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Objectives: To determine the effect of vitamin D supplementation and maintaining sufficient serum vitamin D on depressive symptoms in patients with knee osteoarthritis (OA) and vitamin D deficiency., Design: A prespecified secondary analysis of a multicentre, randomized, double-blind, placebo-controlled trial. Participants were randomly assigned to receive oral vitamin D 3 (50,000 IU, n = 209) or placebo (n = 204) monthly for 24 months. In addition, participants who completed the trial were classified into 2 groups according to their serum 25(OH)D levels at month 3 and 24 as follows: not consistently sufficient (serum 25(OH)D ≤ 50 nmol/L at month 3 and/or 24), and consistently sufficient (serum 25(OH)D > 50 nmol/L at both month 3 and 24). Multilevel mixed-effect models were used to compare differences of change in PHQ-9 scores between groups., Setting and Participants: This clinical trial was conducted in participants with symptomatic knee OA and vitamin D deficiency from June 2010 to December 2013 in Tasmania and Victoria, Australia., Measures: The primary outcome was the depressive symptoms change over 24 months, which was measured using the Patient Health Questionnaire (PHQ-9, 0-27)., Results: Of 599 participants who were screened for eligibility, 413 participants were enrolled (mean age: 63.2 years; 50.3% female) and 340 participants (intervention n = 181, placebo n = 159, 82.3% retention rate) completed the study. The baseline prevalence of depression (PHQ-9 score ≥5) was 25.4%. Depressive symptoms improved more in the vitamin D supplementation group compared to the placebo group [β: -0.66, 95% confidence interval (CI): -1.22 to -0.11, P for difference = .02] and in the participants who maintained vitamin D sufficiency compared to those who did not (β: -0.73, 95% CI: -1.41 to -0.05, P for difference = .04) over 24 months., Conclusions/implications: These findings suggest that vitamin D supplementation and maintaining adequate vitamin D levels over 24 months may be beneficial for depressive symptoms in patients with knee OA., (Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Summary: Sunlight deprivation results in vitamin D deficiency but serum vitamin D levels can be maintained above 50nmol/L when supplemented with 50,000IU at least every alternate month. Introduction: Antarctic expeditioners are exposed to prolonged sunlight deprivation resulting in vitamin D deficiency. We hypothesised that monthly dosing of 50,000 IU vitamin D (~1,600 IU daily) will increase serum 25-hydroxyvitamin D (25(OH)D), suppress parathyroid hormone (PTH) and improve bone mineral density (BMD), 50,000 IU alternate months (~800 IU daily) will maintain these measures, while a single 50,000 IU dose pre-departure (~1,00 IU daily) will not be protective. Methods: This was a randomised double-blind study involving 110 healthy adults: 91 males, mean age 41 years (range 24-65 years) working in Antarctica for up to 12 months, who we administered 50,000 IU vitamin D3 monthly, alternate months or a single dose pre-departure. Serum 25(OH)D, PTH, osteocalcin, CTx and calcium were assessed at baseline, mid- and end of expedition. Proximal femur and lumbar spine BMD were assessed pre- and post-expedition. Results: Baseline 25(OH)D was 59 ± 14 nmol/L. By mid-expedition, 25(OH)D increased by 7 nmol/L in those supplemented monthly ( p < 0.05) and remained unchanged in those supplemented in alternate months. In those given a single dose pre-departure, 25(OH)D decreased by 8 nmol/L ( p < 0.05) and PTH increased by 27% ( p < 0.09). Serum osteocalcin increased by ~22% in all groups but BMD remained unchanged. If serum 25(OH)D was >50 nmol/L at baseline, 25(OH)D was maintained above this level with all regimens. If 25(OH)D was <50 nmol/L at baseline, monthly or alternate month regimens were needed to achieve levels >50 nmol/L, the single pre-departure dose was ineffective. Conclusion: During sunlight deprivation of up to 12 months, serum 25(OH)D levels can be maintained above 50 nmol/L when expeditioners are provided with 50,000 I U at least every alternate month. [ABSTRACT FROM AUTHOR]

Background - The Menzies Centre has employed a strategy of including physical and biological measures of exposure in its studies where these might be relevant. The Centre has used such measures not surprisingly where the alternative - questionnaire or direct observation - could not obviously provide the desired information. The Centre has also used physical and biological measures to assist the interpretation of data obtained from questionnaire measures or simpler physical measures. Review - In research on the occurrence of dysplastic naevi, a risk factor for melanoma, three physical/biological measures were used in parallel with two established questionnaire measures. Amid the risk factors of interest, in place of sun exposure questions direct sun exposure using polysulphone badges was undertaken and in conjunction with self reported measures of tendency to burn or tan a non-invasive measure of melanin density using a spectrophotometer was included. Also a measure of the type of melanin each individual was producing was obtained from hair samples. In a cohort study of children where the endpoint of interest was bone density information on diet was obtained and physical activity via questionnaire. In addition, physical activity was measured using pedometers, vitamin D was measured from a serum sample. Both the abovementioned studies were able to obtain valuable extra insights for an inclusion of the biological and physical measures.The relevant results will be presented. The Menzies Centre currently has a large NHMRC grant to follow a cohort of over 8,484 children who had physical and biological measurements made on them between the ages of 7 and 15, as well as having had information on diet and physical activity collected through self report. Both sets of information will be used to estimate childhood exposures in a study which now seeks to re-measure the cohort members at age 25-33. As the first step in a longer process of following them until later life diseases, such as coronary heart disease, occur. Conclusions - The goal of this study will be to separate the effect of childhood exposures from exposures in early adulthood on risk of adult coronary heart disease and some other conditions. [ABSTRACT FROM AUTHOR]