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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.
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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
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Cui Y, Zhou HL, Wei MH, Song WJ, Di DS, Zhang RY, Wei S, Liu JA, Wang Q. Multiple vitamin co-exposure and mortality risk: A prospective study. Clin Nutr 2021; 41:337-347. [PMID: 34999328 DOI: 10.1016/j.clnu.2021.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/06/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS Existing epidemiological studies explored the associations of circulating vitamins and mortality focusing on individual vitamin effects, and controversial findings were obtained. The joint effects of multiple vitamin co-exposure are worth studying. The study aimed to elucidate the associations of circulating vitamins and the joint effects of these vitamins' co-exposure with all-cause and cause-specific mortality risks. METHODS We prospectively evaluated the associations of the concentrations of six kinds of vitamins (A, D, E, C, B12 and B9) in serum with risks for all-cause and cause-specific mortalities among U.S. adults. Mortality status and cause of death were determined by NHANES-linked public available files dated up to 31 December 2015. An unsupervised K-means clustering method was used to cluster the participants into several vitamin co-exposure patterns. The Cox proportional hazards model was used for statistical analysis. RESULTS A total of 1404 deaths occurred during a median of 10.9 years follow-up among 8295 participants. In multivariable adjustment, increasing levels of vitamin D were associated with reduced all-cause and cause-specific mortality risks. A J-shaped nonlinear exposure-response relationship was observed between all studied vitamins (except for vitamin D) and all-cause mortality risk. Four co-exposure patterns were generated based on the studied vitamins, as follows: low-level exposure (cluster 1), vitamin A/D exposure (cluster 2), water-soluble vitamin exposure (cluster 3) and high-level exposure (cluster 4). Compared with those in cluster 1, participants in cluster 2 had lower all-cause and cancer mortality risks, with hazard ratios (95% confidence intervals [CIs]) of 0.67 (0.53, 0.85) and 0.45 (0.29, 0.71), respectively. CONCLUSIONS The findings in this study indicated that high circulating vitamin D levels were associated with reduced mortality risk among U.S. adults. Vitamin co-exposure at moderate levels appropriately contributed to low all-cause and cancer mortality risks. Our findings provided a novel perspective for exploring the joint health effects of multivitamin co-exposure. Future investigations are needed to further unravel the underlying mechanisms of possible vitamin interactions.
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Affiliation(s)
- Yuan Cui
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hao-Long Zhou
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mu-Hong Wei
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wen-Jing Song
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong-Sheng Di
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ru-Yi Zhang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng Wei
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-An Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
| | - Qi Wang
- MOE Key Lab of Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Levy B, O'Callaghan KM, Qamar H, Mahmud AA, Gernand AD, Islam MM, Roth DE. Basal Vitamin D Status and Supplement Dose Are Primary Contributors to Maternal 25-Hydroxyvitamin D Response to Prenatal and Postpartum Cholecalciferol Supplementation. J Nutr 2021; 151:3361-3378. [PMID: 34302350 PMCID: PMC8562081 DOI: 10.1093/jn/nxab265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/28/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Variability in the 25-hydroxyvitamin D [25(OH)D] response to prenatal and postpartum vitamin D supplementation is an important consideration for establishing vitamin D deficiency prevention regimens. OBJECTIVES We aimed to examine interindividual variation in maternal and infant 25(OH)D following maternal vitamin D supplementation. METHODS In a randomized trial of maternal vitamin D supplementation (Maternal Vitamin D for Infant Growth Trial), healthy pregnant women (n = 1300) received a prenatal cholecalciferol (vitamin D-3) dose of 0, 4200, 16,800, or 28,000 IU/wk from 17 to 24 wk of gestation followed by placebo to 6 mo postpartum. A fifth group received 28,000 IU cholecalciferol/wk both prenatally and postpartum. In a subset of participants, associations of 25(OH)D with hypothesized explanatory factors were estimated in women at delivery (n = 655) and 6 mo postpartum (n = 566), and in their infants at birth (n = 502) and 6 mo of age (n = 215). Base models included initial 25(OH)D and supplemental vitamin D dose. Multivariable models were extended to include other individual characteristics and specimen-related factors. The model coefficient of determination (R2) was used to express the percentage of total variance explained. RESULTS Supplemental vitamin D intake and initial 25(OH)D accounted for the majority of variance in maternal 25(OH)D at delivery and postpartum (R2 = 70% and 79%, respectively). Additional characteristics, including BMI, contributed negligibly to remaining variance (<5% increase in R2). Variance in neonatal 25(OH)D was explained mostly by maternal delivery 25(OH)D and prenatal vitamin D intake (R2 = 82%). Variance in 25(OH)D in later infancy could only partly be explained by numerous biological, sociodemographic, and laboratory-related characteristics, including feeding practices (R2 = 43%). CONCLUSIONS Presupplementation 25(OH)D and vitamin D supplemental dose are the major determinants of the response to maternal prenatal vitamin D intake. Vitamin D dosing regimens to prevent maternal and infant vitamin D deficiency should take into consideration the mean 25(OH)D concentration of the target population.
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Affiliation(s)
- Benjamin Levy
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Karen M O'Callaghan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Huma Qamar
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Abdullah Al Mahmud
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Alison D Gernand
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - M Munirul Islam
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
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Arranz B, Sanchez-Autet M, San L, Safont G, Fuente-Tomás LDL, Hernandez C, Bogas JL, García-Portilla MP. Are plasma 25-hydroxyvitamin D and retinol levels and one-carbon metabolism related to metabolic syndrome in patients with a severe mental disorder? Psychiatry Res 2019; 273:22-29. [PMID: 30639560 DOI: 10.1016/j.psychres.2019.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/15/2018] [Accepted: 01/01/2019] [Indexed: 11/27/2022]
Abstract
There is a scarcity of studies assessing the influence of biomarkers in metabolic syndrome in psychiatric patients. Our aim was to correlate serum or plasma levels of 25-hydroxyvitamin D (25-OH-VD), retinol, vitamin B12 (VB12), folate and homocysteine (Hcy), with the metabolic status, in a sample of 289 outpatients with Schizophrenia or Bipolar Disorder. Logistic regression and multiple linear regressions were performed to assess the ability of biomarkers to predict the presence of MetS, the number of risk factors for MetS, and insulin resistance indexes (HOMA and QUICKI). Regarding the association between biomarkers and the QUICKI index, the model explained 6.8% of the variance, with folate and 25-OH-VD levels contributing significantly to the model. The model predicting the number of MetS risk factors was significant and explained 21.7% of the variance, being 25-OH-VD and retinol the statistically significant factors. As for the impact of biomarkers on MetS, the model was statistically significant, being 25-OH-VD and retinol levels the significant factors. We report for the first time an association between MetS and both low 25-OH-VD and high retinol concentrations. Inflammation-related biomarkers may help identify patients with a high risk of MetS who might benefit from healthy lifestyle counselling and early intervention.
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Affiliation(s)
- Belén Arranz
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Mónica Sanchez-Autet
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; University of Barcelona, Barcelona, Spain.
| | - Luis San
- Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Gemma Safont
- Hospital Universitari Mutua Terrassa, Terrassa, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain; University of Barcelona, Barcelona, Spain
| | - Lorena De La Fuente-Tomás
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | | | | | - María Paz García-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Heath AK, Kim IY, Hodge AM, English DR, Muller DC. Vitamin D Status and Mortality: A Systematic Review of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030383. [PMID: 30700025 PMCID: PMC6388383 DOI: 10.3390/ijerph16030383] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 12/31/2022]
Abstract
Epidemiological evidence suggests that vitamin D deficiency is associated with increased mortality, but it is unclear whether this is explained by reverse causation, and if there are specific causes of death for which vitamin D might be important. We conducted a systematic review of observational studies investigating associations between circulating 25-hydroxyvitamin D (25(OH)D) concentration and all-cause or cause-specific mortality in generally healthy populations. Relevant studies were identified using PubMed and EMBASE searches. After screening 722 unique records and removing those that were ineligible, 84 articles were included in this review. The vast majority of studies reported inverse associations between 25(OH)D concentration and all-cause mortality. This association appeared to be non-linear, with progressively lower mortality with increasing 25(OH)D up to a point, beyond which there was no further decrease. There is moderate evidence that vitamin D status is inversely associated with cancer mortality and death due to respiratory diseases, while for cardiovascular mortality, there is weak evidence of an association in observational studies, which is not supported by the data from intervention or Mendelian randomization studies. The relationship between vitamin D status and other causes of death remains uncertain due to limited data. Larger long-term studies are required to clarify these associations.
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Affiliation(s)
- Alicia K Heath
- School of Public Health, Imperial College London, London W2 1PG, UK.
| | - Iris Y Kim
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK.
| | - Allison M Hodge
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010, Australia.
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, Victoria 3004, Australia.
| | - Dallas R English
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010, Australia.
- Cancer Epidemiology & Intelligence Division, Cancer Council Victoria, Melbourne, Victoria 3004, Australia.
| | - David C Muller
- School of Public Health, Imperial College London, London W2 1PG, UK.
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Li J, Cordero P, Nguyen V, Oben JA. The Role of Vitamins in the Pathogenesis of Non-alcoholic Fatty Liver Disease. INTEGRATIVE MEDICINE INSIGHTS 2016; 11:19-25. [PMID: 27147819 PMCID: PMC4849418 DOI: 10.4137/imi.s31451] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Revised: 11/19/2015] [Accepted: 11/24/2015] [Indexed: 02/06/2023]
Abstract
The incidence of non-alcoholic fatty liver disease (NAFLD) is rising rapidly in parallel with obesity rates. The underlying pathogenesis of NAFLD remains an enigma but is largely influenced by individual lifestyle choices involving diet and exercise. Therefore, studies have highlighted the importance of calorie reduction and macronutrient composition (eg, carbohydrate and fat) in modifying disease outcomes. Micronutrients are also believed to play a role in disease progression. There are now an increasing number of studies linking vitamins with NAFLD, particularly vitamin E, and the supplementation of several different vitamins has been demonstrated as a promising therapeutic option in the treatment of NAFLD. This review provides a broad overview of the potential role of vitamins in NAFLD development and disease management.
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Affiliation(s)
- Jiawei Li
- Institute for Liver and Digestive Health, University College London, London, UK
| | - Paul Cordero
- Institute for Liver and Digestive Health, University College London, London, UK
| | - Vi Nguyen
- Institute for Liver and Digestive Health, University College London, London, UK.; Department of Gastroenterology and Hepatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
| | - Jude A Oben
- Institute for Liver and Digestive Health, University College London, London, UK.; Department of Gastroenterology and Hepatology, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK
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