title: Vitamin d deficiency in a multiethnic healthy control cohort and altered immune response in vitamin D deficient European-American healthy controls.
abstract: OBJECTIVE
  In recent years, vitamin D has been shown to possess a wide range of immunomodulatory effects. Although there is extensive amount of research on vitamin D, we lack a comprehensive understanding of the prevalence of vitamin D deficiency or the mechanism by which vitamin D regulates the human immune system. This study examined the prevalence and correlates of vitamin D deficiency and the relationship between vitamin D and the immune system in healthy individuals.
  
  
  METHODS
  Healthy individuals (n = 774) comprised of European-Americans (EA, n = 470), African-Americans (AA, n = 125), and Native Americans (NA, n = 179) were screened for 25-hydroxyvitamin D [25(OH)D] levels by ELISA. To identify the most noticeable effects of vitamin D on the immune system, 20 EA individuals with severely deficient (<11.3 ng/mL) and sufficient (>24.8 ng/mL) vitamin D levels were matched and selected for further analysis. Serum cytokine level measurement, immune cell phenotyping, and phosphoflow cytometry were performed.
  
  
  RESULTS
  Vitamin D sufficiency was observed in 37.5% of the study cohort. By multivariate analysis, AA, NA, and females with a high body mass index (BMI, >30) demonstrate higher rates of vitamin D deficiency (p<0.05). Individuals with vitamin D deficiency had significantly higher levels of serum GM-CSF (p = 0.04), decreased circulating activated CD4+ (p = 0.04) and CD8+ T (p = 0.04) cell frequencies than individuals with sufficient vitamin D levels.
  
  
  CONCLUSIONS
  A large portion of healthy individuals have vitamin D deficiency. These individuals have altered T and B cell responses, indicating that the absence of sufficient vitamin D levels could result in undesirable cellular and molecular alterations ultimately contributing to immune dysregulation.
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America; Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Lauren L
authors.initials: LL
authors.lastname: Ritterhouse
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America; Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Rufei
authors.initials: R
authors.lastname: Lu
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: Hemangi B
authors.initials: HB
authors.lastname: Shah
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Robertson
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: Dustin A
authors.initials: DA
authors.lastname: Fife
authors.affiliation: Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, United States of America.
authors.forename: Holden T
authors.initials: HT
authors.lastname: Maecker
authors.affiliation: Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, United States of America.
authors.forename: Hongwu
authors.initials: H
authors.lastname: Du
authors.affiliation: Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California, United States of America.
authors.forename: Charles G
authors.initials: CG
authors.lastname: Fathman
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: Eliza F
authors.initials: EF
authors.lastname: Chakravarty
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: R Hal
authors.initials: RH
authors.lastname: Scofield
authors.affiliation: Division of Rheumatology, Medical University of South Carolina, Charleston, South Carolina, United States of America.
authors.forename: Diane L
authors.initials: DL
authors.lastname: Kamen
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America.
authors.forename: Joel M
authors.initials: JM
authors.lastname: Guthridge
authors.affiliation: Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America; Departments of Medicine and Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America.
authors.forename: Judith A
authors.initials: JA
authors.lastname: James
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D004967:Estrogens / Q000494:pharmacology; D005006:Ethnicity; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D007109:Immunity / Q000187:drug effects; D007198:Indians, North American; D016015:Logistic Models; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D050794:STAT1 Transcription Factor / Q000378:metabolism; D014466:Ultraviolet Rays; D014481:United States; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood*; D044465:White People; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004967:Estrogens; D050794:STAT1 Transcription Factor; D014807:Vitamin D; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; C104450:25-hydroxyvitamin D
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