1
|
Comerford K, Lawson Y, Young M, Knight M, McKinney K, Mpasi P, Mitchell E. The role of dairy food intake for improving health among black Americans across the life continuum: A summary of the evidence. J Natl Med Assoc 2024; 116:292-315. [PMID: 38378307 DOI: 10.1016/j.jnma.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/22/2024]
Abstract
Decades of health data show major health disparities occurring at every life stage between Black and White Americans. These disparities include greater mortality rates among Black mothers and their offspring, higher levels of malnutrition and obesity among Black children and adolescents, and a higher burden of chronic disease and lower life expectancy for Black adults. Although nutrition is only one of many factors that influence human health and well-being across the life continuum, a growing body of research continues to demonstrate that consuming a healthy dietary pattern is one of the most dominant factors associated with increased longevity, improved mental health, improved immunity, and decreased risk for obesity and chronic disease. Unfortunately, large percentages of Black Americans tend to consume inadequate amounts of several essential nutrients such as vitamin A, vitamin D, calcium, and magnesium; and simultaneously consume excessive amounts of fast foods and sugar-sweetened beverages to a greater degree than other racial/ethnic groups. Therefore, strategies that can help improve dietary patterns for Black Americans could make up a major public health opportunity for reducing nutrition-related diseases and health disparities across the life course. A key intervention strategy to improve diet quality among Black Americans is to focus on increasing the intake of nutrient-rich dairy foods, which are significantly underconsumed by most Black Americans. Compared to other food group, dairy foods are some of the most accessible and affordable sources of essential nutrients like vitamin A, D, and B12, calcium, magnesium, potassium, selenium, and zinc in the food supply, as well as being some of the primary sources of several health-promoting bioactive compounds, including polar lipids, bioactive proteins and peptides, oligosaccharides, and live and active cultures in fermented products. Given the complex relationships that many Black Americans have with dairy foods, due to issues with lactose intolerance, and/or negative perceptions about the health effects of dairy foods, there is still a need to examine the role that dairy foods play in the health and well-being of Black Americans of all ages and life stages. Therefore, the National Medical Association and its partners have produced multiple reports on the value of including adequate dairy in the diet of Black Americans. This present summary paper and its associated series of evidence reviews provide an examination of an immense amount of research focused on dairy intake and health outcomes, with an emphasis on evidence-based strategies for improving the health of Black Americans. Overall, the findings and conclusions from this body of research continue to indicate that higher dairy intake is associated with reduced risk for many of the most commonly occurring deficiencies and diseases impacting each life stage, and that Black Americans would receive significantly greater health benefits by increasing their daily dairy intake levels to meet the national recommendations than they would from continuing to fall short of these recommendations. However, these recommendations must be considered with appropriate context and nuance as the intake of different dairy products can have different impacts on health outcomes. For instance, vitamin D fortified dairy products and fermented dairy products like yogurt - which are low in lactose and rich in live and active cultures - tend to show the greatest benefits for improved health. Importantly, there are significant limitations to these research findings for Black Americans, especially as they relate to reproductive and child health, since most of the research on dairy intake and health has failed to include adequate representation of Black populations or to sufficiently address the role of dairy intake during the most vulnerable life stages, such as pregancy, lactation, fetal development, early childhood, and older age. This population and these life stages require considerably more research and policy attention if health equity is ever to be achieved for Black Americans. Sharing and applying the learnings from this summary paper and its associated series of evidence reviews will help inform and empower nutrition and health practitioners to provide more evidence-based dietary recommendations for improving the health and well-being of Black Americans across the life course.
Collapse
Affiliation(s)
- Kevin Comerford
- OMNI Nutrition Science, California Dairy Research Foundation, Davis, CA, United States.
| | - Yolanda Lawson
- Associate Attending, Baylor University Medical Center, Dallas, TX, United States
| | - Michal Young
- Emeritus, Department of Pediatrics and Child Health, Howard University College of Medicine, Washington D.C., United States
| | - Michael Knight
- The George Washington University School of Medicine and Health Sciences, Washington D.C., United States
| | - Kevin McKinney
- Department of Internal Medicine, Division of Endocrinology, University of Texas Medical Branch, Galveston, TX, United States
| | - Priscilla Mpasi
- ChristianaCare Health System, Assistant Clinical Director Complex Care and Community Medicine, Wilmington, DE, United States
| | - Edith Mitchell
- Sidney Kimmel Cancer at Jefferson, Philadelphia, PA, United States
| |
Collapse
|
2
|
Zhang Y, Yan X, Tan J, Tan J, Liu C, Yang P, Xian Y, Wang Q. Exposure of Reproductive-Aged Women to Multiple Metals and Its Associations with Unexplained Recurrent Miscarriage. TOXICS 2023; 11:830. [PMID: 37888681 PMCID: PMC10611235 DOI: 10.3390/toxics11100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/28/2023]
Abstract
Exposure to heavy metals exerts toxic effects on female reproduction and embryo development. This study examined the exposure of patients with unexplained recurrent miscarriage (uRM) to multiple metals and the correlations among exposures to different metals. A total of 275 participants were enrolled, including 43 healthy women without previous miscarriage (the control group) and 232 uRM women (the case group); among these uRM women, 159 had two miscarriages (2M), 42 had three miscarriages (3M) and 31 had four or more miscarriages (≥4M). A total of 22 elements were measured in serum samples via inductively coupled plasma-mass spectrometry. The levels of calcium (104.37 mg/L vs. 92.65/93.02/92.61/92.47 mg/L) and selenium (131.85 µg/L vs. 117.80/118.04/115.88/124.35 µg/L) were higher in the controls than in the total uRM group and the 2M, 3M and ≥4M subgroups. The level of vanadium was significantly lower in the controls than in the total uRM group (0.15 µg/L vs. 0.23 µg/L), and the level of lead was lower in the controls than that in the total uRM group and the 2M, 3M and ≥4M subgroups (0.01 µg/L vs. 0.28/0.18/0.63/0.34 µg/L). After adjusting for age, body mass index and education level, calcium and selenium exposure were consistently negatively associated with miscarriage, while lead exposure was positively associated with miscarriage. In addition, the correlations among exposures to different metals slightly differed between the control and uRM groups. Therefore, changes in some metal elements in the blood might be related to the risk of uRM.
Collapse
Affiliation(s)
- Yingying Zhang
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510632, China
| | - Xi Yan
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510632, China
| | - Jianhua Tan
- Guangzhou Quality Supervision and Testing Institute, Guangzhou 510632, China
| | - Jifan Tan
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510632, China
| | - Chunsheng Liu
- Guangzhou Institute of Food Inspection, Guangzhou 510632, China
| | - Pan Yang
- Department of Public Health and Preventive Medicine, Jinan University, Guangzhou 510632, China
| | - Yanping Xian
- Guangzhou Quality Supervision and Testing Institute, Guangzhou 510632, China
| | - Qiong Wang
- Reproductive Medicine Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510632, China
| |
Collapse
|
3
|
Turesheva A, Aimagambetova G, Ukybassova T, Marat A, Kanabekova P, Kaldygulova L, Amanzholkyzy A, Ryzhkova S, Nogay A, Khamidullina Z, Ilmaliyeva A, Almawi WY, Atageldiyeva K. Recurrent Pregnancy Loss Etiology, Risk Factors, Diagnosis, and Management. Fresh Look into a Full Box. J Clin Med 2023; 12:4074. [PMID: 37373766 DOI: 10.3390/jcm12124074] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Recurrent pregnancy loss is a complex health challenge with no universally accepted definition. Inconsistency in definitions involves not only the number of spontaneous abortions (two or three) that are accepted for recurrent pregnancy loss but the types of pregnancy and gestational age at miscarriage. Due to the heterogeneity of definitions and criteria applied by international guidelines for recurrent pregnancy loss, the true incidence of recurrent miscarriage, which is reported to range from 1% to 5%, is difficult to estimate. Moreover, the exact etiology of recurrent pregnancy loss remains questionable; thus, it is considered a polyetiological and multifactorial condition with many modifiable and non-modifiable factors involved. Even after thoroughly evaluating recurrent pregnancy loss etiology and risk factors, up to 75% of cases remain unexplained. This review aimed to summarize and critically analyze accumulated knowledge on the etiology, risk factors, relevant diagnostic options, and management approach to recurrent pregnancy loss. The relevance of various factors and their proposed roles in recurrent pregnancy loss pathogenesis remains a matter of discussion. The diagnostic approach and the management largely depend on the etiology and risk factors taken into consideration by a healthcare professional as a cause of recurrent miscarriage for a particular woman or couple. Underestimation of social and health consequences of recurrent pregnancy loss leads to compromised reproductive health and psychological well-being of women after miscarriage. Studies on etiology and risk factors for recurrent pregnancy loss, especially idiopathic, should be continued. The existing international guidelines require updates to assist clinical practice.
Collapse
Affiliation(s)
- Akbayan Turesheva
- Department of Normal Physiology, West-Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan
| | | | - Talshyn Ukybassova
- Clinical Academic Department of Women's Health, CF "University Medical Center", Astana 010000, Kazakhstan
| | - Aizada Marat
- Department of Obstetrics and Gynecology #1, NJSC "Astana Medical University", Astana 010000, Kazakhstan
| | - Perizat Kanabekova
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Lyazzat Kaldygulova
- Department of Obstetrics and Gynecology #2, West-Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West-Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan
| | - Svetlana Ryzhkova
- Department of Obstetrics and Gynecology #2, West-Kazakhstan Marat Ospanov Medical University, Aktobe 030000, Kazakhstan
| | - Anastassiya Nogay
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
| | - Zaituna Khamidullina
- Department of Obstetrics and Gynecology #1, NJSC "Astana Medical University", Astana 010000, Kazakhstan
| | - Aktoty Ilmaliyeva
- Department of Medicine #3, NJSC "Astana Medical University", Astana 010000, Kazakhstan
| | - Wassim Y Almawi
- Faculte' des Sciences de Tunis, Universite' de Tunis El Manar, Tunis 5000, Tunisia
| | - Kuralay Atageldiyeva
- Department of Medicine, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan
- Clinical Academic Department of Internal Medicine, CF "University Medical Center", Astana 010000, Kazakhstan
| |
Collapse
|
4
|
Lumme J, Morin-Papunen L, Pesonen P, Sebert S, Hyppönen E, Järvelin MR, Herzig KH, Ojaniemi M, Niinimäki M. Vitamin D Status in Women with a History of Infertility and Decreased Fecundability: A Population-Based Study. Nutrients 2023; 15:nu15112522. [PMID: 37299485 DOI: 10.3390/nu15112522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Infertility and fecundability problems have been linked with lower 25-hydroxyvitamin D (25(OH)D) concentrations, but studies conducted with small, heterogenous or selected populations have shown inconsistent results. METHODS This study included women at age 31 from prospective population-based Northern Finland Birth Cohort 1966. Serum 25(OH)D concentrations were evaluated between women with or without previous infertility examinations or treatments (infertility group, n = 375, reference group, n = 2051) and time to pregnancy (TTP) of over 12 months (decreased fecundability group, n = 338) with a wide range of confounders. Furthermore, 25(OH)D concentrations were also compared among reproductive outcomes. RESULTS The mean 25(OH)D concentration was lower and 25(OH)D < 30 nmol/L was more frequent in women with a history of infertility compared to reference group. Moreover, 25(OH)D > 75 nmol/L was more frequent in the reference group. The mean 25(OH)D concentration was lower in women who had had multiple miscarriages. Both history of infertility (β = -2.7, 95% confidence interval (CI) -4.6, -0.7) and decreased fecundability associated with lower 25(OH)D concentration (β = -4.1, 95% CI -7.4, -0.8) after adjustments. In conclusion, this population-based study demonstrated that previous infertility and decreased fecundability were associated with lower 25(OH)D.
Collapse
Affiliation(s)
- Johanna Lumme
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Laure Morin-Papunen
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Paula Pesonen
- Northern Finland Birth Cohort, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
| | - Sylvain Sebert
- Research Unit of Population Health, University of Oulu, 90014 Oulu, Finland
| | - Elina Hyppönen
- Australian Centre for Precision Health, Cancer Research Institute, University of South Australia, Adelaide 5000, Australia
- Unit of Clinical and Health Sciences, University of South Australia, Adelaide 5000, Australia
- South Australian Health and Medical Research Institute, Adelaide 5000, Australia
| | - Marjo-Riitta Järvelin
- Research Unit of Population Health, University of Oulu, 90014 Oulu, Finland
- Department of Epidemiology and Biostatistics, MRC Centre for Environment and Health, School of Public Health, Imperial College, London W2 1PG, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London Kingston Lane, Uxbridge UB8 3PH, UK
- Unit of Primary Care, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Karl-Heinz Herzig
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, 90014 Oulu, Finland
- Department of Gastroenterology and Metabolism, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Marja Ojaniemi
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Department of Pediatrics and Adolescence, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| | - Maarit Niinimäki
- Research Unit of Clinical Medicine, University of Oulu, 90014 Oulu, Finland
- Medical Research Center, Oulu University Hospital and University of Oulu, 90220 Oulu, Finland
- Department of Obstetrics and Gynecology, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, 90220 Oulu, Finland
| |
Collapse
|
5
|
Amzajerdi A, Keshavarz M, Ghorbali E, Pezaro S, Sarvi F. The effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss: a randomized clinical trial. BMC Womens Health 2023; 23:138. [PMID: 36973702 PMCID: PMC10045437 DOI: 10.1186/s12905-023-02284-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Primary dysmenorrhea is considered as one of the women's main problems during reproductive age. The present study aimed to investigate the effect of vitamin D on the severity of dysmenorrhea and menstrual blood loss. METHODS This double-blind, randomized, placebo-controlled trial, was performed on 84 single female college students between 18 and 25 years old who living in dormitories. Students with primary dysmenorrhea and vitamin D deficiency were divided into experimental (n = 42) and control (n = 42) groups. Five days before the putative beginning of their next menstrual cycle, the experimental group received 300,000 IU vitamin D (50,000 IU, two tablets every 8 h), and the control group received a placebo (oral paraffin). The effects of the supplement on the severity of dysmenorrhea and menstrual blood loss were evaluated one cycle before and during two successive cycles. Using the visual analog scale (VAS), verbal multidimensional scoring system (VMS), and pictorial blood assessment chart (PBLAC) questionnaires. Fisher's exact, Chi-square, independent sample t-test and repeated measurements were used. RESULTS In total, 78 of the 84 students completed the study (39 students per group). The intervention resulted in a significant reduction in the mean scores of both the VAS and VMS in the experimental group, in the first and second menstrual cycles (p < 0.001, p < 0.001, respectively), but not in the means score of PBLAC. Mefenamic acid consumption at the first and second menstruation period, in the experimental group was lower than the control group (p = 0.009, p < 0.001, respectively). CONCLUSIONS The results indicate that vitamin D supplementation could decrease the severity of primary dysmenorrhea and the need to consume pain-relief medications. Contrariwise vitamin D supplementation had no significant effect on menstrual blood loss. TRIAL REGISTRATION This trial was registered in the Iranian Registry of Clinical Trials with code IRCT201305212324N on 18/1/2014. URL of registry: https://en.irct.ir/trial/1964 .
Collapse
Affiliation(s)
- Azam Amzajerdi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Keshavarz
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Reproductive Sciences and Technology Research Center, Department of Midwifery and Reproductive Health, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr St, Tehran, 1996713883, Iran.
| | - Elham Ghorbali
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- Centre for Healthcare Research, Coventry University, Coventry, UK
- The University of Notre Dame, Fremantle, Australia
| | - Fatemeh Sarvi
- Department of Public Health, School of Health, Larestan University of Medical Sciences, Shiraz, Fars, Iran
| |
Collapse
|
6
|
Maurya VK, Shakya A, Bashir K, Jan K, McClements DJ. Fortification by design: A rational approach to designing vitamin D delivery systems for foods and beverages. Compr Rev Food Sci Food Saf 2023; 22:135-186. [PMID: 36468215 DOI: 10.1111/1541-4337.13066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 12/09/2022]
Abstract
Over the past few decades, vitamin D deficiency has been recognized as a serious global public health challenge. The World Health Organization has recommended fortification of foods with vitamin D, but this is often challenging because of its low water solubility, poor chemical stability, and low bioavailability. Studies have shown that these challenges can be overcome by encapsulating vitamin D within well-designed delivery systems containing nanoscale or microscale particles. The characteristics of these particles, such as their composition, size, structure, interfacial properties, and charge, can be controlled to attain desired functionality for specific applications. Recently, there has been great interest in the design, production, and application of vitamin-D loaded delivery systems. Many of the delivery systems reported in the literature are unsuitable for widespread application due to the complexity and high costs of the processing operations required to fabricate them, or because they are incompatible with food matrices. In this article, the concept of "fortification by design" is introduced, which involves a systematic approach to the design, production, and testing of colloidal delivery systems for the encapsulation and fortification of oil-soluble vitamins, using vitamin D as a model. Initially, the challenges associated with the incorporation of vitamin D into foods and beverages are reviewed. The fortification by design concept is then described, which involves several steps: (i) selection of appropriate vitamin D form; (ii) selection of appropriate food matrix; (iii) identification of appropriate delivery system; (iv) identification of appropriate production method; (vii) establishment of appropriate testing procedures; and (viii) system optimization.
Collapse
Affiliation(s)
- Vaibhav Kumar Maurya
- Centre for Food Research and Analysis, National Institute of Food Technology Entrepreneurship and Management, Sonepat, India
| | - Amita Shakya
- Agriculture and Environmental Sciences, National Institute of Food Technology Entrepreneurship and Management, Sonepat, India
| | - Khalid Bashir
- Department of Food Technology, Jamia Hamdard, New Delhi, India
| | - Kulsum Jan
- Department of Food Technology, Jamia Hamdard, New Delhi, India
| | - David Julian McClements
- Department of Food Science, University of Massachusetts, Amherst, Massachusetts, USA.,Department of Food Science & Bioengineering, Zhejiang Gongshang University, Hangzhou, China
| |
Collapse
|
7
|
Subramanian A, Steiner AZ, Weinberg CR, Doss GL, Jukic AMZ. Preconception vitamin D and miscarriage in a prospective cohort study. Hum Reprod 2022; 37:2465-2473. [PMID: 35834313 PMCID: PMC9527460 DOI: 10.1093/humrep/deac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/27/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION Is preconception vitamin D level associated with the risk of miscarriage? SUMMARY ANSWER Preconception vitamin D levels are not associated with the risk of miscarriage in a population of women conceiving naturally. WHAT IS KNOWN ALREADY In humans, low vitamin D has been associated with prolonged menstrual cycles, delayed ovulation and a lower probability of conception. Animal and in vitro data indicate that vitamin D may affect implantation. STUDY DESIGN, SIZE, DURATION This prospective time-to-pregnancy study included 362 women who were trying to conceive naturally between 2008 and 2015. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included participants who had been trying to conceive naturally for 3 months or less at enrollment and aged 30-44 years. A preconception blood sample was collected and 25-hydroxyvitamin D [25(OH)D] was measured. Women who conceived (N = 362) were at risk of a miscarriage from the day of a reported positive pregnancy test until either a participant-reported pregnancy loss or 20 weeks post day of last menstrual period, whichever came first. Gestational age was defined by ovulation. Time to miscarriage (days) or censoring was modeled using a multivariate Cox proportional hazards model. Multiple imputation was performed for missing covariates and missing day of ovulation. MAIN RESULTS AND THE ROLE OF CHANCE The mean age was 33 years (SD: 3.0 years). Mean 25(OH)D was lower among those who reported their race as African-American and those with a higher BMI. After adjustment for age, race, BMI, education, exercise, alcohol and caffeine intake, compared to the referent group (30-<40 ng/ml), the hazard ratio (HR) and 95% CI for those with a low 25(OH)D level (<30 ng/ml) was 1.10 (CI: 0.62, 1.91). Among participants with a higher 25(OH)D level (≥40 ng/ml), the HR was 1.07 (CI: 0.62, 1.84). LIMITATIONS, REASONS FOR CAUTION This study was limited by a 25(OH)D measurement at only a single time point. A large percentage of women in this study had sufficient vitamin D levels, which may have limited our power to detect an effect of deficiency. Women in this study were older (30-44 years), and predominantly reported their race as White which may limit generalizability. WIDER IMPLICATIONS OF THE FINDINGS The findings of this study do not suggest an association between preconception vitamin D and miscarriage. Future research should focus on women at greater risk for miscarriage or in populations at risk for vitamin D deficiency or on supplementation. STUDY FUNDING/COMPETING INTEREST(S) This research was supported in part by the Intramural Research Program of the NIH, National Institute of Environmental Health Sciences (Z01ES103333). This research was also supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health (NIH) under award numbers R00HD079659 and R01HD067683. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- A Subramanian
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - A Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, NC, USA
| | - C R Weinberg
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - G L Doss
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - A M Z Jukic
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| |
Collapse
|
8
|
Simanjuntak L, Simanjuntak BC, Lumbanraja SN. Comparison of Serum Vitamin D Level between Normal Pregnancy and Abortion in Outpatient Settings. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Abortion is pregnancy termination or loss before 20 weeks gestation or with a fetus delivered weighing <500 grams. One of the pathogenic mechanisms associated with abortion was immunological factors. The human fetus represents a semi-allograft, which cannot survive without maternal immune tolerance. Vitamin D may be implicated in the risk of miscarriage due to its function as an immune modulator and its potential importance for the maternal-fetal immunologic response
Objective: This study aimed to compare the level of serum vitamin D in abortion patients and normal pregnant women.
Methods: This is a cross-sectional study using primary data from a private maternity clinic in October 2020-February 2021. The subjects recruited in this study were 98 women at first-trimester pregnancy with either viable gestation (46 subjects) or abortion (52 subjects). Demographic data (maternal age, gestational age, BMI, parity level, history of miscarriage, and occupation) and their association to abortion were determined. The serum 25(OH)D level was measured and then compared using statistical analysis.
Results: Mean age of the subjects was 30.45 ± 4.56 years and the mean gestational age of the recruitment was 58.31 ± 17.89 days. Abortion group has lower serum 25(OH)D level (16.95 ± 5,51 mg/L) than normal pregnant group (17.89 ± 4,74 mg/L), although it was not statistically significant (P = 0.527). The results also showed there was no statistically significant association between the classification of vitamin D deficiency, BMI, parity level, history of miscarriage, occupation, and abortion (P > 0.05).
Conclusion: In our study, we found that abortion patients had lower vitamin D levels than normal pregnant women, but it was not statistically significant. Abortion also was not associated with BMI, parity level, history of miscarriage, and occupation
Collapse
|
9
|
Tafti FD, Zare F, Miresmaeili SM, Fesahat F. Evaluating Vitamin D and foxp3 mRNA levels in women with recurrent spontaneous abortion. JBRA Assist Reprod 2022; 26:232-236. [PMID: 34812598 PMCID: PMC9118952 DOI: 10.5935/1518-0557.20210062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/29/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This current survey investigated the role of the Forkhead 3 box protein (foxp3) gene and serum vitamin D levels in women with recurrent spontaneous abortion (RSA). METHODS The mRNA level of the foxp3 gene in peripheral blood was evaluated in women with a history of RSA (N=40) and in controls (N=40) via quantitative polymerase chain reaction. We employed the enzyme-linked immunosorbent assay to assess the serum levels of 1,25-dihydroxyvitamin D3 (1,25(OH)2 D) in both groups. The Mann-Whitney U test and Pearson's correlation coefficient were used to statistically compare study groups between and within themselves, respectively. RESULTS Although mRNA levels of foxp3 were higher in women with RSA than in controls, we observed no significant change in mRNA levels of foxp3 between the two groups (p=0.16). An important positive correlation was observed between foxp3 mRNA levels and 1,25(OH)2 D in controls (p=0.003). In contrast, the correlation between foxp3 expression and 1,25(OH)2 D was not significant in the case group (p=0.14). Serum vitamin D levels were lower in women with RSA than in controls (p<0.001). CONCLUSIONS Our findings demonstrated that 1,25Vitamin D3 along with other molecules might help prevent RSA by providing for an anti-inflammatory state not necessarily through foxp3 expression or T cell differentiation.
Collapse
Affiliation(s)
| | - Fateme Zare
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | | | - Farzaneh Fesahat
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
10
|
Rodrigues CZ, Correia TC, Neves PAR, Malta MB, Cardoso MA, Lourenço BH. Predictors of 25-hydroxyvitamin D concentrations during pregnancy: A longitudinal analysis in the Brazilian Amazon. Eur J Clin Nutr 2022; 76:1281-1288. [PMID: 35190660 DOI: 10.1038/s41430-022-01102-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine predictors of 25-hydroxyvitamin D3 (25(OH)D3) concentrations (25th, 50th, and 75th percentiles) in the third trimester of pregnancy. SUBJECTS/METHODS Data on sociodemographic, obstetric, lifestyle and pregnancy characteristics, including serum 25(OH)D3 and retinol, were collected among 448 pregnant women who participated in the Maternal and Child Health and Nutrition in Acre, Brazil (MINA-Brazil Study) in Cruzeiro do Sul, Brazilian Amazon (latitude 7°S). Simultaneous-quantile regression was fitted to prospectively assess predictors at the 25th, 50th and 75th percentiles of 25(OH)D3 concentrations. RESULTS In the third trimester, 25(OH)D3 <50 nmol/L was observed in 26% of pregnant women. Exposure to the Amazonian dry season during follow-up and vitamin D status ≥75 nmol/L in the second trimester of pregnancy were positively associated with 25(OH)D3 concentrations in the third trimester. Pregnant women who were the main providers of family income presented lower 25(OH)D3 concentrations (50th and 75th percentiles: -15 nmol/L, 95%CI -24; -3, p = 0.02, and -22 nmol/L, 95%CI -36; -7, p = 0.004, respectively), as well as those with sustained vitamin A insufficiency (25th and 50th percentiles: -27 nmol/L, 95%CI -40; -15, p < 0.001, and -17 nmol/L, 95%CI -33; -1, p = 0.04, respectively). Sun protection practices had a smaller negative impact on 25(OH)D3, restricted to participants whose concentrations were at the 25th percentile of the distribution. CONCLUSIONS Seasonality and vitamin A status were important predictors of 25(OH)D3 concentrations in the third trimester. Adequate exposure to sunlight and dietary sources of vitamin A within safe intake levels may help ensuring a good nutritional status of vitamin D during pregnancy.
Collapse
Affiliation(s)
- Caroline Zani Rodrigues
- Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Thaís Carlos Correia
- Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Paulo Augusto Ribeiro Neves
- Public Health Nutrition Program, School of Public Health, University of São Paulo, São Paulo, Brazil.,Postgraduate Program in Epidemiology, School of Medicine, Federal University of Pelotas, Pelotas, Brazil
| | - Maíra Barreto Malta
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.,Postgraduate Program in Public Health, Catholic University of Santos, Santos, Brazil
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | |
Collapse
|
11
|
Perikonzeptioneller Einfluss von Ernährung und Mikronährstoffen auf die Reproduktionsfunktion. GYNAKOLOGISCHE ENDOKRINOLOGIE 2022. [DOI: 10.1007/s10304-022-00437-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
ZusammenfassungDie Bedeutung von Mikronährstoffen und einer insgesamt „gesunden Ernährung“ in der Schwangerschaft ist unstrittig. Im Gegensatz dazu ist die Datenlage zum Einfluss der perikonzeptionellen Ernährung auf die Konzeption, Implantation und den weiteren Schwangerschaftsverlauf weit weniger klar. Gesichert scheint, dass ein hoher Anteil von Vollkornprodukten, Früchten, Gemüse, Fisch und Olivenöl bei moderatem Anteil von Kohlenhydraten günstige Effekte entfaltet. Bei Kinderwunsch ist heute die Folsäuresubstitution obligat, diese kann nach aktuellen Leitlinien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften durch Vitamin D ergänzt werden.
Collapse
|
12
|
Banks N, Sun F, Krawetz SA, Coward RM, Masson P, Smith JF, Trussell JC, Santoro N, Zhang H, Steiner AZ. Male vitamin D status and male factor infertility. Fertil Steril 2021; 116:973-979. [PMID: 34289935 DOI: 10.1016/j.fertnstert.2021.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. DESIGN Secondary analysis of a randomized, controlled trial. SETTING Nine fertility centers in the United States. PATIENT(S) Men (n = 154) with sperm concentration between 5 and 15 million/mL, motility ≤40%, or normal morphology ≤4% were eligible. Female partners were ovulatory, ≤40 years old, and had documented tubal patency. INTERVENTION(S) Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (25(OH)D) levels. They were randomly assigned to receive a vitamin formulation including vitamin D 2,000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6. MAIN OUTCOME MEASURE(S) Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline. Secondary: cumulative pregnancy, miscarriage, and live birth rates. RESULT(S) Semen parameters and sperm DNA fragmentation were not statistically significantly different between men with vitamin D deficiency and men with 25(OH)D levels ≥20 ng/mL. In addition, clinical pregnancy and live birth rates were similar. Male 25(OH)D level <20 ng/mL was associated with a higher rate of pregnancy loss (adjusted odds ratio 9.0; 95% confidence interval 1.3 to 61.3). CONCLUSION(S) Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.
Collapse
Affiliation(s)
- Nicole Banks
- Department of Obstetrics and Gynecology, Virginia Commonwealth University Health, Richmond, Virginia.
| | - Fangbai Sun
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
| | - R Matthew Coward
- Department of Urology, University of North Carolina, Chapel Hill, North Carolina
| | - Puneet Masson
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Smith
- Department of Urology, University of California, San Francisco, California
| | - J C Trussell
- Department of Urology, Upstate University Hospital, Syracuse, New York
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado
| | - Heping Zhang
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Anne Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
| |
Collapse
|
13
|
Aramesh S, Alifarja T, Jannesar R, Ghaffari P, Vanda R, Bazarganipour F. Does vitamin D supplementation improve ovarian reserve in women with diminished ovarian reserve and vitamin D deficiency: a before-and-after intervention study. BMC Endocr Disord 2021; 21:126. [PMID: 34154571 PMCID: PMC8218405 DOI: 10.1186/s12902-021-00786-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 06/02/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Evaluation of vitamin D supplementation on ovarian reserve in women with diminished ovarian reserve and vitamin D deficiency. METHODS The study is a before-and-after intervention study that was performed on women with diminished ovarian reserve referred to Shahid Mofteh Clinic in Yasuj, Iran. Eligible women were prescribed vitamin D tablets at a dose of 50,000 units weekly for up to 3 months. Serum levels of vitamin D and AMH were evaluated at the end of 3 months. Significance level was also considered P ≤ 0.05. RESULTS Our results have been showed there was a statistically significant difference in vitamin D levels of participants before [12.1(6.5)] and after [26(9.15)] the intervention (P < 0.001). Moreover, there was a statistically significant difference in serum AMH levels of participants before [0.50(0.44)] and after [0.79(0.15)] the intervention (P=0.02 ). CONCLUSION In conclusion, the results of the current study support a possible favorable effect of vitamin D on increase AMH expression by acting on the AMH gene promoter. Therefore, it is possible that vitamin D increases AMH levels without changing the antral follicle count/ovarian reserve.
Collapse
Affiliation(s)
- Shahintaj Aramesh
- Department of Gynecology and Obstetrics, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Touran Alifarja
- Department of Gynecology and Obstetrics, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ramin Jannesar
- Department of Pathology, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Parvin Ghaffari
- Department of Gynecology and Obstetrics, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Raziyeh Vanda
- Department of Gynecology and Obstetrics, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Fatemeh Bazarganipour
- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
| |
Collapse
|
14
|
Vitamin D receptor gene polymorphisms and haplotypes in the etiology of recurrent miscarriages. Sci Rep 2021; 11:4646. [PMID: 33633340 PMCID: PMC7907056 DOI: 10.1038/s41598-021-84317-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 02/09/2021] [Indexed: 12/27/2022] Open
Abstract
A few years ago it was shown that disturbed metabolism of the vitamin D/receptor (VD/VDR) complex may be important in the etiology of spontaneous abortion, as well as in the etiology of recurrent miscarriages (RM). The goal of this study was to investigate the association between four maternal VDR polymorphisms as well as haplotypes settings and RM occurrence in a Polish population of women in reproductive age. A total of 230 women were recruited to this study (110 with RM, 120 consecutively recruited age-matched healthy women with at least two full-term pregnancies and with no history of miscarriages). DNA samples were genotyped for VDR polymorphisms: FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232) and TaqI (rs731236). Significant differences in genotype distributions and allele frequencies between case and control groups were observed in VDR BsmI polymorphism (GG vs. GA and AA, OR = 0.56, p = 0.036 and OR = 1.49, p = 0.035, respectively). The best evidence of an association with RM prevention was observed for the TTGT haplotype, which was more frequent among controls than cases even after permutation test (0.09 vs. 0.017, p = 0.0024). Other haplotypes were also significantly more frequent in the control group: TGT (rs7975232, rs1544410, rs2228570), TG (rs7975232, rs1544410), TTG (rs731236, rs7975232, rs1544410), TT (rs731236, rs7975232). Our research indicated the possible role of VDR BsmI genetic polymorphism in RM etiology, suggesting at the same time the active role of maternal VD metabolism and its influence on pregnancy outcome. The significant influence of several maternal haplotypes was shown to prevent RM occurrence.
Collapse
|
15
|
Radzinsky VE, Ramazanova FU, Khamoshina MB, Azova MM, Orazov MR, Orazmuradov AA. Vitamin D insufficiency as a risk factor for reproductive losses in miscarriage. Gynecol Endocrinol 2021; 37:8-12. [PMID: 34937516 DOI: 10.1080/09513590.2021.2006451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To study the relationship between vitamin D deficiency, VDR gene polymorphism rs10735810 (A > G), and a missed abortion in the first trimester of gestation; to determine the predictors of its risk. RESEARCH METHODS 178 women aged between 18 and 41 were surveyed. The main group consisted of patients with miscarriage (n = 101), verified at the hospital stage (O02.0; O02.1), which were stratified by I group (n = 58, patients with the first miscarriage) and II groups (n = 43, patients with repeated miscarriage). The control group (n = 77) consisted of women with a successful pregnancy (Z34.0), which subsequently ended in delivery at term with a live fetus. Patients were surveyed and data was extracted from primary medical records. The level of 25(OH)D in the blood serum was investigated by mass spectrometry (n = 99). Genotyping for the vitamin D receptor gene polymorphism rs10735810 (VDR A > G) was performed for 177 patients. Statistical data analysis was performed via Statistica 10 and SAS JMP 11 application packages, using single-factor prediction for quantitative and binary factors, ROC analysis, and CHAID decision tree construction. RESULTS OF THE STUDY WE found that patients with miscarriage in the first trimester of gestation (n = 60) more frequently than those in the control group (n = 39) had vitamin D insufficiency (93.3% versus 76.9%, p = .0183) including its deficiency, occurring at 25(OH)D of blood <20 ng/ml (71.7% versus 51.3%, p = .0392). This pattern was found in patients with the first miscarriage, where significant differences in the frequency of vitamin D deficiency were also detected in comparison with the control group (80.0% versus 51.3%, p = .0026). No direct correlation was found between the frequency of miscarriages in the first trimester and the variant of the polymorphism of the vitamin D receptor gene (VDR A > G [rs10735810]); the GG genotype in patients with repeated miscarriages was even less frequent compared to the control group (14.0% versus 23.7%, p = .3344). However, the decision tree has identified four risk classes and has determined that the highest risk of missed abortion in the cohort studied is formed by three predicates: smoking, serum level 25(OH)D < 6.5 ng/ml and VDR AA and GG genotypes. CONCLUSION The data obtained show that vitamin D insufficiency plays a pathogenetically significant role in early reproductive losses associated with miscarriages, both first and recurrent.
Collapse
Affiliation(s)
- V E Radzinsky
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| | - F U Ramazanova
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| | - M B Khamoshina
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| | - M M Azova
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| | - M R Orazov
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| | - A A Orazmuradov
- Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship, Moscow, Russia
| |
Collapse
|
16
|
The Association between Vitamin D and Anti-Müllerian Hormone: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12061567. [PMID: 32481491 PMCID: PMC7352921 DOI: 10.3390/nu12061567] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/22/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence from animal and human studies indicates a role for vitamin D in female reproductive physiology, and numerous clinical studies have suggested its potential benefit for various aspects of human reproduction. Anti-Müllerian hormone (AMH) is an ovarian biomarker that plays an important role in folliculogenesis. It is the most sensitive ovarian reserve marker and is widely used clinically in reproductive medicine. While initial studies have suggested that vitamin D may be associated with ovarian reserve markers, including AMH, evidence has been conflicting. Currently, there is considerable debate in the field whether vitamin D has the capacity to influence ovarian reserve, as indicated by the AMH level. The current systematic review aims to evaluate and summarize the available evidence regarding the relationship between vitamin D and AMH. In total, 18 observational studies and 6 interventional studies were included in this systematic review. Cross-sectional studies have reported largely discrepant findings regarding an association between serum vitamin D and AMH levels, which are likely due to the heterogeneity in study populations, as well as the apparently complex relationship that may exist between vitamin D and AMH. However, meta-analysis of interventional studies performed herein that examined the effects of vitamin D supplementation on serum AMH levels indicates a cause-effect relationship between vitamin D and AMH, the direction of which appears to depend on a woman’s ovulatory status. Serum AMH was significantly decreased following vitamin D supplementation in polycystic ovarian syndrome (PCOS) women (standardized mean difference (SMD) −0.53, 95% CI −0.91 to −0.15, p < 0.007), while it was significantly increased following vitamin D supplementation in ovulatory women without PCOS (SMD 0.49, 95% CI 0.17 to 0.80, p = 0.003). In conclusion, the results of this systematic review demonstrate that the relationship between vitamin D and AMH is a complex one, and large, randomized trials of vitamin D supplementation focusing on different vitamin D status ranges are necessary to gain more insight into the nature of this relationship and the potential benefit of vitamin D to female reproduction in general.
Collapse
|
17
|
Altered decidual and placental catabolism of vitamin D may contribute to the aetiology of spontaneous miscarriage. Placenta 2020; 92:1-8. [PMID: 32056782 DOI: 10.1016/j.placenta.2020.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/13/2020] [Accepted: 01/24/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Vitamin D catabolizing enzymes, along with vitamin D receptor (VDR) and vitamin D binding protein (DBP) are expressed in the decidua and placenta during pregnancy and capable of synthesizing active vitamin D. Vitamin D plays roles in immunoregulation and trophoblast invasion, key features of a successful pregnancy. Epidemiological data suggests that vitamin D deficiency is associated with both spontaneous and recurrent miscarriage but few studies have investigated the expression of the key vitamin D catabolizing enzymes in miscarriage. METHODS Placenta and decidua were collected after termination of apparently normal pregnancies (controls, n = 22) or spontaneous miscarriage (n = 20). Immunohistochemical staining, Western Blot and qRT-PCR were performed for CYP27B1, CYP24A1, CYP2R1, VDR and DBP (not qRT-PCR). HTR-8/SVneo cells were cultured in CoCL2 (hypoxic mimetic) or LPS (bacterial infection mimetic) for 24 h, RNA extracted and qRT-PCR performed for CYP27B1, CYP24A1, CYP2R1 and VDR. RESULTS In spontaneous miscarriage, placental and decidual expression of CYP27B1 was reduced, while expression of CYP24A1, VDR and DBP was increased. When a trophoblast cell line was treated with CoCL2 expression of CYP27B1 was increased and CYP24A1 was reduced, while LPS induced expression of VDR. DISCUSSION This is the first report of altered utero-placental vitamin D catabolism in spontaneous miscarriage. It is becoming accepted that women who are undergoing assisted reproductive technologies should ensure they have sufficient vitamin D levels prior to pregnancy, these data support that all women should ensure they are vitamin D replete before planning to get pregnant.
Collapse
|
18
|
Bialy L, Fenton T, Shulhan-Kilroy J, Johnson DW, McNeil DA, Hartling L. Vitamin D supplementation to improve pregnancy and perinatal outcomes: an overview of 42 systematic reviews. BMJ Open 2020; 10:e032626. [PMID: 31964667 PMCID: PMC7044866 DOI: 10.1136/bmjopen-2019-032626] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To review the evidence to assess effectiveness of vitamin D supplementation during pregnancy and associations of serum vitamin D levels with perinatal outcomes. DESIGN Overview of systematic reviews (SRs). DATA SOURCES Searches conducted in January 2019: Ovid Medline (1946-), Cochrane Library databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Two reviewers independently screened titles and abstracts, and full texts using predefined inclusion criteria: SRs evaluating vitamin D supplementation in pregnant women and/or examining the association between serum vitamin D levels reporting at least one predefined perinatal outcome. Only SRs with high AMSTAR scores were analysed. DATA EXTRACTION AND SYNTHESIS Data were extracted independently by one reviewer and checked by a second. Results were assessed for quality independently by two reviewers using GRADE criteria. RESULTS Thirteen SRs were included, synthesising evidence from 204 unique primary studies. SRs of randomised controlled trials (RCTs) with the highest level of evidence showed no significant benefit from vitamin D in terms of preterm birth (RR 1.00 (95% CI 0.77, 1.30); high quality), pre-eclampsia (RR 0.91 (0.45, 1.86); low quality), gestational diabetes (RR 0.65 (0.39, 1.08); very low quality), stillbirth (RR 0.75 (0.50, 1.12); high quality), low birth weight (RR 0.74 (0.47, 1.16); low quality), caesarean section (RR 1.02 (0.93, 1.12); high quality). A significant difference was found for small for gestational age (RR 0.72 (0.52, 0.99); low quality). SRs of observational studies showed associations between vitamin D levels and preterm birth (RR 1.19 (1.08, 1.31); moderate quality), pre-eclampsia (RR 1.57 (1.21, 2.03) for 25-hydroxy vitamin D (25 (OH)D)<50 nmol/L subgroup; low quality), gestational diabetes (RR 1.12 (1.02, 1.22) for 25 (OH)D<50 nmol/L and RR 1.09 (1.03, 1.15)<75 nmol/L; moderate quality) and small for gestational age (RR 1.35 (1.18, 1.54)<50 nmol/L; low quality). SRs showed mixed results for associations between vitamin D and low birth weight (very low quality) and caesarean section (very low quality). CONCLUSION There is some evidence from SRs of observational studies for associations between vitamin D serum levels and some outcomes; however SRs examining effectiveness from RCTs showed no effect of vitamin D supplementation in pregnancy with the exception of one predefined outcome, which had low quality evidence. Credibility of the evidence in this field is compromised by study limitations (in particular, the possibility of confounding among observational studies), inconsistency, imprecision and potential for reporting and publication biases.
Collapse
Affiliation(s)
- Liza Bialy
- Alberta SPOR SUPPORT Unit Knowledge Translation Platform, University of Alberta, Edmonton, Alberta, Canada
| | - Tanis Fenton
- Community Health Sciences, Institute of Public Health, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Nutrition Services, Alberta Health Services, Calgary, Alberta, Canada
| | - Jocelyn Shulhan-Kilroy
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - David W Johnson
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
- Departments of Pediatrics and Physiology and Pharmacology, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Deborah A McNeil
- Maternal Newborn Child and Youth Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
- Faculty of Nursing and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Lisa Hartling
- Alberta SPOR SUPPORT Unit Knowledge Translation Platform, University of Alberta, Edmonton, Alberta, Canada
- Alberta Research Centre for Health Evidence (ARCHE), Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
19
|
Abstract
Vitamin D is a lipid soluble vitamin synthesized by the skin upon exposure to UV light. Approximately 10–20% of vitamin D comes from dietary sources and 25OH-D is its circulating form. Vitamin D receptors are found in reproductive tissues including ovary, uterus, and endometrium permitting investigators to hypothesize a role for vitamin D in reproduction. Indeed, a number of animal studies provide evidence of vitamin D’s importance in fertility. Studies in humans, however, generally have not supported an effect of vitamin D on fertility outcomes. Several retrospective cohort studies did not demonstrate an association between vitamin D levels and pregnancy. Similarly, one study did not find correlation between anovulatory infertility and vitamin D intake. Very low levels of vitamin D, however, were associated with miscarriage in another study. A large meta-analysis of 11 studies and 2700 women did show an improvement in IVF success rates in those with higher levels of vitamin D. Finally, two small studies on vitamin D supplementation and pregnancy did not show a benefit of increasing vitamin D intake. In conclusion, the literature at best shows a minimal impact of vitamin D on infertility and IVF outcomes.
Collapse
Affiliation(s)
- Mark D. Hornstein
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
20
|
Chiu YH, Chavarro JE, Souter I. Diet and female fertility: doctor, what should I eat? Fertil Steril 2019; 110:560-569. [PMID: 30196938 DOI: 10.1016/j.fertnstert.2018.05.027] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 05/23/2018] [Indexed: 12/15/2022]
Abstract
Fecundity is the capacity to produce offspring. Identifying dietary factors that influence human fecundity is of major clinical and public health significance. This review focuses on the evidence from epidemiologic literature for the relationships between key nutritional factors and female reproductive potential. According to existing data, women trying to achieve pregnancy are encouraged to increase consumption of whole grains, omega-3 fatty acids, fish, and soy and to reduce consumption of trans fats and red meat. In addition, a daily multivitamin that contains folic acid before and during pregnancy may not only prevent birth defects, but also improve the chance of achieving and maintaining a pregnancy. In contrast, there is limited evidence supporting an association between vitamin D and human fecundity outcomes despite promising evidence from nonhuman studies. Questions for future research included the roles of other types of fat (especially omega-6 and monounsaturated fats) and protein (especially white meat and seafood) on female fertility; particular attention should also be paid to exposure to environmental contaminants in foods. Although much work remains, this review accrued best available evidence to provide practical dietary recommendations for women trying to conceive.
Collapse
Affiliation(s)
- Yu-Han Chiu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Irene Souter
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Harvard Medical School, Massachusetts General Hospital Fertility Center, Boston, Massachusetts.
| |
Collapse
|
21
|
The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102241. [PMID: 30322097 PMCID: PMC6210343 DOI: 10.3390/ijerph15102241] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 09/29/2018] [Accepted: 09/29/2018] [Indexed: 12/19/2022]
Abstract
Vitamin D deficiency is common and there exists a huge gap between recommended dietary vitamin D intakes and the poor vitamin D supply in the general population. While vitamin D is important for musculoskeletal health, there are accumulating data suggesting that vitamin D may also be important for fertility, pregnancy outcomes and lactation. Significant changes in vitamin D metabolism during pregnancy such as increased production of the “active vitamin D hormone” calcitriol support the important role of vitamin D in this setting. Observational studies show that vitamin D deficiency is a risk marker for reduced fertility and various adverse pregnancy outcomes and is associated with a low vitamin D content of breast milk. Meta-analyses of randomized controlled trials (RCTs) document that physiological vitamin D supplementation during pregnancy is safe and improves vitamin D and calcium status, thereby protecting skeletal health. Although certain RCTs and/or meta-analyses reported some other beneficial effects, it is still not clear whether vitamin D supplementation improves fertility or decreases the risk of adverse pregnancy outcomes such as low birth weight, pre-eclampsia and neonatal mortality, or reduces wheeze/asthma in the infants. Nevertheless, vitamin D supplementation in pregnant women is frequently required to achieve a sufficient vitamin D status as recommended by nutritional vitamin D guidelines. In this review, we provide an overview of systematic reviews, meta-analyses and large trials reporting clinical data on the role of vitamin D for fertility, pregnancy and lactation.
Collapse
|
22
|
Gonçalves DR, Braga A, Braga J, Marinho A. Recurrent pregnancy loss and vitamin D: A review of the literature. Am J Reprod Immunol 2018; 80:e13022. [PMID: 30051540 DOI: 10.1111/aji.13022] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 06/20/2018] [Indexed: 12/18/2022] Open
Abstract
Recurrent pregnancy loss (RPL) affects approximately 1%-2% of reproductive women. Auto- and cellular immune responses seem to be associated with RPL. Vitamin D (VD) has been shown to play a role in the modulation of the immune system. Effects of VD deficiency (VDD) in pregnancy have been associated with preeclampsia, gestational diabetes, fetal growth restriction, preterm labor, and sporadic spontaneous abortion (SA). We systematically reviewed articles that studied women with 2 or more SA and its association with VD. Eleven studies were included. Studies reported a high prevalence of VD insufficiency (VDI) or VDD in women with RPL and suggested that this could be associated with immunological dysregulation and consequently with RPL. Immunological benefits were reported in the peripheral blood of women with RPL after VD exposure. Thus, it is possible to speculate a beneficial role for VD supplementation in RPL. It seems that there are not differences in the vitamin D receptor (VDR) and CYP27B1 expression in endometrium of women with RPL but, in villous and decidual tissues, RPL women seem to have a decreased expression of VDR and, perhaps, a decreased expression of CYP27B1. Further randomized controlled studies are required to investigate the association between VDD or VDI and RPL.
Collapse
Affiliation(s)
| | - António Braga
- Department of Obstetrics and Gynecology, Centro Hospitalar do Porto, Porto, Portugal
| | - Jorge Braga
- Department of Obstetrics and Gynecology, Centro Hospitalar do Porto, Porto, Portugal
| | - António Marinho
- UMIB, Instituto de Ciências Biomédicas de Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.,Clinical Immunology Unit, Centro Hospitalar do Porto, Porto, Portugal
| |
Collapse
|
23
|
Saggese G, Vierucci F, Prodam F, Cardinale F, Cetin I, Chiappini E, de’ Angelis GL, Massari M, Miraglia Del Giudice E, Miraglia Del Giudice M, Peroni D, Terracciano L, Agostiniani R, Careddu D, Ghiglioni DG, Bona G, Di Mauro G, Corsello G. Vitamin D in pediatric age: consensus of the Italian Pediatric Society and the Italian Society of Preventive and Social Pediatrics, jointly with the Italian Federation of Pediatricians. Ital J Pediatr 2018; 44:51. [PMID: 29739471 PMCID: PMC5941617 DOI: 10.1186/s13052-018-0488-7] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/16/2018] [Indexed: 02/07/2023] Open
Abstract
Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur.Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents.
Collapse
Affiliation(s)
- Giuseppe Saggese
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | | | - Flavia Prodam
- Division of Pediatrics, Department of Health Sciences, Interdisciplinary Research Center of Autoimmune Diseases (IRCAD), University of Piemonte Orientale, Novara, Italy
| | - Fabio Cardinale
- Pediatric Unit, Division of Pulmonology, Allergy, and Immunology, AOU Policlinico-Giovanni XXIII, Bari, Italy
| | - Irene Cetin
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Elena Chiappini
- Pediatric Infectious Disease Unit, Department of Health Sciences, University of Florence, Anna Meyer Children’s University Hospital, Florence, Italy
| | - Gian Luigi de’ Angelis
- Gastroenterology and Digestive Endoscopy Unit and Clinical Paediatrics Unit, Department of Paediatrics and Maternal Medicine, University of Parma Hospital Trust, Parma, Italy
| | - Maddalena Massari
- Department of Mother and Child, Hospital Luigi Sacco, University of Milano, Milan, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Miraglia Del Giudice
- Department of Woman, Child and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Diego Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatrics, University of Pisa, Pisa, Italy
| | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
| | | | - Domenico Careddu
- Pediatric Primary Care, National Pediatric Health Care System, Novara, Italy
| | - Daniele Giovanni Ghiglioni
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianni Bona
- Division of Pediatrics, University of Piemonte Orientale, Novara, Italy
| | - Giuseppe Di Mauro
- Pediatric Primary Care, National Pediatric Health Care System, Caserta, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care, Neonatal Intensive Care Unit, AOUP, University of Palermo, Palermo, Italy
| |
Collapse
|
24
|
Berridge MJ. Vitamin D deficiency: infertility and neurodevelopmental diseases (attention deficit hyperactivity disorder, autism, and schizophrenia). Am J Physiol Cell Physiol 2017; 314:C135-C151. [PMID: 29070492 DOI: 10.1152/ajpcell.00188.2017] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The process of development depends on a number of signaling systems that regulates the progressive sequence of developmental events. Infertility and neurodevelopmental diseases, such as attention deficit hyperactivity disorder, autism spectrum disorders, and schizophrenia, are caused by specific alterations in these signaling processes. Calcium signaling plays a prominent role throughout development beginning at fertilization and continuing through early development, implantation, and organ differentiation such as heart and brain development. Vitamin D plays a major role in regulating these signaling processes that control development. There is an increase in infertility and an onset of neurodevelopmental diseases when vitamin D is deficient. The way in which vitamin D deficiency acts to alter development is a major feature of this review. One of the primary functions of vitamin D is to maintain the phenotypic stability of both the Ca2+ and redox signaling pathways that play such a key role throughout development.
Collapse
Affiliation(s)
- Michael J Berridge
- Laboratory of Molecular Signalling, The Babraham Institute , Cambridge , United Kingdom
| |
Collapse
|