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da Silveira EA, Moura LDANE, Castro MCR, Kac G, Hadler MCCM, Noll PRES, Noll M, Rezende ATDO, Delpino FM, de Oliveira C. Prevalence of Vitamin D and Calcium Deficiency and Insufficiency in Women of Childbearing Age and Associated Risk Factors: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14204351. [PMID: 36297034 PMCID: PMC9612098 DOI: 10.3390/nu14204351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/01/2022] [Accepted: 10/01/2022] [Indexed: 11/25/2022] Open
Abstract
Vitamin D deficiency and insufficiency as well as low serum calcium levels can trigger negative health outcomes in women of childbearing age. Therefore, we aimed to estimate the prevalence of serum vitamin D and calcium deficiencies and insufficiencies and associated risk factors in Brazilian women of childbearing age and to assess whether there are differences in prevalence according to regions of the country and the presence or absence of pregnancy. The systematic literature review was performed using the following databases: PubMed, LILACS, Embase, Scopus, and Web of Science. Cross-sectional, cohort, and intervention studies were included. Among pregnant women, the prevalence of vitamin D deficiency ranged from 0% to 27% and of vitamin D insufficiency from 33.9% to 70.4%. Among non-pregnant women, the prevalence of vitamin D deficiency ranged from 0% to 41.7% and of vitamin D insufficiency from 38.5% to 69.3%. We found a high prevalence of vitamin D deficiency and insufficiency in women of childbearing age, with insufficiency affecting more than half of these women. The highest prevalence of vitamin D deficiency and insufficiency was observed in the South region. It was not possible to assess the prevalence and factors associated with calcium deficiency.
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Affiliation(s)
- Erika Aparecida da Silveira
- Health Science Graduate Program, Faculty of Medicine, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
- Correspondence: ; Tel.: +55-6232096146
| | | | - Maria Clara Rezende Castro
- Health Science Graduate Program, Faculty of Medicine, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro, Federal University of Rio de Janeiro, Rio de Janeiro 21941-902, RJ, Brazil
| | - Maria Claret Costa Monteiro Hadler
- Health Science Graduate Program, Faculty of Medicine, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
- Graduate Program in Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
| | - Priscilla Rayanne E. Silva Noll
- Department of Obstetrics and Gynaecology, University of São Paulo, São Paulo 05403-000, SP, Brazil
- Campus Ceres, Federal Institute Goiano, Ceres 76300-000, GO, Brazil
| | - Matias Noll
- Health Science Graduate Program, Faculty of Medicine, Federal University of Goiás, Goiânia 74605-050, GO, Brazil
- Campus Ceres, Federal Institute Goiano, Ceres 76300-000, GO, Brazil
| | | | - Felipe Mendes Delpino
- Postgraduate Program in Nursing, Federal University of Pelotas, Pelotas 96010-610, RS, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
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Relationship between Maternal Vitamin D Levels and Adverse Outcomes. Nutrients 2022; 14:nu14204230. [PMID: 36296914 PMCID: PMC9610169 DOI: 10.3390/nu14204230] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/28/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022] Open
Abstract
Vitamin D (VD), a fat-soluble vitamin, has a variety of functions that are important for growth and development, including regulation of cell differentiation and apoptosis, immune system development, and brain development. As such, VD status during pregnancy is critical for maternal health, fetal skeletal growth, and optimal pregnancy outcomes. Studies have confirmed that adverse pregnancy outcomes, such as preeclampsia, low birth weight, neonatal hypocalcemia, poor postnatal growth, skeletal fragility, and increased incidence of autoimmune diseases, can be associated with low VD levels during pregnancy and infancy. Thus, there is growing interest in the role of VD during pregnancy. This review summarizes the potential adverse health outcomes of maternal VD status during pregnancy for both mother and offspring (gestational diabetes mellitus, hypertensive gestational hypertension, intrauterine growth restriction, miscarriage, stillbirth, and preterm birth) and discusses the underlying mechanisms (regulation of cytokine pathways, immune system processing, internal secretion, placental function, etc.) of VD in regulating each of the outcomes. This review aims to provide a basis for public health intervention strategies to reduce the incidence of adverse pregnancies.
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Si S, Peng Z, Cheng H, Zhuang Y, Chi P, Alifu X, Zhou H, Mo M, Yu Y. Association of Vitamin D in Different Trimester with Hemoglobin during Pregnancy. Nutrients 2022; 14:nu14122455. [PMID: 35745185 PMCID: PMC9230968 DOI: 10.3390/nu14122455] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/11/2022] [Accepted: 06/11/2022] [Indexed: 02/01/2023] Open
Abstract
The association between vitamin D and hemoglobin has been suggested. Vitamin D can affect erythropoiesis by the induction of erythroid progenitor cell proliferation and enhance iron absorption by regulating the iron-hepcidin-ferroportin axis in monocytes. However, this relationship in pregnant women is scarce. The purpose of this study was to investigate the association between plasma vitamin D levels with hemoglobin concentration in pregnant women considering each trimester and iron supplementation. The data were obtained from Zhoushan Pregnant Women Cohort, collected from 2011 to 2018. Plasma 25(OH)D was measured in each trimester using liquid chromatography−tandem mass spectrometry. Generalized estimating equations and multiple linear regressions were performed. Finally, 2962 pregnant women and 4419 observations in the first trimester were included in this study. Plasma 25(OH)D in first trimester (T1) (β = 0.06, p = 0.0177), second trimester (T2) (β = 0.15, p < 0.0001), and third trimester (T3) (β = 0.12, p = 0.0006) were positively associated with Hb. Association between plasma 25(OH)D levels in T1 and Hb concentration was positively associated with gestational age (β = 0.005, p = 0.0421). Pregnant women with VD deficiency in T1 (OR = 1.42, 95% CI: 1.07−1.88) or T2 (OR = 1.94, 95% CI: 1.30−2.89) presented an increased risk of anemia, compared with women without VD deficiency. Moreover, the significant relationship between VD and Hb was only observed among women with iron supplementation during pregnancy. Plasma 25(OH)D levels in each trimester were positively associated with Hb concentration. Iron supplementation might be an important factor affecting the relationship between VD and Hb.
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Affiliation(s)
- Shuting Si
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Zhicheng Peng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haoyue Cheng
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yan Zhuang
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Peihan Chi
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xialidan Alifu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Haibo Zhou
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Minjia Mo
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Yunxian Yu
- Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310058, China; (S.S.); (Z.P.); (H.C.); (Y.Z.); (P.C.); (X.A.); (H.Z.); (M.M.)
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou 310058, China
- Correspondence: ; Tel.: +86-571-8820-8191
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Lucchetta RC, Lemos IH, Gini ALR, Cavicchioli SDA, Forgerini M, Varallo FR, de Nadai MN, Fernandez-Llimos F, Mastroianni PDC. Deficiency and Insufficiency of Vitamin D in Women of Childbearing Age: A Systematic Review and Meta-analysis. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2022; 44:409-424. [PMID: 35211934 PMCID: PMC9948108 DOI: 10.1055/s-0042-1742409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of inadequate vitamin D level and its associated factors for women of childbearing age in Brazil. METHODS A systematic review was conducted (last updated May 2020). Meta-analyses were performed using the inverse-variance for fixed models with summary proportion calculation by Freeman-Tukey double arcsine. Reporting and methodological quality were assessed using the Joanna Briggs Institute tool for prevalence studies. RESULTS Our review identified 31 studies, comprising 4,006 participants. All the studies had at least one weakness, mainly due to the use of convenience sampling and small sample size. The overall prevalence of vitamin D deficiency, insufficiency, and both deficiency and insufficiency were 35% (confidence interval, 95%CI: 34-37%), 42% (95%CI: 41-44%), and 72% (95%CI: 71-74%), respectively. CONCLUSION Although the magnitude of the prevalence of inadequate levels of vitamin D is uncertain, the evidence suggests that presence of vitamin D deficiency or insufficiency in women of reproductive age can cause moderate to severe problems.
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Affiliation(s)
- Rosa Camila Lucchetta
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual de São Paulo, São Paulo, SP, Brazil
| | - Isabele Held Lemos
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual de São Paulo, São Paulo, SP, Brazil
| | - Ana Luísa Rodriguez Gini
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual de São Paulo, São Paulo, SP, Brazil
| | | | - Marcela Forgerini
- Department of Drugs and Medicines, School of Pharmaceutical Sciences, Universidade Estadual de São Paulo, São Paulo, SP, Brazil
| | - Fabiana Rossi Varallo
- Department of Pharmaceutical Sciences, Faculty of Pharmaceutical Sciences of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Mariane Nunes de Nadai
- Department of Dentistry, Pediatric Dentistry and Public Health, Bauru School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
| | - Fernando Fernandez-Llimos
- Department of Drug Sciences, Laboratory of Pharmacology, Faculty of Pharmacy, Universidade do Porto, Porto, Portugal
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Lima MS, Pereira M, Castro CT, Santos DB. Vitamin D deficiency and anemia in pregnant women: a systematic review and meta-analysis. Nutr Rev 2021; 80:428-438. [PMID: 34969067 DOI: 10.1093/nutrit/nuab114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
CONTEXT Epidemiological studies suggest an association between vitamin D deficiency and anemia. Evidence of this relationship in pregnant women, however, is scarce. OBJECTIVE The aim of this systematic review was to investigate the association between vitamin D deficiency and gestational anemia through observational studies. DATA SOURCES The PubMed, Scopus, Web of Science, ScienceDirect, Embase, and Virtual Health Library databases were searched from inception to April 2021. STUDY SELECTION Original articles reporting observational studies that investigated the association between vitamin D deficiency and gestational anemia were included. Articles that did not have an abstract, as well as reviews articles, experimental studies, and editorials, were excluded. Two reviewers independently performed study selection, data extraction, and assessment of study quality. Disagreements between the reviewers were resolved by a third reviewer. DATA EXTRACTION Study quality was assessed by 2 scales. Data were extracted from eligible studies and arranged in a 2 × 2 table. Odds ratios with 95% confidence intervals for the risk of the outcome were estimated using a fixed-effect model. RESULTS In total, 985 studies were retrieved, of which 17 were included in the systematic review: 11 cohort studies, 3 case-control studies, and 3 cross-sectional studies. For the meta-analysis, 8 studies with a total of 6530 women were included. There was a 61% increase in the odds of anemia in pregnant women with vitamin D deficiency (OR = 1.61; 95%CI, 1.41-1.83; I2 = 48%). CONCLUSIONS Vitamin D deficiency may be a risk factor for anemia in pregnant women. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42020182697.
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Affiliation(s)
- Michele S Lima
- M.S. Lima is with the Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil. M. Pereira and C.T. Castro are with the Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. D.B. Santos is with the Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Marcos Pereira
- M.S. Lima is with the Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil. M. Pereira and C.T. Castro are with the Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. D.B. Santos is with the Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Caroline T Castro
- M.S. Lima is with the Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil. M. Pereira and C.T. Castro are with the Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. D.B. Santos is with the Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
| | - Djanilson B Santos
- M.S. Lima is with the Department of Health, Feira de Santana State University, Feira de Santana, Bahia, Brazil. M. Pereira and C.T. Castro are with the Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil. D.B. Santos is with the Health Sciences Center, Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, Bahia, Brazil
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The effect of prepregnancy body mass index on maternal micronutrient status: a meta-analysis. Sci Rep 2021; 11:18100. [PMID: 34518612 PMCID: PMC8437962 DOI: 10.1038/s41598-021-97635-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/09/2021] [Indexed: 12/17/2022] Open
Abstract
The relationship between prepregnancy body mass index (BMI) and maternal micronutrient status is inconsistent and has not received sufficient attention. This meta-analysis aimed to evaluate the effect of prepregnancy BMI on micronutrient levels in pregnant women. PubMed, Embase, Web of Science, and the Cochrane Library were searched for articles that contained information on micronutrient levels and prepregnancy BMI. A random-effects model was used to determine the association between prepregnancy BMI and maternal micronutrient status. Sixty-one eligible articles were eventually included, with 83,554 participants. Vitamin B12, folate, vitamin D, iron and ferritin were the main micronutrients evaluated in our meta-analysis. Prepregnancy obesity and overweight may lead to an increased risk of micronutrient deficiency, including vitamin B12, folate and vitamin D deficiency, while prepregnancy obesity or overweight may have no significant association with ferritin deficiency. Additionally, the results of the dose-response analyses demonstrated a possible significant inverse correlation between prepregnancy BMI and levels of micronutrient, except for iron and ferritin. Compared with women with normal weight, women who were overweight or obese prepregnancy have lower micronutrient concentrations and are more likely to exhibit micronutrient deficiency during pregnancy, which is harmful to both mothers and neonates.
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Arévalo NB, Castillo-Godoy DP, Espinoza-Fuenzalida I, Rogers NK, Farias G, Delgado C, Henriquez M, Herrera L, Behrens MI, SanMartín CD. Association of Vitamin D Receptor Polymorphisms with Amyloid-β Transporters Expression and Risk of Mild Cognitive Impairment in a Chilean Cohort. J Alzheimers Dis 2021; 82:S283-S297. [DOI: 10.3233/jad-201031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Amyloid-β peptide (Aβ) deposition in Alzheimer’s disease (AD) is due to an imbalance in its production/clearance rate. Aβ is transported across the blood-brain barrier by LRP1 and P-gp as efflux transporters and RAGE as influx transporter. Vitamin D deficit and polymorphisms of the vitamin D receptor (VDR) gene are associated with high prevalence of mild cognitive impairment (MCI) and AD. Further, vitamin D promotes the expression of LRP1 and P-gp in AD-animal model brains. Objective: To associate VDR polymorphisms Apa I (rs7975232), Taq I (rs731236), and Fok I (rs2228570) with the risk of developing MCI in a Chilean population, and to evaluate the relationship of these polymorphisms to the expression of VDR and Aβ-transporters in peripheral blood mononuclear cells (PBMCs). Methods: VDR polymorphisms Apa I, Taq I, and Fok I were determined in 128 healthy controls (HC) and 66 MCI patients. mRNA levels of VDR and Aβ-transporters were evaluated in subgroups by qPCR. Results: Alleles A of Apa I and C of Taq I were associated with a lower risk of MCI. HC with the Apa I AA genotype had higher mRNA levels of P-gp and LRP1, while the expression of VDR and RAGE were higher in MCI patients and HC. For Fok I, the TC genotype was associated with lower expression levels of Aβ-transporters in both groups. Conclusion: We propose that the response to vitamin D treatment will depend on VDR polymorphisms, being more efficient in carriers of protective alleles of Apa I polymorphism.
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Affiliation(s)
- Nohela B. Arévalo
- Center for Integrative Biology, Faculty of Science, Universidad Mayor, Santiago, Chile
- Programa de Genética Humana, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | | | | | - Nicole K. Rogers
- Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gonzalo Farias
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
- Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carolina Delgado
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Mauricio Henriquez
- Programa de Fisiología y Biofísica, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Red para el Estudio de Enfermedades Cardiopulmonares de Alta Letalidad (REECPAL), Universidad de Chile, Santiago, Chile
| | - Luisa Herrera
- Programa de Genética Humana, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - María Isabel Behrens
- Departamento de Neurociencia, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
- Centro de Investigación Clínica Avanzada (CICA), Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de Neurología y Psiquiatría, Clínica Alemana de Santiago, Santiago, Chile
| | - Carol D. SanMartín
- Center for Integrative Biology, Faculty of Science, Universidad Mayor, Santiago, Chile
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
- Escuela de Tecnologia Médica, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
- Escuela de Biotecnología, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
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Vitamin D during pregnancy and its association with birth outcomes: a Brazilian cohort study. Eur J Clin Nutr 2020; 75:489-500. [PMID: 32879447 DOI: 10.1038/s41430-020-00733-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/14/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Evidence is lacking on how variation in vitamin D concentrations during gestation affects perinatal outcomes. Therefore, we evaluated the association between vitamin D serum concentrations during pregnancy and neonatal outcomes. METHODS A prospective cohort of 180 healthy Brazilian pregnant women was followed and plasma 25-hydroxyvitamin [25(OH)D, nmol/L] was measured at 5-13 (baseline), 20-26 and 30-36 gestational weeks. Birth weight (BW), birth length (BL), BW z-scores, BL z-scores, first minute Apgar, small for gestational age (SGA), large for gestational age (LGA) and preterm birth were the outcomes. Multiple linear and Poisson regression models were estimated. Best linear unbiased prediction of random coefficients model was used to determine the association between the mean rate of change in vitamin D during pregnancy concentrations and neonatal outcomes. RESULTS Mean (SD) BW was 3300 (600) g, BW z-score 0.34 (1.11), BL 49.3 (3.3) cm, BL z-score 0.44 (1.5), and first minute Apgar score 8.2 (1.4). Prevalence of SGA, LGA and preterm birth were 6%, 18% and 13%, respectively. 25(OH)D was directly associated with the risk of preterm birth at all trimesters. Incidence-rate ratios were 1.02, 1.05 and 1.04 for the 1st, 2nd and 3rd trimester, respectively. Mean rate of change during pregnancy in 25(OH)D was directly associated with BW z-score (β: 0.36, 95% CI 0.07; 0.65), LGA risk (IRR: 1.97, 95% CI 1.07; 3.63) and preterm birth (IRR: 7.35, 95% CI 2.99; 18.07). CONCLUSIONS Mean 25(OH)D rate of change during pregnancy was directly associated with BW z-scores, and increased LGA and preterm birth risk.
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Joukar F, Naghipour M, Hassanipour S, Fakhrieh Asl S, Pourshams A, Mansour-Ghanaei F. Vitamin D deficiency associated with reproductive factors in northern Iranian women: The PERSIAN Guilan Cohort Study (PGCS). Clin Nutr ESPEN 2020; 38:271-276. [PMID: 32690168 DOI: 10.1016/j.clnesp.2020.03.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 02/15/2020] [Accepted: 03/23/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND One of the public health concerns is Vitamin D deficiency. The aim of this study was to determine the prevalence of vitamin D inadequacy and to determine its reproductive factor correlates in northern Iranian women. METHODS This study, conducted on 5096 females aged 35-70 years. The study was based on data from PERSIAN Guilan Cohort Study (PGCS), a prospective, population-based cohort study in Guilan, Iran. History of reproductive and gynecologic factors, including age at menarche, age at first marriage, number of pregnancies or live births, age at first pregnancy, duration of breastfeeding, number of abortions, age and type of menopause status, use of oral contraceptives or hormone replacement therapy, history of hysterectomy, tubectomy or oophorectomy and history of gestational diabetes and hypertension was collected. Serum 25(OH) vitamin D was measured. RESULTS The mean 25(OH)-D concentration was 21.78 ng/mL, and 53.5% of women had vitamin D inadequacy. The multivariate analyses revealed that younger age (36-45 years) [>66 years adjusted odds ratio (aOR) = 2.1, 95% CI 1.7-2.7, 56-65 years aOR = 1.7, 95% CI 1.3-2.1 and 46-55 years aOR = 1.4, 95% CI 1.1-1.7], not consuming oral contraceptives [aOR = 1.1, 95% CI 1.05-1.3] and pre-menopausal status [aOR = 1.4, 95% CI 1.2-1.6] were significantly independently associated with vitamin D inadequacy. CONCLUSION Vitamin D inadequacy is common in northern Iranian women. The reproductive factors that independently correlated with vitamin D statues are oral contraceptive consumption and menopausal statue.
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Affiliation(s)
- Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran; Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammadreza Naghipour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Soheil Hassanipour
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Saba Fakhrieh Asl
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Akram Pourshams
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran; Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Nandi A, Wadhwani N, Joshi SR. Vitamin D deficiency influences fatty acid metabolism. Prostaglandins Leukot Essent Fatty Acids 2019; 140:57-63. [PMID: 30553405 DOI: 10.1016/j.plefa.2018.11.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/28/2018] [Accepted: 11/28/2018] [Indexed: 12/20/2022]
Abstract
Reports indicate that maternal vitamin D deficiency may be associated with increased inflammation. Long chain polyunsaturated fatty acids (LCPUFAs); omega-3 and omega-6 fatty acids are known to have anti-inflammatory and pro-inflammatory properties respectively. The present study examines the effect of vitamin D deficiency on fatty acid composition and metabolism in a rat model. Female Wistar rats were randomly divided into two groups (n = 8/group) as follows; control and vitamin D deficient (VDD). Diets (control: 1000 IU D3/kg diet; VDD: 0 IU D3/kg diet) were given from weaning and continued throughout pregnancy. Pregnant female rats were dissected on gestational day 20 to collect blood, liver and placenta. The VDD diet reduced maternal serum 25-hydroxyviatmin D3 levels (p < 0.001) as compared to control. Maternal vitamin D deficiency resulted in lower total weight gain and placental weight (p < 0.05 for both) during pregnancy. Animals from VDD group demonstrated higher arachidonic acid (AA) levels in both the liver and plasma (p < 0.05 for both) as compared to control. Liver, plasma and placental monounsaturated fatty acid levels (MUFA) were lower (p < 0.01 for all) while plasma total saturated fatty acids (SFA) (p = 0.05) were higher in the VDD group. Animals from the VDD group demonstrated lower ∆9-desaturase activity index (p < 0.01 for all) in the liver, plasma and placenta. The plasma ∆5-desaturase activity index (p < 0.05) was higher although no change was observed in the ∆6-desaturase activity index. However, the mRNA levels of liver ∆6-desaturase was lower (p < 0.05) in the VDD group. Our findings indicate that maternal vitamin D deficiency influences fatty acid desaturase activity and expression and therefore alters maternal fatty acid metabolism.
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Affiliation(s)
- A Nandi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune411043, India
| | - N Wadhwani
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune411043, India
| | - S R Joshi
- Mother and Child Health, Interactive Research School for Health Affairs (IRSHA), Bharati Vidyapeeth (Deemed to be University), Pune Satara Road, Pune411043, India.
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Longitudinal association of 25-hydroxyvitamin D with adipokines and markers of glucose metabolism among Brazilian pregnant women. Br J Nutr 2018; 121:42-54. [DOI: 10.1017/s0007114518003057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AbstractThis study aimed to evaluate the longitudinal association of vitamin D status with glycaemia, insulin, homoeostatic model assessment of insulin resistance, adiponectin and leptin. A prospective cohort with 181 healthy, pregnant Brazilian women was followed at the 5th–13th, 20th–26th and 30th–36th gestational weeks. In this cohort, 25-hydroxyvitamin D (25(OH)D) plasma concentrations were analysed using liquid chromatography–tandem MS. Vitamin D status was categorised as sufficient or insufficient using the Endocrine Society Practice Guidelines (≥75/<75 nmol/l) and the Institute of Medicine (≥50/<50 nmol/l) thresholds. Linear mixed-effect regression models were employed to evaluate the association between vitamin D status and each outcome, considering interaction terms between vitamin D status and gestational age (P<0·1). At baseline, 70·7 % of pregnant women had 25(OH)D levels <75 nmol/l and 16 % had levels <50 nmol/l. Women with sufficient vitamin D status at baseline, using both thresholds, presented lower glycaemia than those with insufficient 25(OH)D. Pregnant women with 25(OH)D concentrations <75 nmol/l showed lower insulin (β=−0·12; 95 % CI −0·251, 0·009;P=0·069) and adiponectin (β=−0·070; 95 % CI −0·150, 0·010;P=0·085) concentrations throughout pregnancy than those with 25(OH)D levels ≥75 nmol/l. Pregnant women with 25(OH)D <50 nmol/l at baseline presented significantly higher leptin concentrations than those with 25(OH)D levels ≥50 nmol/l (β=−0·253; 95 % CI −0·044, 0·550;P=0·095). The baseline status of vitamin D influences the biomarkers involved in glucose metabolism. Vitamin D-sufficient women at baseline had higher increases in insulin and adiponectin changes throughout gestation than those who were insufficient.
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Kassai MS, Cafeo FR, Affonso-Kaufman FA, Suano-Souza FI, Sarni ROS. Vitamin D plasma concentrations in pregnant women and their preterm newborns. BMC Pregnancy Childbirth 2018; 18:412. [PMID: 30348112 PMCID: PMC6198501 DOI: 10.1186/s12884-018-2045-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/05/2018] [Indexed: 12/20/2022] Open
Abstract
Background Vitamin D deficiency is a global public health issue. More than half of pregnant women are affected by vitamin D insufficiency/deficiency. Studies suggest an association between low vitamin D concentrations during pregnancy with intrauterine growth restriction and prematurity. This study aimed to describe the concentrations of 25(OH)D (25-hydroxyvitamin D) of mothers who delivered preterm newborns compared to women with full-term pregnancy deliveries, as well as to relate 25(OH)D blood concentrations of mothers with those of their newborns. Method This cross-sectional study was conducted with 66 mothers who had given birth to preterm babies and their preterm newborns (PTNB, < 32 weeks), and 92 women who had given birth at the full-term of their pregnancy and their newborns (FTNB). Data were collected on the characteristics of mothers (gestational age, diseases, and habits) and newborns (anthropometry and adequacy for gestational age). Ten milliliters of blood were drawn from the mothers and the umbilical cord of newborns at birth to identify the 25(OH)D, parathyroid hormone, calcium, phosphorus, and alkaline phosphatase concentrations. Results Mothers in the PTNB group had significantly lower mean 25(OH)D blood levels (21.7 ± 10.8 ng/mL vs. 26.2 ± 9.8 ng/mL; p = 0.011) and were three times more likely to have insufficiency when compared to mothers in the FTNB group (OR = 2.993; 95%CI 1.02–8.74). Newborns in the PTNB group also had lower 25(OH)D concentrations compared to FTNB group (25.9 ± 13.9 ng/dL vs. 31.9 ± 12.3 ng/dL; p = 0.009). There was a directly proportional correlation between mother and newborn umbilical cord 25(OH)D concentrations in PTNB (r = 0.596; p < 0.001) and FTNB (r = 0.765; p < 0.001). Conclusion Mothers who delivered preterm babies and their preterm newborns had lower 25(OH)D concentrations compared to women who had given birth at the full-term of their pregnancy. In both groups, 25(OH)D concentrations of the mothers correlated directly with those of the newborns, and this correlation was higher in the full-term birth group. Nevertheless, the recommended universal vitamin D supplementation in pregnant women to curb the risk of preterm birth is still incipient. More studies are required to clarify the particularities of vitamin D metabolism further and define the adequate 25(OH)D concentrations throughout pregnancy.
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Affiliation(s)
- Milene Saori Kassai
- Department of Pediatrics, Faculdade de Medicina do ABC, Avenida Lauro Gomes, 2000. Vila Sacadura Cabral, Santo André, São Paulo, 09060-870, Brazil
| | - Fernanda Ramirez Cafeo
- Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina, Rua Botucatu, 898, Vila Clementino, São Paulo, 04023-062, Brazil
| | - Fernando Alves Affonso-Kaufman
- Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina, Rua Botucatu, 898, Vila Clementino, São Paulo, 04023-062, Brazil
| | - Fabíola Isabel Suano-Souza
- Department of Pediatrics, Faculdade de Medicina do ABC, Avenida Lauro Gomes, 2000. Vila Sacadura Cabral, Santo André, São Paulo, 09060-870, Brazil. .,Department of Pediatrics, Universidade Federal de São Paulo - Escola Paulista de Medicina, Rua Botucatu, 898, Vila Clementino, São Paulo, 04023-062, Brazil.
| | - Roseli Oselka Saccardo Sarni
- Department of Pediatrics, Faculdade de Medicina do ABC, Avenida Lauro Gomes, 2000. Vila Sacadura Cabral, Santo André, São Paulo, 09060-870, Brazil
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