new evidence that the effect of  decreased serum vitamin D concentration on T2DM may proceed through increased systemic inflammation in males . Longitudinal studies and r and omized control trials are needed to confirm the present findings OBJECTIVE To study daily intake of calcium , phosphorus and vitamin D , to determine the biochemical findings of rickets and the effect of sunlight exposure and vitamin D supplementation in school girls with hypovitaminosis D. METHODS A cross-sectional study was conducted on school girls aged 11 - 15 years selected r and omly from various areas of Tehran , Iran .  Dietary information and amount of sunlight exposure were estimated by a 7 day recalling method using self-reported question naire . Hypovitaminosis D defined as low serum 25-hydroxyvitamin D concentration with two or more others abnormal biochemical findings . Girls with hypovitaminoses D were r and omly divided into two groups . The faces and h and s of girls in group 1 were exposed to sunlight for one hour per day for twenty days , while those in group 2 were administered vitamin D capsules , 50,000 IU per day for the same period . RESULTS four-hundred fourteen girls evaluated , mean daily calcium intake , sunlight exposure and vitamin D acquirement were 360 mg , 10 minutes and 119 IU , respectively . Mean serum 25-hydroxyvitamin D concentration was 30 ng/ml among all girls whereas in 15 ( 3.63 % ) of 414 girls was 7.8 ng/ml . Abnormal biochemical findings in these girls included hypocalcemia ( n=4 ) , hypophosphatemia ( n=5 ) , raised serum alkaline phosphatase ( n=13 ) , and parathyroid hormone ( n=15 ) . After intervention , mean serum 25-hydroxyvitamin D concentration  in sunlight exposure ( n=8 ) and vitamin D ( n=7 ) supplementation increased to 14.4+/-4 ng/ml and 23+/-4 ng/ml respectively . There was a significant difference between the two groups ( p<0.05 ) . CONCLUSION Vitamin D deficiency developed in rapid growth period of girls without clear clinical rickets in sunny temperate climate city in Iran which vitamin D supplementation improved biochemical findings better than sunlight exposure OBJECTIVE To examine cross-sectional relationships between plasma vitamin D and cardiometabolic risk factors in young adults . DESIGN Data were collected from interviews , physical examinations and biomarker measurements . Total plasma 25-hydroxyvitamin D ( 25(OH)D ) was measured using LC-t and em MS . Associations between 25(OH)D and cardiometabolic risk factors were modelled using weighted linear regression with robust estimates of st and ard errors . SETTING Individuals born in Jerusalem during 1974 - 1976 . SUBJECTS Participants of the Jerusalem Perinatal Study ( n 1204 ) interviewed and examined at age 32 years . Participants were over sample d for low and high birth weight and for maternal pre-pregnancy obesity .  RESULTS Mean total 25(OH)D concentration among participants was 21·7 ( sd 8·9 ) ng/ml . Among males , 25(OH)D was associated with homeostatic model assessment of insulin resistance ( natural log-transformed , β=-0·011 , P=0·004 ) after adjustment for BMI . However , these associations were not present among females ( P for sex interaction=0·005 ) . CONCLUSIONS We found evidence for inverse associations of 25(OH)D with markers of insulin resistance among males , but not females , in a healthy , young adult Caucasian population . Prospect i ve studies and studies conducted on other population s investigating sex-specific effects of vitamin D on cardiometabolic risk factors are warranted PURPOSE We examined the cross-sectional associations among cardiorespiratory fitness ( CRF ) , different measures of adiposity , and serum vitamin D levels in women . METHODS Between 2007 and 2010 , 1320 women completed a health examination . Measures included body mass index ( BMI ) , waist circumference ( WC ) , waist/hip ratio , percent body fat , CRF based on a maximal treadmill exercise test , and measurement of serum vitamin D.  Participants were classified by CRF as unfit ( lowest 20 % ) and fit ( remaining 80 % ) based on age , as well as by clinical cutoff points for adiposity measures , and by categories of serum vitamin D. We examined trends of CRF and adiposity exposures across serum vitamin D categories . We calculated odds ratios ( OR ) of serum vitamin D insufficiency or deficiency across levels of adiposity exposures before and after adjustment for CRF . RESULTS We observed a significant positive trend for CRF across incremental serum vitamin D categories ( p<0.001 ) . When compared to ORs for normal weight women , ORs for serum vitamin D insufficiency or deficiency were significantly higher for overweight women within each adiposity exposure ( p<0.05 ) . When grouped into categories of fit and unfit ( upper 80 % and lower 20 % of CRF distribution , respectively ) ,  serum vitamin D  was significantly lower in unfit than in fit women within each stratum of WC and waist/hip ratio and within the normal weight BMI stratum . CONCLUSIONS Serum vitamin D levels are positively associated with CRF and negatively associated with different measures of adiposity in women . Higher CRF attenuates the relationship between adiposity level and serum vitamin D. Future prospect i ve studies are warranted Summary The various factors that may contribute to vitamin D deficiency or insufficiency were examined among healthy Saudi pre- and postmenopausal women .  Vitamin D 
    Output:
    
agent
In conclusion , the deficiency of vitamin D is associated with an increased level of BMI in the studies of both diabetic and non-diabetic subjects .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Vitamin D deficiency is widely prevalent and has been associated with many diseases . It has been suggested that vitamin D has effects on the immune system and inhibits inflammation . The aim of our study was to investigate whether vitamin D has an inhibitory effect on systemic inflammation by assessing the association between serum levels of vitamin D and C-reactive protein . We studied the association between serum 25-hydroxyvitamin D and C-reactive protein through linear regression in 9,649 participants of the Rotterdam Study , an observational , prospect i ve population -based cohort study . We used genetic variants related to vitamin D and CRP to compute a genetic risk score and perform bi-directional Mendelian r and omization analysis . In linear regression adjusted for age , sex , cohort and other confounders , natural log-transformed CRP decreased with 0.06 ( 95 % CI : -0.08 , -0.03 ) unit per st and ard deviation increase in 25-hydroxyvitamin D. Bi-directional Mendelian r and omization analyses showed no association between the vitamin D genetic risk score and lnCRP ( Beta per SD = -0.018 ; p = 0.082 ) or the CRP genetic risk score and 25-hydroxyvitamin D ( Beta per SD = 0.001 ; p = 0.998 ) . In conclusion , higher levels of Vitamin D are associated with lower levels of C-reactive protein . In this study we did not find evidence for this to be the result of a causal relationship OBJECTIVE —Accumulating epidemiological evidence suggests that hypovitaminosis D may be associated with type 2 diabetes and related metabolic risks . However , prospect i ve data using the biomarker serum 25-hydroxyvitamin D [ 25(OH)D ] are limited and therefore examined in the present study . RESEARCH DESIGN AND METHODS —A total of 524 r and omly selected nondiabetic men and women , aged 40–69 years at baseline , with measurements for serum 25(OH)D and IGF-1 in the population -based Ely Study , had glycemic status ( oral glucose tolerance ) , lipids , insulin , anthropometry , and blood pressure measured and metabolic syndrome risk ( metabolic syndrome z score ) derived at baseline and at 10 years of follow-up . RESULTS —Age-adjusted baseline mean serum 25(OH)D was greater in men ( 64.5 nmol/l [ 95 % CI 61.2–67.9 ] ) than women ( 57.2 nmol/l [ 54.4,60.0 ] ) and varied with season ( highest late summer ) . Baseline 25(OH)D was associated inversely with 10-year risk of hyperglycemia ( fasting glucose : β = −0.0023 , P = 0.019 ; 2-h glucose : β = −0.0097 , P = 0.006 ) , insulin resistance ( fasting insulin β = −0.1467 , P = 0.010 ; homeostasis model assessment of insulin resistance [ HOMA-IR ] : β = −0.0059 , P = 0.005 ) , and metabolic syndrome z score ( β = −0.0016 , P = 0.048 ) after adjustment for age , sex , smoking , BMI , season , and baseline value of each metabolic outcome variable . Associations with 2-h glucose , insulin , and HOMA-IR remained significant after further adjustment for IGF-1 , parathyroid hormone , calcium , physical activity , and social class . CONCLUSIONS —This prospect i ve study reports inverse associations between baseline serum 25(OH)D and future glycemia and insulin resistance . These associations are potentially important in underst and ing the etiology of abnormal glucose metabolism and warrant investigation in larger , specifically design ed prospect i ve studies and r and omized controlled trials of supplementation Background & objectives : Patients with diabetes and vitamin-D insufficiency have increased insulin resistance . Similar observations among individuals with prediabetes are not well documented . The aim of this study was to find the occurrence of vitamin-D insufficiency/deficiency among individuals with prediabetes and to evaluate the relationship between vitamin-D status and insulin resistance . Methods : One hundred fifty seven individuals with prediabetes who fulfilled all the inclusion and exclusion criteria underwent clinical examination , anthropometric measurements ( waist circumference , waist-hip ratio , waist-height ratio ) and blood sampling after overnight fast for estimation of fasting blood glucose , fasting insulin , 25(OH)vitamin-D , intact parathyroid hormone ( iPTH ) and lipid profile . One hour post 75 g glucose ( 1hPG ) blood glucose during oral glucose tolerance test was measured . Results : Vitamin-D deficiency/insufficiency was found in 115 ( 73.25 % ) individuals with prediabetes .  Severe vitamin-D deficiency ( < 10 ng/ml ) was seen in 14.65 per cent individuals . Individuals with the lowest vitamin-D levels ( < 10 ng/ml ) had the highest insulin resistance ( HOMA2-IR : 2.04 ± 0.67 ) . Serum 25(OH)D had a statistically significant inverse correlation with insulin resistance ( HOMA2-IR ; r=-0.33 ; P=0.008 ) , and positive correlation with insulin sensitivity ( QUICKI ; r=0.39 ; P=0.002 ) , after adjusting for BMI and HbA1c . There was no correlation between vitamin-D status and estimated beta cell mass ( HOMA-β ) . The mean waist-height ratio among individuals with prediabetes was 0.57 ( normal<0.5 ) indicating a high risk of cardiovascular morbidity . Individuals with elevated 1hPG>155 mg/dl had significantly higher BMI and worse insulin resistance , and 1hPG correlated well with 2 hour post glucose blood glucose ( r=0.57 ; P<0.001 ) . Interpretations & conclusions : Vitamin-D deficiency/insufficiency may have some role in the development/worsening of insulin resistance in individuals with prediabetes in our country who have a high cardiovascular risk . Prospect i ve studies on a large group of individuals need to be done to confirm the findings Background and Aims . Despite growing interest in the protective role that vitamin D may have in health outcomes , little research has examined the mechanisms underlying this role . This study aim ed to test two hypotheses : ( 1 ) serum 25-hydroxyvitamin D [ 25(OH)D ] is inversely associated with type 2 diabetes mellitus ( T2DM ) and elevated hemoglobin A1c ; ( 2 ) these associations are mediated by serum C-reactive protein ( CRP ) . Methods . Participants aged 20 and older in 2001–2006 National Health and Nutrition Examination Surveys ( n = 8,655 ) with measures of serum 25(OH)D , CRP , hemoglobin A1c , and other important covariates were included in the present study . Logistic regression and path analysis methods were applied to test the study hypotheses . Results . Decreased serum 25(OH)D concentration was significantly associated with increased odds of T2DM .  In males , an estimated 14.9 % of the association between 25(OH)D and hemoglobin A1c was mediated by serum CRP . However , this mediation effect was not observed in females . Conclusion . Using a nationally representative sample , the present study extends previous research and provides new evidence that the effect of  decreased serum vitamin D concentration on T2DM may proceed through increased systemic inflammation in males . Longitudinal studies and r and omized control trials are needed to confirm the present findings OBJECTIVE To study daily intake of calcium , phosphorus and vitamin D , to determine the biochemical findings of rickets and the effect of sunlight exposure and vitamin D supplementation in school girls with hypovitaminosis D. METHODS A cross-sectional study was conducted on school girls aged 11 - 15 years selected r and omly from various areas of Tehran , Iran .  Dietary information and amount of sunlight exposure were estimated by a 7 day recalling method using self-reported question naire . Hypovitaminosis D defined as low serum 25-hydroxyvitamin D concentration with two or more others abnormal biochemical findings . Girls with hypovitaminoses D were r and omly divided into two groups . The faces and h and s of girls in group 1 were exposed to sunlight for one hour per day for twenty days , while those in group 2 were administered vitamin D capsules , 50,000 IU per day for the same period . RESULTS four-hundred fourteen girls evaluated , mean daily calcium intake , sunlight exposure and vitamin D acquirement were 360 mg , 10 minutes and 119 IU , respectively . Mean serum 25-hydroxyvitamin D concentration was 30 ng/ml among all girls whereas in 15 ( 3.63 % ) of 414 girls was 7.8 ng/ml . Abnormal biochemical findings in these girls included hypocalcemia ( n=4 ) , hypophosphatemia ( n=5 ) , raised serum alkaline phosphatase ( n=13 ) , and parathyroid hormone ( n=15 ) . After intervention , mean serum 25-hydroxyvitamin D concentration  in sunlight exposure ( n=8 ) and vitamin D ( n=7 ) supplementation increased to 14.4+/-4 ng/ml and 23+/-4 ng/ml respectively . There was a significant difference between the two groups ( p<0.05 ) . CONCLUSION Vitamin D deficiency developed in rapid growth period of girls without clear clinical rickets in sunny temperate climate city in Iran which vitamin D supplementation improved biochemical findings better than sunlight exposure OBJECTIVE To examine cross-sectional relationships between plasma vitamin D and cardiometabolic risk factors in young adults . DESIGN Data were collected from interviews , physical examinations and biomarker measurements . Total plasma 25-hydroxyvitamin D ( 25(OH)D ) was measured using LC-t and em MS . Associations between 25(OH)D and cardiometabolic risk factors were modelled using weighted linear regression with robust estimates of st and ard errors . SETTING Individuals born in Jerusalem during 1974 - 1976 . SUBJECTS Participants of the Jerusalem Perinatal Study ( n 1204 ) interviewed and examined at age 32 years . Participants were over sample d for low and high birth weight and for maternal pre-pregnancy obesity .  RESULTS Mean total 25(OH)D concentration among participants was 21·7 ( sd 8·9 ) ng/ml . Among males , 25(OH)D was associated with homeostatic model assessment of insulin resistance ( natural log-transformed , β=-0·011 , P=0·004 ) after adjustment for BMI . However , these associations were not present among females ( P for sex interaction=0·005 ) . CONCLUSIONS We found evidence for inverse associations of 25(OH)D with markers of insulin resistance among males , but not females , in a healthy , young adult Caucasian population . Prospect i ve studies and studies conducted on other population s investigating sex-specific effects of vitamin D on cardiometabolic risk factors are warranted PURPOSE We examined the cross-sectional associations among cardiorespiratory fitness ( CRF ) , different measures of adiposity , and serum vitamin D levels in women . METHODS Between 2007 and 2010 , 1320 women completed a health examination . Measures included body mass index ( BMI ) , waist circumference ( WC ) , waist/hip ratio , percent body fat , CRF based on a maximal treadmill exercise test , and measurement of serum vitamin D.  Participants were classified by CRF as unfit ( lowest 20 % ) and fit ( remaining 80 % ) based on age , as well as by clinical cutoff points for adiposity measures , and by categories of serum vitamin D. We examined trends of CRF and adiposity exposures across serum vitamin D categories . We calculated odds ratios ( OR ) of serum vitamin D insufficiency or deficiency across levels of adiposity exposures before and after adjustment for CRF . RESULTS We observed a significant positive trend for CRF across incremental serum vitamin D categories ( p<0.001 ) . When compared to ORs for normal weight women , ORs for serum vitamin D insufficiency or deficiency were significantly higher for overweight women within each adiposity exposure ( p<0.05 ) . When grouped into categories of fit and unfit ( upper 80 % and lower 20 % of CRF distribution , respectively ) ,  serum vitamin D  was significantly lower in unfit than in fit women within each stratum of WC and waist/hip ratio and within the normal weight BMI stratum . CONCLUSIONS Serum vitamin D levels are positively associated with CRF and negatively associated with different measures of adiposity in women . Higher CRF attenuates the relationship between adiposity level and serum vitamin D. Future prospect i ve studies are warranted Summary The various factors that may contribute to vitamin D deficiency or insufficiency were examined among healthy Saudi pre- and postmenopausal women .  Vitamin D 
    Output:
    