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Mehdad S, Belghiti H, Zahrou FE, Guerinech H, Mouzouni FZ, El Hajjab A, El Berri H, El Ammari L, Benaich S, Benkirane H, Barkat A, Aguenaou H. Vitamin D status and its relationship with obesity indicators in Moroccan adult women. Nutr Health 2023; 29:673-681. [PMID: 35435056 DOI: 10.1177/02601060221094376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Although vitamin D deficiency has been studied in various populations, there are few data on its prevalence and associated factors among Moroccan women. Aim: To determine the prevalence of vitamin D deficiency and investigate its association with body mass index (BMI), waist circumference, and serum concentrations of parathyroid hormone, calcium, and phosphorus in a sample of Moroccan adult women. Methods: This is a cross-sectional study conducted at Mohammed V Military Hospital of Instruction, Rabat. Anthropometric measurements and biochemical analyses were performed using standard procedures Results: A total of 714 women aged 18-65 years participated in this study. The overall prevalence of vitamin D deficiency was 74.4%. Approximately 24% and 51% of women had severe and moderate vitamin D deficiency, respectively. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were inversely correlated with BMI in vitamin D-deficient subjects (P = 0.036) and with parathyroid hormone 1-84 (PTH1-84) levels in the study sample (P = 0.010). PTH1-84 concentrations were greater among overweight/obese individuals compared to their non-overweight peers (P = 0.001) and tended to be higher among vitamin D-deficient women than vitamin D-sufficient women (P = 0.053). Conclusion: This study showed a very high prevalence of vitamin D deficiency in this sample of Moroccan women. Lower serum 25(OH)D levels were associated with increased BMI in vitamin D-deficient women and with elevated PTH1-84 levels among the study sample. Although these findings come from a convenience sample of women that attended a nutrition clinic, they underscore the urgent need to develop public health interventions to improve women's vitamin D status.
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Affiliation(s)
- Slimane Mehdad
- Physiology and Physiopathology Research Team, Research Centre of Human Pathologies Genomics, Faculty of Sciences, Mohammed V University in Rabat, Morocco
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hakim Belghiti
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Fatima Ezzahra Zahrou
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hassania Guerinech
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
| | | | - Amina El Hajjab
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | | | | | - Souad Benaich
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hasnae Benkirane
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Amina Barkat
- Health and Nutrition Research Team of the Mother-Child Couple, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Hassan Aguenaou
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
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2
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Dadda S, El Houate B, El Bouhali B. Multifactorial hypovitaminosis D among women in the South-East Oases of Morocco. Arch Osteoporos 2022; 18:14. [PMID: 36574180 DOI: 10.1007/s11657-022-01204-8] [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] [Received: 07/06/2022] [Accepted: 12/15/2022] [Indexed: 12/28/2022]
Abstract
This study assessed the vitamin D status among women in South-East Oases of Morocco. Two hundred thirty-three healthy volunteer women were recruited at five urban and rural health centers. Hypovitaminosis D is very common in this region and correlated to age, monthly income, skin color, daily sun exposure, BMI, and body fat percentage. PURPOSE This study assessed the vitamin D status among women in the Draa-Tafilalet region and its relationship with clinical, anthropometric, and behavioral parameters. METHODS The study was carried out with 233 women in consultation at five urban and rural health centers in the South-East region of Morocco. The data collected relate to age, monthly income, educational level, BMI, body fat percentage, daily sun exposure, physical activity level, veil wear, and skin color. The plasma determination of vitamin D was measured by immunofluorescence. Statistical analyses were performed using Python and Jamovi. RESULTS The median 25(OH)D plasma concentration was 9.95 ng/mL (IQR: 8-13.18). A total of 50.64% of women had 25(OH)D levels below 10 ng/ml and 47.21% had levels between 10 and 30 ng/mL. Statistical tests showed an association between hydroxyvitamin D plasma levels and age (r = - 0.139; p = 0.034), monthly income (p = 0.001), BMI (r = - 0.200; p = 0.002), body fat percentage (r = - 0.131; p = 0.049), daily sun exposure (r = 0.165; p = 0.012), and skin color (p < 0.001). Binomial logistic regression showed that darker skin was associated with vitamin D deficiency (< 10 ng/mL). It also showed that high income and longer sun exposure could be protecting factors against vitamin D deficiency. CONCLUSION The plasma concentrations of vitamin D in women in the Draa-Tafilalet region were low compared to expected results for a high sunshine time area.
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Affiliation(s)
- Sakhr Dadda
- Department of Biology, Faculty of Science and Techniques of Errachidia, Moulay Ismail University of Meknes, Errachidia, Morocco
| | - Brahim El Houate
- Higher Institute of Nursing and Health Professions, Ouarzazate, Morocco
| | - Bachir El Bouhali
- Department of Biology, Faculty of Science and Techniques of Errachidia, Moulay Ismail University of Meknes, Errachidia, Morocco.
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3
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Miller KM, Klerk NHD, Davis EA, Lucas RM, Hart PH, Haynes A. Demographic and clinical predictors of vitamin D status in pregnant women tested for deficiency in Western Australia. Aust N Z J Public Health 2021; 45:474-481. [PMID: 34473387 DOI: 10.1111/1753-6405.13150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 06/01/2021] [Accepted: 07/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study aimed to describe the vitamin D status of pregnant women in Western Australia and identify predictors of deficiency in pregnancy. METHODS A cross-sectional study was conducted using linked data from statewide administrative data collections. Participants included pregnant women aged 18-44 years who gave birth between 2012 and 2014. RESULTS The mean 25-hydroxyvitamin D (25[OH]D) concentration was 70.7 nmol L-1 (SD 25.7; range 5-255 nmol L-1 ). Approximately one-fifth of the pregnant women were vitamin D deficient (<50 nmol L-1 ). Maternal age (under 25 years) was identified as an independent risk factor of vitamin D deficiency in addition to known predictors. Only 20% of women were screened within the first 10 weeks of their pregnancy. CONCLUSIONS In addition to the existing risk factors for deficiency, maternal age was an independent predictor of vitamin D deficiency. There was a large discrepancy between the time of first antenatal visit and screening for vitamin D deficiency. Implications for public health: Our findings support the addition of maternal age (under 25 years) to the current clinical guidelines for targeted screening of 25(OH)D levels in pregnancy and the practical application of screening for vitamin D deficiency at the first antenatal visit.
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Affiliation(s)
- Kate M Miller
- School of Medicine, University of Western Australia.,Telethon Kids Institute, Western Australia
| | - Nick H de Klerk
- School of Medicine, University of Western Australia.,Telethon Kids Institute, Western Australia
| | - Elizabeth A Davis
- Telethon Kids Institute, Western Australia.,Perth Children's Hospital, Nedlands, Western Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Australian Capital Territory
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4
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Ncayiyana JR, Martinez L, Goddard E, Myer L, Zar HJ. Prevalence and Correlates of Vitamin D Deficiency among Young South African Infants: A Birth Cohort Study. Nutrients 2021; 13:nu13051500. [PMID: 33946851 PMCID: PMC8146842 DOI: 10.3390/nu13051500] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/18/2021] [Accepted: 04/20/2021] [Indexed: 12/21/2022] Open
Abstract
Early-life vitamin D deficiency is associated with adverse child health outcomes, but the prevalence of vitamin D deficiency and its correlates in infants remains underexplored, particularly in sub-Saharan Africa. We aimed to investigate the prevalence of vitamin D deficiency and its correlates among young infants in South Africa. This study included 744 infants, aged 6–10 weeks from the Drakenstein Child Health Study, a population-based birth cohort. Infants were categorized into distinct categories based on serum 25(OH)D concentration level including deficient (<50 nmol/L), insufficient (50–74 nmol/L), and sufficient (≥75 nmol/L). Using multivariable Tobit and logistic regression models, we examined the correlates of serum 25(OH)D3 levels. The overall prevalence of vitamin D deficiency was 81% (95% confidence intervals (CI]) 78–83). Multivariable regression analysis showed that serum 25(OH)D3 concentration was independently associated with study site, socioeconomic status, and sex. Birth in winter and breastfeeding were the strongest predictors of lower serum 25(OH)D3 concentration levels. Compared to non-breastfed children, children breastfed were at higher risk of vitamin D deficiency (AOR, 1.96; 95% CI, 1.04–3.67) and breastfeeding for more than one month was associated with greater likelihood of vitamin D deficiency (AOR, 5.40; 95% CI, 2.37–12.32) and lower vitamin D concentrations (−16.22 nmol/L; 95% CI, −21.06, −11.39). Vitamin D deficiency in infants is ubiquitous, under-recognised, and strongly associated with season of birth and breastfeeding in this setting. Nutritional interventions with vitamin D supplementation in national health programs in low- and middle-income countries are urgently needed to improve early-life vitamin D status in infants.
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Affiliation(s)
- Jabulani R. Ncayiyana
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
- Division of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Correspondence: ; Tel.: +27-31-260-4459
| | - Leonardo Martinez
- Department of Epidemiology, School of Public Health, Boston University, Boston, MA 02118, USA;
| | - Elizabeth Goddard
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town 7700, South Africa; (E.G.); (H.J.Z.)
| | - Landon Myer
- Division of Epidemiology & Biostatistics, School of Public Health and Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa;
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town 7700, South Africa; (E.G.); (H.J.Z.)
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5
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Dominguez LJ, Farruggia M, Veronese N, Barbagallo M. Vitamin D Sources, Metabolism, and Deficiency: Available Compounds and Guidelines for Its Treatment. Metabolites 2021; 11:metabo11040255. [PMID: 33924215 PMCID: PMC8074587 DOI: 10.3390/metabo11040255] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 02/06/2023] Open
Abstract
Studies on vitamin/hormone D deficiency have received a vast amount of attention in recent years, particularly concerning recommendations, guidelines, and treatments. Moreover, vitamin D’s role as a hormone has been confirmed in various enzymatic, metabolic, physiological, and pathophysiological processes related to many organs and systems in the human body. This growing interest is mostly due to the evidence that modest-to-severe vitamin D deficiency is widely prevalent around the world. There is broad agreement that optimal vitamin D status is necessary for bones, muscles, and one’s general health, as well as for the efficacy of antiresorptive and anabolic bone-forming treatments. Food supplementation with vitamin D, or the use of vitamin D supplements, are current strategies to improve vitamin D levels and treat deficiency. This article reviews consolidated and emerging concepts about vitamin D/hormone D metabolism, food sources, deficiency, as well as the different vitamin D supplements available, and current recommendations on the proper use of these compounds.
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Giustina A, Bouillon R, Binkley N, Sempos C, Adler RA, Bollerslev J, Dawson-Hughes B, Ebeling PR, Feldman D, Heijboer A, Jones G, Kovacs CS, Lazaretti-Castro M, Lips P, Marcocci C, Minisola S, Napoli N, Rizzoli R, Scragg R, White JH, Formenti AM, Bilezikian JP. Controversies in Vitamin D: A Statement From the Third International Conference. JBMR Plus 2020; 4:e10417. [PMID: 33354643 PMCID: PMC7745884 DOI: 10.1002/jbm4.10417] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/18/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022] Open
Abstract
The Third International Conference on Controversies in Vitamin D was held in Gubbio, Italy, September 10–13, 2019. The conference was held as a follow‐up to previous meetings held in 2017 and 2018 to address topics of controversy in vitamin D research. The specific topics were selected by the steering committee of the conference and based upon areas that remain controversial from the preceding conferences. Other topics were selected anew that reflect specific topics that have surfaced since the last international conference. Consensus was achieved after formal presentations and open discussions among experts. As will be detailed in this article, consensus was achieved with regard to the following: the importance and prevalence of nutritional rickets, amounts of vitamin D that are typically generated by sun exposure, worldwide prevalence of vitamin D deficiency, the importance of circulating concentrations of 25OHD as the best index of vitamin D stores, definitions and thresholds of vitamin D deficiency, and efficacy of vitamin D analogues in the treatment of psoriasis. Areas of uncertainly and controversy include the following: daily doses of vitamin D needed to maintain a normal level of 25OHD in the general population, recommendations for supplementation in patients with metabolic bone diseases, cutaneous production of vitamin D by UVB exposure, hepatic regulation of 25OHD metabolites, definition of vitamin D excess, vitamin D deficiency in acute illness, vitamin D requirements during reproduction, potential for a broad spectrum of cellular and organ activities under the influence of the vitamin D receptor, and potential links between vitamin D and major human diseases. With specific regard to the latter area, the proceedings of the conference led to recommendations for areas in need of further investigation through appropriately designed intervention trials. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital Milan Italy
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases Metabolism and Ageing KU Leuven Leuven Belgium
| | - Neil Binkley
- Osteoporosis Clinical Research Program on Aging, University of Wisconsin Madison WI USA
| | | | - Robert A Adler
- McGuire Veterans Affairs Medical Center and Virginia Commonwealth University School of Medicine Richmond VA USA
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway, and Faculty of Medicine University of Oslo Oslo Norway
| | - Bess Dawson-Hughes
- Jean Mayer USDA Nutrition Research Center on Aging Tufts University Boston MA USA
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences Monash University Calyton Victoria Australia
| | - David Feldman
- Department of Medicine Stanford University School of Medicine Stanford CA USA
| | - Annemieke Heijboer
- Endocrine Laboratory, Department of Clinical Chemistry Amsterdam UMC, Vrije Universiteit Amsterdam and University of Amsterdam, Amsterdam Gastroenterology & Metabolism Amsterdam The Netherlands
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences Queen's University Kingston Ontario Canada
| | - Christopher S Kovacs
- Faculty of Medicine Memorial University of Newfoundland St. John's Newfoundland and Labrador Canada
| | - Marise Lazaretti-Castro
- Division of Endocrinology Escola Paulista de Medicina-Universidade Federal de Sao Paulo (EPM-UNIFESP) São Paulo Brazil
| | - Paul Lips
- Department of Internal Medicine, Endocrine Section Amsterdam University Medical Center Amsterdam The Netherlands
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine University of Pisa Pisa Italy
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines University of Rome "Sapienza" Rome Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes Campus Bio-Medico, University of Rome Rome Italy.,Division of Bone and Mineral Diseases Washington University in St. Louis St. Louis MO USA
| | - Rene Rizzoli
- Service of Bone Diseases Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Robert Scragg
- School of Population Health University of Auckland Auckland New Zealand
| | - John H White
- Department of Physiology McGill University Montreal Quebec Canada
| | - Anna Maria Formenti
- Institute of Endocrine and Metabolic Sciences, San Raffaele, Vita-Salute University and IRCCS Hospital Milan Italy
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, College of Physicians and Surgeons Columbia University New York NY USA
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7
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Shrestha D, Budhathoki S, Pokhrel S, Sah AK, Shrestha RK, Raya GB, Shrestha R, Pasakhala R, Smith C, Dhoubhadel BG. Prevalence of vitamin D deficiency in pregnant women and their babies in Bhaktapur, Nepal. BMC Nutr 2020; 5:31. [PMID: 32153944 PMCID: PMC7050914 DOI: 10.1186/s40795-019-0294-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 05/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background Vitamin D deficiency has been observed worldwide in pregnant women and their newborns. Maternal vitamin D deficiency can lead to deficiency in their newborn baby and has been linked with various complications during pregnancy and delivery. There is risk of premature delivery and it is associated with high neonatal mortality. Methods Seventy-nine pregnant women who were admitted to the Siddhi Memorial Hospital for delivery and their newborn babies were enrolled in the study. Maternal blood samples were taken before delivery while umbilical cord blood samples of their babies were taken after delivery. Serum vitamin D level and calcium level were assessed by fluorescence immunoassay using Ichromax vitamin D kit and endpoint method, respectively in the Siddhi Memorial Hospital laboratory. Results Mean +/− SD serum vitamin D and calcium levels in pregnant mother before delivery were 14.6 +/− 8.5 ng/ml and 8.0 +/− 0.5 mg/dl, respectively, and in the cord blood were 25.7 +/− 11.2 ng/ml and 8.6 +/− 0.9 mg/dl, respectively. Eighty-one percent of the mothers and 35.8% of their babies were found to have vitamin D deficiency. Although 97.5% of the pregnant women were taking calcium supplementation, serum calcium was found lower than the normal reference value in 67% of the pregnant women and 64.2% of their babies. There were a linear relationship between the maternal and baby’s serum vitamin D (P < 0.001) and calcium (P < 0.001) levels. Conclusion There is high prevalence of vitamin D and calcium deficiency in pregnant mothers and newborn babies in Bhaktapur, Nepal. Pregnant women need to be supplemented with adequate amounts of these nutrients.
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Affiliation(s)
- Dhruba Shrestha
- Department of Paediatrics, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | | | - Sabi Pokhrel
- Department of Paediatrics, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | - Ashok Kumar Sah
- Department of Paediatrics, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | | | | | - Reena Shrestha
- Department of Paediatrics, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | - Rasila Pasakhala
- Department of Paediatrics, Siddhi Memorial Hospital, Bhaktapur, Nepal
| | - Christopher Smith
- 2School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan
| | - Bhim Gopal Dhoubhadel
- 2School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan
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8
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Jones KS, Meadows SR, Schoenmakers I, Prentice A, Moore SE. Vitamin D Status Increases During Pregnancy and in Response to Vitamin D Supplementation in Rural Gambian Women. J Nutr 2020; 150:492-504. [PMID: 31834380 PMCID: PMC7056615 DOI: 10.1093/jn/nxz290] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 10/11/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vitamin D is important to maternal, fetal, and infant health, but quality data on vitamin D status in low- and middle-income countries and response to cholecalciferol supplementation in pregnancy are sparse. OBJECTIVE We characterized vitamin D status and vitamin D metabolite change across pregnancy and in response to cholecalciferol supplementation in rural Gambia. METHODS This study was a secondary analysis of samples collected in a 4-arm trial of maternal nutritional supplementation [iron folic acid (FeFol); multiple micronutrients (MMN); protein energy (PE) as lipid-based supplement; PE + MMN]; MMN included 10 μg/d cholecalciferol. Plasma 25-hydroxycholecalciferol [25(OH)D3], 24,25-dihydroxycholecalciferol [24,25(OH)2D3], and C3-epimer-25-hydroxycholecalciferol [3-epi-25(OH)D3] were measured by LC-MS/MS in 863 women [aged 30 ± 7 y (mean ± SD)] in early pregnancy (presupplementation) and late pregnancy, (gestational age 14 ± 3 and 30 ± 1 wk). Changes in 25(OH)D3 and vitamin D metabolite concentrations and associations with pregnancy stage and maternal age and anthropometry were tested. RESULTS Early pregnancy 25(OH)D3 concentration was 70 ± 15 nmol/L and increased according to pregnancy stage (82 ± 18 and 87 ± 17 nmol/L in the FeFol and PE-arms) and to cholecalciferol supplementation (95 ± 19 and 90 ± 20 nmol/L in the MMN and PE + MMN-arms) (P < 0.0001). There was no difference between supplemented groups. Early pregnancy 25(OH)D3 was positively associated with maternal age and gestational age. Change in 25(OH)D3 was negatively associated with late pregnancy, but not early pregnancy, triceps skinfold thickness. The pattern of change of 24,25(OH)2D3 mirrored that of 25(OH)D3 and appeared to flatten as pregnancy progressed, whereas 3-epi-25(OH)D3 concentration increased across pregnancy. CONCLUSION This study provides important data on the vitamin D status of a large cohort of healthy pregnant women in rural Africa. Without supplementation, vitamin D status increased during pregnancy, demonstrating that pregnancy stage should be considered when assessing vitamin D status. Nutritionally relevant cholecalciferol supplementation further increased vitamin D status. These data are relevant to the development of fortification and supplementation policies in pregnant women in West Africa.
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Affiliation(s)
- Kerry S Jones
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK,Address correspondence to KSJ (e-mail: )
| | - Sarah R Meadows
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,NIHR Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Inez Schoenmakers
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ann Prentice
- MRC Nutrition and Bone Health Research Group, MRC Elsie Widdowson Laboratory, Cambridge, UK,MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Sophie E Moore
- MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia,Department of Women and Children's Health, King's College London, UK
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9
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Mahmoud SZ, Saad AA, Mohieldein AH, Nasr AM, Adam I. Serum level of 25-hydroxyvitamin D and obesity among early pregnant women. J Obstet Gynaecol Res 2019; 45:2338-2342. [PMID: 31487758 DOI: 10.1111/jog.14114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 08/25/2019] [Indexed: 11/29/2022]
Abstract
AIM To assess serum 25-hydroxyvitamin D 25(OH)D level in obese pregnant Sudanese women in early pregnancy. METHODS A match case-control study was conducted in Saad Abualila Hospital (Khartoum, Sudan). The cases were obese (body mass index [BMI] ≥ 30.0 kg/m2 ) women. Controls were women with normal BMI (18.5-24.9 kg/m2 ) matched for age, parity and gestational age. The 25(OH)D level was measured using ELISA. RESULTS There was no significant difference between the two groups in their age, parity or gestational age. There was no significant difference in the median (interquartile) level of the serum (25(OH)D between obese pregnant women and normal weight pregnant women (3.05 [11.100-15.937] ng/ml vs 13.05 [10.950-17.362] ng/ml, P = 0.237). There was no significant correlation between BMI and 25(OH)D level (r = -0.133, P = 0.149). CONCLUSION There was no significant difference in the 25(OH)D level between the obese pregnant women and normal weight pregnant women in this study.
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Affiliation(s)
- Sally Z Mahmoud
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Alfarazdeg A Saad
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.,Faculty of Medicine, University of Taibah, Almadinah Almunawwarah, Kingdom of Saudi Arabia
| | | | - Abubakr M Nasr
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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10
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Gaffer AA, Rayis DA, Elhussein OG, Adam I. Vitamin D status in Sudanese pregnant women: a cross-sectional study. Trans R Soc Trop Med Hyg 2019; 113:569–571. [DOI: 10.1093/trstmh/trz054] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/27/2019] [Indexed: 12/31/2022] Open
Abstract
Abstract
Background
Maternal vitamin D deficiency is associated with maternal and perinatal adverse effects. This study was conducted to assess the vitamin D status among pregnant Sudanese women.
Methods
A total of 180 pregnant women were enrolled in a cross-sectional study in Saad Abualila Hospital, Khartoum, Sudan. The medical history of each woman was collected and 25-hydroxyvitamin D [25(OH)D] was measured using an electrochemiluminescence immunoassay.
Results
The median age, gravidity and gestational age was 27.7 y, 1.0 and 10.7 weeks, respectively. Of the 180 woman, 169 (93.9%) had vitamin D deficiency (≤20 ng/ml). There was no correlation between the 25(OH)D level and body mass index (r=−0.135, p=0.071) or haemoglobin level (r= 0.001, p=0.999).
Conclusions
The current study showed a high prevalence of vitamin D deficiency. Further studies investigating the risk factors for vitamin D deficiency and the outcome of pregnancy are needed.
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Affiliation(s)
| | | | | | - Ishag Adam
- Faculty of Medicine, University of Khartoum, Sudan
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Lips P, Cashman KD, Lamberg-Allardt C, Bischoff-Ferrari HA, Obermayer-Pietsch B, Bianchi ML, Stepan J, El-Hajj Fuleihan G, Bouillon R. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol 2019; 180:P23-P54. [PMID: 30721133 DOI: 10.1530/eje-18-0736] [Citation(s) in RCA: 368] [Impact Index Per Article: 73.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) <50 nmol/L or 20 ng/mL) is common in Europe and the Middle East. It occurs in <20% of the population in Northern Europe, in 30-60% in Western, Southern and Eastern Europe and up to 80% in Middle East countries. Severe deficiency (serum 25(OH)D <30 nmol/L or 12 ng/mL) is found in >10% of Europeans. The European Calcified Tissue Society (ECTS) advises that the measurement of serum 25(OH)D be standardized, for example, by the Vitamin D Standardization Program. Risk groups include young children, adolescents, pregnant women, older people (especially the institutionalized) and non-Western immigrants. Consequences of vitamin D deficiency include mineralization defects and lower bone mineral density causing fractures. Extra-skeletal consequences may be muscle weakness, falls and acute respiratory infection, and are the subject of large ongoing clinical trials. The ECTS advises to improve vitamin D status by food fortification and the use of vitamin D supplements in risk groups. Fortification of foods by adding vitamin D to dairy products, bread and cereals can improve the vitamin D status of the whole population, but quality assurance monitoring is needed to prevent intoxication. Specific risk groups such as infants and children up to 3 years, pregnant women, older persons and non-Western immigrants should routinely receive vitamin D supplements. Future research should include genetic studies to better define individual vulnerability for vitamin D deficiency, and Mendelian randomization studies to address the effect of vitamin D deficiency on long-term non-skeletal outcomes such as cancer.
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Affiliation(s)
- Paul Lips
- Endocrine Section, Department of Internal Medicine, Amsterdam University Medical Center, VUMC, Amsterdam, The Netherlands
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, Department of Medicine, University College Cork, Cork, Ireland
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutritional Sciences, University of Helsinki, Helsinki, Finland
| | | | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University Graz, Graz, Austria
| | | | - Jan Stepan
- Institute of Rheumatology, Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, American University of Beirut Medical Center, Beirut, Lebanon
| | - Roger Bouillon
- Clinic and Laboratory of Endocrinology, Gasthuisberg, KU Leuven, Leuven, Belgium
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Bhimji KM, Naburi H, Aboud S, Manji K. Vitamin D Status and Associated Factors in Neonates in a Resource Constrained Setting. Int J Pediatr 2018; 2018:9614975. [PMID: 30105058 PMCID: PMC6076921 DOI: 10.1155/2018/9614975] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/20/2018] [Indexed: 02/07/2023] Open
Abstract
Vitamin D deficiency (VDD) is emerging as a serious public health problem globally; however due to lack of resources, vitamin D levels are not routinely measured among neonates. The study was conducted to determine vitamin D levels in neonates and factors associated with the same. A cross-sectional study was conducted among neonates admitted at neonatal ward of a tertiary care hospital. Means and proportions were calculated from summarized data in frequency tables. Chi square test was used to determine association between vitamin D and various associated factors such as sex, infant birth weight, gestation age, parity of the mother, maternal age, and HIV status of the mother. A total of 170 neonates were studied, out of which 80% had vitamin D deficiency. Neonates born to HIV-infected mothers were significantly less likely to have vitamin D deficiency (OR 0.21, 95% CI 0.06 - 0.77, p = 0.009). Subgroup analysis revealed the association to be stronger in terms neonates (p = 0.005). The association was not observed among preterm newborns. The prevalence of vitamin D deficiency in neonates was observed to be very high and needs more attention.
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Affiliation(s)
- Khadija Murtaza Bhimji
- Departments of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Helga Naburi
- Departments of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Tanzania
| | - Said Aboud
- Microbiology and Immunology, Muhimbili University of Health and Allied Sciences. P.O. Box 65001, Dar es Salaam, Tanzania
| | - Karim Manji
- Departments of Paediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Tanzania
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Judistiani RTD, Gumilang L, Nirmala SA, Irianti S, Wirhana D, Permana I, Sofjan L, Duhita H, Tambunan LA, Gurnadi JI, Seno U, Ghrahani R, Indrati AR, Sribudiani Y, Yuniati T, Setiabudiawan B. Association of Colecalciferol, Ferritin, and Anemia among Pregnant Women: Result from Cohort Study on Vitamin D Status and Its Impact during Pregnancy and Childhood in Indonesia. Anemia 2018; 2018:2047981. [PMID: 29888000 PMCID: PMC5985097 DOI: 10.1155/2018/2047981] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/29/2018] [Indexed: 12/21/2022] Open
Abstract
Studies had shown that iron-cycling was disturbed by inflammatory process through the role of hepcidin. Pregnancy is characterized by shifts of interleukin. Our objective was to determine if 25(OH) vitamin D (colecalciferol) status was associated with ferritin, anemia, and its changes during pregnancy. Method. A cohort study was done in 4 cities in West Java, Indonesia, beginning in July 2016. Subjects were followed up until third trimester. Examinations included were maternal ferritin, colecalciferol, and haemoglobin level. Result. 191 (95.5%) subjects had low colecalciferol, and 151 (75.5%) among them were at deficient state. Anemia is found in 15 (7.5%) subjects, much lower than previous report. Proportion of anemia increased by trimester among women with colecalciferol deficiency. Ferritin status and prepregnancy body mass index in the first trimester were correlated with anemia (r = 0.147, p = 0.038 and r = -0.56, p = 0.03). Anemia in the second trimester was strongly correlated with anemia in the third trimester (r = 0.676, p < 0.01). Conclusion. Our study showed that the state of colecalciferol was not associated with either ferritin state or anemia, but proportion of anemia tends to increase by trimester in the colecalciferol deficient subjects.
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Affiliation(s)
| | - Lani Gumilang
- Public Health Department, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Sefita Aryuti Nirmala
- Public Health Department, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Setyorini Irianti
- Obstetric and Gynecology Department, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia
| | - Deni Wirhana
- Obstetric and Gynecology Department, Waled Regency Public Hospital, Cirebon, West Java, Indonesia
| | - Irman Permana
- Department of Child Health, Waled Regency Public Hospital, Cirebon, West Java, Indonesia
| | - Liza Sofjan
- Department of Child Health, Waled Regency Public Hospital, Cirebon, West Java, Indonesia
| | - Hesty Duhita
- Obstetric and Gynecology Department, Syamsudin SH Public Hospital, Sukabumi, West Java, Indonesia
| | - Lies Ani Tambunan
- Obstetric and Gynecology Department, Cibabat General Hospital, Cimahi, West Java, Indonesia
| | - Jeffry Iman Gurnadi
- Obstetric and Gynecology Department, Cibabat General Hospital, Cimahi, West Java, Indonesia
| | - Umar Seno
- Obstetric and Gynecology Department, Kota Bandung General Hospital, Bandung, West Java, Indonesia
| | - Reni Ghrahani
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Agnes Rengga Indrati
- Clinical Pathology Department, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Yunia Sribudiani
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Tetty Yuniati
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Budi Setiabudiawan
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
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Is vitamin D deficiency a public health concern for low middle income countries? A systematic literature review. Eur J Nutr 2018; 58:433-453. [PMID: 29344677 DOI: 10.1007/s00394-018-1607-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Vitamin D deficiency has been receiving increasing attention as a potential public health concern in low and lower-middle income countries (LMICs), of which there are currently 83. We aimed to conduct a comprehensive systematic literature review (SLR) of available data on vitamin D status and prevalence of vitamin D deficiency in all 83 LMICs. METHODS We followed the general methodology for SLRs in the area of serum 25-hydroxyvitamin D. Highest priority was placed on identifying relevant population-based studies, followed by cross-sectional studies, and to a lesser extent case-control studies. We adopted the public health convention that a prevalence of vitamin D deficiency (serum 25-hydroxyvitamin D < 25/30 nmol/L) at > 20% in the entire population and/or at-risk population subgroups (infants, children, women of child-bearing age, pregnancy) constitutes a public health issue that may warrant intervention. RESULTS Our SLR revealed that of the 83 LMICs, 65% (n = 54 countries) had no published studies with vitamin D data suitable for inclusion. Using data from the remaining third, a number of LMICs had evidence of excess burden of vitamin D deficiency in one or more population subgroup(s) using the above convention (Afghanistan, Pakistan, India, Tunisia and Mongolia) as well as possibly other LMICs, albeit with much more limited data. Several LMICs had no evidence of excess burden. CONCLUSION Vitamin D deficiency is a public health issue in some, but certainly not all, LMICs. There is a clear need for targeting public health strategies for prevention of vitamin D deficiency in those LMICs with excess burden.
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Badfar G, Shohani M, Mansouri A, Soleymani A, Azami M. Vitamin D status in Iranian pregnant women and newborns: a systematic review and meta-analysis study. Expert Rev Endocrinol Metab 2017; 12:379-389. [PMID: 30058894 DOI: 10.1080/17446651.2017.1365596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Vitamin D deficiency is a common health problem worldwide. The present study was conducted to assess the vitamin D status in Iranian pregnant women and newborns. METHODS A systematic review was conducted following PRISMA guidelines. The Scopus, PubMed, Science Direct, Cochrane, Web of Science, CINAHL, Magiran, Iranmedex, SID, Medlib, IranDoc databases, and Google Scholar were searched until 2017. The data were combined using random effects model. p < 0.05 was considered significant. RESULTS In 23 studies including 6,127 Iranian pregnant women were eligible for inclusion. The prevalence of vitamin D deficiency based on cutoff points of 10, 20, and 30 ng/ml was estimated to be 42.42% (95%CI: 26.90-57.93), 55.84% (95%CI: 31.75-79.93) and 80.82% (95%CI: 71.20-90.45), respectively. The mean 25-hydroxyvitamin D [25(OH)D] concentration was estimated to be 15.69 ng/ml (95%CI: 14.39-17.00) in pregnant women. The mean 25(OH)D concentration was estimated to be 14.97 ng/ml (95% CI: 10.63-19.31) in Iranian newborns. The difference in mean 25(OH)D concentration between pregnant women and their newborns was significant (p = 0.0002). CONCLUSIONS Vitamin D status in Iranian pregnant women and newborns are critical. Therefore, paying attention to the issue of vitamin D deficiency in this group should be a health priority in Iran.
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Affiliation(s)
- Gholamreza Badfar
- a Department of Pediatrics , Behbahan Faculty of Medical Sciences , Behbahan , Iran
| | - Masoumeh Shohani
- b Department of Nursing, Faculty of Allied Medical Sciences , Ilam University of Medical Sciences , Ilam , Iran
| | - Akram Mansouri
- c School of Nursing and Midwifery , Ahvaz jundishapour university of Medical science , Ahvaz , Iran
| | - Ali Soleymani
- d Faculty of Medicine , Dezful University of Medical Sciences , Dezful , Iran
| | - Milad Azami
- e Student Research Committee , Ilam University of Medical Sciences , Ilam , Iran
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Mohammad KI, Kassab M, Shaban I, Creedy DK, Gamble J. Postpartum evaluation of vitamin D among a sample of Jordanian women. J OBSTET GYNAECOL 2016; 37:200-204. [DOI: 10.1080/01443615.2016.1234443] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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